HomeMy WebLinkAbout2003-P06330 - attached deck ��� ITY OF R N PERMIT
� � � permit Number:
2750 �elley Parkway- PO Box 66 P06330
Crystal Bay, Minnesota 55323 Pef1711t Typ@: Addition/RemodeURepair
(952) 249-4600 Date Issued: 6is�2oo3
SITE ADDRESS: 2730 Shadywood Rd
Excelsor,MN55331
P I D: 21-117-23-24-0064
DESCRIPTION: i1BC Occupancy R3
Construcrion Type VN
Proposed Use: Residential
Pernut Class: Building Census Code 434
Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#: 2884
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Pernut Fee: $ 9�•25 Valuation• $ 3,900.00
Plan Review Fee: $ 63.18
State Surcharge Fee: $ 2.45
TOTAL F'EE: $ 162.88
APPLICANT: MN Rusco,Inc. OWNER: John Fiebekorn
5558 Snetana Dr. 2730 Shadywood Rd
Minnetonka,MN 55343 Excelsior MN 55331
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.
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APPLIC T PERMITEE SIGNATURE ISSUED BY SIGNATURE
Couies: 1-File(SiQniiures Requiredl, 1-Auplicant 1-Monthlv Reuorts, 1-Assessins, 1-Finance Page 1
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Total Fee: $ ��-�--�-��� 1' � K �� Date Received: �Q �� 30
Entered By: ������� Permit#: �=;� I� I (>=�
T-�,�,y-y-}`� L > l__ j C`'`,
CITY OF ORONO - BUI�DING PERNIIT APPLICATIOleT
All information must be submitted in full before plan review will be started.
(please print all information)
-----------------------------------------------------------------------�=__ --------------------------------
THE APPLICANT IS: (circle one) OWNER O ONTRACTOR
,.___.
JOB SITE ADDRESS: 3 v � A�l ,� 1L ZIP: ���� i
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NAME OF OWNER:� v�r '�'<<�h� � �-���' PHONE: (home)�t5� - `-171- r�lo�(�
(work)
MAILIl\'G ADDRESS: �,.�� r�� .ni jo�J� CITY: ZIP:
t _
CONTRACTOR: �('� ,�J 12us«� �.-�c. ��`�� PHONE• �'15�-�Z 35- �'2���`�� ,�.,�-�
CONTACTPERSON:��-"r�� d3i� �,�, MOBII.E/PAGER. �a� ��% i3�� �C�N
MAILINGADDRESS:�"S5� �'riE;i��� d7c-, CITY: XI�,nnc-.-r�.-.�P ZIP: "
STATE LICENSE: # � �� 3
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� � Land Alteration
����L�-.� o-.��
PROPOSED WORK(describe in detai�: �� �,�(�>c� ���;�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��,���
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 w' ved plan.
7
APPLICANT'S SIGNATURE�_ ' � DATE: S �G a�
����--,o.� ��f�.
NOTE! Parade of Homes events require separate p¢rmit approval by Police Department and
City Council 60 days prior to the event. Non-permitted events will not be allowed.
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Sec.13.04 RIGIi'TS OF SUBJECTS 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 in this secdon.
Subd.2. Information req�rired to be given individual. An individual asked to supply private or confidential dara conceming himself sha11
be informed of: (a)the purpose and intended use of the csquested data within the collecting�tate agency,political subdivision,or sratewide sysum;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any imown consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the idenriry of o[her persons or enuaes authorized by stace or fede�al law to receive the data. This requirement shall
not appty when an individual is asked to supply invesrigadve data,pursuant to secdon 13.82,subdivision 5,to a law enforcement o�cer.
The commissioner of revenue mav alace the nodce required under this subdivision in the individual income taz or aropertv tax refund
instcuctions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whe[her it is classified as public,private or confidenaal. Upon his further request,an individual who is the subject
of stored private or pubtic data on individuals shall be shown che data wi[hout 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 meaniag,the data need not be disclosed to him for
six months thereafur nniess a dispute or acdon pursuanc to this secdon is pending or addidonal 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 iadividual subject of the data. The responsible authoriry
may require the requesang person to pay the actual costs of making,certifying,and compiling the copies.
The responsible au[horiry 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 possibie. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an addiaonal 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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing che nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and aaempt to nodfy past recipients of
inaccurate or incomplete data, iacluding recipients named by[he 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 wirh the disclosed data.
The determination of the responsible au[hority may be appealed pursuant to the provisions of the adma►istrarive procedure act reladng 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 pemut 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 shazed 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 Middle Last
Address
Ciry Stau Zip Phone
I understand my rights as stated e
Signamre
CHECK OFF LIST FOR ISSUANCE OF PERMITS
, FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2�3 v 5 N A�W�d�,0 z.o,�D
PID:
DESCRIPTION OF WORK: 1�JcLK '
ZO.�tI�Ti G REVIEW BY: DATE APPROVED: 5�2z-03
BUII..DING REV�W BY: DATE APPROVED; 5 -z9-.-�3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes ,/� No
PLAi�t REVIEW Yes � No SEWER CONNECI'ION
STATE SURCHARGE Yes _�/ No WATERCONNECTION
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC�Units OTHER (specify)
ZOYING CHECK LIST Zoning District: .
Fire Department: � Post O�ce: School District: •
Lot Area: Sq.ft. Acres � Width Depth
Survey Submitted: Yes�_ No Date of Survey:
Proposed Setbacks:
£�ea�(Lake): 6�-3 �' Right Side: Z g�
Re�tr(Sueet): '7'�� �' Left Side: y5� '�_
Adjacent Structures: i4%�'�-�*-''� Wetland: N�- .
Building Height: Def. Hgt. i✓/� Peal:Hgt. �
Lot Coverage:
Gradino: Staff Approval Date: — By: Council Approval Date:
Sepdc: Staff Approval Date: �' By:
Zoaing File: # vT-2.�Sy Resolution: # ResolutionDate: N-2g'�3
Shoreland District: ps
Avg. Setback. �wvt.� Bluff Setback: — LotCoverage: —
Ezistia; Proposed
Hazdcover: 0-75' �'B
75-��� 5 Z•3
2$�-500�
500-1000'
Hazdcover Variance Required: Yes oC No Date of Council Approval: Y•�"��
�REI�'t�RKS (in house): P�ezw.�-r � Po s Z o s w�►s �ss� o,•� � �-a3,�2 . y-e.� ,��-u�
4R eNo .A�aC /�.y� �tM�� �. G► H..�� Ar►� A6�c. oQ�6rivA�-
, w�4- .1�l L 6�o� � ,,..a �� � �1�6 Soo , c t�� ConrST �y'P
-ko � (�l��'!�°-'^t-P. I bi�o
_ r2�bo� 7
3,Hvv
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BUII,DING REVIE`y CHECg LIST
UBC: /`' 3 � CONSTRUCTTON TYPE: �//� �
_ Sq Footage $Per Sq Ftg
� Basement . . x _
lst Floor x . . _
2nd F1oor x _
Garage x _
x =
TOTAL
Estimated Construction Value: $ -}�.,��s0 '�,�i o c��y� �,a+e oN ✓L�v?-�s e S�QO
Inspections Required: `vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical
Footing Water Connecuon
� —�Framing Septic Sewer Connection �
Fireplace Lawn Ircigation
Insulation (Masonry) Other
Wall Boazd • (Mgg,) Well(State Permit)---
—�F�� Grading/Filling Electrical(State Permit)
Other
REMARI�.S(IN HOUSE):
REVIEW BY OTHERS• DATE: --- ------------- __
Access: Existing New .
Access Approval: Date �
By:
-------------------------------------------------
REMA.RI�S (TO BE NOTED ON PERi1�IIT�;
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KE�..P THIS PtAN 3ET OiJ SffE AT AL1.71ME&
C� � T TIME J
CITY OF ORONO CALLED IN ��
INSPECTION N TIC SCHEDULED -Z'O %3?�
PERMIT NO. o33D COMPLETED
ADDRESS a7i3� �S c� ��-
OWNER CONTR.
TELEPHONE NO. 95� '�7� �' 9�v��
� DESCRIPTION D'eC'� �
� 01 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,., �0 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
'�/�S,RINAI� � 14 SEWER HOOK-UP O6 PROGRESS
��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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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Catl for the n xt inspection 24 hours in advance. (g52) 249-4600
OwnerlContra o ite:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
ATE M �
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CITY OF ORONO CALLED IN '!d a�
INSPECTION NOT SCHEDULED __� S��'��y
PERMIT NO. ���a COMPLEfED �9vl�r
ADDRESS � -�. �l� �
OWNER ONTR. �SC�C�
TELEPHONE N0. ��� a�� y�z2- �"— ��c/ �}�°`
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� D N ��� �1C� I� �— �� (� Y i�G'c�
� 01 FOOTIt�G 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 ING 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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cal1 for the nex inspection 24 hours in advance. (952� 249-4600
OwnerlContract�n s :
Inspector. �
White Copy/lnspector's File Canary CopylSite Notice
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I,� DATE � � TIME
CITY OF ORONO CALL�DN� � +
INSPECTION NOT�CEf ,, � -�y,; SCHEDULED ��
PERMIT NO. �r � � COMPLETED
ADDRESS ��� ��C� v���'r"�c,�_ __ �'
OWNER CONTR. �
TELEPHONE N0. �J�,:� ��'����- C��, ��
� DESCRIPTION �� �`� � � ���� ,C>>��-
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti
Q 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 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� EFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� 249-46��
Owner/ConUact�on�te:
Inspector.
White Copyllnspector's Fil Canary Copy/Site Nolice