HomeMy WebLinkAbout2000-P02908 - deck ..
" PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 Po29os
Crystal Bay, Minnesota 55323 PerCTllt Typ2: Addition/Remodel/Repair
(612) 249-4600 Date Issued: 9i26i2oo
SITE ADDRESS: 4109 North Shore Dr
MO[JND,MN 55364
PID: 07-117-23-44-0038
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Census Code 434
Permit Class: Building
Permit T e: Addition/Remodel/Re air Permit Sub-type(s): Deck
YP P Single Family
DE�AILS:
Approved per resolution#:
Separate permits required: Yium�ing iviecnanicai �.iectricai�siaie j
NOTICES/REMARKS:
FEE SUIIIIMARY: Permit Fee: $ 441.75 Valuation: $ 30,000.00
Plan Review Fee: � 287.13
State Surcharge Fee: $ 15.00
TOTAL FEE: $ 743.88
APPLICANT: JAMES CLEARY OWNER: JAMES M CLEARY
4109 NORTH SHORE Dr 38 ADDRESS UNASSIGNED
MOUND,MN 55364 MN 00000
TI�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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LI AN PERMITEE ATURE SSUEDBYSIGNATLJRE
Copies: City, Applicant,Assessor, Finance Page 1
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Total Fee: $ -'��� -L'�`� Date Received: �'�-��
Entered By: �!?,� Permit#: � C r, ��%f
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CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: O �, �l,�c,c�. ZIP: � '3E.;`�
�u.� � �.%_
NAME OF OWNER: � �` � ' PHONE: (home) �f�2-��
(work) ��c�.
MAILII�TG ADDRESS: ��� CITY: ZIP:
CONTRACTOR: PHONE:
CONTACT PERSON: ` MOBILE/PAGER:
MAII,ING ADDRESS: � cst�:.�t CITY: ZIP:
STATE LICENSE: # �o�,���,,,,�
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 detain: v���� �e,�..sc.�- c� ���
f
STORIES: SQ. FEET OF EACH FLOOR: �F��'
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTTVi IATED 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 not a permit and work is not to start without a
permit; and that the work will be in cordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: ' �3
NOTE! Parade of Homes events�e�uire 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 SCTBJECTS OF DATA
- Subd. 1. Type of data. The righu 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 i�ividual asked to supply private or confidential data concerning himself
shall be informed of: (a)the purpose and i�ended 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 known consequence azising from his supplying or
refusing ro�pply private or confide�tial data;a�(d)the identiry of other persons or entities aurhorized by state or federal law W receive the data.
This requirement shall not apply when an individual is asked to supply invesdgative data,pursuant to section 13.82, subdivision 5,to a law
eaforcement officer.
The commissioner of revernie mav nlace the notice reauired under this subdivision in the individual income tax or mm�ertv 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 whedier it is classified as public,private or confidendal. Upon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown the data without acry charge W him and,if he desires,shall be informed
of the wntent 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 mondis thereafrer nnless a dispute or acfion pursuant to diis section is pending or addiflonal data on the individual has been
wllec�d or created. The responsible authority shall provide copies of die private or public data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible audiority shall comply immediately,if possible,with azry request made pursuant to this subdivision,or within five days
of the da[e of the request,excluding Saturdays,Sw�days 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 aa addidonal five days within which to comply with the request,
exciuding Saturdays,Sundays and legal hoGdays.
Subd.4. Pracedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
privace data co�erning himself. To exercise this right,an individual shall noafy in writing the respoasible authority descn'bing the nature of the
disagreemecu. The responsible audiority shall withic►30 days eidier: (a)correct the data found to be inaccurate or iacomplete and attempt to notify
past recipients of inaccurate or incomplete daha,including recipients named by the i�lividual;or(b)no6fy the individual that he believes the data
to be correct. Data in dispute shall be disclosed oaly if the individual's statement of disagreement is included with rhe disclosed data.
The determinaaon of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating
to contested cases.
DATA PRIVACY A,DVISORY
In accordance with M.S. 13.Q4, 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 departments may require you to fumish certain
private or confidential information.
You aze 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 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 acaon 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 this application or germit.
Fnst Middle Last
Address
City State Zip Phone
I understand my rights as stated above.
Signature
6
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* _� .
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �/1 ��! �� cS H�2c: /J/L
PID:
DESCRIPTION OF WORK: I�e c t�s �- c.o�•.s� cae.�►-e.� 1=�.v�s N ..
ZONING REVIEW BY: , �. .,.., DATE APPROVED: Q- Z�.-o�
BUII.DING REVIEW BY: v ,,� �_ DATE APPROVED: q-2�- o0
FEES TO BE CIiARGED: Misc. Fees Calculated By:
PERMIT Yes �' No
PLAN REVIEW Yes v- No SEWER CONNECTION
STATE SURCHARGE Yes ri No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE .
SAC Yes No � SITEINSPECTION
Number of 5AC�Units OTHER (specify)
ZONING CHECB LIST Zoning District: N� c c�a��p
e
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes� No Date of Survey: Oa �c�.c:
At4teS lJeu�S
Proposed Setbacks: F'�'""r �ti �/�"''r 1�='�
Front(Lake): �f� !S� Right Side: !�(0 ( (?
� Rear(Street): �3 3L Left Side: �15� 'jS
Adjacent Structures: �1-T�►-c.t�� Wetland: /`f//`�
Building Height: Def. Hgt. N I�} Peak Hgt. —
Lot Coverage: f1 IL
Grading: Staff Approval Date: � By: Council Approval Date:
Septic: Staff Approval Date: � By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District: /W
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
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BUII..DING REVIEW CHECB LIST
UBC: �' 3 CONSTRUCTION TYPE: V�
� Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
�
Estimated Construction Value: $ �e9, trv-� .
Inspections Required: Work Requiring Separate Permits:
Site �_Plumbing Fire
Hazdcover Removal �_Mechanical Water Connection
_�c Footing Septic Sewer Connection
�_Framing Fireplace Lawn Irrigation
�Insulation (Masonry) Other
�Wall Boazd (Mfg.) Well(State Permit)
_�Final Grading/Filling iC Electrical(State Permit)
Other
. . •
REMARI�S(IN HOUSE): � �
REVIEW BY OTHERS• DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMII�:
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