HomeMy WebLinkAbout2004-P07493 - attached deck . PERMIT
C�TI�' OF ORONCJ Permit Number:
2750 Kelley�arkway- PO Box 66 P07493
Crystal Say, Minnesota 553�3 Permit Type: Addirion/RemodeURepair
(952) 249-4600 Date Issued: 6i2ai2ooa
SITE ADDRESS: 2170 Shevlin Dr
Way�ata,M1�1155391
PID: 03-117-23-34-0018
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
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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• Twin Lake Design Group Inc. OWNER: Georgayn Kramer
� 3071 Colbert Ave.N.W. 2170 Shevlin Dr
Buffalo,MN 55313 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WOItK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE;REQUIREMENTS.
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AP I T ERMIT ATURE SUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Avplicant 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
��� s'/2�/o�
� Total Fee: $ c.30 5� 53 Date Received: S-�Z'��
Entered By: �9..5 Permit#: Ao 7Yg3
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All inform�tion must be submitted in full before plan review will be started.
(please print all inforn:ation)
THE APPLICANT IS: (circle one) OWNER O ONTRACTOR
JOB SITE ADDRESS: �� 7v �e��; "� �f _ �o'`'� � '`'` ZIP: ��3 9/
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 Department and City
Council approval 60 days prior to the event. Non permitted events will not
be allowed.
NAME OF OWNER: (� �o���yN ��►���-�' PHONE: (home) �Sz�Yo y�Z�
(work)
MAILING ADDRES : Zl7o Sj,��1�N �r. CITY: ORoNv ZIP• .��39 �
CONTRACTOR: ,%� � kc �,S�r�c-�.i o� PHONE: 7C-3 �2���33.s'z
CONTACT PERSO : �'Y1,'1�C _S�c+�•�i� MOBILE/PAGER: S��*Q-
MAILING ADDRES : 3v 71 �1 b��� �_ N•G: CITY: ,�3c�1a ZIP: .�S"3�.3
STATE LICENSE: °Z�i 3 7-'�3 y
i
ARCHITECT/ENGI�TEER: N �-- PHONE:
MAILING ADDREStS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure
Addition Move
RemodeVAlteration Land Alteration
PROPOSED WORI�(describe in detai�: �cww�� `,� �'X�;s�"NS �«�, �oti ���+
r w /✓CG/� !P� S/��"�e. L-vGA-�,v,v
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GAR.AGE STALLS: ATT. DET.
ESTII�IATED CONISTRUCTION VALUATION (excluding land): $ f� v��- �
I hereby apply for a bui�ding permit and I aclrnowledge that the information above is complete and accurate;that the
work will be in confortnance with the ordinances and codes of the City and with the State Building Code; that I
understand this is not a pernut and work is not to start without a permit;and that the work will be in accordance with
the approved plan.
APPLICANT'S SI�NATURE: DATE: � ��/��
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.l. Type of data. The rights of Individual on w6om the data ts stored or to be stored shall be as set forth tn thfs sectlon.
Subd.2. Informallon required to be given individusl. .1n tndivtdual asl•ed to sapply private or contidentisl data concerning himself shail be
tnformed of: (a)the purpose and intended use of t6e requested data within the collectlag state agency,political subdivision,or statewtde system;(b)
whether he may refuse or Is legaily requlred to supply the requested data;(c)an�•laowa coasequeoce ar(sing from hIs suppl.ing or re[using to suppiy
private or contidenHal data;and(d)the identity of other persons or eatities suthoraed b�stste or tederal law to receive the data.This requIrement shall
not appiy when an individual is asked to supply investtgative data,pursuant to section li.82,subdivision 5,to s law enforcement ofticer.
The rnmmissioner oi revenue mav olace the noHce reauired under this sub�isision in the individual income taz or nraoertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible aathor3n-,aa ladivtdual shatl be informed whether he is the subject of
stored data on Indivtduals,and whether it(s ciassifIed as pubitc,prn•ate or conRdentlaL L'pon his further request,an iadl�idual 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,shatl be informed of the conteat aad
meaning of that data. After an indtvidusl has been shown the pri�•ate data and informr,d of its mesning,the data need not be disclosed to 61m forsix
months thereafter unless a dlspute or action pursuant to this sectiou is pending or addi�oaal data on t6e individual has been collected or created. The
responsible authority shall provide coptes of the private or public data upon request by the Fndividual subject of the data The responsible suthortty may
requlre the requesting person to pay the actual costs o[making,certitying,and compiling the cop(es.
The responsible authoHty shall rnmply immedlately,if possible,with an.requ�est made punusnt to this subdlvision,or within five days of the
date o[the request,excluding Saturdays,Sundays and legal hollda�•s if immediate eomplisnce is not possible.If he cannot comply with the request within
that time,he shall so in[orm the individuai,and may have an additional tive days M•ithln whic6 W comply with the request,eacluding Saturdays,Sundays
and legal holidays.
Subd.4. Procedure when data(s not accurate or rnmplece.An indlvidual ma�coatest the accuracy or completeness of public or prtvate data
concerntng himself. To exercise this right,an indivtdual shall notif�•In writiag the respoafl'ble autho�ity descrtbing the nature of the dlsagreemeat.The
responsible suthority shall within 30 days either: (a)correct the data found to be inaacrate or incomplete and attempt to notify past recipients of
inaccurate or inmmplete data,including recipients named by the individual;or(b)aodf�ffie individual t6at he believes the data to be rnrrecG Data in
dispute shaU be disclosed only if the ind(vfdual's statement of disagreement is tnduded w�i2h the disclosed data.
The determinatton ot the responsibie authoriry may be appealed pursuant W the provislons of the administrative procedure aM relating to
wntested cases.
DATA PRIVACY ADVISORY
In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform}•ou that your request
for a permit or license from the City of Orono or an}•of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish wil!be used to determine yoar qualification for thepermit or license requested.
2. You may refuse to supply data,but refusal may reqnire that the City deny the permit or license.
3. The information may be shared with other local,state or federal agencies to the eztent necessary to process
the permit or license.
4. If your requested perarit or license requires Council acuon to approve, some information may become
public.
5. You have certain rights under M.S.13.0-i(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
City State Zip Phone
I understa d m as stated above. .
Signature
• CI�ECK OFF LIST FOR ISSUANCE OF PERMITS
, FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Zti 7 O S H Ev L�u p2 .
PID:
DESCRIPTIONOFWiORK: ��.�,k �,(���,�, _ r
ZOYIvi G REVIEW BY: DATE APPROVED: s=z y-o�(
BI,TII.�DING REVIEW BY: DATE APPROVED: s-zY-a�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAi�i REVIEW Yes v' No SEWER CONNECITON
STATE SURCHARGE Yes _� No WATER CONNECTION
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CI�CK LIST Zoning District: N o C Na�r�►,Q i9rJ d �•1c .
Fire Department: Post Office: School District: �
I.ot Area: Sq.ft. Acres idth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: �
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: �Vetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: � Resolution: # esolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: LotCoverage:
Existin; Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):.
7
BUII.,DING REVIEW CHECK LIST
�C� �� 3 CONSTRUCTION TYPE: �N
_ Sq Footage $Per Sq Ftg
Basement x _
lst Floor x _
2nd Floor x _
Garage x _
z =
TOTAL
Fstimated Construction Value: $_ �O,V�p°°
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removai Mechanical Water Connection
�Footing " Septic Sewer Connection
_�Framing Fireplace Lawn Inigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well (State Perm.it)
D�- Final Grading/Filling Electrical (Sta[e Permit)
Other
REMARKS (I'�i 1 HOUSE): .
_______�_- --------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gy;
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REMARKS (TO BE NOTED ON PERII�IIT�:
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CITY OF ORONO LCAL ED IN. !
INSPECTION NO ICE SCHEDULE�3 �L.��
PERMIT NO. COMPLETED
ADDRESS_ �r��� ��I�V���� D1� ,
OWNER CONTR. �f U1)h �.I� %�2S(�
TELEPHONE NO.�p� �-8'�O ' J���-
� DESCRIPTION ���N� �K—
� 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
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q OS FINAL 14 SEWER HOOK-UP 06 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
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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� ❑CORRECT WORK&PROCEED '- ISSUE CERTIFICATE OF OCCUPANCY
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� �CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next i pection 24 hours in advance. �95Z� Z49-46��
Owner/Contracto �t
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME �
CITY OF ORONO CALLED IN -v� �a,
INSPECTION NOT E SCHEDULED 'd �'..'�U�t^/I
PERMIT NO. C�� .� COMPL TED
ADDRESS �I7U �J�L�L(%l1'l �(Ji�.
OWNER CONTR. //.t�'� C��E: L�i��
TELEPHONE NO. 7II��� ���� J�S,�
� DESCRIPTION / /lZ�-�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� O-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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W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,� pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe xt inspection 24 hours in advance. (952� 249-4600
OwnerlCont 'n site:
Inspector. \ -
White Copyllnspector's ile Canary Copy/Site Notice