HomeMy WebLinkAbout2003-P05682 - addn/remodel/repair PERMIT
Gi�'Y OF ORONO Permit Number:
2750r<�iley Parkway- PO Box 66 Pos6s2
Crystal �ay, Minnesota 55323 PefCTllt Typ@: Addition/RemodeURepair
(952) 249-4600 Date Issued: 6�6i2oo3
SITE ADDRESS: 1385 Rest Point Rd
Mound,MN 55364
PID: 07-117-23-33-0011
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Pernut Class: Building Census Code 434
Pernut Type: Addition/RemodeURepair Pernut Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#: 2791
Separate pernuts required: riumbing iviec;nanicai Eiecmcai�sratej
NOTICES/REMARKS:
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......_. . .......... �ri���iv......_..._..._ vaa�vvv�u��v�i ....._ _. . ... . ___
ar�uv�vv���r�� �ti��v���vaa�v �� •v..+ � Ya�v �v vvv�.
FEE SUMMARY: Pernut Fee: $ 482.15 Valuation: $ 33,661.00
Plan Review Fee: $ 313.41
State Surcharge Fee: $ 17.35
TOTAL FEE: $ 812.91
APPLICANT: Owner/Self OWNER: David&Jodi Rahn
� 1385 Rest Pt Rd
Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPL[CANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required). 1-Avnlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
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Total Fee: $ � 1 � Dat � . �
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• Entered By: `` (` � � ��� '����'C/�( �� „�ermit#: _ � �� l
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CITY OF ORONO - BUIL�'DING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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r � �-� THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
�' , JOB SITE ADDRESS: � g� � ZIP: ���
NAME OF OWNER: � � PHONE: (home) T�i�- 7�
(work) � -����-'�
MAILING ADDRESS: /��� ���'� �;� ��CITY:����� ZIP: 5��
CONTRACTOR: ��/'��i PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICEI�ISE: #
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�: ���C.��f ��oG.�Q���j� r�e �''�/�c.,-f'v�j tj
f�bc v� �N��r,�►��- o.v��� ��� e��,�-�-,�N� ����//.�9
STORIES: � SQ. FEET OF EACH FLOOR: �� �
NO. OF BEDROOMS: GARAGE STALLS: ATT. 2, DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �3� 6�` �,
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 Ciry 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 p'L- DATE: ���d�-
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.
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Sec.13.04 RIGHTS OF S[JB.TECTS OF DATA • ' `
Subd. 1. Type of data. The righu 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 privau or confidential data conceming himself
shall be informed of: (a)the purpose and inteaded 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 t6e requested data;(c)any Irnown consequence arising from his supplying or
refusiug oo supply private or confidential dara;and(d)the idendty of other persons or entities authorized by state or federal law to receive the data.
1'his requirement shall not apply when an individual is asked to supply invesdgative data, pursuant to section 13.82, subdivision 5, to a law
enforcement o�cer.
The commissioner of revernie mav nlace the rrotice rewired under this subdivision in the individual income tax or nropertv tax refund
insavctions instead of on those forms.
Subd.3. Access to data by indiridual. Upon request to a responsible authority,an individual shall be informed whether he is the
subject of swred 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 daa on individuals shall be shown the data without a�ry 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 daCa 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 addirional data on the individual has been
collected or created. The responsible authoriry 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 maldng,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 data co�erning 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 data faud ro be inaccurate or incomplete and attempt to nodfy
past recipients of inaccurate or incomplete data,including recipienu named by the i�ividual;or(b)nodfy the individual that he believes the data
to be correct. Data in dispute shall be disclosed only if the individual's sCatement of disagreement is included with the disclosed data.
The determina6on of the responsible authoriry 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�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 City deny the permit or license.
3. The information may be shazed 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.
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First ✓ iddle I.ast
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Ciry State Zip Phone
I understand m ri ts as stated above.
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� • � CHECK OFF LIST FOR ISSUANCE OF PERMITS
. • FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: t 345 Rcs i C01NT 2 oa� -
PID:
DESCRIPTION OF WORK: p rJb�-r �o�
ZONING REVIEW BY: a,,,_. DATE APPROVED: �o-s—-o z.
BUILDING REVIEW BY: DATE APPROVED: i o •s�n z
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW Yes �/' No SEWER CONNEC"TION
STATE SURCHARGE Yes � No WATER COrfNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No � STTEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: C.R-�(3
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes �C No Date of Survey:
Proposed Setbacks: �
Froat(Lake): b1 Right Side: H7
R�ar(Street): �D Left Side: ( 0 t
Adjacent Structures: ATT'+aa��� Wetland: N/A
Building Height: Def. Hgt. �.�.. Peak Hgt. o•fL
Lot Coverage:
Grading: Staff Approval Date: • By: Council Approval Date:
Septic: Staff Approval Date: 011 (A By:
Zoning File: # 2-Z�q� Resolution: # 4'�3'� Resolution Date: R-� -02
Shoreland District: '/t5
Avg. Setback: ^r��a Bluff Setback: �v/�- Lot Coverage:
Existing Proposed n
Hazdcover: 0-75' �H t•
75-250' ��23 �.�
250-500'
500-1000'
Hazdcover Vaziance Required: Yes �C No Date of Council Approval:
REMARKS(in house):
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BUILDING REVIEW CHECK LIST
UBC: R• 3 \ CONSTRUCTION TYPE: �!N
Sq Footag� $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ 33,b1.► °Q
Inspections Required: Work Requiring Separate Permits:
Site �Plumbing Fire
Hardcover Removal ot Mechanical Water Connection
� Footing Septic Sewer Connection
_�Framing Fireplace Lawn Inigation
��Insulation (Masonry) Other
�Wall Boazd (Mfg.) Well(State Permit)
�_Final Grading/Filling �Electrical(State Permit)
Other
REMARKS(IN HOUSE): �
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMII7: ywv s-r c.o n�l..� w .,-�-t FLF�{,v,�vF-�✓w.f-s
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CITY OF ORONO LED IN
INSPECTION N ICE SCHEDULED G �-�j _�
PERMIT N0. � `���Z COMPLETED
ADDRESS i 3 � �-� ►Z--�-S+ �-i . 1Zc��
OWNER CONTR. �'`� �C� �Z �/`�s-�l
TELEPHONE NO. 1� � � �-� �G � ..r`7���
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� DESCRIPTION �/'� '' ����N � " L`�"1 ,
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WEfLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP OFDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContrac it :
Inspector.
White Copy/lnspector's File Canary Copy/Sfte Notice
V
��I�3TIME
CITY OF ORONO CALLED IN �
INSPECTION ICF�.� SCHEDULED �-Jp�� �G
PERMIT N0. �0 COMPLETED
ADDRESS � C�
OWNER CONTR. ��V�^�� 1�1�
TELEPHONE N0. �� �a - �� �� '� ��,�,��
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� DESCRIPTION C.�C��T f �I�7
� 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 OS FINAL 14 S�1NER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 S PTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTORTOMEETYOU: YES_NO
� COMMENTS:
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O ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance. (952) 249-4600
OwnedContract s' :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
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DATE)� TIME
CITY OF ORONO CALLED IN 1:�'-�C.�
INSPECTION NOTICE SCHEDULED � 'V ��
PERMIT N0. �(Q�'� COMPLETED
ADDRESS �3 0 5 /�. S� Pd�� l��%°
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OWNER %C�- �-�- CONTR. ��'-�
TELEPHONE NO. �'l�� L� � I S��'r��
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� DESCRIPTION
W 01 FO TING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q2 FRAMI G 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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:
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W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CAIL INSPECTOFI
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for ihe next i spection 24 hours in advance. (g52) 249-46��
Owner/Contract n i :
Inspector.
White Copylinspector's File Canary Copy/Site Nolice
J
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED �' � ��M
PERMIT NO. a` COMPLETED
ADDRESS .3 � � ��`�
OWNER l � CONTR. �7Yiv�I�Y
TELEPHONE N0. �.f� C� C!✓ (� S�
� DESCRIPTION ���^ �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMI 13 MECHANICAL FINAL 19 LAKESHORE/WETLANOS
y 3 INSULATIO�I 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z D. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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V BEFOREC�/ERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next nspection 24 hours in advance. (g52) 249-460�
OwnerlContr n �t :
Inspector.
White Copyllnspector's Ffle Canary Copy/Site Notice