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Home My WebLink About2005-P08761 - minor alterations PERMIT �IT`.! OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: po8761 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 5/20/2005 SITE ADDRESS: 1367 North Arm Dr Unit# Mound,MN 55364 PID: 07-117-23-41-0065 DESCRIPTION: Proposed Use: Residential i' Census Code . O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side DETAI LS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 54.00 Valuation: $ 1,500.00 State Surcharge Fee: $ OJS TOTAL FEE: $ 54.75 APPLICANT: Owner/Self OWNER: Linda Theisen 1V1N 1367 North Arm Dr Mound,MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPI,IANCE WITH ALL CITY OF ORONO�ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. hz.� � ��`�<<i:, � � APPLICANT PERMITEE SIGNATURE �� ISSUED BY SIGNATURE Copies: 1-File(SignaturesReguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � , w PERMIT �IT� OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p08761 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 5/20/2005 SITE ADDRESS: 1367 North Arm Dr Mound,MN 55364 P�� 07-117-23-41-0065 DESCRIPTION: Proposed Use: Residential Pernut Class: Building Census Code 434 Permit Sub-type(s): Building-Re-Side Permit Type: Minor Alterations DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 54.00 Valuation: $ 1,500.00 State Surcharge Fee: $ 0.75 TOTAL FEE: $ 54.75 APPLICANT: Owner/Self OWNER: Linda Theisen � 1367 North Arm Dr 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 STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. �, r-, � � , ' �,��'+� :G...._._ ��'LZ- APPLICANT PERMIT E SIGNATURE � ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-AUplicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1 / • - Total Fee: $ Date Received: � Entered By: Permit#: 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: � �(D7 Iv, ��4'�/l �f2, IU�U�'� ��J�07 Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑Yes ❑NO If yes,a special event permit is required with Police Department and City Cou�cil approval 60 days prior to the event. Shtrttle bus se�vice will be required unless a�plicant dernonstrates su�cient on-site parking is available. Non permitted events wi11 not be allowed. NAME OF OWNER: I.._L N�� TN'�S�N PHONE: (home) �Z-�(' Z-��d MAILING ADDRESS: ��jlp� N, (work) {�'�if(►�. ��CITI': ZIP: CONTRACTOR: �� PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PFIONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home RemodeUAlteration �/ PROPOSED WORK(describe in detai�: �,D � S � �V�, �S'� ��.Q,�� 5�-- . dr�Si��(..� t�,�in�G(.en.� � STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �J��.�� • 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 pertnit and work is not to start without a permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: G1/'�� DATE: U✓ D� 31 - � 1� Sec.]3.04 RIGHTS OF SUBJECTS OF DATA Subd.l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any kno�vn consequence arising from his supplying o�refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federdt law to receive the data.This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,W a law enforceinent officer. The cnm�,,;�sioner of revenue mayplace the notice required under this subdivision in the individual income tax or propertv tax refund instructions 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 whether it is classified as public,piivate or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter uniess a dispute or action pursuant to this section is pending or additional data on the individual has been collccted 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 requiro the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shatl comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of che date of the roquest,excluding Saeurdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comply with che request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4.Proceduro when data is not accurate or complete.An individual may contes[the accuracy or completeness of public or private data conceming himself.To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipiencs af inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that 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 determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act rolating 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 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 fumish 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 publia 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. 1-(N��- Nl � Ttf�`�S�I First Middie Last � 3e� N� � t�� . . Address —��n� ��,�� (� � qs�-�7a-,�'7� City State Zip Phone I understand my rights as stated above. ��'� 1'�►-�-� - 5ignature 32 �� (;�%��" D TE „�.- TIME �,/ CITY OF ORONO CALLED IN / �J ds INSPECTION N I��._�� . SCHEDULED =�� PERMIT NO. � COMPLETED -�� "" ADDRESS �.'�C_L' / �� OWNER�� ( I Jd�� CONTR. TELEPHONE NO. J� � C��L� ' O �� DESCRIPTION / �--( � ��/ /�- �� lL 01 FOOTING 11 MECHANICAL RI 18 EXCA RADING/FILLIN � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS� ti Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION �� Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING Rt 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES NO � COMMENTS: � W a � � O �. � O � W � Q ti Z W � W � j d � W� ❑WORKSATISFACTORY:PROCEED OJECTCOMPLETE W ❑CORRECT WORK R PROCEED !7 ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C, pH0T0 TAKEN INSPECTOR WILL RETURN �� CITATION ISSUED ❑STOP ORDER POSTED.CAIL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 ours in advance. (952� 24J-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice