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Home My WebLink About2007-P11549 - addn/remodel/repair � PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p11549 Crystal Bay, Minnesota 55323 Permit Typ2: Addirion/RemodeURepair (952) 249-4600 Date Issued: 10/12/2007 SITE ADDRESS: 1635 Shadywood Rd unit# Mound,MN 55364 PID: 17-117-23-21-0030 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/RemodeURepair Pernvt Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanicai Electrical(state) NOTICES/REMARKS: Finish Basement FEE SUMMARY: Pernut Fee: $ 181.25 valuation: $ 10,000.00 Plan Review Fee: $ 117.81 State Surcharge Fee: $ 5.00 TOTAL FEE: $ 304.06 APPLICANT: Owner/Self OWNER: Joseph Leland MN 1635 Shadywood Rd 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. �� - LIC RMITEE SIGNA J�- SUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 C�.� G�" � f �,.J C 'b �./ 0'1D 1 TotalFee: $ t��j�. �5�' DateReceived: �� (r"D7 Entered By: Permit#: /,�//,5�� 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: / �,��j S�'IA��/ t�c� /`7 � ZIP: S� ! � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No lf yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shutde bus service will be reguired unless applicant demonstrates su�cient on-site parking is available. Non permitted events will not be allowed. NAMEOFOWNER: � ,��,p1�t 1�.-�J(� PHONE: (home) ��d (work) MAILING ADDRESS: S.�cM� CITY: ZIP: CONTRAZ"�'4R. E; CONTACT PERSON:.`._ _ _.__.__.___ ...__,_� _ ILE/PAGER: MAILING ADDRESS: �---��y�T--��_ _ZIP: STATE LICENSE:,�_-..----" EXPIRATION DAT : ARCHITECT/ENGINEE�:_.______.. _____---,----_ HONE: MAILING ADDRESS: tZ"��-_� ZIP: NAME: � REGISTRATIO V�'.�# — TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement may require MCWD review and permits! PROPOSED WORK(describe irr detai�: i=iiv;' !.�}��r�.�f" STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ (Q�� I hereby apply far 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 wark is not to start without a permit;and that the work will be in accordance with the approved plan. __. ___ . > _.._,._.� _... APPLICANT'S SIGNATURE: L�_` ��,�.---- " � DATE: � 7 c___ _ --.__...._. 31 Sec.13:04 RIGHTS OF SUBJECTS OF DATA Subd..i. Type.o�'data. The rights of individual on whom the data is stored or to be sfored 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 shal l 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 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,pwsuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may olace the notice required under this subdivision in the individual income tax or property tax refund insUuctions mstead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible suthority,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 authoriry 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 wifhin five days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe 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 conceming himself. To exercise this right,an individual sha(1 notify in writing the responsible authority describing the nature ofthe disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipienis 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 adminisVative 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 perrnit 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: l. 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. t )osPnl, �A�( �/R�r� First Middle Last �� .f�) R,� Address �� r�i� �3�� o��?�� C��J' State Zip Phone I understand my rights as stated above. .,,.---- __.�.____..._...__.., S' e� ----�-'"" I '� ; II 32 B UILDING REVIEW CHECK LIST UBC: 12- jl' CONSTRUCTION TYPE: t(�V Sq Footage $Per Sq F[g Basement x = Ist Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Va[ue: S�� Inspections Required: Work Requiring Separate Permits: Site �_Plumbing Fire Hardcover Removal oC Mechanical T�Y'ater Connection Footing Septic Sewer Connection �Framing Fireplace Lawn Irrigation _�_Insulation (Masonry) Other _�Wall Board (Mfg.) Well(State Permit) _�Final Grading/Filling _�Electrical(State Permit) Other REMARKS(INHOUSE): REVIEW BY OTHERS: DATE: � Access: Existing New Access Approval: Date By: REMARKS(TO BE NOTED ON PERMIT): 34 CHECK OFF LIST FOR ISS UANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: I 63� S��Oti W��p ,�� PID: DESCRIPTION OF WORK: �.3A-3t=/�/��r'� F7��Sr� ZONING REVIEW BY.� �N I I� � Y� DATEAPPROVED.��y BUILDINGREVIEWBY: DATEAPPROVED: ,�.,�. o� FEES TO BE CHARGED: Misc. Fees Calculated By: w �~ � PERMIT Yes ./ No PLAN REVIEW Yes ✓ No SEWER CONNECTION STATE SURCHARGE Yes / No GT ATER CONNECTION INVESTIGATION FEE Y'es No—� PARK FEE SAC Yes No � SITEINSPECTION Number of SAC Units OTHER (spec�) ZONING CHECK LIST Zoning District: �/1/J C(�i+�/�� „� �y�� N^ Fire Department: Post O�ce School District: Lot Area: Sg.ft. Acres W'idth Depth Survey Submitted: Yes 1Vo Date of Survey: Proposed Setbacks: Front (Lake�: Righ Side: Rear(Street): Left de: Adjacent Structures: Wetland: Building Height: Def Hgt. Peak Hgt. Lot Coverage: Grading: StaffApproval Date: Bt�: Council Approva!Date: Septic: StaffApproval Date: _ By: � ��,� Zoning File: # Resolution: � Resolution Date: Shoreland District: MCKD Pernzit: .4vg. Setback.• Bluf Setback: LotCoverage: F�is ing Proposed Hardcover: 0-7.i' ��-��D' ?JD-�0�� .i 00-1000' Hardcover Fariance Required: Yes :�'o Date of Council.4pproval: REM.4RKS(in house): 33 _ I63S s�,�� RD �e� �.e ��e� r 5��A� I��TE �E� ATT��i�� E'�E:T F(�� +' .�vw w�. rv�ri.�a•-� o s . ,;,--, ..�;,. G�."`C?E r'��t ti�=�ar�:,-� +� , :} ! � f _ ,� . 3� ,_,__.___--___._....._.._,�.._ _ -- ___..--______..._..._--------------- -- T + O � �„ -— _ ` _ V �A�� ,�� 14tECTLY UTSIQ�. ; ��'►�1 V U�� l'f:��c: ,r i::.� . ... . ; •_ � . _. _ t.�A`Y�'sD QN Gfl�i�.'�� ! — � � i � s , a � i � � ; .� ?� j � � �� ; .�, �� I � � �� <. � . � Q � i ; � � i i � -------- _ _. CITY OF ORONO BUILDiNG P-FM T f'LAi`d R�ViEW ��""'��`"`�''-`� ��" � IN6RECTOW �E� :�.f LL�-k�i"�.'"�' �:-`�:..�� DATE f 0-10-�___� `'�=�','�'iT i�0._____ ❑ AFr^nC�i�=�' " i�`,iTTE'a �+�}�.N�N��vOo� *we`L h::�.��.,: /� g� } ��,p �p �,��.J,l� � 'It�!i�;'�r��:t��r :{��.��1 ��;A:JT�� V� YS.�...��ia'Y_t�.dlt�:.u�.•l+�i ❑ n,.;,�;a�� ,,,,v�---cor;.,__c�R,r,�__��,�l;�r .,,;;�, � -:.,.c;;..,,a, �,:; 't 'fhese comr G� t��r}� + � � s �a done �� fl fi�i� t,^Ill��1��C v �r'�Il i,� d^7�iC:.i�+ hl:iCi��l,] c7 ] �Jn�;�iJ COt�B. FeG�tit R i s i�a�an;g i!ernc r �t spr 'c.?li;ra'�n in th� r2view. �� kEEP THIS P11UV SET ON��E AT ALL TIMES �� L(/- " /�,�`T TIME / CITY OF ORONO CALLED IN <<� INSPECTION NOTICE SCHEDULED /O � PERMIT NO. COMPLETED ADDRESS �G�.3� S�'��`?�� OWNER ��P LP��C� CONTR. � TELEPHONE NO. 3� �� Z �,�� DESCRIPTION ` "' �� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUM8ING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: � W a � J O a � O � ti � Q � Z W � W � � d W� WORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC01/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WFLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContra site: Inspector. White Copyllnspector's ile Canary CopylSite Notice / /oDAT�., TIME CITY OF ORONO CALLED IN �oC.� INSPECTION N ICE SCHEDULED '�c�_'D �O� PERMIT NO. 9 COMPLETED ADDRESS ��35 S��U�,l�J.[/, OWNER lJd� LEf CONTR. TELEPHONE NO. 3� �9� .3.3�'� �. • � DESCRIPTION � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD�COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMEN S: � � � L � J O � � O � W � Q � Z W � W � j d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDiTION WITHIN HOURS. p pHpTO TAKEN INSPECTORIMLL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance. (952) 249-46�� OwnerlContracto " e: Inspector. White Copyllnspector's File Canary CopylSite Notice