HomeMy WebLinkAbout2000-P02401 - addn/remodel/repair �� � '� PERMIT
��TY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number. Po24oi
Crystal Bay, Minnesota 55323 PeftTllt Typ2: Addition/Remodel/Repair
(612) 249-4600 Date Issued: s�23ioo
SITE ADDRESS: 40 Stubbs Bay Rd S
MAPLE PLAIN,MN 55359
PID: os-ii�-23-i2-0009
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Single Family
DETAILS:
Approved per resolution#:
Separate permits required: �,iectricai (siaie j
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 251.25 Valuation: $ 15,000.00
Plan Review Fee: $ 163.28
State Surcharge Fee: $ 7.50
TOTAL FEE: $ 422.03
APPLICANT: ALLEN SCHMIDT OWNER: �LDON H DUNN ETAL
1415 CHERRY PL 40 STUBBS BAY RD S
MOUND, MN 55364 MAPLE PLAIN MN 55359
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECTFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
C t�-_ S�--=-o� . � �
APPLICANT PERMITEE S[GNA1'URE ISSLTED BY SiGNATUR�
Copies: City,Applicant,Assessor,Finance Page 1
1 �
Total Fee: $ �a.?.p3 Date Received: �!/,ZB/oo
Entered By: ��1, Permit#: � (',� �Q/
CITY OF ORONO - SUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR �
JOB SITE ADDRESS: �f c-' � . ��Jf3.�j i�.��-1 '!�� ZIP: ,S 5 3��f
NAME OF OWNER: l.e)����,� p�N:J PHONE: (home) `��1,3 - �3 l dZ
(work)
MAILING ADDRESS: �fo S • 5•;�,�s g#�`/ CITY:/a'�/�G� p�...F};ti ZIP: �7 3 7�
R�
CONTRACTOR: RL.�ix a �'- �-m� o'�" PHONE: `f�l—Q y�� :3
CONTACTPERSON: S'�wi'rL MOBILE/PAGER: 3� b•- 5�.s y
MAILING ADDRESS: !��5 G�f��f PL- CITY: /�'lo.;�-� ZIP: ����: �
STATE LICENSE: # �5'Z �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition 7� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: ��� R� 5rt-o7' / v 6�-��C_�
STORIES: i SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ /,7 t��, ��'
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 with the approved plan.
APPLICANT'S SIGNATURE: �.���.s— �� DATE: `r Z � �v
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
� �
Sec.13.04 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 reqirired to be gi�en mdividual. An i�ividual asked to supply private or confidential data concerning himself
shall be informed of: (a)the puipose and intended use of the requested data within the collecting state agency,political subdivision,or statewide
s�stem;(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 supply private or confidential dare;and(d)dY identiry of other persons or entiues authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law
eniorcement officer.
The commissioner of revenue mav olace tfK noace required under this subdivision in the individual income tax or orooertv tax refund
insuuctions instead of on those forms.
Subd. 3. Access to data by individual. Cpon request to a responsible authoriry, an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or conf'idential. Upon his further request,an individual who
is che 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 indi�-idual has been shown the private data and informed of its meaning,the data need not be
dis:.losed to him for six months rhereafter unless a disp�or acUon pursuant ro this secrion is pending or additional data on the individual has been
cotlected or created. The responsible authoriry shall pro��de copies of the private or public data upon request by the individual subject of the data.
Tlie responsible authority may require the requestin�person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immzdiately,if possible,with any request made pursuant to this subdivision,or within five days
of[he date of the request, excluding Saturdays,Sunda�s and legal holidays, if immediate compliance is not possible. If he cannot comply with
thz request within that time,he shall so inform the iniividual, and may have an additional five days within which to comply with the request,
ezcluding Saturdays,Sundays and legal holidays.
Subd.4. Procedure Rhen data is not acecaate or complete. An individual may contest the accuracy or completeness of public or
pri�•ate data conceming himself. To exercise this righ� an individual shall notify in writing the responsible authority describing the nature of the
disaereement. The responsible authoriry shall within.i0 days either: (a)correct the data found ro be inaccurate or incomplete and attempt to notify
past recipients of inaccurate or incomplete data,includi�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.
'I'he determinadon of the respoasible authorin•may be appealed pursuant to the provisions of the adminisnative procedure act relating
�o contested cases.
D�TA PRIVACY ADVISORY
In accordance with Nf.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 Ciri- 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:v1.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required co process this application or permit.
First tifiddle Last
Address
C(�y State Zip Phone
I understand my rights as stated above.
�. � �� -S��'...=.-��
s;�natu�e
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: y O 5�'u n�(�S �3fl� I��
PID•
DESCRIPTION OF WORB: �A-?A to� rA�J� � � a�
ZO�G REVIEW BY: DATE APPROVED: .3- • �( —v�
BUILDING REVIEW BY: DATE APPROVED; .�- �{--ou
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes ✓ No
PLAN REVIEW Yes c/' No SEWER CONNECTION
STATE SURCHARGE Yes / No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZOYING CH�CK LIST zoning District: 2 R.-1�
Fire Department: " Post Office: 1 School District: D2c�.�v v
Lot Area: Sq.ft. No c H.tiv6 z Acres Width Depth
Survey Submitted: Yes_� No Date of Survey: DN /'��
Proposed Setbacks:
Front(be�e): l t13� �' Right Side: 17 C7
Reaz(St�eet3: I t3O�'�' Left Side: c! 7 �
Adjacent Structures: ATT�,H�h Wetland: N(/� .
Building Height: Def. Hgt. �.4L Peak Hgt. ���
Lot Coverage: N �✓�'
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resoludon Date:
Shoreland District:
�, • Avg. Setback: Bluff Setback: LotCoverage:
N Existing Proposed
Hardcover: 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: lQ'- '� CONSTRUCTION TYPE: �//�J
Sq Footage $Per Sq Ftg
Basement . . x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ I J,Uut� a"—
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
_�Footing ' Septic Sewer Connection -
_�Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
_�C Fina1 Grading/Filling � Electrical(State Permit)
Other
REI�ZARK.S(IN HOUSE): .
REVIEW BY.OTHERS: DATE:
Access: Ezisting New
Access Approval: Date By:
RE1I�IARI�S (TO BE NOTED ON PERMI�:
8
DATE q. TIME
CITY OF ORONO CALLED IN S'3 a- /' U�
INSPECTION TICE SCHEDULED .5-3, -6 ° ��� *'��
PERMIT NO. 0 � COMPLETED ��'} � 'd�
ADDRESS �Q S � - S� � b b 5 ,� �u /� �
OWNER ��'�� CONTR. � . �� �a��
TELEPHONE NO. 1 � o � 9 7�--
� DES TION
~ 111-FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
�
Q 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 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 FINA� 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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W [_1 WORKSATISFACTORY:PROCEED :: PROJECTCOMPLETE
� �I�CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
C: CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTO TAKEN
INSPECTOR WILL RETURN
' CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site:
Inspector. �C�z-�/�
White Copyllnspector's File Canary CopylSite Notice
DATE �IME
CITY OF ORONO CALLED IN �U d //R"�'
INSPECTION N TICE scHE�u�Eo � � �'� �
PERMIT NO. c � �
� COMPLETED e� �� ��
ADDRESS �C S7`Z C hl�S � %�� ��S
OWNER(1�III� � �� CONTR. �'� �
TELEPHONE NO. �b�r �—����`
� DESCRIPTION ����`�� `— ������
ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
4Qi 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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�WORK SATISFACTORY:PROCEED /�ROJECT COMPLETE
� ❑CORRECT WORK&PROCEED � _ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
Ci INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContr r on site: 4
Inspector� . DW�da-v1-� _ _ __
White Copyllnspector's File , Canary CopylSite Notice
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ChariiaI55cn, MN 55,!51'7
TF -1, (612) 9�4-7440 FAX (612) 954-4505 e-mails mtkade5icroaol.com
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