HomeMy WebLinkAbout2002-P04979 - plumbiing G.1TY�OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: P04979
Crystal Bay, Minnesota 55323 Permit Type: Aaditio�xemodevx�au
(952) 249-4600 Date Issued: 3i2si2oo2
SITE ADDRESS: 1386 Rest Pt Rd
Orono,MN 55364
PID: 07-117-23-33-0006
DESCRIPTION: UBC Occupancy R3
Construcrion Type VN
Proposed Use: Residenrial
Permit Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#: 2699
Separate pernuts required: riumoing iviecnanicai �iecmcai�siaiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 321.25
Valuation: $ 20,000.00
Plan Review Fee: $ 208.78
State Surcharge Fee: $ 10.00
TOTAL FEE: $ 540.03
APPLICANT: ��er/Self OWNER: Jay&Kendall Nygard
M� 1386 Rest Point Rd.
Orono,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�� •�
A PLIC TPERMI SIGNATURE I S YSIGNATURE �
Conies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Reports, 1-Assessin¢, 1-Finance Page 1
Total Fee: $ �-} y, �- ' Date Received:
. a
,
� Entered By: ,°'-j ' Pernut#: �`-} 7��
;�• -,
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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 R CONTRACTOR
JOB SITE ADDRESS: ��G,3� ��S� 1 G���t '� I�E-' ZIP: �j > ,� �'
NAME OF OWNER: Gi� P�' G �/� PHONE: (home) ��S � �� � � ���
(work)
MAILING ADDRESS: �3 � U �-<S � �� ���CITY: G��'''�G� ZIP: � t -
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
>-
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition�� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(des/cribe in detai�: ��1� � � �'���'-�'�� vn ��� ��9�,n�r� �i�
�,,f,��� (� ���''� I�(<',✓!�7r����; (C'^� r�7;�si�''� � /��'!'r��c j
,
STORIES: �' SQ. FEET OF EACH FLOOR: �--I �
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� �C���
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: ! ��r DATE: �� ��-
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.
5
. ,
Sec.13.04 RIGH'TS 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 inte�ed use of the requested data within the collecring 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 tus supplying or
refusing to supply private or confidential data;and(d)the idenliry 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 investigative data, pursuant to secdo❑ 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav olace the nodce reauired under this subdivision in the individual income tax or orooertv 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 conf'idendal. 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 hun 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 secdon is pending or addirional 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 cosu of making,certifying,and compiling the copies.
The responsible authoriry 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 compty 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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible authoriry shall within 30 days either: (a)correct the data 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 �ity of Orono or any of its departments may require you to fumish certain
private or confidential information.
You are notified that:
1. The information you fumish 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 pernut 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.
_�c,y ����;,,,., ��,� �y�;�;, �
Firs� iddle � Last
I.��� ��� + ('�f � �I'�
����^��� �, �'��, � � G� �j� � ���- 2 ��f,�
Ciry State Zip Phone
I understand my rights as stated above. �
� � �� � v
Signamre
�
6
. � CHECK OFF LIST FOR ISSUANCE OF PERMITS
• FOR OFFICE USE ONLY
, ADDRESS OR LEGAL: (3`a� lZ�ST r�a��t► (��
PID:
DESCRIPTION OF WORK: ,/�,�,r�, �-,a�,
Z0�1I1�TG REVIEW BY: DATE APPROVED: 3-zz-o z
BUII.DING REV�W B : DATE APPROVED; 3 .zz-�,Z
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes __� No
PLAN REVIEW Yes � No SEOVER CONNECTION
STATE SURCHARGE Yes c/ No WATER CONNECTION
INVESTIGATION FEE Yes No ►/� PARK FEE
SAC Yes No ,� SI'fEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CI�CK LIST zoning Districc: (,2-I/� .
Fire Department: W�,o�,�,�/� Post Office: ��,�,� School District: �,v c,—s,—o,v�u.
LotArea: Sq:ft. �a� 2�1.'� Acres • 'L3 Width �S Depth /.SSd•Y�
Survey Submitted: Yes�_ No Date of Survey: t�- 3—O I
Proposed Setbacks: _
Front(Lake): � ION Right Side: 3�1�
Reaz(Street): � �I l•1 Left Side: ��
Adjacent Structures: q�x� Wetland: N L A
Building Height: Def. Hgt. c9.(�. Peal:Hgt. l��l�
Lot Coverage: �`'�•L
�
Grading: Staff Approval Date: PP.�vA�ruG �PJZ �y: Council Approval Date:
Septic: Staff Approval Date: /1!' � �4 By:
Zoning File: # DI-26 91 Resolution: # Resolution Date: �-Z 5-��-
Shoreland District: v,�5
Avg. Setback N f/� Bluff Setback: ��/a- Lot Coverage: ��{•(o
T— Eaisting Proposed
Hazdcover: 0-75' �{.Nt ' 2.5
75-250' SZ• 5�(•c.
250-500'
500-1000'
Hardcover Variance Required: Yes_�, No Date of Council Approval: Z- 2�- a Z
REMARKS(in house):
7
BUILDING REV�W CHECK LIST � '
�C: R-3 CONSTRUCTION TYPE: V N
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x _
2nd Floor x =
Garage x = �
x =
TOTAL
Estimated Construction Value: $ Lv,��o`�
Inspections Required: `Vork Requiring Separate Permits:
Site K Plumbing Fire
Hardcover Removal iC Mechanical Water Connection
�C Footing ' Septic Sewer Connection
` �,Framing Fireplace Lawn Irrigation
�_Insulation (Masonry) Other
_p�Wall Boazd � (Mfg.) Well(State Permit) .
_�F�� Grading/Filling �Electrical(State Permit)
Other
REMARKS(IN HOUSE): .
��---- ' =-----------------------------------
RE'VIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
REMARKS (TO BE NOTED ON PERMII�:
8
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V DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N IC SCHEDULED �-� __�-�f
PERMIT NO. 7 COMPLETED � � 4
ADDRESS__� , / �C'Z�/c.d�_
OWNER CONTR. .D.1e�-e
TELEPHONENO. C S~ �7� v��yc�
� D TION '
� 1 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
`� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBfNG 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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y�/�ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
p ❑GORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
Owner/Contracto i
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME i�
CITY OF ORONO CALIED IN '�
INSPECTION N ICE SCHEDULED o"�- - Z �� /�
PERMIT N0. � � COMPLETED
ADDRESS 'fi 7`
OWNER � ��-�-i l�-��R��� CONTR.
TELEPHONE N0. G��� `� �� � �`/ �-
�
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRA 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 3 INSULATIO 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
ZBD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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 F AL 35 HARD COVER REMOVAL
BING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/ ONTRACTOR TO MEEi YOU:_YES_NO
� MENTS:
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W� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
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� 249-46QQ
OwnedContr r te:
Inspector.
Whiie Copylinspector's Fil Canary CopylSfte N�•'
CERTIFICATE OF SURVEY FOR
JAY YGARD �
N
OF LOT 5, SIJBDIVISION �OF LOT 14, REST POINT PARK
HENNEPIN COUNTY, MINNESOTA � q ;a°�� � :� 1,,:,
���o� ����� ��� �
o�o�e
�o���'P� _�._�.�......___.____.___ _.�._____�
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STEPS � SHED
� �Q �`''•75' SETBACK LINE
A O �
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ST4NES
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�x LAKE
1� INNETOI� KA
LEGAL DESCR I PT I ON OF PREM I SES : WEST AR�V)
Lot 5 , Subdivision of Lot 14 , Rest Point Park
o : denotes iron marker
Bearings shown are based uporr an assumed datum.
This survey intends to show the boundaries of the above
described property , the location of an existing house , tl�e
proposed location of a proposed addition , and the location
of all visibie "hardcover " thereon . It does not purport to
s h o w a n y o t h e r i mp r o v eme n t s o r e n c r o a c hme n t s . „_,a-o,: Hn�covER a�v�n �Ec��
3-14-02: PROPOSED ADDITION "
I h�r'eby certify that this survey was prepared by me or under my direct super- SCA�E
GftONBERG & ASSOCIATES, INC. y g g' y ���=20�
vision, and that 1 an a dul re istered Civil En u�eer and L�d Surve or urxier
��.����� ��� the laws of the State of Minnesota. DATE
10-3-01
445 N� WLlOYI DRNE LONG LAKE, IN. 55356 �-�9-02 �ei.r.•�,1',Va�•�
JOB N0.
Eco g52-4�3-4�4� Mark S. GronberJ klinnesota L� Number 12755 01-379
01-379