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HomeMy WebLinkAbout2001-P03556 - addn/remodel/repair ` CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Po3ss6 Crystal Bay, Minnesota 55323 P@Cllllt Typ2: Addition/Remodel/Repair (952) 249-4600 Date Issued: 3i6i2ooi SITE ADDRESS: 1375 Rest Point Rd MOUND,MN 55364 PID: 07-117-23-32-0037 DESCRIPTION: UBC occupancy R3 Construction Type VN Proposed Use: fcesidentiai Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 265.25 Valuation: $ 16,000.00 State Surcharge Fee: $ 8.00 TOTAL FEE: $ 273Z5 APPLICANT: METRO HANDYMAN INC OWNER: M B&L K GERLICHER 1935 W WAYZATA BLVD 1375 REST POINT RD LONG LAKE,MN 55356 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 NIINNESOTA BUILDING CODE REQUIREMENTS. ��.X _�c,l ' ,/�'L�-c.._.._— �•!y�-t'�. AP LI A [TE S N TURE SSUED BY SIGNATURE � Copies: City,Applicant,Assessor,Finance Page 1 ' Total Fee: $ � �� � �S Date Received: �� Entered By: /�y� Permit#: ���S�� .�-/ �� � o� `' CITY OF ORONO - BUILDING PERNIIT 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: (37 5 1��ST f I OI AI T ��• ZIP: ��3�� NAME OF OWNER: (,YAIIV � (K���.RLI�I�� PHONE: (home) Z 7�- 299 (work) MAILINGADDRESS: 131� t-'Z�,tr �uT ��, CITY: /n�u�V� ZIP:_���C� CONTRACTOR: �E.�Rp ��lpY(yL411( PHONE: 2 ' 8� CONTACT PERSON: �R�{�( (�� MOBILE/PAGER����qp.�.(c�p ��t�.(p��tr MAII.ING ADDRESS: Iq35 t,.�.�,.,�A�zA-r� �vLp CITY:_�� t.q� ZIP:��3SC� STATE LICENSE: #�poqq�a� 1*�y 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 detai�: ����g Q��u� TO Et,���I�IAT� 1-�vA��"E.Y t or.l �X 1 ST�Ill C 12[3O1°C STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��D��� 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: j�,n,.e,,., �CM�.t l� DATE: Z '2-O p NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 ' f Sec.13.04 RIGHTS OF SUB.TECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be az set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidearial data concerning himself shall be informed of: (a)the purpose azd intended use of the requested data within the collecring state agency,polirical 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 refasing w supply private or confidendal data;and(d)the identiry of other persons or entiaes authorized by state or federal law to 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 enforcement officec The commissio�r of revenue mav olace the notice reauired under this subdivision in the individual income taz or nrocertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall lx informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or conf'idential. Upon his furthzr 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 iu meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acdon pursuant to this section is pending or additional dara on the'u�dividual has been collected or created. The responsible authoriry shatl provide copies of the private or public data upon request by the individua!subject of the data. The responsible authoriry may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this sutdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possirl=. If he cannot comply with the request within that time,he shall so inform the i�ividual,and roay have an addidonal five days within wlrich co comply with the request, excluding Saturdays,Sundays az►d legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accurac.•or completeness of public or private da�concerning himself. To ezercise this right,an individual shall notify in writing the responsible authoricm describing the�nature of the disagreement. The responsibie authority shall within 30 days either. (a)correct the data found to be inaccurate or mcomplete and attempt to notify past recipients of inaccurate or incomplete data,i�luding recipiencs named by the i�ividual;or(b)notify the indi�-idual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's sratement of disagreement is included wirh the disclosed data. The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the adminL-�arive 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 �ity of Orono or any of its departments may require you to furnish 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 Ciry 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 pemut 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 Middle Last Address C��y State Zip Phone I understand my rights as stated above. Signature 6 � , CHEC�i OFF LIST FOR ISSUA.1�►rCE OF PERitiIITS ' FOR OFFICE USE ONLY ' . ADDRESS OR LEGAL: I 3 7 S 2.��T �O rn�r �f PID: DFSCR�'J.'ION OF�ORK: (La i�� 1�.�;�� c_t,�..�2 . ZO�'L�G REY�ti'y BY: �( /� DATE APPROVED: BUILD�'G REYIE�BY: � . DATE APPROYID: Z-z� =c�t FEES TO BE CH.4RGED: bSisc. Fees Calcuiated By: pERNLIIT Yes � No :• pI,ATt REVIEW Yes No�- SEWER CONNECTION STATE SURCHARGE Yes� No WATERCONNECTION INVESTIGATION FEE Yes No pARK FEE SAC Yes No STTEINSPECrION Number of SAC•Units OTHER (specify) ZO\"L�IG CA�CK LIST Zonin�Districc: /�� C/�yh^�C� _ . Fire Department: Post Office: School District: • ' � Lot Area: Sq.ft. Acres � Width Depth Surve;Submitted: Yes No Date of Survey: Proposed Setbacks: � Front(La.ke): Right Side: ' D` /C 1 Rear(Screet): Lefr Side: Adjacent Structures: �Vetland: • Buile�in,Hei�ht: Def. Hgt. Pea�:Hgt. Lot Covera;e: Grading: Scaff Approval Date: gy; Couacil Approval Date: Septic: Staff Approval Date: By: Zonin,File: � Resolution: : Resolutioa Date: . Shoreland District: Av;. Setback: Blufi Setback: LAtCocera�e: E���� Proposed Hardcover: 0 75' 75-250' 230-500' 500-1000' Hardcover Variance R�quired: Yes No__ Dat�of Couacil Aoproval: gEI�IARb'S (in house): 7 BUII.DING REVIEW CHECK LIST UBC: 2-3 - CONSTRUCTTON TYPE: �/^� Sq Footage � Per Sq Ftg Sasement z = lst Floor z = 2nd Floor z = Garage x = x = TOTAL Fstimated Construction Value: $ l 6,��� Inspections Required: ��ork Requiring Separate Permits: Site - Plumbing ' Fire Hazdcover Removal Mechanical Water Connection Footing Septic Sewer Connection � Framin� Fireplace Lawn Irrigadon _p�,Insulation (Masonry) Other �Wall Boazd (Mfg.) Well (State Permit) _�Final Grading/Fill'mg Electrical(State Perm.it) Other RE��iARKS(IN HOUSE): REVIEW BY OTI3ERS: ' DATE: Access: Existing New Access Approval: Date By: RE`�IARKS (TO BE 1`TOT'ED ON PERMI'1�: 8 , . . ' -?- �,��` . 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JUE"%�'CO f l/�.tir�U�il st-.c� TELEPHONE NO. ���. _ �'�1� � yS�f� � DESCRIPTION ��C,�1M i�V(> l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING ���RAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 IN �`TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z 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 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � d W ORK SATISFACTORY:PROCEED = PROJECT COMPLETE W ❑CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT 11NSAFE CONDITION WITHIN HOURS. — pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next ins tion 24 hours in advance. 249-46�� OwnerlContracto i : Inspector. White Copyllnspector's File Canary CopylSite Notice