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Home My WebLink About2000-P02835 - land alteration PERMIT CITY CaF ORONO 2750,Keiley Parkway - PO Box 66 Permit Number: Po283s Crystal Bay, Minnesota 55323 Permit Type: UserDefined (612) 249-4600 Date Issued: 8�1s�2oo SITE ADDRESS: 1305 North Arm Dr MOUND,MN 55364 P I D: 07-117-23-41-0031 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu y DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00 TOTAL FEE: $ 50.00 APPLICANT: WAYNE SIMNIONI OWNER: W P SIMNIONIW&C L KENNEDY 1305 NORTH ARM DRIVE 1305 NORTH ARM DR ORONO,MN 55364 MOLJND MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMI'ROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. W Cl�y..� 1 �-�—� `�'l� APPLI ANT P RMITEE SIGNATURE ISSUEDBY SIGNATCJRE , Copies: City,Applicant,Assessor,Finance Page 1 Total Fee: $ �� .c�� Date Received: 1�� En�ered By: � . Permit#: /�Q �- �' 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 SITE ADDRESS: ,�0 S �I V �� . ZIP: SS 3 � �{ NAME OF OWNER: � ca,i.,,,.,� � �,,�,,,.�., PHONE: (home) (�j�.- Ml�-�� I 3 (work) �1�- `�3�- S 1�t Z MAILING ADDRESS: 13 0 5 �l�. �-,�� p�n CITY: Q r o.-� � ZIP: S-S 3 I� y CONTRACTOR: �t�cL� s �--�--�� S c o...� c PHONE: CONTACT PERSON: � � }�� MOBILE/PAGER: 3��(� — S� S 3 MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration�_ PROPOSED WORK(describe in detain: L�� \ �r��k v c�.,r� 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 accordance with the approved plan. APPLICANT'S SIGNATURE: � ��- \�u�-�^�� DATE: � � I � I (�(� NOTE! Parade of Homes events require separate perntit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. � Sec.13.04 RIGHTS OF SUBJECTS OF DATa Subd. 1. Type of data. The righ[s of individual on whom the data is stored or to be scored shall be as set forth in this secdon. Subd.2. Information reqtrired to be given individual. An individual asked ro suppiy private or confidendal data concerning himself shall be informed of: (a)the purpose and inrended use of the requested data within the collecting§tau agency,polidcal subdivision,or statewide system; (b)w6ether he may refuse oY is legally required to supply the requested data:(c)any Irnown consequence arisiag from Ivs supptying or refusing to suppty privace or confidendal dara;and(d)che idendry of o[her persons or enrides authorized by sta[e or federal law to receive the data. This requiremenc shall not apply when an individual is asked to supply investigadve dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of re�enue mav place the noace reauired under this subdivision in the individual income tax or properri tax refund insccuctions ins[ead of on those forms. Subd. 3. Access to data by individual. Upon reques[to a responsible authority,an individual shall be informed whether he is the subject of swred data on individuals,and whether it is classified as public, private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data wichout any charge to him and, if he desires,shall be informed of the content and meaning of chat data. After an individual has been shown[he private data and informed of its meaning,che dara need not be disclosed to him for six months rhereafter unless a dispute or acdon pursuanc to[his section is pending or additional data on the individual has been coilected or created. The responsible authority shall provide copies of the private or public data upon requesc by the individual subject of rhe dara. The responsible authority may require the requesting person to pay the actua!costs of making,certifying,and compiling the copies. Ttte cesponsible 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 immediate compliance is not possible. If he cannot comply with the request within that dme,he shail 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 accuncy or completeness of public or private data concerning himself. To exercise this right,an individual shall nodfy in wridng che responsible authoriry describing[he nature of ihe disagreement. The responsibie authoriry shall within 30 days ei[her: (a)correcc the data found to be inaccurate or incomptete and attempt to nodfy past recipienu of inaccurate or incomplete data, including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if ihe individual's statement of disagreement is included with the disclosed data. The decerminaaon of the responsible authority may be appealed pursuant to che provisions of the administracive procedure act relating to conresud 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 fumish 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 refusal may require that the City deny the permit or license. 3, The information 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. (, Your full name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand my rights as stated above. c Signature CHECK OFF LIST FOR ISSUANCE OF PER1vIITS - , FOR OFFICE USE ONLY � . _ADDRESS OR LEGAL: 1 �O S /lk� Af2�►� D� PID: DESCRIPTION OF WORK: d��) N C� . � � ZO�'G REV�W BY: DATE APPROVED: �/�i—� BUII.DING REV�W BY: i+i'//� DATE APPROYED: FEES TO BE CHARGED: ��p!�j Misc. �ees Ca cufatedyBy: f PERNIIT Yes r/✓ No ; PLAN REVIEW Yes _� No SERTER CONNECTION STATE SURCHARGE Yes No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No STTEINSPECTION Number of SAC�Units OTHER (specify) Z0�1I:�iG CHE.CS LIST zoning Districr. v C � Firo Department: Post Office: School District: • Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Right Side: Reu(Street): Left Side: Adjacent Strucmres: We and: . Building Height: Def. Hgt. Pe •Hgt. Lot Covera�e: Grading: Staff Approval Date: y: Council Approval Date: Septic: Staff Approval Date: y: Zoning File: # Resolutioa: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setb k: I.ot Coverage: E�t�g Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes Date of Council Approval: RE�iAR��S(in house): 7 BUII.DING REVIEW CHECK LIST UgC; -- CONSTRUCTION TYPE: � Sq Footage $ Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Garage x = x = TOTAL Fstimated Construction Value: $ Inspections Required: Work Requiring Separate Permits: Site Plumbing ; Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) �Finai Grading/Filling Elecuical(State Permit) Other REMARKS(IN HOUSE): � REVIEW BY OTHERS: DATE: Access: Ezisting New Access Approval: Date By� RENIARKS (TO BE NOTED ON PERMI'1�: 8 \ ti � � �a �� R�D � T � ti � , ,q v °�S � � � � � � ` �o ��, S 33o O � O°' �� ` �0�>2 ��I/ o �W S� S., ✓/� ' �1! \ � � 2 J W � � . C/J� O� � � �2'3 � . b rp N , �y°' ta� o� W m N, f� �. ., N o' . k n N � y.a3 � ,_Sr ,. , �� •�I ��•4 1 ��E�Y�AA�F °' � �/ �� L� i ,°� ?•o0 13as G L � m s.� c� " s,°i � 12,3 n � � � , o .33e� � S[�, \ i cn a � �,� 9'8� �'4 c�0 F�, � �'L,' � �s� � � ��o'7 �P�oo��o�� '`�as� � _ _ . � � CiTY Of OR�10 � � � SITE PUN GHADING l�AN � �^ ,°.�� PPROV�,� -- �l1_�-�,N� �� CJ APPROV�D WITN REVISlO'M� . �• � � �oo ❑ DISAPt R �' ; �' ��o� �Y —c.s� ',� '�� ,: �• D�14TE � -� � , o" N I I ' � � � �.,.-s �-, � (d-c 1 � (� � n .� �' l\f-b , . � , , h• , .� , (�,��v e c.�� ✓�F-�tr� . , � ,. � � � i , � , �� i . � �� I, , , , •, , ; I, � `' �� r.� 6 v" ► T-r-}-t �► „ r ` //�� \ ' r l �� ,� _ � 6-�= ,/� � ( t ,, � - J �� -�-e� . - .�• - --_.. � � ` ,, � �� , , �_ �_ � , �\ _ C�N �� " ��R�sy \ � � CO�SN S�e. .. �- ` .' � FO RO � � N`AiniE-R ' . ` C� e, ,-�. ` �' _ N• 9�1 Z'4,��RiVE � � � � �- ;;;:�;��, `Y, , ''.59 E' � \ \ �. ;� -.. 58-- _f j r r,— _ � / , . � �l I . \ _� � � �i/�y �'( ��• fI'` • F� � 1 1 � ~~�1� \ � � � \ \ \ JOB N0. 94 288