HomeMy WebLinkAbout2005-P08348 - building permit (revised location from P02064) 9 . w
CITY F N PERMIT
� �R� � Permit Number:
2750 Kelley Parkway- PO Box 66 Pos34s
Crystal Bay, Minne$ota 55323 Permit Type: Addirion/RemodeURepair '�.
(952) 249-4600 Date Issued: 2i�i2oos
SITE ADDRESS: 1354 Rest Pt Cr
Mound,MN 55364
PID: 07-117-23-32-0062
DESCRIPTION: UBC occupancy R3
Construction Type VN
Proposed Use: Residential
Pernut Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Pernut Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 83.25 Valuation• $ 2,500.00
Plan Review Fee: $ 54.08
State Surcharge Fee: $ 1.75
TOTAL FEE: $ 139.08
APPLICANT: Lecy Construction OWNER: Dennis Walsh&Amanda Helen
15012 Hwy.7 1354 Rest Pt Cr
Minnetonka,MN 55345 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.
` 1 /�
G���V
APPLICANT PE ITEE SIGNATU ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Requ�ed), 1-Atmlicant 1-Monthlv Reports, 1-Assessin¢, 1-Finance Page 1
, . �
Total Fee: $ � � � ��� � Date Received: � �1 �b�
Entered By: �, Permit#: � c�3 3�(
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CITY OF ORONO — BUILDING PERMIT APPLICATION
All information must be submitted in full before plan revie�v will be started.
(please print all i�rfornzatio�i)
THE APPLICANT IS: (circle orae) OWNER OR NTRACTO
JOB SITE ADDRESS: j ��'j�— ��'17 -�p�',�'� Ct��c�,p:
Will this be a Para of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes o If yes, a special evei�t per�nit is required with Police Depai�tmerzt and City
� Council c�ppiroval 60 dczys prior to tlze evertt. Non per��zitted eveizts will r7ot
be allowed.
NAME OF OWNER: �n1 Y1JY V`J�-S� PHONE: (home)
(work)
MAILING ADDRESS: ��- ���$�'�'a„nfiC'i+��TY: ��/�.� ZIP:
CONTRACTOR: (� m ' PHONE: ��'Z�J� -
CONTACT PERSON: + MOBILE/PAGER: ' b "Z-Z
MAILING ADDRESS: �<�<'"�p l Z ��`7 CITY: y�l;�,,.,�,�„�.ZIP: 53 �
STATE LICENSE: # G(J�p,�SS
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: R.EGISTRATION #
TYPE OF WORK: Ne�d�� Accessory Structure
A �hon Move
Remodel/Alteration Land Alteration
r
PROPOSED WORK(describe i�i detai�: J��� �' �' �'i LG�C�I�z�,�..a
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $2 .�����Q
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 wor �s not to start without a permit; and that the wo�ill be in accordance with
the approved plan. �
APPLICANT'S SIGNATU DATE: � � �c�
. . ,
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.1. Type of data. The rights of indi��idual 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 or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or conGdential data;and(d)the identity ot 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 o[Cicer.
The commissioner of revenue mav place thc notice required under this subdivision in the individual income tax or pronertV tax re(und
instructions instcad 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 classificd as public,private or conCdential. 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 cliarge 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 intormed 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.
Thc responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or r�ithin five days otthe
date ot the request,excluding Saturdays,Sundays and Iegal holidays,if immediate compliance is not possible. If he cannot comply with thc request within
that time,he shall so inform the individual,and may have an additional Gve days�vithin which to comply with the request,excluding Saturdays,Sundays
and legal holidays.
Subd.4. Procedure when datn is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
concerning himself. To exercise this right,an individual shall notify in writing the responsible authocity describing the nature of the disagreement. The
responsible authority shatl within 30 days eithci: (a)correct the data found to bc inaccurate or incomplete and attempt to notify past recipients o(
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bclieves the data to bc correct. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The dctermination of the responsible authority may bc appcaled pursuant to the provisions of the administrativc 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 ta on yourself.
6. Your full name is required to process this application or permit.
�--� 1� . �ii�--��
� First Middle Last
�/'�c� C���✓ �i_��.. r�
A�ress
� i.�-���^S� � /-r�-� �J.���-
City State Zip Phone
I understa d my rights as stated abov .
Signatur
T ♦ �
CHECK OFF LIST FOR ISSUAtvCE OF PERcti,fITS
FOR OFFICE USE ONL Y �
ADDRESS OR LEGAL: t35`l ��s'�- Aow-r' C���
PID:
DESCRIPTIONOF Yf/ORK: p�c.l,c (RR.ev�s�o Cp�r�u r--.� �w��-# PO��y
------------------------------------------------------------------------------------------
ZOtVI�YG REVIE tV B X: AATE APPROVED: /-?� -o S �
B UILDING REV.FEW B I', DATEAPPROVED: �-�-��
--------------------------------
FEES TO BE CHARGED: tL�Iisc. Fees Calciclated By:
PERI�IIT Yes ✓ No
PLAtV RET/IEYV Yes t/ t�lo SEYVER GO�VNECTION
ST.�.TE SURCH.4RGE Yes ✓ tVo tiVATER COt tWECTl01V
ItVVESTIG 4 TION FEE Yes No PARK FEE
St!C .Yes No SITE INSPECTIO�V
Number of SAC U�tits OTHER (specify) "
--------------------------------------------------------------------------------------------------------
2'ONIIYG CHECh'LIST Zoriiitg Dish•ict:
Fire Deparhne�rt: Post O�ce: Sclioo!Dish•ict: _..
Lot Area: Sq.ft. ficres 6YidtlT Deptli
Sac�vey Subrnitted: Yes_� No Date af Scuvey:
Proposed Setbncks:
F�re,cu(La�e): 9'd � 1' Right Side: 7 5�
Rem•(Sh•eet): /'�� � Left Side: ?�o`
Adjacent Structu�•es: Rr'rAc H� ��etlnnd: iV/A
Buifding Height: Def. Hgt. r✓�A Peak Kgt. —
LotCovernge: � 13•N
Grading: Stnff.4pp►'ova!Date: '— By: Cot�nci!Approva!Date:
Septic: Stnff Approval DRIe: BY�
Zonirtg File: #oy-30�7 Resofution: # Resolcition Dnte: /I- ZZ-o�(
Shorelancl Disd•ict: ve5
,4vg.Setback: o_�c _ BlufjrSet6ack: LotCoverage:
Existing Proposecf
Hnrdcove�•: 0-7�'
75-250' YN.9� 29�!!�',
250-500' _T—
500-!000' !
H'ardcover Variance Reqccired: Yes�_ No Date of Cauncil'�lpproval: I-Zz�o
REMARKS(in house): ;
�
31
- �i ii , ji 7c ri . . . ' �d� �Ili�': 4, ���j ��d �hs �•�' �� �� � s`u�Y �a�; 'f�'t��
' •, . .
B UILDItVG.RE VXE tY CHECh'LIST
UBC: �• 3 COIYSTRUCTIO�Y TYPE: �VnJ
Sq Footage .�Per Sq Ftg
Basenier�t � _
!st Flooi• x =
2nd Floa• x =
Gnrcge s =
x =
TOTAG
0
Estimated Constructiai Valcce: ,S 2 S00�
Inspectiaits Required: 6Vork Requii•i��;Separate Perniits:
Site Plu�ribing Fire
Har�lcover Removnl A�fechanica! GYater Connection
_�L Footing Septic Sewer Co�utection
_S[_F�-ami►�g Fireplace Lawn h-rigntiat
lnsulation • (�L[asonr}.) O�her
6Vall Board (A�Ifg.) GVefl(Stc�te Perntit)
�c Final GradiiTg/Fillin,� Electrical(Sta�e Pen�iit)
Otlier '
REtYI.�RXCS(XN HO USE): �
REVIEyV BY OTHERS: DATE:
.4ccess: Existing rVew
.Qccess�lpproval: Date B�•:
REttilhtRh'S (TO 8E NOTED OtY PE,R�ti,tIT):
32
:`r�Y �:1� PR^'�1��.
��, '��� �'�� . ��.�� �',a''��'��
r'
f�� �
/�/29�'a q /,c�r+a�a-� �c,.����'
HAR.DCOVER C;a1.c:�t,a�l�iu�v wuxx�r�.�,�1� � i/�,�os
SETBACK�ZONE: (CIRCLE O�'E) 0-75' 75-Z50' 2�0-500' �00-1000' '��u�J'6t� ��Cl�
• Nv fN.},N�'6 i.v N/�
E?�TSTI\G HARDCO�rER IN 7..U�'E
.�. House • x = �'� �/ S.F.
, Lenc�h Width
. � ��", .'��'�;,w`?� x = �� S.F.
,/��.�f9�,�,�': x = -��2 S.F�. �
F/zanir P�Tiv /-��:o�x s x = 4'7 S.F.
.. , , ,�.
B. Garase � � x = S.F.
C.• Driveway x = 833 S.F.
x — � 5� ' 5.�.....
2oc� l��r.al,�c�.�°
D. Si�' �� x D.� = Go Z S.F.
90 x D, 7 = . �3 " s.F. '
. �� . iZ. 2 //�5 �
E. �atto/Deck Z 4, � x 3.Z = 7� S.F.
x — S.F. ..
F. Landscape �.�Pe��� x = .5�� S.F.
Underlain 1�/ , ��� �`�'�+�e��n'�- x = lS/� S.F.
By Pl�stic E2oG/G, �l.��?,��5 x � _ ¢�o S.F. . �
. Or Fabric � �
�'�°���L� 2 Z 2 a,�, g� , .
G. Ocher x = S.F.
�
TOTAL HARDCOVER IN ZONE - , v39S S.F. A
TOT.�L PROPERTY AREA IN ZO;VE - lS7oo S.F. B
. . � . �39� - s !�?oc► x ioo = ¢¢.�'i ��
PROPOSED H.ARDCOVER I�t ZO1�'E �
A. House x = ,��4 3 S.F,
Leneth Width ' . ' .' ' ,
/�''0!+?/d�v�t GM �A�`�P..d fmnrG� X = /SB S.F. .
X = S.F.
� . �
X = S.F.
.,
B. Garage x = S.F.
C. Driveway z = 8 3 3 S.F.
X = S.F. ,
iPaPK Bo�eo Eil i o X 0. 7 7
D. Sidewalk z = � S.F.
.. z = S.F.
E. Patio/Deck Ex��-„vG x = / S.F.
� i'rrrrp�rx�'� z = / 72 . S.F.
/,ra/�O r�r� r az�F,,.� �c�R c N
� �F. Landscape � _ x = S.F. �
Underlain x = � S.F: �
By Plastic x = S.F.
O;.Fabric ,
, , �„
G. Other �Q�rt�K Gv�c.Gs x a Z/ 6 S.F.
TOTAL HARDCOVER 1N ZONE - � SS90 '"S.F."' A
TOTAL PROPERTY AREA IN ZONE - /8 7ao S.F. B
A ' - B /g?O o x 100 = 2 . 8� %
14 .
DATE TIME "
CITY OF ORONO CALLED IN
INSPECTION N�ICE ��-/ SCHEDULED cT•��
PERMIT NO. � OS3 b COMPLETED
ADDRESS �3 5�'1 �3% �d��T
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
L� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FI�LING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q �/ INAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
J
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
�
a " /VO (3vArt.� Rf�9��r'lA�� ON lLu�lC. a� aT?1���
O � ,�J1�C�[tu< Wd•[ rJ�J�Stu�l/vi0�
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d ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE
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� ❑ CORRECT WORK&PROCEED �SSUE CERTIFICATE OF OCCUPANCY
W �
� Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING �pERMANENT S �I��
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN ' � �)`
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContractor
Inspector.
White Copyllnspector's File Canary CopylSite Notice
�p� �j�-� ' /
�
� ��'S`� �/ � AT / / TIME �/
CITY OF ORONO 83�g CALLED IN � � `�` �
INSPECTION NOTI E SCHEDULED � ���
PERMIT NO. cOMPLETED
ADDRESS �� � y /`�� � � '{ ��
OWN ER CONTR. '
TELEPHONE N0. CiX�f �p�a� �D 3 �o��� �OZ'Y'Q-D
� DESCRIPTION � �-��� �T//U�-��
� 01 FOOTING 11 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
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOH TO MEET YOU: YES_NO
� COMMENTS:
�
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� WORK SATISFACTORY:PROCEED f_� PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED �: ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTfON REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlCon r site:
Inspector. �
White Copyllnspect 's File Canary CopylSite Notice
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