HomeMy WebLinkAbout2000-P03246 - addn/remodel/repair PERMIT
CI�Y OF ORONO
275�Kei`e� Parkway - PO Box 66 Permit Number: Po3246
Crystal Bay, Minnesota 55323 P@C1711t Type: Addition/Remodel/Repair
(612) 249-4600 Date Issued: 12�13i2o
SITE ADDRESS: 2500 Shadywood Rd
EXCELSIOR,MN 55331
PID: 2o-i t�-23-t t-oo�4
DESCRIPTION: UBC Occupancy B
J�
Proposed Use: ;,�
Buildin Census Code 4�ij'?�
Permit Class: g -
Permit Type: Addition/Remodel/Repair 1'ermit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: r.ieciricai (siate j
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 1,352.15 Valuation: $ 163,286.00
Plan Review Fee: $ 900.83
State Surcharge Fee: $ 85.00
TOTAL FEE: $ 2,337.98
APPLICANT: Cargill Inc OWNER: FRESHWATER FOUNDATION
PO Box 5699 2500 SHADYWOOD RD
Mpls,MN 55440 EXCELSIOR MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERNIISSION TO MAKE THE REAL 1MPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
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PPLICANT PERMITEE NATURE -�SSUED BY SIGNATiJRE
Copies: City,Applicant,Assessor,Finance Page 1
. � Tota? Fee: $ �; � � � <,`� Date Received: 1 f � �J�
; Entered By; f:��� Permit#: /{ �:: "� �y�
�_C�.��r= �-j i� _'���,r -_T�;-�--�+--��- ���!� //h
r��ITY OF ORONO - BUILDING PERMIT APPLICATION
�'.i'1/"��,�.�_ /�:� /� - �,�� (,' /t fC:�;__.�_.
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 �� T���'U � '
JOB SITE ADDRESS: Z Sm p �'/-�,q���u W�o D �D. ZIP: SS 3 3/
NAME OF OWNER: ��Q�sflU/�TF"� �ocr�G Ty_ PHONE: (home)�/,�.y�l.7zG�
(work)_ �/2. �7/. � 77,3
MAILING ADDRESS: 2S� S�Avy�.t�oQ ,�CITY:�(/'�1/����' ZIP: SS33/
CONTRACTOR�T�_ ,q,�) G�2 f�/c.C. . /NG PHONE: �/Z� 7'`f Z. 3 D/G,
CONTACT PERSON: J,DN ��"M�L7'-'D ti MOBILE/PAGER: �iZ. S3�'. z lP Z �
NIAILING ADDRESS: �D�•�3v�S'� �c, CITY:�in�is�r`AR��S ZIP: S3'�f4�aSZ�y9
STATE LICENSE: #
SU� C�N Tl�'A► C 7�01C� Li/��G G �P,�.}/ �'EPr9�'AT�t-c�/ �'=-� �
ARCHITECT/ENGINEER: PHONE: ����•
1��I.AILING ADDRESS: CITY: ZIP:
rJ�ME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: ��-�Dp�'L ��/���-1`Z' !� �-/ ,
���P H T1'�C' �ErJ ,f� //lJ`7` -
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ll0 3 Z- ��
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: DATE: � ��,
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
. d .
Sec.13.04 RIGIiTS OF S[lB.TECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth ia this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidendal dara concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting 3tate agency,political subdivision,or stauwide system;
(b)whether he may refuse oY is legally required to supply[he requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or confidenrial dare;and(d)the idenrity of other persons or enrides auchorized by state or federsi law to�eceive the dara. This requirement shall
not apply when an individual is asked to supply invesdgadve data,pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of re�enue mav place the nodce rewired under this subdivision in the individual income rax or prooem 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 wherher he is the subject
of scored data on individuals,and whe[her it is class�ed as public, privace or confidential. Upon his further request,an individual who is the subject
of stored private or public dara on individuals shall be shown rhe dara without any charge to him and,-if he desires, shall be informed of the content
and mea�lih��of di�t dara. Afrer an individual has been shown che private data and informed of iu meaning,the data need not be disclosed to him for
six monchs.thereafter unless a dispuu or action pursuanc w chis secdon is pending or addiuonal data on the individual has been collected or created.
The responsible authority sha�(pcovide copies of the private or public data upon requesc by the individuai subject of the data. The responsible authoriry
may�require the requesting person to•pay the acmal cosu of making,certifying:and compiling the copies. ..
The responsible au[horiry sf�all comply immediately,if possible,with aay 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 informa[he individual,and may have an addidonal five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays. '
Subd.4. Procedure when data is not aceurate or complete. An individua[cn�y eontest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall notify in wri[ing the responsible authoriry describing che nature of ihe disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found m be inaccuiate or ihcomplete and attempt to nodfy 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 shail be disclosed only if the individual's statement of disag�eement is included with the disclosed data.
• Tha decerminadon of the.responsibte au[horiry may be appealed pursuant to the provisions of the administradve procedure act relating to
. , contested eases.• . . . ' . �
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 fumish 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 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.
First vtiddle Last
Address
���, Sta[e Zip Phone
I unde d my rights as stated above.
Sign re
CHECK OFF LIST FOR ISSUA��'CE OF PER.I�IITS
_ FOR OFFICE USE ONLY . � .
ADDRESSORLEGAL: ZSOQ SI�kM�4Wt�O�J ��
PID:
DESCRLPTION OF WORK: 1'Lt: O�D tsL U4�3
.
ZO.�i'G REVIEti�BY: DATE APPROVED: //-Z�i -�
BU]TrDING REVIE�BY: . D4TE APPROYID; 1�• ZQi�-'oo
F'EES TO BE CHARGED: Misc. Fees Calculated By:
pg�tMlT Yes �'' No :•
pI,AN REVIEW Yes �' No SEW�CO�iNECTION _
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No p�RK FEE
SAC Yes No . SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZO\1,iG CH�Cg LIST zoning Districc: Nv G f�4�/JC' � _ .
Fire Department: Post Office: School District: • � �
Lot Area: Sq.ft. Acres � Width Depth
Surve;Suba:itted: Yes No Date of Survey:
Proposed Setbacks:
Fron[(La.ke): Riaht Side: �
Reaz(Street): Left Side:
Adjacent Scructures: W tland: •
Buildin�Height: Def. H�t. Pe •Hgt.
I,ot Coverage:
Grading: Staff Approval Date: y: Council Approval Date:
Septic: Staff Approval Dace: y:
Zoaing File: # Resqlution: � Resolution Date: _ .
Shoreland Disuict:
Avg. Setback: Blufi Setbac : I.otCoven�e: _
E���o Propos�d
Hardcover: 0-75'
75-250'
250-500' -
500-1000' -
Hardcover Variance R�quire : Yes No Date of Council Approval:
REI�IARKS (in house):
7
BUII.DING REVIEW CHECK LIST
UBC: � CONSTRUCTION TYPE: /�/IL
Sq Footage $ Per Sq Ftg
�asement x =
1 st Floor x =
2nd F1oor z =
Garage x =
z =
TOTAL
F,stimated Construction Value: $_ ��3f Z,��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing ' Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
�_Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
_�Wall Board (Mfg.) Welt (State Permit)
_�Final Grading/Filling e� Elecaical(State Permit)
Other
REivIARKS(IN HOUSE):
REVIEW BY OTHERS: � DATE:
Access: Ezisting New
Access Approval: Date By:
REVIARKS (TO BE NOTED ON PERMIT�:
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BUIL�!I�'JG �i!�� P1..AR REVIEW .
INSPECTOR --.
DA�c (�'Z�l`C'X� ___Pc�;P1ilT h10. '
�.f I�:�,�vr(�lJf��l�r'.:uLli� i..:Q
❑ ?',;'t�';�;V�:� �+n';.�.;-i::C�=;itiECi'::�i,iS,4c P�OTr� �
C �iOT AP��ir'r'tL�---CORrtcCT&�+%SUS;•.�1T � ,
Tli2se ccmments are i�r your inic�^nation. Ai;wcrk siia+;ba done
(n t�:!I complianc@ Vfih a�j d�JjJ�ICB�i�G �'L'iiding Gnd zoning C6�.
RsGuiremeMs inciuding i,ems��ot 5per,:fic�ily nr,;ed in this review.
KEEP THIS PLAN SEt ON SI i E AT ALL TtME'3
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LOWER LEVEL �
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LOWER LEVEL �
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DATE TIME
CITY OF ORONO ���� CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. `�'� MPL TED lZ�� �
ADDRESS !� �C� � �°�
OWNER �S �✓u- � CONTR.
TELEPHONE N0.
� DESCRIPTION
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
NSULATION 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
J 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� � ORKSATISFACTORY:PROCEED i:` PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED S ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on site:
'^ �
Inspector.._;�'/� i (� C�
White Copyllnspector's File Canary CopylSite Notice
� ATE TIME
CITY OF ORONO CALLED IN _,��Y�� l D .�30
INSPECTION NO IC SCHEDULED ��� ��U
PERMIT NO. � ���a�G COMPLETED � — -�� 3�
ADDRESS v�J`JDD -�����-1 �--v�� ��
OWNER CONTR. �(Z/�c�.c .� .�'� �
TELEPHONE NO. �T��� - 3d�(
� DESCRIPTION ' �CG • / / '-��'''`-
� 01 FOOTING i t MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �,VORKSATISFACTORY:PROCEED Q�ROJECTCOMPLEfE
W �O CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p PHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALI INSPECTOR
❑ INSPECTIONREOUIRED.CALLTOARRANGEACCESS.
Call forthe next inspection 24 hours in advance. (g52) 249-4600
Owner/Contrac or on site:
r -
Inspector.
White Copyllnspector's File Canary CopylSite Notice