HomeMy WebLinkAbout2002-P05370 - solarium PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P05370
Crystal Bay, Minnesota 55323 P21"Illlt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: �ii2i2oo2
SITE ADDRESS: 3925 North Shore Dr
Mound,MN 55364
PID: i�-ii�-23-22-000�
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Pernut Class: Building Census Code 434
Pernut Type: Addition/RemodeURepair Pernut Sub-rype(s): Solarium-Residential
DETAILS:
Approved per resolution#:
Separate pernuts required: Eiecfficai�staiej
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 441.75
Valuation: $ 30,000.00
Plan Review Fee: $ 287.13
State Surcharge Fee: $ 15.50
TOTAL FEE: $ 744.38
APPLICANT: Owner/Self OWNER: Lynn Christine
M� 3925 North Shore Dr
Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL W � IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNE TA BUILD �E UIRE ENTS.
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APPLICA PERMITEE SIGNATURE ISSUE S[GNATURE
. .
Conies: 1-File(SiQnitures Required), 1-Annlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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Total Fee: $ ���`f . � �� Date Received: �:' v� � /�
' Entered By: ,-�?�/ Permit#: ��', i �� �,�
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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 R CONTRACTOR
JOB SITE ADDRESS: ��as" �/ s�h�►�� ����� ZIP: J`-� 2J � ��
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NAME OF OWNER: �N ��'d � ��/v� PHONE: (home) ��d� 7� (����j
(work)
MAILING ADDRESS: ���� �� ��'''�'���CITY: j/ti1,U-11/l q/C� ZIP: s � G �
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CONTRACTOR: ��,1��IJ�..i ' PHONE:
CONTACT PERSON: MOBILE/PAGER:
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 detai�: � � l�-� � �JC � S%(/��
�' �2 � � �1,�v���� (�+�l �(/�t/ C 0 r�. S P � �/Gt,� �-y
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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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 a permit and work is not to start without a
permit; and that the work will be i ccorda e 'th the pproved plan.
�- �
APPLICANT'S SIGNATURE: �� � DATE: �� a� �
NOTE! Parade of Homes events equire separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
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Sec.13.04 RIGHTS OF SUBJECTS 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 tivs section.
Subd.2. Information required to be given individual. An irdividual asked to supply private or co�dential data concerning himself
shall be informed of: (a)the purpose and inte�ed use of the requested data within the collecdng state agency,poliacal subdivision,or statewide
system;(b)whether he may refuse or is legaUy required to supply the requested data;(c)any lrnown consequence arising from his supplying or
refusing to supply private or confidenaal dara;and(d)the idendry of other persons or entides authorized by state or federal law to roceive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav olace the notice rewired under this subdivision in the individual income taz or orocertv 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 ctassified as public,private or confidenaal. Upon his further request,an individual who
is the subject of swred private or pvblic data on individuals shall be shown tfie 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
disciosed to him for six months thereafter unless a dispute or action pursuant to this secdon 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 requesring person to pay the actual costs of making,certifying,and compiling the copies.
The responsible 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 time,he shall so inform the i�ividual,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 conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the t�ature of the
disagreement. The responsible authority shall within 30 days either: (a)correct the data found ro be inaccurate or i�omplete and attempt to nodfy
past recipients of inaccurate or i�omplete data,i�luding 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 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 administradve 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�ity of Orono or any of its deparunents may require you to furnish 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 Ciry 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.
6. Your full name is required to process tlus application or permit.
First Middle Last
Address
City 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�Z 5 nf a2 nf syy��►►�u2 p�
PID:
DESCRIPTION OF WORK: C�•�s��e v��rvir.�, -�-�o /�va�-�. c3R�s rr.v�
ZONING REVIEW BY: ..._. DATE APPROVED: 7-�n-o z.
BUILDING REVIEW BY: DATE APPROVED: --�_ ,o-oZ
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Y�s �' No
PLAN REVIEW Yes _� No SEWER CONNECI'ION
STATE SURCHARGE Yes v No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District:
Fire Department: Past Office: School District: �
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes_Q� No Date of Survey: p►.� �-��
Proposed Setbacks:
Front(�): �7 � t Right Side: �l�{� -�
Rear(SE�eet): LIH� t Left Side: -7 6' =
Adjacent Structures: Zo' + Wetland: .�lq
Building Height: Def. Hgt. p .�C Peak Hgt. e9�(�
Lot Coverage: N� C�-+��
Grading: Staff Approval Date: !-- By: Council Approval Date:
Septic: Staff Approval Date: -- By:
Zoning File: # � Resolution: # Resolution Date:
Shoreland District: y.Cf
Avg. Setback: ^r�/d Bluff Setback: /��/-� L.otCoverage: N•C.
Existing Proposed
Hardcover: 0-75' �p
75-250' �� G(��7'
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: lZ• 3 CONSTRUCTION TYPE: �(!�
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Gazage x =
R =
TOTAL
Estimated Construction Value: $ 3 p,v c�0 0�
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 _�Electrical (State Permit)
Other
REMARKS(IN HOUSE): •
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT�:
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