HomeMy WebLinkAbout2002-P05626 - addn/remodel/repair � PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P05626
Crystal Bay, Minnesota 55323 Pet'CTllt Typ@: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 9iisi2oo2
SITE ADDRESS: 3860 North Share Drive
Mound,MN 55364
PID: 08-117-23-33-0095
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 181.25 Valuation: $ 10,000.00
State Surcharge Fee: $ 5.50
TOTAL FEE: $ 186.75
APPLICANT: Maverick Construction OWNER: D Handlin&N Krause
11227 River Road NE 3860 North Shore Drive
Hanover,MN 55341 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.
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PL ANT PERMITEE SIGNATURE , ISSUED BY SIGNATURE
Cooies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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s Total Fee: $ �,�5 Date Received: q-r�-aoo�
Entered By: Q��. Permit#: �05CP o�(P
�� � CITY OF ORONO - BUILDING PERMIT APPLICATION
,11'�� All information must be submitted in full before plan review will be started.
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THE APPLICANT IS: (circle one) OWNER OR` ONTRACTO
JOB SITE ADDRESS: ���,����/-E�i���� ZIP:-
NAME OF OWNER: /%�� PHONE: (home)
� (work)
MAILING ADDRESS:���Q ' Q'� TY: ZIP:
CONTRACTOR: PHONE: 7lp�L�9� ��l
CONTACT PERSON: M BILE/PAGER: �/� �'l8—�JQ'7 7
MAILING ADDRESS: � CITY: �/O/��ni 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 de�in: ,�1��//�/���� ���,s
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STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ID,Q�/�
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
pemut; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: � DATE: ��j�j����/
NOTE! �arade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SL7BJECTS 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 forth in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidendal data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide
system;(b)whether he may refuse or is legaUy required to supply the requesred data;(c)any lrnown consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply invesrigative data, pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav olace the norice rewired under this subdivision in the individual income hax or nrocem tax refund
insavcrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be infortned whether he is the
subject of stored data on individuals,and whether 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 i�ividuals shall be shown the data without any charge to him ac�,if he desires,shall be informed
of the content and meaning of that data. After an i�ividual has been shown the private data ar�d informed of its meaning,the data need not be
disclosed to him for six months thereafter unless a dispute or acdon Fwrsuant to dus section is pending or additional 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 authoriry may require the requesting person to pay the acNal cosu of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or withict 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 time,he shall so inform the individual,and may have an additional five days within which to comply with the request,
ezcluding 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 cocKeming himself. To ezercise dris right,an individual shall notify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authoriry shall within 30 days either: (a)correct the data fouM to be inaccurate or i�omplete and attempt to notify
past recipients of inaccurate or incomplete data,ic�luding tecipients 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 determinaaon of the responsible authoriry 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 permit or license from the Giry of Orono or any of its departments may require you to fumish certain
private or confidential information.
You aze 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 shazed with other local, state or federal agencies to the eztent 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.
First Middle Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 3�96o No2T'1� SHo�u: n2.
PID:
DESCRIPTION OF WORK: ,a�,ns..-f E6rtx'sr t.w..�nawS t r,���s�+2 o,4m� /1.�'�°,�,�c
ZONING REVIEW BY: DATE APPROVED: Q-r�.d-L
BUII.DING REVIEW BY: DATE APPROVED: � - ��.m�,
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes _� No
PLAN REVIEW Yes No �� SEWER CONNECTION
STATE SURCHARGE Yes _�� No WATER CONNECTION
INVESTIGATION FEE Yes No. PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: /U d G�y�vc,,t
a
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Sid :
Rear(Street): I.eft Side:
Adjacent Structures: etland:
Building Height: Def. Hgt. P Hgt.
Lot Coverage:
Grading: Staff Approval Date: y: Council Approval Date:
Septic: Staff Approval Date: y:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Vaziance Required: Yes No Date of Council Approval:
REMARKS(in house):
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BUII..DING REVIEW CHECK LIST
UBC: �-'3 CONSTRUCTION TYPE: VN
Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor z =
Gazage x =
R =
TOTAL
Estimated Construction Value: $ 1 b.pc�p o"
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
oC Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
K Final Grading/Filling Electrical (State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERNIIT�:
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