HomeMy WebLinkAbout2004-P07438 - sports court � � �
CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: po�43s
Crystal Bay, Minnesota 55323 Permit Type: a��essory snu��ures
(952) 249-4600 Date Issued: �i2ii2ooa
SITE ADDRESS: 2725 Shadywood Rd
Excel si or,MN 55 331
P I D: 21-117-23-24-0004
DESCRIPTION:
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Pernut Type: Accessory Shuctures Pernut Sub-type(s): Sports Court
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 181.25 Valuation: $ 10,000.00
Plan Review Fee: $ 117.78
State Surcharge Fee: $ 5.50
TOTAL FEE: $ 304.53
APPLICANT: Rock Solid Concrete/Bulldog Athletic OWNER: Micheal&Robert Meek
232 Queen Ave. S 2725 Shadywood Rd
Minneapolis,MN 55405 Excelsior MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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LI NT PERMITEE SIGNATURE IS ED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Renorts. 1-Assessine, 1-Finance Page 1
. �„ ,
Total Fee: $
�`� S3 Date Received: -Z -��'
Entered By: Permit #: � 3 S
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: (ci�cle one) OWNER 0 CONTR�►CTOR
JOB SITE ADDRESS: 7� � � ZIP: -�`�33/
NAME OF OWNER: �Yt��.,/ ►�►��e� PHONE: (home)4'S'-�,/�/- t���
(work) ���- 3f� - /�3/
MAILING ADDRESS: �25 �� 1��1� CITY: �o..� ZIP: s 3
CONTR.ACTOR: .S� - �� ��� `�I��PHONE: Co,��-38/r��i�
CONTACT PERSON: �� MO IL�/PAGER: G/o?�3(03- 03��
MAILING ADDRESS: �32 �x�.. � CITY: ZIP: ;�
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
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Move Remodel/Alteration Land Alteration
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PROPOSED WORK (describe in detai�: �s1�e�- ��� f►oG�- F �d�4/ s�v � �-
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: aTT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /O ooe —
I hereby apply for a building permit and [ 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 ap roved plan.
APPLICANT'S SIGNATURE: DATE: � 3b -o�
NOTE.� Parade ofHomes events require separate permit approval byPolice Depa�ment and C�ty
Council 60 days prior to the event. Non permitted events wI/I not be allowed.
. •-. -
Sec.l 3.04 RIGHTS 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 rnnfidential data concerning himseU shali 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 supph•
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 suppiy investigative data,pursuant to section.I 3.82,subdivision 5,to a law enforcement officer. •
The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income tax or oropertv tax refund
instructions mstead 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 confldential. 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, sMall be informed of the content and
meaning of that data. Aher an individual has been shown the private data and informed of its meaning, the data need not be disclosed to him for sir
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 ma}•
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. 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 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 pubGc or prnate
data concerning 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 ADVtSORY
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 noti6ed that:
1. The information you furnish will be used to determine your quali�cation 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.
�-e � 4� i— � �l �..�,��e
First Middle Last
�� / �i.vP1 Yl��P �
Address
/1�n�s �1 SS�lc�S- ��-3�/-��l�a
City State Zip Phone
I understand my rights as stated above.
Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z� 25 S�l�*#�wun� /l,t��
PID:
DESCRIPTION OF WORK: SP�2T Co��t.t—
---------------------------------- ------------------------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: �$ •o�
BUILDING REVIEW BY: DATE APPROVED:
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FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes f No WATER CONNECTION
INVESTIGATION FEE Yes No � � PARK FEE
SAC Yes No � SITE INSPECTION
Number of SAC Units OTHER (specify)
--------------------------------------------------�---------------------------------------------------------------------
ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes � No Date of Survey: �-Z�•S,�
Proposed Setbacks:
F�rept (Lake): 330� �- Right Side: 70� ='
$,�ar (Street): 1 S�� Left Side: �y`
Adjacent Structures: 9S f � Wetland: Nlr4
Building Height: Def. Hgt. "'" Peak Hgt. �
Lot Coverage:
Grading: Staff Approval Date: '— By: Council Approval Date:
Septic: Staff Approval Date: —' By:
Zoning File: # � Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: N/�.�} Bluff Setback: �t///-� L o t C o v e r a g e : —
Eristing Proposed
Hardcover: 0-75'
75-250'
250-500' �
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
BUILDING REVIEW CHECK LIST
UBC: �� CONSTRUCTION TYPE: �
. Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ /o�tJoo �
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal hlechanical Water Connection
_�Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (.�iasonry) Other
Wall Board (Mfg.) Well (State Permit)
� Final Grading/Filling Electrical (State Permit)
� Other
REMARKS (IN HOUSE): �
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT):
/�l��N.���. M���< � , ^� � , �� -��, ��
6-2s-o�+ r,, ,: J,' � '� � ,
v��'``'` " �'4``4 ` �`��`
HAIZDCOVER CALCULATION WORKSI-I��`r
SETBACK ZONE: (CIItCLE ONE) 0-75 �J-2JO' 2�0-500' S00-1000'
EXISTING HARDCOVER iN ZONE
A. House x = S.F.
L,ength W idU�
- x = S.F.
x = S.F.
._. x = S.F.
B. Garage x = S.F.
C. Dnveway x = S.F.
� x = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
.... . . __ _ x = S.F:. .
F. Landscape x = S.F.
Underlain x = S.F.
� Bv Plastic x = S.F.
Or Fabric
G. Ocher x = S.F.
TOTAL HARDCOVER IN ZONE - S.F. A '
.. TOTAL PROPERTY Ai2EA IN ZONE - 5550 S.F. B
A = B x 100 = %
PROPOSED HARDCOVER IN ZONE� ..
A. House x = S.F.
-. Length - Width
x = S.F.
x = S.F.
. _ _. x = S.F.
B. Garage x = S.F.
C. Dnveway x = S.F.
...__ . . __ x = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Landscape x = S.�.
Underlain � = S.F.
_ By Plastic - x = S.F.
Or Fabric
._. pRo�os�D
G. Other 3� x �O = �GI� S.F.— SPOi2T
cov��T
_.__ TOTAL F-IARDCOVER IN.ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE - 5550 S.F. B
A = B x 100 = 17,$4 %
DATE TIME ✓
CITY OF ORONO CALLED IN 7`2� '�
INSPECTION NOTICE SCHEDULED Z� �
PERMIT NO. PO 7�.��' COMP�ETED
ADDRESS � - '/1.�� •, -_---��
OWNER CONTR. �C��a/i^
TELEPHONENO. � I � 3Cp� O.3 �Co
� D ION
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PAOGRESS
� 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
� OWNERICONTRACTOR TO MEET YOU:_YES NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERINC, PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Call for the n t inspection 24 hours in advance. �952� 249-4600
OwnerlCon o ' ite:
Inspector_ �
White Copyllnspector's Fi Canary CopylSite Notice
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SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB NO. ���� �
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS,MN 55420 • (952)881-9000 TEST RECORD
ADDRESS ���S ��-"" y G!�""`z' T�J� CITY `'�`� �' L/�n�J
OCCUPANT / ' � � ���r� OWNER �_
SOLD BY� INSTALLED BY N
��-�/ � • n
MAKE � ���^ , MODEL � ��
SERIAL NO.���� I � � INPUT '✓� iU�-'L/ ��� �
THERMOSTAT�/'�� �"`�"'�� VENT SIZE v t� ��+ �� •
VALVE TYPE OF LINER f✓'��
LIMIT � LINER SIZE
LIMIT SETTING ��v FILTERS: SIZE ����`,`��� NUMBER �
FAN SETTING��'r ��-� WIRING �Z'j���R-� //'�
PILOT TYPE ��/'/i�1,1 ���N%�!' TEST TAG
��
IGNITION MODEL ���.� LIGHTING INST.
PILOTTIMING ���`� � � �j�
3 �-1) w �' �� b DATE TESTED
PRESSURE PERCENT CO2 �A � �
t' COMPANY TESTWG �'�F'
INPUT CFH � PERCENT 02 � b
STACK TEMP. � PERCENT CO � NAME OF TESTER C � '
FORM 235(REV.11/69) FORM DISTRIBUTION: WHITE COPY-JOB FILE YELLOW COPY-CITY