The URL can be used to link to this page

Home My WebLink About2006-P09934 - attached deck � '` PERMIT CITY OF ORONO Permit ►vumber: 2750 Kelley Parkway- PO Box 66 P09934 Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 6/14/2006 SITE ADDRESS: 4140 North Shore Dr Unit# Mound,MN 55364 PID: 07-117-23-44-0052 DESCRIPTION: Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached DETAILS: Approved per resolution#: Separate permits required: Ad� Znc.-✓ Tier �o �e c.,�c.. NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 69.25 Valuation: $ 2,000.00 Plan Review Fee: $ 45.01 State Surcharge Fee: $ 1.00 TOTAL FEE: $ 115.26 APPLICANT: Owner/Self OWNER: Ted&Carrie Woychick MN 4140 North Shore 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. � _,�==�; ��^ ;, �� . ,,� �-�- e;w�,a-� "r APPL[CANT�E TE SI�RE � ISSUED BY SIGNATURE C __. � _ _ .._ . Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 • �� lP�� Total Fee: $ // . Date Received: (�� "r� �� Entered By: Permit#: �-�,J ��i�� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (plerise print a!l information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle o�ze) OWNER OR CONTRACTOR < . ,, .._ . ' . : ) JOB SITE ADDRESS: "t' ��G !lG�i ��1 __.-)"� IG✓-c_ ,`-// ZIP: � 5;:� ,�� Will this be Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �o If yes, a specia!event pernzit is��eqi�ired��vith Police Departrnent and Citv Coarncil approvnl 60 clays prior to the event. Shaittle Gus service rnill be�•equired unless applicant de��aonstr•ates sz fficient on-site parking is avai/able. R�on-perr�aitted events ivil!not be allowed. NAME OF OWNER: ,��c G( f �_ Gt f� i� ;'�( GC/�`/U<i��_�'HONE: (home) `�'� ��-'{ y�� y,� `%�; " � ` f- ,� (work) MAILING ADDRESS: ��:' ; ��Gi`�/? �'rG/< f�CITY: �. f. '� ��f- ZIP: `> > �-�-�� CONTRACTOR: � '�'/1,� < <�. C.z j �.� } PHONE: CONTACT PERSON: �,' j�; ��, �'��r�� _ MOBILE/PAGER: MAILING ADDRESS: ` �; i�,� .�" CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: � f �j}��.c �. Cc 'r�_c / PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement ay require MCWD review and permits ! PROPOSED WORK descr�ibe in detrri : r . f %��`� � ��=`�i�;.� -�_� � � � __f� ��L� � " �'�_ ��'�� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED �) - ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ,,�� L 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 Buildin� Code;that I understand this is not a pennit and work is not to start without a permit;and that the work will be in accordance with the approved plan. '� , ,� `�.�� 7 : , l r APPLICANT'S SIGNATURE: �:- �L' �=C� `� DATE: - , �.-�C.�� .��G"��j .-- - <- , 31 r Sec.13.Od RIGHTS OF SUBJECTS OF DATA Subd. I. 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 dataconceming himselfshall be informed of. (a)the purpose and intended use ofthe 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 arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shal I not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement otticer. The commissioner of revenue may_pllce the notice required under this subdivision in the individual income ta�or propertv tax refund instructions instead of on those fonns. 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�vliether it is classified as public,private or contidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown tl�e data without any charge to him and,ifhe desires,shall be informed of the content and meaning of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disdosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected 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 audioriry may require the requesting person to pay the actuai costs of making,certitying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant ro this subdivision,or within tive 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[ime,he shall so inform the individual,and may have an additional tive days within which to comply with the request,excluding 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 concerning himself. To e�ercise this ri�ht,an individual shall notity in writing the responsible authority describing the nature of die disagreement. The responsible authoriry shall within 30 days either (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notily the individual that he believes the data to be correct. Data in disp�!!e shall be disclosed only ifthe individual's statementofdisagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADV[SORY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to infomz you that your request for a pecmit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: l. The information you furnish will be used to detercnine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the City deny the pennit 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 rec�uested permit or license requires Council action to approve, some infom�ation may become public. 5. You have certain rights under M.S. 13.04(available upon request)to revie�v private data on yourself. 6. - Your fuil name is required to process this application or permrt �-„� � �� .� � �' �"t S � . C; j i � e:._. , 't G �/�� L�L��. �_ First � Niiddle _ Last �; �� ; . ;'�-� �� jlL/ � � �r Address � , ��—J ��l l��.' !f� l� G� �'7�!/ /.�%` �/ 'J` �� Cih� State Zip Phone I understand my rights as stated above. � �i/� - , �;�� . '��-- �/ �� SignAtura � \ Reset Form �� , • CHEC�K OFF i,IST FOR ISSUANCE OF �ERNIITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: U I UU N�Is`��i�,i+C ��' PID: DESCRIPI�O�T OF WORK: R�CT" w�►c-�� -�-� P�-�� --- ---------__--___—__--------------------- -----------------------------�------- ZO�G REVLEtiV BY: �� G��G� DATE APPP OVED: (�C�'D'�� BUII�DING REVIEtiV BY: DATE APPROVED: � - -� �� ly`EES TO BE CHA.RGED: / Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIE`V � Yes —� No SEWER CONNECTION STATE SURCHARGE Yes � No tiVATERCONNECTION INVESTIGATION FEE Yes No P�K FEE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) ZO��IG CTriE.CK LIST Zoning Distria: nl�� t�Cs-_I��2 Fire Department: Post O�ce: School District: Loc Area: Sq.ft. Acres Width Depth Survey Submitted: Yes I�Io Date of Survey: Proposed Setbacks: Froa[ (Lake); Riaht Side: Rear (Street): Left Side: Adjacenr �r��n1res: etland: Buil�lin� Hei�t: Def. Hgt, eal:Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Scaff Approval Dace: � �Y� ��Ll� Zoaing File: !# Resolution: � Resolution Date: Shoreland District: Avg. Se[back: Bluff e[back: L.o[Coverage: E�ist' � Proposed 0 Hardcover: 0-7�' 7�-250' Zso-5oo� �• �G. 500-1000' �� Hardcover Va;iance Required: Yes No Da�e of Council Approv2.1: �E1L�RKS (in house): � BLT�DING REVIE�Y CHECK LIST �C� — � CONSTRUCTION TYPE: `— Sq Footaae $Per Sq Ftg ' Basement � . . .. x _ . . lst Floor ' . x ' — . • � . 2nd Floor x _ � � • Garage x _ . z = TOTAL Estimated Construction Valae: $_2,doa `'� Inspections Required: tiYork Requiring Separate Permits: Site Plumbing Fire • Hardcover Removal Mechanical Water Connection Footing ` Septic Sewer Connection �• Fr�b • Firepiace Lawa Irrigation Insulation (Masonry) Other Wall Boazd (Mpg,) Wetl (Scate Permit) —�F�� Grading/Filling Electrical (State Permit) Ocher REI�2�.RK�(IN�iOUSE): . . . ___________..�___________�---- --- — — _�_��--------------------------------------------- REV�W BY OTHERS: DATE: Access: Existing New • Access Approval: Date By; � - - ---------------------------------------__--------- REI�IARKS (TO SE NOTED OV'PERMiZ�: � . c.. 8