HomeMy WebLinkAbout2001-P03734 - foundation only Cl�lf' �F RONO PERMIT
O Permit Number:
2750 Kelley Parkway - PO Box 66 P03734
Crystal Bay, Minnesota 55323 P@I'fTllt Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 4�2ai2ooi
SITE ADDRESS: 4760 North Arm Dr W
MOiJND,MN 55364
PID: 06-117-23-23-0010
DESCRIPTION:
Proposed Use: itesidentiai
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Foundation Only
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ g3•25 Valuation: $ 3,000.00
State Surcharge Fee: $ 1.50
TOTAL FEE: $ 84.75
APPLICANT: Patrick Fleming OWNER: Patrick Fleming
4760 North Arm Drive 4760 North Arm Drive
Orono, MN 55364 Orono, 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.
\
� ��1 --� G��'��1't-c�s-�-� N?
APPLI ANT E ITEE I NATURE IS DBYSIGNATLJRE
Copies: City,Applicant,Assessor,Finance Page 1
T"otal Fee: $ Date Received: y a�0
Entered By: Permit#: D 3
CITY �F ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before pla.n review will be started.
' (please print all information)
THE APPLICANT IS: (circle one) OWNER O CONTR.ACTOR
�--- ____.�
JOB SITE A.DDRESS: ��l�C� 1,� d t� i4f� ' r�_ ZIP: � S � �y
NAME OF OWNER:��6\'1 ' �- �' ��L� t?� _ PHOiVE: (home) � S Z"`t��z"l l S z.
(work) (c`�I - �3�!- %Sb2 _
�IA_II�Pt 1G.A.DDRESS: `���oC� �2�f-H-�{�(Co.� -D('CITY: �,('C7/�L�- ZIP: 55��1 ,
CONTRA.CTOR: ' PH0�1E:
CON'TACT PERSON: IIOBILE/PAGER:
MAII_,ING ADDRESS• CTTY: Z�'
STATE LICENSE: #
ARCHITECT/ENGI�EER: PHONE:
MA,IL�'G A.DDRESS: CITY: ZIP:
N��: REGISTRATION# �
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED`VORK(describe in detai�: ����r'a-2(' tc,��� ,`o �
STORIES: SQ. FEET OF EACH FLOOR I��v
NO. aF B�DROOMS:�� GARAGE STALLS: ATT�. Z- � DET. : . � = :..:-. -.< ._
ESTII�i IA.TED COtiTSTRUCTION VALUATIO\ (exclud.ing land): � "�,�,�,c, _F,
I hereby apply for a buildin�perm.it and I acknowled;e that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the Ciry and with
the State BuildinJ Code; that I undeF�and this is not a perm.it and work is not to start without a
permit; and that the work will be in ord nce with the approved plan.
, � ��. �-
APPLICANT'S SIGNATURE: ` �> , _ _`\�. ` DATE:�" 2 �
1VOTE! Parade of Homes events require separate ermi approval by Police Department and
City Council 60 days prior to the ev�e�nj. Non permitted events will not be allowed.
�j,c C '� c s s� �JGc�.-- r�c�✓a�/ � N s,� o� ��
�
, � s
Sec.13.0-1 RIGHTS OF SUBJECTS OF D:�TA
Subd. 1. Type of data. The ri¢h�s of individual on whom c�e data is sto:_3 or to be scored shall be as set forth in this secaon.
Subd.2. Information reqirired to be given individual. An ir.c'i�idual ask�to suppiy priva�e or confidenaal dara concecning himself shall
be informed of: (a)the purpose and intended use of the requestcd data wiain che coll�cang'sute agency,poliacal subdivisioo,or sntcwide sysum;
(b)whe�ler he may refuse oY is legally required to supply che requesced daa:(c)any Icovra eonsequeace arising from his supplying or refusing to suppiy
priva�e or conndeneal data;and(d)the idendry of o�her persoas or eaadcs aechorized by srate or federal!aw to receive the data..'Ihis requiremen�shall
not apply whzn an individual is asked to suppfy invesdeadve dara,purn:_.�co seccoa 13.82,subdivision 5, to a law enforcemenc o�cer.
"Ihe commissioner of revenu� riav place the norice rauirtd e^d-r this sutdrvision in the individual ir.come tax or proDern tax refund
instrvctions instead of on chose forms.
Subd.3. access to data b�indi�idual. Upon requesc to a r_s�oaSible aec:oriry,an iadividual shall be informed whether he is the subject
of scored data on individuals,and whe�her ic is ctassified as public,priva�or confcd=r.ria1. Upon his furcher requesc, an individual who is the subjecc
of scored priva�e or public data on individuals shall be shown che data w•i�out any c;.3rge to him and;if he desues, shall be informed of the concenc
and meaning of chac dara. After an individua!hu been shown[he priva��aa and iL:or.ned of i�s meaning,the data need not be disciosed to him for
six monchs thereatter uniess a dispute or acaon pursuanc to �his secrion is�eading or addidonal data on the individual has been collected or crea�ed.
The responsible auchoriry shalt pcovide copies of the private or public daca c�on reques:by the individual subject of[he data. T'he responsible authoriry
may requir� the requesring person to pay[he acniai coscs of makine,ce_.;:ing, ar:d eompiling the copies.
The responsible authoriry shall comply immediacely, if possib'.=,wich any r_quesc made punuant to chis subdivision, o�wichin five days of
the dacs of[he request,excluding Sa�urdays,Sundays and legal holidays,i;ir..mediace compliance is noc possible. If he cannot comply with the requesc
wichin�ha[dme,he shall so inform[he individual,and may have an addi::er.a1 five da�s wichin which to comply with the request,ezcluding Sacurdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. �n individu=1 may contest the accuracy or completeness of public or pri�•ate
daca conceming himself. To exercise�his right,an individual shall nodfy ia wriring�:o rsponsible authoriry dzscribing�he nacure of the disagreemene.
Tfie responsibie auchoriry shall wichin 30 days either: (a)comct[he dae icand to be inaccurate or incomptece and aaempe to nodfy past recipien�s of
inaccunce or incomplece data, including recipien�s named by che individ::�;or(b) eorify the individual thac he bzlieves the data to be correcc. Da[a
in dispu�e shall be disclosed only if the individual's statemenc of disagree�=nt is i.c:::3ed with the disclosed data.
'I'tie decerminarion of the rosponsible au[horiry may be appea�_� punuat:to the provisions of the adminiscrarive procedure act relaang to
conces.ed cases.
DATA PRIV�CY AD�ZSORY
In accordance with M.S. 13.04, Subd.2, "RiQhts of sub;ects oi data", we would like to inform you tha[your reauest
for a permit or license from the Ciry of Orono or any ot ia depar�u-.ents may require you to furnish cenain priva�e or
confidential information.
You are notified that:
1, The informa�ion you furnish will be used to de:zrmine �'our qualification for the permit or license requested.
?. You may refuse to supply da�a, buc refusal rsay require tha[ the Ciry deny the perm.it or license.
3, 'Ihe information may be shared wi[h ocher locz, state or federal agencies to the excent necessary to process
the permit or license.
4, If your requested permit or license requires Council accion to approve, some information may become
. , public.
�, You ha��e certain riQhts under M.S. 13.04 (z�ailable upon reques[) to review private data on yourself.
6, Your full name is required to process this applica�ion or perm.i�.
Firsc Middle Lasc
Address �
Ciry Stace Zip Phone
\
\ \ I undl� d ',hts as stated above.
� � �- � r
Signacure
DAT TIME
CITYOFORONO CALLEDIN J`-' ia`3o
INSPECTION NOTIC SCHEDULED ' d -��y�
PERMIT N0. y COMPLETED —d '
ADDRESS `'`��� /�� ��1 �K x=
OWNER ��P/Y1/� CONTR._ C�-11—
TELEPHONE N0. S_ � � �S� � ��C
� DESCRIPTION ��-°�"'L- l On 2e�OGt�'r U���O�� G��>
� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARO COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
�
d
� �`�/VORK SATISFACTORY:PROCEED �ROJECT COMPLETE
W� ❑CORRECT WORK 8 PROCEED � C ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
,
Call for the next inspection 24 hours in adva ce. (J52� Z49-46
Owner/Contractor on ' e:
- �
Inspector.
White Copyllnspector's File Canary CopylSite Notice