HomeMy WebLinkAbout2002-P05391 - addn/remodel/repair � PERMIT
CQTY �F ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P05391
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: �iio�2oo2
SITE ADDRESS: 2693 Shadywood Rd
EXCEISIOR,MN 55331
PID: 21-117-23-24-0055
DESCRIPTION: UBc occupancy R3
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Pemut Type: Addirion/RemodeURepair Pernut Sub-type(s): Deck-Attached
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00
Plan Review Fee: $ 117.78
State Surcharge Fee: $ 5.50
TOTAL FEE: $ 304.53
APPLICANT: Pietsch Bldrs Inc. OWNER: TODD A ROBIDEAU
12299 Lucerne Trail 2693 SHADYWOOD RD
Lakeville,MN 55044 EXCELSIOR MN 55331
Tf�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.
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APPLICAN RMITEE SIGNATURE IS BYSIGNATURE
Covies: 1-File(SiQnitures Required), 1-At�nlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
Jun-Oa-2002 '1:05am Frem-CITY OF ORONG +85224S4S16 T-385 P.006/D09 F-'7a
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Total �ee: � �D �. .5 3 _ D�ie Receiv�d; r,.� ;�7- n�
' .� Enter�d �y: Perrn'tt#: =��_
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r�r� ;;y� CIT'Y" OF ORONO - BUILI)IIVG pER1VIIT ,A,ppILICAT'1C1N
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� � AIi information must be submitted in full befor� plan revie� will be started.
� (ple�se print aIl information)
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�'� APPLICA:�iT IS: �circle one) {)WNER OR,CQNTRACTqR '
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1�'A�NIE OF O'WNER: I t:�j �� � ,�,)Li,�.� ��1Z�i���t.iJ. PHONE: (home) ��-��i I ' �'I� �
; �, (work)
MATLING ADDRESS � �:���1� �"�l�k���r)t� � �����c� �'�: YTY� �Ci�� 1���r �_� 2�IF;_ ��,=�'��
�j��+�(�;�c�✓�, fL1;�� .
CONTRACTOR: �����(,�i7 �71,�� I ���J� ���i� _ � PH4?�'E: `'�` ��- �-(G���_ �)�:r1�-I-
C4N'TACT PE�2SO�i: : �✓ . �1���� M4BILEIPA,GER: ;:,�:? - ? .Z - I�-►i
MAlT',It�'G A.DARESS: �'�; . �_-G X- LI ;� CITY: �;�",''�.�� ; i�c� LIP: T�
STA� I.ICENSEr #�!�, ' ',�;�' -
ARC�TECT/ENG]NE��t:_ I',. ��-1 PHONE:
MA][�TNG ADDRESS: . CYTY� Z1P:
���� RECISTXZATI4N#
TYPE QF WORK: rlew Addition � Accessory Stxucnzre
Move �Remodel/Alteration Land Ai�eration
PR(�POSED WORI�{describe in detail�: �- C•� �t't�,�.i y - � i� 7� �'� j - C +�;% i i
�, _ ��� ",' � 'i �� � i ���1� li�.�v�, �,�, �t, �-��C���t�,� =l
STQ�ES: +����`" SQ. �'EET OF�ACH FLOUR: ��`,��' ',�,�:
NQ. QF BED,ROOi1�IS: �� GARAGE STALLS: ATT. ►�_ DET. f i��
EST1s1rIATED COrYSTRUCTION VALUA,TJfON (excluding land): $ i'�� C 0��;. "'�
I her�by apply for a buildin� permit and T ackno�vIedge that tlZe informatiora above is complete and
accurace; tbat the work wiIt be in conformance wirh the ardinances ar;d codes of the Ci�y arxi with
che S�ate Building �ode; chat I ur.derstar.d this is not a permit and v�rork is not ta sFarc �vithout a
permit; and that thc work will be in acco:danc:� with the apprvved pian.
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APPLICANT'S SYGNA�'LTRE: ���f ���i'.'i-�-- Dr�iT�+:
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NOTE! �arade Q 1�'om� events require separate permit approval by Police Depqrtnaent an�'
City Council �S�day,c prior ta the event. Non permitted evenzs wiIl not he allawed.
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Jun-06-2002 '�.05am From-C!TY 0� ORONC +55224846!6 T-386 P.00T0009 F-1�6
°ec.13.03 R7GH7'S OF SUH,I�CTS OF DqT.�►
SubC. 1. 'Y�pe oP data, 'i'he�;ghts of individua3 on whom thc dara is scorcd or to be srared shall be As sec Parth iz ihis sccti4n,
Subd.2. Iafartteac}oe required to be pvea fndividual. An individuai asked to supply priva�e o;confidentia!dxn coacernutg himyclf
sha�!be inYcr^ied e[: (a}�;z p�,����k���sr af rhe reques�ed dau wi,hin cho cvliecung scxt�a6��Y,poli�ical subdivision,or s�a:swida
sysrcm;�b}wheshen c�may refcise or is PegalJy reQuired m supply che requcsccd da�a;(c)any lcnowa cansequenee�risiag from his supplying or
refusing ra supply privs:e o�sa�lmcal datu;and(d)ihc identiry of o�her person>or cnddes authori,zrd by scatc o�Ped�ral 1aw eo rcceive�ha data.
This r:quirer.ien[shai!not spply wAan en individual is asked to wpply inves:ibacivc dat�, pursu�nc ta secty0n i3.8?, subdivision S, �o a taw
enforcerneru affce:.
� c cn ' ' er n° v o c c ' tc1 unQet jhis cuh�livi4iort in C i 'v ' ' cn x r o e r
insr:verienS in+trad�on[!��u fn�<. �it�L...�QLr�lY_.aX..rcfund
Subd. 3. Aeeeu to dato by indivldual, �fpon reque>c ro a responsible au�horiry,�n individuaE shali be infarrned whc�er he is�a
subjecc flf Storcd data on individuals,ard whe�her ic is clA�aifieQ as public,pri+a�n or wnfden�iai. Upon his turther requ:sc,an iadividual who
is cha st,bjeet of s:ored privatc o;publi,:d�p�on indivi�uals s�tai]be s��nwn�Y�e d.n�withou�any charga cu him and, if he de;fres,shall bc informed
of Lhe can�ent and mcaniag ot that dara. Aftrr an individaal has been shown�he privacr da�a and inPnrmed of i[s mcaning,chc dara need not be
discIoud to h,ine for six monUis dsarcaircr unless r dispuce or action pursuanc ro chis sccrian is pc,xlu,g or�ddicio�ai d:�r��n�he inaiva�ual bas baen
coi;e�sfl or creased. T,�a responsiblt authorip+shaU provido copies of thc privaTe er pyyji;dara upon rrques�by shc individual subjecc vf the d�ni,
Tht responsibkc ausherGry may rrquire che requescing penon co pxy eh�acn,Al cusrs oP meking,cer�iFying,xnd compili�he copies.
'i'tse responsibk�u[har;ry shall comply imntadiaieiy,if po�:iible,wiu�a�ry requesz rr:nde purwanc sa chis subdivision,or wirhin five days
of tha dacc of ihe reqaest,exe3udiny 9aturdays,SundKys nnd leg�;Itioiidays,ef immcdia�a compiianec is aot passibl�. I,'he;annoc eomply wi[h
che rec�:��c wiihin sha�rime,hc s'�all so inform rhe indivictual,as�d muy RRvr an addiciar,al five dsys within which�comply winc�he requesc,
czclud.^g San�rdays,Sundays a�icgai holidays.
Subd.a. pFocedura w6eA daea is not accurate or complete. An indi�idual may eenccsE�ho accuracy or eomplaceness of pubiic or
privscc�asa consarnins himac►f. To exetroist dvc right, ut individual;hall notify In wriring die responsibtc auctsuriry doscribins tho nseur�Of che
disaercrment, The rasponsiblc au�heriry shat!wi�hin 30 d�ys ci�her: (u)correct�he dara fowid to be;n;;ccur3sc or�ncomplete anQ attcmpt to norify
pasc r.:i;.izn�of inAccurare or incomple[e dap„including reeipicnia rarnaQ by thc inQividaal;ar(b)no�ify dte individnal Ihai he believes tAc data
ro be eortee�. Dara ia dispvre shni!be disclosad only if rha individuat's s�aeement ef disagreement is inc!uded with che disc9osrd data.
'IAe decarnur�aaon of rhe responsible aushoriry may ba rppca!ed pursuar[to tha provisi�ns pf che admin:straava procedure ac�::t�dng
to aonies�ed cases.
DA_�i'�.PB�A SdRY
In accordance with M.S, 13.Q�, Subd. 2, "ltights of subjeca of data"', we vaould Iibe to inform you chat your
req�,�est for a permi�or licea�e from the Ciry of Orono or any of us depanrr:encs may require you to furnish certaui
privac� or cor.�dernial informacion.
You are notified that�
1. The information you furnish wijl be used to dztecmine your qualifcation for zhe permit or iicerue
requestcd,
? Y"ou may refust to suppiy data, bu�re�.;al may require that the Ciry deay the permit or liceasc.
3. The inforcraation may be shared wi�h ot��er Iacal, s�ate or federaI agcr.cics co tht extent n��essary to
pr�cess the permit or license.
a. If your requested permit or license raquires Council acuon to apprave, some informa�ion may become
public.
>. You hav�certa:n rip,hss ander M,S. 13.On(available upan request)to review private data on yonrself.
5. Your fuli name is cequired to process t,'�i.y application or permic.
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C'ry Sta�e 2'sp Fhone
I underscand my ri�3its as Stated above.
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� CHECK OFF LIST FOR ISSUANCE OF PERMITS
' FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 26�,� sµ,�.��, wo 0•4 ��
PID:
DESCRIPTION OF WORK: (>,,:c_tc.s
�,, . . .
ZOYING REVIEW BY: DATE APPROVED: 7-q► - o-2
BUILDING REV�W BY: DATE APPROVED; -�. � - o-L.
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ./� No
PLAN REVIEW Yes ✓' No SEWER CONNECITON
STATE SURCHARGE Yes c/ No WA'TFR CONNECTION
INVESTIGATION FEE Yes I�Io ✓' PARK FEE
SAC Yes I�10 T�� SIT'EINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District: �
Lot Area: Sq�.ft. �(ZY O�b Acres . 91. Width Depth
Survey Submitted: Yes_� No Date of Survey: � /g 'a Z
Proposed Setbacks: �
Front(�tee): $2� Right Side: ,3�$�
Reaz(S�reet): b� Left Side: /`3� ,,
Adjacent Structures: A�17"�lrv� Wetland: N��
Building Height: Def. Hgt. � Peak Hgt. �
Lot Coverage: c}K
Grading: Staff Approval Date: -" By: Council Approval Date:
Septic: Staff Approval Date: " By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: v 1 S
Avg. Setback: nr�A Bluff Setback: N ti4 LotCoverage:
Existing Proposed
Hardcover: 0-75'
75-250' Za a
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
BUII.DING REV�W CHECK LIST
UBC: IZ•3 CONSTRUCTION TYPE: V1'J
�• Sq Footage $Per Sq Ftg .
Basement x = _
lst Floor x _ .
2nd F1oor x =
Garage x = , �
x _ .,
TOTAL
Estimated Construction Value: $ �d��pp�=
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
- �F���g � Septic Sewer Connection
` _g Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) : ,Well(State Permit)• : ,
o'�Final Grading/Filling Electrical(State Permit)
Other � �
REMARKS(IN HOUSE): ' • . F .
REVIEW BY OTHERS: DATE:
., .,Y.
Access: Existing New � • .
P � �
Access Approval: Date gy;
REMARI�S (TO BE NOTED ON PERMI�: '
8
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�93 S/{� y � 6,_II:� ti,►�. ,-;�.�t,��L �.��; _������ -�� . ��- (
�j �- �NDRA1� RtQUIRED COD� n�•� �Y-- I i G L
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CITY OF ORONO � • -_
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BUILDIN E fT Pt�W REVIEW �� �
INSPECTOR .
DATE 7'g'`�Z- PERMIT NO. �V1 D
�
Q APPP.OVED AS SU6(vil�tTED � �
�'kr^'riOVED 11V�TH CGRRECTlO��S AS�lOTED
[ �;�:�T A?PRGVcD---CORRcCT&RESUBtv11T � --- — - �/
Th cc�r.ments are tor your in`ormation.NI work shali be d�na /
in ��aipliar,ce with�.,Ri''pppli;.�bla building and zon;�g code. /�,,,
RE, ;;induding�i;,•r+s not specitic311y n�tad�n t114s►evisw.
K��cr'.7HiS PLAi� SET ON SITE AT ALL TlMES
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO E SCHEDULED ;7-�a'�L .' a
PEFiMIT NO. 0 3 COMPLETED
ADDRESS��� 3 � _
OWNER CONTR. �--�C.E?��'l 0_.'���
TELEPHONE NO.�L_ � � LI CoCI-- �`��
��I�ON
� 1 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
Z 04 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMME S: -
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W� ❑WOR SFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ORREGT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEM POAARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspectio `hours i van e. 2� 249-4600
Owne o ctor on site: �
Inspector.
e Copyllnspector's File Canary CopylSH�lotice
'',c�, . . -.��,,�_
/
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION C T�� �J/ SCHEDULED 7-f�.�-0� ��- �
PERMIT NO. COMPLETED �
ADDRESS ' � '�� -�-r`� a �c�.
,
OWNER :¢ONTR.
TELEPHONE NO. �.� � �-f-Cc%� � � ��5�
� DESCRIPTION _ c��.c.��i
� 01 FOOTIN 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q FRAMING 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 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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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46�0
OwnedContra r���k:
Inspector. �_
White Copylinspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN � ��h
INSPECTION N ICE SCHEDULED
PERMIT NO. ��� COMPIETED
ADDRESS v�7�.� 'C.�CX.� !� •
OWNER CONTR. � �S
TELEPHONE NO. �� 2 - TC� � '" �����
� DESCRIPTION / � / ` , I ��
� Ot FOOTING 11 MECHANICAL RI 1 X /GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 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
� 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/CONTRACTORTOMEETYOU:_YES NO
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❑WO SATISFACTORY:PR C ❑ PROJECTCOMPLETE
� ❑C FRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
o y�oRRECT WORK,CALI FOR REINSPECT�ON TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REOUIRED.CALLTO ARRANGE ACCESS.
Cail forthe next inspectio G�� a �e.,�52� 249-4600
OwnerlCo actor on site:
lJ��'"�-----.
Inspector. `
hit Copyllnspector's File Canary Copy/Site Notice