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Home My WebLink About2001-P04313 - re-side 4 't PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P04313 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 9/7/2001 SITE ADDRESS:' 1120 North Shore Dr W MOUND,MN 55364 PID: 07-117-23-23-0005 DESCRIPTION: UBC Occupancy R3 Proposed Use: BuildingCensus Code O/S-Building Permit Class: Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $209.25 Valuation: $ 12,000.00 State Surcharge Fee: $ 6.00 TOTAL FEE: $215.25 APPLICANT: Jay A Lezer OWNER: Jay A Lezer 1120 North Shore Dr.W. 1120 North Shore Dr.W. Mound,MN 55364 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. a LICANT PE II E ISSUED BY SIGNATURE Copies: 1-File(Signatures Required),1-Applicant,1-Monthly Reports,l-Assessing,1-Finance Pagel Total Fee: $ ��5 �S Date Received: q-7-0 Entered By: DA41t, Permit#: �3 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 OR CONTRACTOR JOB SITE ADDRESS: 112-0 No P-T N &hM6 .09, W. ZIP: 6-53(a y NAME OF OWNER: yJA� LIZ PHONE: (home) 1/ 2—,g2Z.,723o (work) WZ- 9b3 -(cl3Z MAILINGADDRESS: 16-LO 064UY -6 oPe ®(,,CITY: Mov-&)ip ZIP:`553�y wcsT CONTRACTOR: C ktt, PHONE: CONTACT PERSON: Im-y-K.6 Ag*0 MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # 6C 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 detail): 5WA ®a-& ado�S STORIES: c`t SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: _ GARAGE STALLS: ATT. DET. 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 not a permit and work is not to start without a permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: ?` 7-0 NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 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 concerning 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 of 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 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 may place the notice required under this subdivision in the individual income tax or property 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 classified as public,private or confidential. Upon his further request,an individual who is the subject of 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 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 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 private or public data upon request by the individual subject of the data. The responsible authority may require the requesting 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 individual,and may have an additional five 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 dam concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the dam 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)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 determination of the 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 subjects of data",we would like to inform you that your request for a permit 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: 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 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 this application or permit. First TP C Middle last 51 id7dress M 0 City State Zip Phone I understand my rights as stated above. Wlamre DATE TIME CITY OF ORONO CALLED IN INSPECTION NO3�3 SCHEDULED PERMIT N0. COMPLETED ADDRESS ho Y OWNER �,/CONTR. TELEPHONE NO. `Z 59—`T 7a - '2,430 DESCRIPTION (N ��5 ^��l�dYtl 01 FOOTING 11 MECHANICAL RI 18 EXCAWG ING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 09 PLUMBING RI 23 SEPTI FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU: YES_NO COMMENTS: W cc - ve` Cr O LL W cc Q 2 W W CC j LIJ g NORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE cc W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnedContra ttgr on site- 01 Inspector. White Copy/Inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NE j1 / �j SCHEDULED PERMIT NO. 7 1 COMPLETED ADDRESS O OWNER CONTR. �f TELEPHONE NO. DESCRIPTION tel/aL4 ' / 01 FOOTING 1 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS 07OEMO SITE 27 SEPTIC MAINT. 21 COMPLAINT 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP LU 09 PLUMBING RI 23 SEPTIC FIN A 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNERICONTRACTORTOMEETYOU:_YES ' NO C C NTS: cc O W cc Q Z W W CC GW ❑WORK SATISFACTORY:PROCE PROJECT COMPLETE LU( WORK&PROCEED / El ISSUE CERTIFICATE OF OCCUPANCY ��❑CORRECT WORK,CALL FOR REINSPECTION ( TEMPORARY C1 BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contr"or on site: Inspector 1L Lt'.r White CopylInspector's File Canary Copy/Site Notice