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Home My WebLink About2000-P02862 - land alteration � PERMIT �,ITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Po2s62 Crystal Bay, Minnesota 55323 Permit Type: User Defined (612) 249-4600 Date Issued: s�23�200 SITE ADDRESS: 1317 North Arm Dr MOUND,MN 55364 P I D: 07-117-23-41-0032 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: LORIN DERBY OWNER: 1317 N ARM Dr 1317 NORTH ARM DR MOUND,MN 55364 MOUND MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI� REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. ,'r y/:�v�.�, ,_��3'L -�'�'�t �rr�"n AP L ERMITE A RE SUED BY SIGNATLJRE Copies: City,Applicant,Assessor,Finance Page 1 O � ' Total Fee: $ --5� � Date Received: $��--v� Entered By: Permit#: O �,$ (�� °� CITY OF OR NO - BUILDING PERMIT APPLICATION �� All information must be su6mitted in full before plan review wi116e started. (please print all information) ------------------------------------------------------ - ---------------------------------------------------- _.� THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: 1�17 �, �d✓1 � 2 � ZIP: �_'3�7— NAME OF OWNER: ��Z�� `�/Z�3 PHONE: (home) �v� ��o�� (work) �� — � ` � MAII.ING ADDRESS: CITY: ZIP: CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: /V D N c� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration_�_ PROPOSED WORK(d scrib in detain: i/� ' �� /'z�- ��—� a �'�� ,2�� j/'`� -- �- i li �� /e / z� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. o � ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ 0��8� 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 ' e ordinances and codes of the City and with the State Building Code; that I understand s ' ot a pemut and work is not to start without a permit; and that the work will be in ac r ce wi approved plan. APPLICANT'S SIGNATURE: DATE: �3 � NOTE! Parade of Homes events require separate perm' approval by Police Department and Ciry Council 60 days prior to the event. Non permitted events will not be allowed. • Sea 13.04 RIGFITS OF S[JB.TECTS OF DATa Subd. i. Type of data. 'Ihe righcs of individual on whom rhe data is stored or to be stored shall be as set forth in this secrion. Subd.2. Information reqirired to be given individual. An individual asked ro supply private or confidenriai data concerning himseif shall be informed of: (a)the pucpose and inttnded use of the requested data within the collecdng state agency,poliIIcal subdivision,or sratewide sysum; (b)whether he may refuse oY is legally required co supply the requesud data;(c)any laiown consequence arising from his supplying or refusing to supply priva[e or confidential data;and(d)the idendry of ocher persons or enddes authorized by state or federal law to receive the dat�. This requirement shall not apply when an individual is asked to supply invesrigadve dara,punuant to section 13.82, subdivision 5, to a law enfor�ement officer. The commissioner of re�enue mav place the noace reauired under this subdivision in the individuai income tax or propem tax refund instructions instead of on those forms. Subd. 3. Access to data bv individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stnred data on individuals,and whecher it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown[he dan wichout any charge to him and, if he desires, shall be informed of the content and meaning of rhat data. After an individuai has been shown the private data and informed of iu meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acdon pursuant to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesdng person to pay the accual cos[s of making,certifying,and compiling the copies. The responsible authoriry 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 immediace compliance is noc possib(e. If he cannot comply with the requesc within that time,he shall so inform the individuai,and may have an additional five days within wtuch to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise[his right,an individual shall notify in wriang the responsible authority describing�he nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual tha[he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The decerminarion of the responsible au[horiry may be appealed pursuant to the provisions of the administrative procedure act relating to contested 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 pemut 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 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 information may be shared with other local, state or federal agencies to the extent necessary to process the pernut 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 C�� Stace Zip Phone I underst d rights as ove. 1 i re , CHECK OFF LIST FOR ISSUANCE OF PER�I�IITS � _ FOR OFFICE USE ONLY � ADDRESS OR LEGAL: I 3 I 7 NoR�nf A�t� ,d2 . PID: DESCRIPTION OF WORK: C�lt��i rv� �-- � L! — , - . ZO�'G REVIE`v BY: DATE APPROVED: � 'L3 �o BUII..DING REVIEtii�BY: N�/a- . DATE APPROVED: 6(1A�O� •� Sc�o c.�ar c. w�o G�• � FEES TO BE CHARGED: � A` ^�Misc. Fees Calculated B�� pERMIT Yes �� No : pLAN REVIEW Yes No SEWER CONNECTION STATE SURCHARGE Yes No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) ZOYLVG CHECg LIST Zoning Districr. /!/U C G¢�� _ � Fire Deparcment: Post O�ce: School District: • Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Right Sid • � Reaz(Street}: Left Side _ � Adjaceat Structures: etland: . Building Height: Def. Hgt. eal:Hgt. Lot Covera�e: Grading: Staff Approval Date: By: Council Approval Date: __ Septic: Staff Approval Date: By: Zoning File: /# Resoludon: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setb ck: I.otCoverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: gEbiARKS (in house): 7 BUII,DING REVIEW CHECK LIST UBC: � CONSTRUCTION TYPE: ^ Sq Footage $ Per Sq Ftg Basement z = lst Floor x = 2nd Floor x = Gazage z = z = TOTAL F.stimated 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 Boazd (Mfg.) Well (State Permit) _�Final Grading/Filling Elecuical(State Permit) Other REMARKS(IN HOUSE): yh��,� l=��-�� 2trs C•'��l�,.�vs � v� 4�� REVIEW BY OTHERS: DATE: Access: Ezisting New Access Approval: Date By: REVIARKS (TO BE NOTED ON PERMIT�: 8 ' � � �. __ , /i��.� COP'� � � -� �� s � ��- � �� -�- � . � � � -% �`-�`� --� ��. ��..�� r � � C�, �� . � �,-�,�-��- �� . �,� /�..��/s .-- �n /� �j 7 � / / ��I / � f� . ��7�''�� `f - "" � ' C=� � ��z� � G� �� — �� - — �.� � �� °�- ��° � �`� , �„ � y ��,. �� 6,�� . � ��. �� 1��1 rY�^'.~ _ � 1. ��>�-1 r' Ccrtific�te of Suz•vey � for J�res D. Carson � a� i�-� of i�o�. 3� :?1Cc�c '7� 5t�� :�ill i3��'��6c3 � H�nne�in Ccunty, i!innesot� i � �r ; � . -� � C��, �'�O P�S C`� �,� �Z � . �r . ,� � � �raa �. � ;�� ,��o, � ��%� �� — �. , ��ea s� �\�, � �a � `� �/ � � �� / � � .� �r' �� 6� �E��F,b �/ / � . i / �\t' ;'r;�'r'-1/�6; .^ �/ ` , � , ��'''u„y�d�,3.'� _� _ __. �/ ._ _ Jo � � �'�,', � � . � zo• oe• / � ��— � �� f. / � ° �� 3 v ti �o�� Q£-�k ,� F�,3j, + e,,: .r� Y 9°o 09 N� 2t-�„�,�v�o - ti � , r�. o, ' � �., � 9e 6 �� ,,y p�� ,, , 6. �� —�(,,��"�� zo. � , ^�° .`" ' � i h � �/ � `� 1� j , I(x..c� � ., 'W f `�- � � 6g� �` � �.i`n �h\ / \ �N4/?v� `�� l�.6 T '� • y 0� � �,�:. � � �i1Y OF Q��HQ �;�,,�.,, ��E PUN ___�' GRADING PLAN �; � � �;APPROVED �— F-�(�. t- �a-��'�'�'�' ��w '� C�c��PPROVED WjTH REVISIONS . �l DISAPP i I h�r•�::_� certif;,� tti;�t tr:as is � true �T� {g � 23 -c�o ano correct represent-jtior. o� -. SL1T'V�:�.' cf ti;�� OLtT".Uc:rics of in. � 3, rl��: 7, / Sa��3 Hi�i it�v.`�.;��, Eienne�in Cc. , h:i r.r.. , � t�tl� �:}'l� LOc`tlt,..01'1 4f ��.i �'X1St1I:4 ��t;i1.-!ir.�•s �,�:c.'I^�^Ot'. ,Y,�`. !:�� 110t DUT'�QT't 'f,0 S}10k' OL�1r:T fi'��TO�•e^-"ents :�r�:��`er:C2^O�C.'iI"�tlt." , _ _-�-.'!--1•-.�---_._ , :iC:_i�.� : �.�� - �r�� I'C70: !t . rO:':''111 u�',�. ..�. �;'��`L. �it:C'. . �--:..�.—ca ui1"�G ..LL Vc'_�C1" :iYli� t'l.a:'.Cl�?i O . Tron �':T'��?i .,02'1f' �2i!�?� 1•�l:illG'SUi:]