HomeMy WebLinkAbout2000-P03112 - addn/remodel/repair ITYO F O RO NO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: P03112
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(61•2) 249-4600 Date Issued: 11/15/20
SITE ADDRESS: 4115 Watertown Rd
MAPLE PLAIN,MN 5 53 59
PID: 31-118-23-41-0014
DESCRIPTION: UBC Occupancy R3
Proposed Use:
Construction Type VN V
Permit Class: Building Census Code 438
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Undefined �L
DETAILS:
Approved per resolution#:
Separate permits required: Eiecgicai(slate)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00
Plan Review Fee: $ 208.78
State Surcharge Fee: $ 10.00
TOTAL FEE: $ 540.03
APPLICANT: PARAGON BUILDING INC OWNER: M J DYER&J DYER
318 ALAN STREET 4115 WATERTOWN RD
HUTCHINSON,MN 55305 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 REQUIREMENTS.
APPLI T PERMI EE GNATURE ISSUED 4SIGNATURE
Copies: City,Applicant,Assessor,Finance Pagel
Total Fee: $ 5 - 83 Date Received: Q l f�
Entered By: Permit#: /10 /
O2 teach i'/d�Y' lc� a7'� /o=yS""
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: � LA&Zrlgy ZIP:
NAME OF OWNER: //111 09 J51'I40X-� PHONE: (home)
'! (wo k)
MAILING ADDRESS: y�� u/ �i�� ''1CITY: ZIP:
Vii
CONTRACTOR: O/� �k t/� PHONE:
CONTACT PERSON: Al /�/t1 , MOBILE/PA R:
MAILING ADDRESS: 319W4401Ver CITY:&kAhA6PIVZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: /(, ��S/ 1 PHONE: 3
MAII.ING ADDRESS:(9 CITY:S( 41 s ZIP:
FAME: :A rA 1<p s`r, REGISTRATION#
TYPE OF WORK: New h Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): Z',4/2 /o)e 7-
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $�204 d
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/xlcor nce ith the approved plan.
APPLICANT'S SIGNATURE: ' DATE:
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.
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 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 of is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
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 supply investigative dam,pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue may place the notice reouired 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 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 public or private
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 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 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.
First Middle Last
Address
City State Zip Phone
I understand my ghts as steed above.
Signam
CHECK OFF LIST FOR ISSUAiINCE OF PERNUTS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: y) (S wpt►�2-ro v.�vJ
PID:
DESCRIPTION OF WORK: C A e- o 2
ZON LNG REVIEW BY: DATE APPROVED: /o .LS-,00
BUILDT.NG REVIEW BY: CZjZ DATEAPPROVED: t0 -7-5`03
OF
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMTI' 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)
ZO\�IG CHECK LIST Zoning District: A R-1✓-1
Fire Department: IMArPUZ Pt/,"W post Office: MA-piZ /04,4(^., School District: 02��a
Lot Area: Sq.ft. ivO C I+?N,-/ Acres Width Depth —
Survey Submitted: Yes No Date of Survey: d^+ to 1-13- 9 3
Proposed Setbacks:
Front(Lake): (D 0, Right Side:
Rear(Street): .51 U f 'L Left Side: 130' _ti_
Adjacent Structures: A-rrA c Wetland: n/ I
Building Height: Def. Hat. — Peak Hat. "
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: � Resolution Date:
Shoreland District:
Ava. 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:
N, L4RKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: /2- 3 CONSTRUCTION TYPE:
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ Z��0vO
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_X Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
_CK- Final Grading/Filling o��Electrical(State Permit)
Other
REINLARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REINLARKS (TO BE NOTED ON PERMIT):
8
V DATE TIME
CITY OF ORONO pQ 3 i (ZCALLED IN
INSPECTION NQJ SCHEDULED
PERMIT NO. COMPLETED -�
ADDRESS �.
OWNER CONTR.
TELEPHONE NO. -7-0 6 70
DESCRIPTION
Lu 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
R 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 AL 14 SEWER HOOK-UP 06 PROGRESS
MO-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
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTORTOMEETYOU:_YES_NO
COMMENTS:
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ORKSATISFACTORY:PROCEED 10ROJECTCOMPLETE
cc ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
OC-) BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contrac n site:
Inspector.
White CopylInspector's File Canary Copy/Site Notice
ON
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