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Home My WebLink About2008-00290 - addn/remodel/repair r � � CITY OF ORONO PERMIT NO.: 2008-00290 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 1U10/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 2455 SHADYWOOD RD PIN : 20-117-23-11-0017 LEGAL DESC : TOWNSITE OF LANGDON PARK : LOT 002 BLOCK 004 PERMIT TYPE : ADDITION/REMODEL/REPA[R PROPERTY TYPE : COMMERCIAL- BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY ;(��: �4'S�-RESID�AL��Y�p/��i �� VALUATION �� : $ 41,337.89 N07'E: SID[NG,WINDOWS,AND EXTERIOR FINISH ONLY. APPLICANT PERMIT FEE SCHEDULE 595.75 KARKELA CONSTRUCTION PLAN REV[EW 387.24 3280 GORHAM AVE ST LOUIS PARK, MN 55426- STATE SURCHARGE(VALUATION) 20.67 (952)922-5512 TOTAL 1,003.66 Minnesota State License#: 7928 OWNER ER1C ENGLUND, DDS 2455 SHADYWOOD RD NAVARRE, MN 55392- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will cxpire and become null and void if construction authorized is not commenced within 180 days of the da[e of issuance,or if construction is suspended for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assu,�ing all required inspections are requested in c�nfoupance with the;'State Building Code.This permit may be revo,ked at ar,�y ti(iie�for due c se: .i , /�' I = /l�t�--�` , vi� l l l l� l�J� //l /O /� � Applicant Permitee Signature Date Iss d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �� y��, �°I�� -- ��-� u�� ✓�e��'�� e v��v, C��' / Total Fee: $ / , � �� pIO� DateReceived: l�l��8 Entered By: ��I� Permit#: -� 00�� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please p��int all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: ��{��j 5��1 Cvac`I P� ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS � NO If yes, a special event permit is required with Police Depart�nent and City Council approval 60 days pria�to the event. Shuttle bus service will be i�eguired unless applicant demonstrates su�cient on-site parking is available. Non-pe��mitted events will not be allowed. NAME OF OWNER: �'�L ��I uv�� PHONE: (home) (wark) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: �Gv�,e1,G, �'ot�5� PHONE: �(�o2-��a-��/? CONTACTPERSON: a MOBILE/PAGER: ��-�17-�73� MAILING ADDRESS: a ��,� �,� CITY;S-�La;�s-�V K ZIP:�f{1�� STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: ,Q I 5��-�„�5 PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) � Any earth movement may require MCWD review and per its! PROPOSED WORK(describe in detuin: �i��r.�ro� ,.,�,,,v,pa�„�� ,, o� �,,,,�s 1.� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��-4�� YlvCel� Sc.�� woR�c. y�.33�.8� � 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 wark will be A2`.��-✓� in accordance with the approved p1an. APPLICANT'SSIGNATURE: � DATE: `(�-ID 'O� 3t � � Y Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.1. Type of data. 1'he 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 himselfshall be informed ot (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 azising from his supplying or refusing to supply private or confidential data;and(d)the identiry 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 mav�lace the notice reauired under this subdivision in the individual income tax or propert�t�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 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 authority 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 within five days of the date of the 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 infortn 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 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 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 City of Orono or any of its departments may require you to furnish certain private or confidential information. You are 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 pxocess this application or permit. �-- ol � � �� ,� �' i 4v�� First Middle Last _�2 d� d crG.G�r►n �e Address �. � ��5 ��.�k �.� �� -��—��c 2 C�tY State Zip Phone I un erst d my r'ghts as stated above. ✓ l � Signature V• 32 •. '1 L CHECg OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: �� y� -� �� ` PID: � ��L� DESCRIPTION OF WORK: (y� i ; ,�� . �� ZONING REifIEW BY.• � � DATEAPPROTIED: 1 j � BUILDING RET�IEW BY.• DATEAPPROVED: �i-�_ �� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ,i� No P�N��E� Y�S—/.� N� SEWER CONNECTION STATE SURCHARGE Yes_1� No WATER CONNECTION WVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION IJumber of SAC Units OTHER (spec�) ZONING CHECK LIST Zoning District: �-- Fire Departmeni: Post O�ce: School District.• Lot Area: Sq.fi. • Acres Width Depth Survey Submitted.� Yes No� Date of Survey: Proposed Setbacks: Front(Lake): Right Side: Rear(Street): Left Side: � Adjacent Structures: Wetland: Building Height: Def. Hgt, peQk Hg1 Lot Coverage: Grading: StaffApproval Date: By: Council,4pproval Date: Septic: StaffApproval Date: By. �� Zoning File; # Resolution: # Resolution Date: Shoreland District.• MCWD Permit: Avg. Setback: B1uffSetback: Lot Coverage: Faisting Pro osed Hardcover: 0-75' p 75-250' 250-SDO' 500-1000' Hardcover I�ariance Reguired: 3'es No Date of Council.9pproval: RE11�4RKS(in house): 33 l . , B UILDING REVIEW CHEC%LIST UBC: C' CONSTRUCTION TYPE: �(l3 Sq Footage �Per Sq Ftg Basement x = Ist Floor x = 2nd Floor x = Garage x = x = TOTAL � Estimated Construction Value: $ ��. 3 31 `d S /�er� �/�.(,(� (}��_� Inspections Required: Work Requiring Separczte Per►nits: Site Plumbing Fire Hardcover Removal Mecnanical Water Con»ection �Footing Septic Sewer Connection �_Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well(Stare Permit) Gr Final Grading/Filling Electrical(State Permit) Other REMARKS(I1V HDUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access tlpproval: Date By: : REMARriS'(TO BE NOTED ON PERMI7?: 34 �^� C' - DATE TIME � CITY OF ORONO CALLED IN � � D �g INSPECTION NOTIC� DD� �SCHEDULED a- 08� PERMIT NO. l` COMPLETED !( /1 . ADDRESS o? S DO� OWNER CONTR. �� TELEPHONE NO. s� -Cf�� SS�� DESCRIPTION �� ' ��TING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FIN L ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O p TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP p 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 J ❑ PLUMBING FINAL ❑ FOUNDATIOWREMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO v�, COMMENTS: � W a � J O a � O � W � Q � 2 W � W � � � d ��IORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CAl.LTO ARRANGE ACCESS. Cat1 for the next inspection 2a hours in advance. (g52) 249-4600 OwnerlContr Inspector. White Copyllnspector's File Canary Copy/Site Notfce � � DATE TIME � CITY OF ORONO CALLED IN � / D f' INSPECTION NO�nTICEp /� SCHEDULED 3 d9 /%.jd PERMITNO. OK/DO ��/��COMPLETED ADDRESS as��55 c� Wdo�-- .� OWN ER CONTR. �� TELEPHONE NO. l�/�-��'�P�/�`al5l- `�7S j� � DESCRIPTION �� ' , � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING y ��MING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS 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. p COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL �( ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:��1'ES_NO � COMMENTS: � W a � � O � � O � W � Q ti Z W � W � � d W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ ORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WlLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�0 OwnerlContractor on site( , Inspector. � White Copyllnspector's File Canary CopylSite Notice C� � �f�l�JF, TIME CITY OF ORONO CALLED IN /`Y/ INSPECTION NOTICE SCHEDULED � l�•'� PERMIT NO.u��1'D�d 90 COMPLETED ADDRESS �TSS �`=�7LUD�� OWNER CONTR. Q �� TELEPHONE NO. �l�- z S� �757� � DESCRIPTION �1�� E�L� � ❑ 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 � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAI ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W C o .J�- •� c�k l K�"•c >9�?sz�"� ��WS '' �-n,� t,✓�.�.��_�1 S �}-S � 0 � `" �a�.-d s Q C�P�� t�� b�SS � z W � W � � � ❑WORK SATISFACTORY:PROCEED �PROJECT COMPLETE W �CORRECT WORK&PROCEED �ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALI FOR REINSPECTION �EMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. ��n��Q s White Copyllnspector's File Ca�ary CopylSite Notfce C �1.� � DATE TIME �CITY OF ORONO � CALLED IN Z-�C�"I INSPECTIQN OTICE (�/�S�CHEDULED �g --.�.�-. ��,� PERMIT NO. �C�`��=[l.c:OMPLETED ADDRESS � � � c7 ��c'��,'L1 0��'.,C`LY� OWNER CONTR. (X I�I(� � � TELEPHONE N0. l � � � ^ '�`�� - � �� r �,��5+ • c- � � DESCRIPTION - ��-�� '� �C_`��t�c.�n � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORFJWETLANDS � 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 � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W 0. � � J O � � O �� W � Q � Z W � W � � d W ❑WORKSATISFACTORY:PROCEED CI PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary Copy/Site Notice