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Home My WebLink About2003-P06361 - land alteration PERMIT CITY OF ORONO Permit Number: 275G Kelley Parkway- PO Box 66 P06361 Crystal Bay, Minnesota 55323 Permit Type: User Defined (952) 249-4600 Date Issued: 6/20/2003 SITE ADDRESS: 2765 Kelley Pkwy Long Lake,MN 55356 PID: 33-118-23-12-0002 DESCRIPTION: Proposed Use: Residenrial Pernut Class: General Pernut Type: User Defined Permit Sub-type(s): Land Alteration(SOl+cu yds DETAILS: Approved per resolution#: Separate permits required: pther-(Permit#02-424 from Watershed District) NOTICES/REMARKS: Grading for new building-Ok by Bruce Vang FEE SUMMARY: Permit Fee: $ 75.00 Valuation: $ 0.00 TOTAL FEE: $ 75.00 APPLICANT: McCarthy Construction(see notes) OWNER: City of Orono(Vacant Land) 11100 Bren Road West,Suite 200 P.O.Box 66 Minnetonka,MN 55343 Crystal Bay, MN 55323 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNE TA BUILDING CODE REQUIRE S. � / , � . � APPLICANT PERMITEE SIGNATURE IS D Y SIGNATURE Conies: 1-File(Si�;nitures Required), 1-Aunlicant, 1-Monthlv Renorts, 1-Assessin¢, 1-Finance Page 1 . Tot�l Fee: $ Date Received: � Entered By: Pemut#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) � THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SIT'E ADDRESS: � � � S_ � �/ Z"� j��ZIP:. NAl�iE OF OWNER: 6c��p [Z� �2 f�' PHONE: (home) � S Z � � � �o S o .. (work) MAILING ADDRESS: CITY: ZIP: CO\1'RACTOR: e��•� �'�" rl�� • PHONE:. Cl �2- CQ S� l0�f Z COr�TACT PERSON: �si WICC�-� 'In-� MOBILE/PAGER: Co! Zr �� Cj �O C� M.4ILING ADDRESS: L t�o v_ �rev� l'o-•a�� CITY: Itit,�-�� ZIP: ST�iTE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAII.,ING ADDRESS: CITY: ZIP: NA.`IE: REGISTRATION�# TYPE OF WORK: New J� Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: r (' �U�.� � C( STORIES: ( SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: � . GA.RAGE STALLS: ATT. DET. ESTLI�IATED CONSTRUCTION VALUATION (excluding land): $ I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I underst this is no d work is not to start without a perm.it; and that the work wi�I be in a o nce w' ap ved plan. APPLICANT'S SIGNATURE: DATE: �U� Z� Q� NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events w t not be allowe . 5 �� , ao ° � �� Sec.13.04 RIGATS OF SUBJECTS OF DATA • Subd. 1. Type oF data. The rights of individual on whom the data is stored or to be stored shall be as set forth in tivs secaon. Subd.2. Information rer�trired to be givea individual, qnind�vidual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data wi[hin the cotlecting state agency,poliacal subdivision,or statewide rystem;(b)whether he may refuse or is legally required to suppiy the requested data;(c)any lmown consequence arising from his supplying or refusing w supply private or confidenGal data;and(d)the identiry of ather persons or entioes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative dare, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of rovernu mav olace the norice reau�nd under this subdivision in the individual income taz or nro x refund instrucaons mstead of on those fortns. Subd.3. Access to data by individual. Upon request ro a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is class�ed as public,private or co�denaal. Upon his further request,aa individual who is the subject of stored private or public data on iadividuals sha11 be shown the data without any charge to him and,if he desires,sUall be informed of the content and meaning of that data. Aher an individual has been shown the private dara and informed of its meaning,the data need aot be disclosed to him for six months thereafter unless a dispute or acaon pursuant to this secaon is pending or additional data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible au[hority may require the requesring person to pay the actual cosu of making,certifying,a�compiling the copies. The responsible authoriry shall comply immediately,if possible,with any request made pursuant ro this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform[he individual,and may have an addiaonal five days within which ro comply widi the request, excluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data Ls not accurate or complete. An individual may contest the accuracy or completeness of pubGc or private data concerming hinueif, To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the�ature of the disagreement. T'he responsibte authoriry shall within 30 days either. (a)correct the data found m be inaccurate or uuomplete and ammpt to noafy past recipients of inaccurate or incomplete data,u�cluding recipients named by the individual;or(b)nodfy the individuat diat he believes the data -- to be correct. Dara in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authoriry may be appealed pursuant ro the provisions of the adminis�ative procedure act relating to contesud cases. DATA PRTVACY ADVI ORY In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your request for a permit or license from the �ity of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: , 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but;efusal may require that the Ciry deny the permit or license. ' 3. The information may be shared with other Iocal, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. � 5. You have certain rights under M.S. 13.04(available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. First Middle I.ast Address C��' State Zip Phone _r 7 I und s s�'my rights at above. 'gnature 6 PE O Z - '� . RMIT NO. `} Z ISSUED TO: � S � � �ro 'Q O�'O FOR: � � t O � LOCATED AT: I Gt r a By The Board of Managers of the MINNEHAHA CREEK WATERSHED DISTRICT 18202 MINNETONKA BLVD., DEEPHAVEN, MN 55391 952.471.0590 �-- Signature: 1�tle: �' l C �6C t'1�N l C PERMIT EXPIRATION DATE: o O , POST CON5PICUOUSLY AT PROJECT SITE FOR PROJECT DURATION , OR A MINIMUM OF 10 DAY5