HomeMy WebLinkAbout2003-P06500 - land alteration „ITI�. OF ORONO PERMIT
27�50 Kelley Parkway - PO Box 66 Permit Number: Po6soo
Crystal Bay, Minnesota 55323 Pe►-mit Type: User Defined
(952) 249-4600 Date Issued: ��s�2oo3
SITE ADDRESS: 1170 Garden Court
Mound,MN 55364
P I D: 07-117-23-24-0048
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Pernut Type: User Defined Pernut Sub-type(s): Land Alteration 0-75
DETAILS:
Approved per resolution#:
Separate permits required:
Other-(Greg Crappa approved work in drainage easment)
NOTICES/REMARKS:
Grading w/o C.U.P.
FEE SUMMARY: PermitFee: $ 50.00 Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: �orn Services Inc. OWNER: Thomas&7ane Sutton
23505 Smithtown Road 1170 Garden Court
Shorewood,MN 55331 Mound,MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLIC PERMI � SIGNATURE ( ISSOEDBYSIGNATURE
Copies: 1-File(Sienitures Required), 1-Apnlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
.
Jun-30-2003 09;42am From-CITY OF ORONO +9522494616 T-732 P.002/003 f-672
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. � 'T'otal Fee: $ ����� ��.��� ��G� Aate Receiv�d� ;1 � ��.i��,U
Entered�y: 1 �1 � �� r Permi�#: � �
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CX�'Y �:F ORONO - B�DING PTRMIT APPL�CA�4N
A!1 information must be submitted in full before plan review will be started.
' (pleas�prinr all information) �
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THE A,ppL�CANT IS:+ (circle one) O�VNER O� ONTRAC."I'd�
JOB SITE A�D1t�S5: i l �G� ����G/� �i` 2IP: �.�3 s�
NAlV1E UF OWNE�.: /G�/� SGi ff"�/s/ PHONE: (home� S� �Z'���3
(wark)
��nv�ann�ss: 5��n� .�s �&�L�� crr�r: zz�:�
CONTRACTUR; . ��'o�N ����c�s y� � �r�o�: ��� ��y-�6 ��
CONTACT�'ERSCEN: Gv� !/�,�ivr ,�C MOB1LE/PAG�R: �/Z /D � 2.5�
1VYAI�YNG A�DR�:SS: 2 3 SG.� Sm�fti latv� �r>• CI'I'Y: S�oru,r,�G� �': S-s3 3 �
STATE L�CENSE: �_ �D3� �/�
ARCHITECT/�NiiT.1�'EER: �/l� �'��y� _pFiQNE: 6/Z ��S-�'63�
MAILTNC AJ)�Ri�SS: S/�-�C _CIT"Y: �Il':�—�- .
NA.IVIE: � REG�IST'RA,TION#
��,� �
TXpE U
F y�Q�;: �eW Addicion A.ccessary Struccure -����.,�
�Q�,e ].2emodel/Alteration�_ L,and AlteratiQn L �,
�� �1 �� fl� �`�
P�tOPOSED V'4'QI�(descrtbe in detail}; � �G � ,� - ��,,., r� �
{�,� ,q� �. , �;�\
�
s�ra�s: �..
SQ.�'EET 4F EACH FT.O4R: �
Nf�. O� BEriRQ�MS: � GARAGE STAI.,LS: ATT. DET.
cc�
ESTIMATEA CC1I�TST�2UCTYaN VAI�XIATIOrT (excluding Ian�): $ � _.._—.--
I hereby apply far a building pern�ic and� acknowledge chat th� info�rnatian above is eomplete and
accurate; that the work will be in conformanee with the ordin�nces and codes of Che City and with
ihe Siate Building Code, that I und�rstand this is not a permit and work is not to sTart withc�ut a
permit; and that the work will be in �ccordance witti the approved plan.
A,PPI,YCA.NT'S SI�NATYJR.E: ���G�'� �
DATE: '' '�
1�pxEr r e vf H�events require separate permit aPProval by Police laepartment and
City Cauncil 6D days prior to the event. Non permitted evenrs wilI not Tie aldowed.
� � • CHECb' OFF' LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: � �� � ����o�-� Go� 2.�- �
PID: _ _ _ -- -
DESCRIP':[TON OF WORK: �,4.� �q���t,f;�-u.v
_----------------------------: _____
ZO�G REV�`V BY: _ ��,,,�C� DATE APPROVED• �- Z-0 3
BUII.DI'iYG REV�W BY: — DA7 E APPROVID:
�,,, �-.�/o G. •�-P
FEES TO BE CHARGED: 6� � Misc. Fees Calculated By:
PER11i1IT Yes �/ No
PLAi�t REVIEW Yes No SEWER COiVNECTIOiv
STATE SURCHARGE Yes No WATER CONNECITON
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZOI�'ING CH�CK LIST Zoning District: /`r° C�S� �� �-� .
Fire Department: Post Office: School District: �
Lot Area: Sq.ft. Acres W th Depch
Survey Submitted: Yes No ate of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: �Vetlan :
Building Hei;ht: Def. Hgt. Peak H t.
Lot Covera�e:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: � Resolution: � esolution Date:
Shoreland Dis[rict:
Avg. Setback: Bluff Setback: L.otCoverage:
Eacisting Proposed
Hardcover: 0-75'
7�-2�0'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council App:oval:
REI�IARKS (inhouse): �- ��� P� �„��-� �� D��•�,
��Scy�n-c.�T
7
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BUII.,DING R�VIEyy CI-�Cg LIST
�C' � CONSTRUCTTON T'YPE; �—
_ Sq Footage $Per Sq Ftg
Basement . . x
lst Floor X . '
2nd Floor x =
Garage x — �
� _ .
TOTAL
Estirnated Construction VaIue: $ �
Inspections Required: �Vork Requiring Separate Permits:
S ite Plumbing Fire
Hardcover Removai Mechanical
Footing ' Water Connection
� Septic Sewer Connection
� Framing Fire lace
Insulation P �wn Irrigation
Wali Board ��0�`� Other
,_�FinaI � � �fg•� Well(State Permit) . :
Grading/Filling Electrical (State Permit)
Other
REI�TARK,S(I�1 gOUSE):
--------_______���
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REV�W BY OTHERS: DAT'E: --�--��-
Access: Ezisting New
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Access Approval: Date
By:
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REVIARKS O BE ----------------------
(�' NOT'ED ON PERil�II1�: --------------
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Jun-30-2003 09:42am From-CITY OF ORONO +9522494616 T-732 P.003/003 F-672
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$ec.13.0�Rl!'xHTS OF SL($.rE�TS OF Dr1.'�A
Subd• 1. Type of dnca. 'lhe rights of individuai oa whom rhe dssa is szorcd or to be sroted shali he as 9ei fotsh in this section.
Subd.Z. Inform$tlon re4sared to be given indl�idv�I. �t iudividnal aslced w supply Fnvat�or confidepQa4 daca coaceraing himsetP sha11
be inEor�ed of: ia)�hC purpase and inrsnded use oP shc roquesud��+wi���e�°o�conse uencc�s'ta�Pmm h,is s��►pplYinS or cfusie6�+uSPPiY
(b)whasher he may refisse oY is lcgaify�quircd co supply ihe requcs�Cd d�ta;(c)any �
private or cv�dendai dsus;and i d)ehe idendry of o�hcr parsons or enudes au[horize d b y srate or fcdat3l!aw ro receive[he data. This requircmna[shall
nqc appty when an individust is askcd ca supp{y invesnSadve dara,pursuan[w secdon 13.8?, subdivision 5,[o a Iaw enfo�e�eas o�cer.
Thc camrnissioner aY r�venue muv Iacc ihc nORCe reoui[ed under this subdi�'sion in rhe i dividual incomc ffix or ro sax tefu d
iesituction insrea of o chnsa forms.
Subd. 3. Aceess ta��ie�by individual. Upon reques�to a resQonsib[c aucharicy.an iridividtsal shall bc info�d whe�hcr he is thz subjccc
oP sroced da�on individuals,an.d wfienc�r ic is ctassif�ed as pu�iic,private or cott�[deensJ. Upon�s futther request,aa individual who is�hc Subjec�
of scored privau or publie da�s an individuals skall bo shnwn thc dats wirt�ouc any ch3rgC to him and,if he desires, sha➢be informed of the contenc
�����oP[hat d3[s. Afu�'an in�tividelal hss been shown rhe priva�e dan and infosmed of its mcanin8,rhe daca need noc be disclesed to him for
six monchs�here�rssr upless a dispute or action pursuans w this secdon is pending or addiuoaal d$ra on the inQividual kas becn cellecud at crcated.
Thc responsib3c auihori�y shall��rovide copies of che privare or public dara upon re4ucst by�tte individual subjec�of the daGa- The responsiblc au�horiry
rnay requirc the nquesdng petson�o pay the accual cosrs of making.cerdfyieg, and cou3pilittg ttie copies.
Thc responsibie autharity shsll comp3y imntedia�cly,if poSsibie,wich auy requea�made pursuan<<o thia subdivision,or wiihin five days af
�he dare of che reqnes�,cxeiuding SantrdaYs�Sundays and le$a]holidays,if immcdiau comF[�anee is noc Possible. If he c�oc eott�piy wich[hc requcst
wirhin th3t iune.hc s5all so infurm che individual,and may have an addiaa�l fivc days wirhin which to eomply wi�h[he requcst,oxcluding Sutu�d�ys,
Sundays and lega!holidays.
Subd.4. Praeedurt whea data is nat accuraie or eomplete. P�n�►�idual may con�st dte accuracy or completeness oP public or private
daca cenccmin8 hirnself- To cxercist this right,an individual shaif aoafy in wriung nc�resP4nslhl�a�Th°nry'describing�ha n8nire af the disagYeemaac.
'I'he rCSpor�sibl�auchoriry shall withits�d days e't[hcr_ (a)cornc�thc dact fauad ro be inaceurasc or incompicte and atutnp�[o noufy past Lecipionts of
inaC�urace or incomple�e data, incEuding r�cipieers named by �he individual;or(b)nodfy the individual tha�he bCtievcs�h�dssa to ba coaec�. �ara
iu disquce shall be disciosed o«ly iP d1e individuai's s�tcmen�of tlisagrcemen[is incltsded wi�h the disClosed data.
Tku deserminarian nf ihe tasponsible auchoriry may bc appealed pursuanc co the provisions of che admimstrarive proced❑re aac rel�dn� to
conccsud c�sas.
DAT� PRIVACY ADV1SaR'Y
In aeeordance with M.S_ 13.Q4, S�bd.2, "Ria,�ts of subjtccs of data", we would like to inform you that your requesc
for a permi� or Iicense lrom ihe Ciry of Orono or any af i�s departznznu may require you to fumish eertain pr's'vaEe �r
COn�den�ial inforcna�ion.
You are notified tliat:
i, The infonnation you furnish wili be used to deternvne your qualificatian f4r the germit or license requestad.
2. You may refuse to supply daza, bn� refusal may require thac rhe Ciry deuy the permi� or license.
9, The infor�aiacion may be shared with o�her locaI, s�ate or federai ageueies to ihe ax�ent neeessary zo process
the permit or lic��se.
4, If your requcsted Qermit or lieense iequires CouAcil �ccion to approve, some utformation may become
public.
$, You have; cenain Tishts under M.S- I3.04 (avail�ble upon request} �o review private d�ta on yourself.
6. Your full name is required to process Lhis apQlication or permic.
�C� 1���4r�,? % ,� .
F�=st
��aa�� �^ l ��
2���S J�'G���� ,v� f���
Addresss a��D J� /v � 7�'�"L --��.3 �
5tate 2ip 1?aone
Ciry
I understand my rigbu as 5=azed above. � .
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Signaaxre