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Home My WebLink About2003-P06840 - move driveway/place black dirt � 1 PERMIT CITY OF ORONO permit Number: 2750 Kelley Parkway- PO Box 66 P06840 Crystal Bay, Minnesota 55323 Pe�mit Type: UserDefined (952) 249-4600 Date Issued: 9/30/2003 SITE ADDRESS: 1101 Elmwood Ave Mound,MN 55364 PID: 07-117-23-14-0023 DESCRIPTION: Proposed Use: Residenrial Pemut Class: General Pernut Type: User Defined Pernvt Sub-type(s): Land Alteration(0-500 cu yc DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Move driveway and place black dirt over existing driveway FEE SUMMARY: Permit Fee: $ 50.00 Valuation• $ 0.00 TOTAL FEE: $ 50.00 APPLICANT: Owner/Self OWNER: Marty Sarenpa M� 1101 Elmwood Ave Mound,MN 55364 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 SI'ATE OF MINNESOTA BUILDING CODE REQUIREMENTS. ERMITEE SIGNATURE SUED BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Apvlicant, 1-Monthlv Renorts, 1-Assessine. 1-Finance Page 1 . - � ,. �,� " �� u Total Fee: $ ��L ` ,..,,� Date Received: Entered By: /�1 �� Permit#: � � �21 �� y�ti�� I�j CITY OF O��NO - BUI G PERNIIT APPLICATIOl�t All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) � OWNER R CONTRACTOR JOB SITE ADDRESS: l�v� �l✓��/��c::� /� l�� r ZIP: ss,�j' �� - NAME OF OWNER: /�k�('��j' ��jN�'4 PHONE: (home) � ^�J�—��`�' (work) �� 3 -- 79 —.2�<�'� MAILING ADDRESS: - : � � � � CITY:�i��i�/rr�,q ZIP: �-�- CONTRACTOR: ' PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAII.ING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration� ( I�e� �� PROPOSED WORK(describe in detai�: � . --� � R.�.� t�c.e t 2 T e v-�� t,.�'x.s-*� (��.-+P � STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED 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 understand this is not a permit and work is not to start without a permit; and that the work will be in accord vith the approved plan. APPLICANT'S SIGNATURE: � DATE: `! �� , NOTE! Parade Qf Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. L Sec.13.04 RIGHTS OF SLJB.iECTS 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 focth in this secaon. Subd.2. Information req�red to be given individual. An individual asked to supply private or confidenaal data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecdng§tate agency,political subdivision,or sratewide sysum; (b)whether he may refuse oY is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply private or confidenaat data;and(d)the identiry of o[her persons or entides auchorized by state or federal!aw to receive the data. This requ'uement shall not apply when an individual is asked to supply invesrigaave data,pursuant to secdon 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the nodce rewired under this subdivision in the individual income tax or aroaertv taz refund insnvctions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whe[her it is classified as public,private or co�dendal. Upon his further request,an individual who is the subject of stored private or public data on individuats shall be shown the data wichout any charge to him and;if he desires,shall be informed of the content and meaning of rhat data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed w him for six months thereafter unless a dispuu or acdon pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The rrsponsible authoriry shall provide copies of the private or public data upon request by the individual subject of the dara. The responsible authoriry may require the requesang person to pay the actual coscs of making,certifying,and compiling the copies. T6e responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if icnmediate compiiance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or comp(eteness of public or private dara concerning himself. To exercise this right,an individual shall nodfy in wridng the responsible authority describing rhe nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt W nodfy past recipients of inaccunte or incomplete data, including recipients named by the individuat;or(b)nodfy the iudividual that he believes the data to be correct. Data in dispute shall be disclosed only if the individuai's statement of disagreement is included with the disclosed data. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminisnaave procedure act relating to contesud cases. DATA PRIVACY ADVISORY 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 City of Orono or any of its departments may require you to furnish certain private or confidential information. You aze notified that: 1. The information you furnish will be used to detemune your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The infarmation may be shared with other local, 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 Last Address Ciry State Zip Phone I unde y rights as stated above. . Signamre � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: I 1 t� � C Ltn�woo� A u-2 � PID: DESCRIPTION OF WORK: Nln�� 02tu2 w u�u �n.e� . __ u J ZO�tni 1G REVIEW BY: DATE APPROVED: t3 Y9-a3 BUII..DI�i 1G REVIEW B : /�1�9 , DATE APPROVED: " � � FEES TO BE CAARGED: r 6'"1Vlisc�ees NCalculate�By� �� PERII�IIT Yes � No PLAN REVIEW Yes _r� No SEWER CONNECITON STATE SURCHARGE Yes No WATERCONNECTION INVESTIGATION FEE � Yes No PARK FEE SAC Yes No STTEINSPECTION Number of SAC�Units OTHER (specify) ZONING CH�CK LIST Zoning District: CeS� d� ��C . Fire Department: � Post Office: School District: • �. Lot Area: Sq�.ft. Acres � Width Depth Survey Submitted: Yes No Date of urvey: Proposed Setbacks: ' � Front(Lake): Right Side: _ Rear(Street): Lefr Side: � Adjacent Structures: Wetland: . Building Hei�ht: Def. Hgt. Peal:Hgt. Lot Coverage: Gradine: Staff Approval Date: By: C uncil Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution ate: � Shoreland District: Avg. Setback: Bluff Setback: Lot Coverage: Existino Proposed Hazdcover: 0-75' . 75-250' 250-500' 500-1000' Hudcover Variance Required: Yes No Date of Council Approval: RE1�ZA,RKS(in house): �� - . . . BUII,DING REV�yV C�Cg LIST UBC: —� _ - . CONSTRUCTION TYpE; — _ Sq Footage $Per Sq Ftg � Basement . . x lst Floor . � x . . . _ . . 2nd Floor x � — � � � � � . . Gazage x — - " � � _ . TOTAL � Fstimated Constructiun Value: $ "'"'-- � Inspections Required: , tiVork Requiring Separate Permits: Site Plumbiag Fire Hazdcover Removal Mechanical g��g - Water Connection Septic Sewer Connection � " Fram.ing Fireplace � Insulation La�+n Irrigation Wall Boazd ��0�'� Other �Final � � �fg•� Well(State Permit) . --_ _____.,._ __ __ � Grading/Filling Electrical(State Permit) Other . � RE1�iARKS(ni T HOUSE): . . REVIEW BY OTHERS: � " "'�"�-"---�'------ DATE: Access: Ezisting New . � Access Approval: Date � By: � REMARKS (TO BE NOTED ON PER1vII1�: � " ��-----------------��_�� 8 ' ' r ' -------------- I � �-� �. S �5"17 �� F __j55.94-- ` � i �� i i �- i � O � �� i �'- `ZS -r I f�_ `� �' � , � � � j� � � � � ' I c � �' ` � � ' N ; � c� , �> , . � �;�, \ � J � ' � I � � � I � `, `� I � � V i �`y � t:'�.. � z �,I �' � � i � � . � � � � I � � .�I 3 �> > � � , ; z C'� � �� r � � ; •' � Q � 3 o g Q .� � c� �, � � �, I � � ,. I o �� N �"� � � � � � i � C`� � � � '� 1 �; � �° � ,^ I i i t� � o � � �� s � oz ��I = o � o V1 , � � � c) �� '^ I ' i � r � � '1 ¢ � � N � i � �'� ' :�' � � 3 J- g � � � �""� oo ` � � o I ' � � , I � � � � � � � � � � ��a � z� � � 9 v� � � I � � � , � � � � � �, � .�� 3 � � �. � � � �{Q �� >- Q � ;` ? `' � � 2 � � � � � I� � C7mC] t� � �9UI � r �� `� d q' ' � I � , , � i � � � ; � I � I . ' ' � � � � , � � � , . 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