HomeMy WebLinkAbout2003-P06492 - new structure CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: P06492
Crystal Bay, Minnesota 55323 Permit Type: New structure
(952) 249-4600 Date Issued: 7/7/2003
SITE ADDRESS: 3743 Watertown Rd
Maple Plain,MN 55359
PID: 32-118-23-34-0012
DESCRIPTION: UBC occupancy R3
Proposed Use: Residential Constriction Type VN
Permit Class: Building Census Code 101
Permit Type: New Structure Permit Sub-type(s): New Home-Single Family
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Eiectricai(state')inner-(Septic Area-Wiii be addressed 3745
Watertown Rd)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 1,693.75 Valuation: $ 225,000.00
State Surcharge Fee: $ 115.50
TOTAL FEE: $ 1,809.25
APPLICANT: Stubbs Building&House Mover OWNER: Ned&Lorna Butterfield
185 Old Crystal Bay Rd 3743 Watertown Rd
Long Lake,MN 55356 Maple Plain MN 55359
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 REQUIREMENT'S.
AA Ao, .� afn�---
PLICANT PE IITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Siznilures Required), 1-ADDlicant, 1-Monthlv ReDorts, 1-Assessine, 1-Finance Page 1
Total Fee: $ 1 �s Date Received: d 112
Entered By: t2 ,io Permit #:
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CITY OF ORON6 — BUILDING 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 R CONTRACTOR
JOB SITE ADDRESS:
ZIP:
NAME OF OWNER: I rt- P v e d PHONE: (home) �� - -� to
(work)
MAILING ADDRESS:`'I �� ��,,,,o� CITY: ZIP: cj
.CONT TOR: PHONE:gSa - 7 3 ` �c,[ 17
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: 1-.on/ ZIP: 3�`�',
STATE LICENSE: #� (6-7 "cw r
ARCHITECT/EN ER: PHONE:
MAILING AD SS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WO ew Addition Accessory Structure
Mo e model/Alteration Land Alteration
l
PROPOSEDW (describ detail):`�� � ��„�
2Wa'-" / 1444
STORIES: SQ.FEET OF EACH FLOOR: cv
NO. OF BEDROOMS: _14 GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $
I hereby apply for a buiWiftg-pefmit 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 SIGNAT DATE: �� 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.
9
Sec.13.04 RIGHTS OF SUBJECTS OF DA TA
Subdivision 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 confidential data concerning himself
shall 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 supplyprivate or confidential data;and(d)the identity of other persons or entities authorized by state orfederal 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
enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax refund
instructions instead 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 confidential. 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,shall be informed of
the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be
disclosed to him for six 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 may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authorityshall comply immediately,ifpossible,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 ofpublic or private
data concerning himself. To exercise this right, an individual shall notes in writing the responsible authority describing the nature of the
disagreement. The responsible authority shall within 30 days either: (a)correct the datafound to be inaccurate or incomplete and attempt to notes
past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)note 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 PRIVACYADVISORY
In accordance with M.S.13.04,Subd.2,'Rights ofsubjects ofdata"we would like to informyou thatyour requestfor apermit 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:
L 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. Ifyour requested permit or license requires Council action to approve,some information may become public.
5. You have certain rights under M.S.13.04(see following page)to review private data on yourself.
6. Your full name is required to process this application or permit.
PLEASE PRINT
I-o NA• e l�
First Middle Last
7.�) !:)
Address c
�S 3 I
City ,i Zip
CiPhone ry t!
I un stand my ri4a;4tated abo /J Y /✓ ✓
S' ature
/0
CHECK OFF LIST FOR ISSUANCE OF PER1IMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 3'1 ti w
PID:
DESCRIPTION OF WORK: PVA oy e H oME
ZONING REVIEW BY: DATE APPROVED: G•z Y-o3
BUILDING REVIEW BY: DATE APPROVED: 6•z-Y-o3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ,/ No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATERCONNECTION
INVESTIGATION FEE Yes No ✓ PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
-----------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: /ZIZ- A
Fire Department: Post Office: School District:
Lot Area: Sq.ft. 2 10, 1 "39 Acres `Y-tl Width Depth
Survey Submitted: Yes_V No Date of Survey: 5_3 " °3
Proposed Setbacks:
Front (Lake): 140.cl Right Side: s 1
Rear (Street): -;>00 , + Left Side:
Adjacent Structures: Al 1.4 Wetland: -11,4
Building Height: Def. Hgt. 0 .lam Peak Hgt.
Lot Coverage: N I y[►
Grading: Staff Approval Date: G ?JO - By:6-/ - Council Approval Date:
Septic: Staff Approval Date: rx c 5n w By:
Zoning File: #_A3 L906 Resolution: # Resolution Date: f2 23- 03
Shoreland District: /V b
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house)
7
BUILDING REVIEW CHECK LIST
UBC: 2 3 CONSTRUCTION TYPE: —V/V
Sq Footage $Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x
TOTAL
Estimated Construction Value: $ ZZ S� p a c)
Inspections Required: Work Requiring Separate Permits:
Site �_Plumbing Fire
Hardcover Removal _pe, Mechanical Water Connection
_jx, Footing Septic Sewer Connection
is Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
oC Final Grading/Filling ac Electrical(State Permit)
Other
REMARKS(IN HOUSE):
-------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT):
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CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED //-/3-03
PERMIT NO. ?6/o419Z COMPLETED
ADDRESS �'� �� d
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OWNERI I,' CONTR. _7 -P-L /3ofrli'�
TELEPHONE NO.
DESCRIPTION
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 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
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:—YES—NO
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN El CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance. (952) 249-4600
OwnedContracite:
Inspector.
White CopylInspector's FL Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. l r-),_- 19Z COMPLETED
ADDRESS
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
4 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h 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
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contra
Inspector.
White CopylInspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED
PERMIT NO. LOX0`19 2-- COMPLETED �l- 'G�t ` 0
ADDRESS ZK1 3-1 C.AJ i4W ^J 12.E
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
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Q 02 FRAMING 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 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
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARFIANGE A ESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contra wac
Inspector.
White Copyllnspectoes File Canary Copy/Site Notice
DAT TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED ��-b-a
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ADDRESS 37q�
OWNER N& 6 C-44-CONTR.
TELEPHONE NO.952 4173-I q53
DESCRIPTION
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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
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call fothee inspection24 hours in advance. (952) 249-4600
Owner/Contt
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
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