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Home My WebLink About2005-P07750 - gazebo � S PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: po775o Crystal Bay, Minnesota 55323 Permit Type: Accessory structures (952) 249-4600 Date Issued: 7/6/2005 SITE ADDRESS: 4480 North Shore Dr Unit# Mound,MN 55364 P�� 07-117-23-31-0009 DESCRIPTION: UBC Occupancy U1 Construction Type VN Proposed Use: Residential Census Code 329 Permit Class: Building Permit T e: Accessory Structures Permit Sub-type(s): Gazebo YP DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Work Started w/o Permit FEE SUMMARY: Perniit Fee: $ 57.05 valuation: $ 1,600.00 Plan Review Fee: $ 37.08 State Surcharge Fee: $ 0.80 TOTAL FEE: $ 94.93 APPLICANT: Owner/Self OWNER: 7ohn Grotans NIN 4480 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. --,� � �� _ __... � i' I i " / _��'�C_ ��f/t.�`��F�l � APPLICANT PE MITEE SI ATURE [SSUED BY SIGNATURE � ' � Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 r . ��i, �.�1 d�� 9 i fQ, �� / �'/L �� .,.�`? ..�o•�h p��.°� .��'��x 0 �' �� -� ;�' ^ � . �>� . �,�, ` � �;-��.;. � �� Total Fee. $ � � ,�Date Received: � � Entered By: �,�vt/ `�-`'� �`� Pernnit#: ,�y� �-J, „ h �\ CITY OF ORONO - BUILDING PERMIT APPLICATION ��° � _ � ;,�.�t \"'-��5 All information must be submitted in full before plan review will be started. (please pf•int all infor��aation�) ------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER R CONTRACTOR JOB SITE ADDItESS: �y 8 V ��`�� 5��`'�� - ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes,a special event perrnit is required with Police Departmer�t and City Council approval 60 days prior to the event. Shzrttle bus se�vice will be reqzrired unless applicant demanstrates sz�cient on-site parking is available. Non J�er�nitted events will not be allowed. NAME OF OWNER: `�a � � G R�"n` j`' S pHONE: (home) ��2 ��C R 88 3 r (work) 7� 2'3� ��2.3 MAILING ADDRESS: �ZOI� a�lr� .�� , CITY: l " _ZIP: �S4F!,�' CONTR.ACTOR: c�c��F•^�' PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIR.ATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure �X Move Home Remodel/Alteration PROPOSED WORK(describe in detai�: �� t ��j 3�� Q' '� ��'t,`�1�� STORIES: SQ.FEET OF'EACH FLOOR: NO. OF BEDROOVIS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land}: $ 6��j Q• '� I hereby apply for a building pernut 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 accordance with the approved p1an. APPLICAI�IT'S SIGNATURE: DATE: (0 2 2- 31 , � 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 this section. Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended 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 knotvn consequence arising from his supplying or refusing to supply private or confidential daca;and(d)the identity of other persons or entities authorized by stafe or federal law ro receive the data.This requirement shall not apply when an individual is asked[o suppty investigative data,pursuant to section 13.32,subdivision 5,to a law enforcement officer. The commissioner of revenue mav nlace the notice required under this subdivision in the individual income tac or propertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shaU be informed whether he is the subject of stored data on individualsx and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject oi stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of[he content and meaning of[hat da[a. After an individual has 6een shown the pnvate data and informed of its meaning,the data need not be disclosed 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 the pnvate or public data upon request by the individual subject of the data. The responsible authonty may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shail comply immediately,if possible,with any request made pursuant to this subdivision,or wi[hin five days of the date of the request,eycluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannoc comp!y with che request within that time,he shall so inform the individuat,and may have an addicional five days widlin which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is noc accutate or complete. An individual may contest the accuracy or completeness of public or private da[a conceming himsel£ To exercise this right,an individual sha11 notify in wiiting the responsible authority describing the nature of the disagreement.The responsible authoriry shall within 30 days either. (a)con�ect the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individuat;or(b)notify the individual that he believes the data to be correcL Data in dispute shall be disclosed only if the individuaPs stat?ment of disa�reement is included with the disdosed data. The determination of[he responsible authority 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 subj ects of data",we would like to infomz you that your request for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or confidential infonnation. You are notified that: 1. The information you furnish will be used to deternune your qualification for the pernzit 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 pernlit or license. 4. If your�equested permit or license requires Council actior.to approve, some infomlation may become public. 5. You have certain rights under M.S. 13.04(available upon request)to review private data on yoursetf. 6. Your full name is required to process this application or permit. First Middle Last Address C�ty State Zip Phone I understand my rights as stated above. __._ r- ' ��, Sig ature 32 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: yY�b �U.S.� PID: DESCRIPTION OF WORK: Gjf Z��v — it�c:��h3 ZO.vI�Ti G REVIE`Y BY: L�C��W�W_- DATE APPROVED: 7 �'-�s' �W BUII..DING REV�tiY B : DATE APPROVED: -�-� -o s FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes � No PLAN REVIEW � Yes �� No SEWER CONNEG"TION STATE SUR.CHARGE Yes / No WATERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SIT'EINSPECTION Number of SAC�Units OTHER (specify) ZOi�TIl�TG CI�CK LIST Zaning District: Fire Degartment: Post Office: School District: � ' Lot Area: Sq.ft. No CN�a^�,,P Acres Width Depth � �— Survey Submitted: Yes_� No Date of Survey: � 9-��-BS Proposed Setbacks: Front(Lake): � /o'�' � Right Side: i 2, Reaz(Sueet): .Sa� a' Left Side: Z� Adjacent Structures: 16 ` Wetland: N //F Building Height: Def. Hgt. p,� Peak Hgt. Lot Coverage: D•1G Grading: Staff Approval Date: N�� By: Council Approval Date: Septic: Staff Approval Date: i1!//�- By: Zoning File: # —' Resolution: # Resolution Date: Shoreland District: y�j Avg. Setback: O.l�- Bluff Setback: /✓/� LotCoverage: O.k Existing Proposed Hazdcover: 0-75' 75-250' Z� � '� 250-500' 500-1000' Hardcover Variance Required: Yes No ic Date of Council Agproval: RENiARKS (in house): � . 1 BUILDING REVIEW CHECK LIST UBC: U- r CONSTRUCTION TYPE: �/n1 Sq Faota;e $Per Sq Ftg Basement . . x _ . 1st Floor x _ 2nd F1oor x _ Garage R _ x — TOTAL Q � /N�,�S�cA -� /nIGw2F li4Ba� o�v' , Estimated Construction Value: $ ((ood°r� Inspections Required: �Vork Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical • Water Connection Footing � Septic �ewer Connection � _�Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Boazd (Mfg.) Well (State Perm.it) �'F� Grading/Filling Electrical(State Permit) � Other REIV�KS(IN HOUSE): . ------- ---- ----------------------------------- REY�W BY OTHERS: DATE: Access: Existing New . Access Approval: Date gy; � --�_-----------��------------------��_�� RENL�RKS (TO BE NOTED ON PERI�: 8 sf"'„"-. . .. .. I � F �1 � e�, � � � ' ,..�- f�E� �� _ d.,:"�° (�.�'3 s , �«- ,. �� ,o' , #� � 3� ,��,� �,;r.; �,% . - � � �� ``�� /J � 3� '_:s�.,vL, :!;�`. . �� .'' �.l' . ,� , �f' �/"��..�'� • � '`� � r? f,,''' �,,� � �...� , ^° ��:� � �� . { � � , r�� M,�`� � 4r �JCf FP , .e., ,r�, ��,\ . ".. r � S y�.{`� ;'',�F�� . rf.��`� � \ .�� ,�F l �" --�--...,. a'\ �',, ' - -.. ,� � �� .__. _, � .. ��` �:��,, _ti_ ,�,y�' .. � �,''�y �'' ,� r /% � , , . �,.� ��r , . F . � � r . r,� . � s .. �. p��`d . ' . �'� .� � !��' �''' . �� .... . . ((``''qq ,.�� ' y� ��!� .... _ .__ � A . . �:� . � . .:. .,., /, , « y � .. �� ' r � � � `�� ,. .� .. � � . '� ��.i�` 4�. � l`�"� '�, �=�, �`�>" � ..3 ,�'� a .�. �� :. �� c�,�1.�.�. �� } _„ �'"- �;� i� �� . ' � a , ....m. � {� '°.� �� t ,�°'�' �' �� `. � �'"�"�� , � ,". , . 4 � -:� ��` ��'�� d , �� :' } �, A +�'�� . . � E rY.� � . `��'� A 4s. � �� = C�TY OF ORO�lQ �,��.� r� =� : � ,.�� SlTF P`LAN GRADING PLARI ' ��F��€�O+I�D- P��3 Gr�zc-t3a ❑ A�F'P�Q��7 VV1TH REVI�a0N5 � �ys��'P VaEt . �.,�,.�,`°�� BY DATE �-s-�s �:� . - /Vo �3�rc.�o�.�.,s �s �..g�.,.� r-�.� '`T' STiZuctv� ra L�e /Lr3vu��nse�P � p^s S � 'C� � � — f'�'v''` SvlW� DAn=� S-�(-�S o� (=�ua "� , `�.;.�; : .;;� � d�" -, ��y .�,.. � P,`�j ., """ b�� 'l ,,,,�"-`"a`e� ,.� r �,�,� � `�'"a' . � 4` *� , `,� '�?'�� ,�-�.a;�,� � -� ` '�s"' Z� :�r�d �,..�<• � (� ; ��,,. �' � s� �