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Home My WebLink About2003 - P06864 - attached deck PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P06864 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 10/14/2003 SITE ADDRESS: 4680 West Branch Rd MOUND,MN 55364 PID: 06-117-23-33-0006 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Deck-Attached DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 83.25 Valuation: $ 2,148.00 Plan Review Fee: $ 54.08 State Surcharge Fee: $ 1.60 TOTAL FEE: $ 138.93 APPLICANT: Owner/Self OWNER: ' _• - :• • '` - paw( /e244_, MN 4680 WEST BRANCH RD MOUND MN 55364 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 : _ILDING ODE 'i QUIREMENTS. 7 1(4 APPLICANT PE' t 'SIG`A URE ISSUED BY SIGNATURE Copies: 1-File(Siinitures Required), 1-Applicant. 1-Monthly Reports. 1-Assessing, 1-Finance Page 1 . Total Fee: $ f7,e., tf 3 Date Received: I o-7-6 3 Entered By: Permit #: 6444F. &n,4 forvi,Y'$ CITY OF ORONO - BUILDING PERMIT APPLICATION Y J' All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: rr�� ff(ciircle one) OWNER R"CONTRACTOR JOB SITE ADDRESS: �1 (0le cJ (�GJ\C1 \ (Zd ZIP: S S 3G Li NAME OF OWNER: G,,UKeI PHONE: (home) cfS2 7a 6.g (work) 6 P2-C9 g S G 1-4 MAILING ADDRESS: /4G.gO yV.‘Q rovv- A CITY: ROUtIQ ZIP:5-S36;t� CONTRACTOR: S( C.$ Pt pp l c C OP1 '" PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROP SED WORK(describe in detail): Q -b U t `& -x I S 4- (1evu c1eck Web - STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION(excluding land): $ c1, I 14 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 .• ord. c with the .pproved plan. APPLICANT'S SIGNATURE: --� �; � ��`r DATE: i � - � � � w 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 DATA 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 arisingfrom 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 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,cert,ing,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 ofpublic 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 datafound to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notes 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 ofdata",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(see following page)to review private data on yourself. 6. Your full name is required to process this application or permit. PLEASE PRINT First Middle Last Address City State Zip Phone I and s nd my ri ht • tated above. S' ature 10 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 1-{(ag0 l3e-sT G c ..NNCl-k (2 PID: DESCRIPTION OF WORK: �p�=z ZONING REVIEW BY: 0_ DATE APPROVED: 10 - v Ct 0 - 3 BUILDENG REVIEW BY: 3 ca,—____ DATE APPROVED: ( o - 1 o -c`? FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes (/' No _ PLAN REVIEW Yes -' No SEWER CONNECTION STATE SURCHARGE Yes i/ No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC-Units OTHER (specify) ZONING CHECK LIST Zoning District: Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: t Front(lie): S ° S- "=. Right Side: t 12 Rear(Suaet): I a't '± Left Side: I`f bi--i_ Adjacent Structures: A-7771c/fc=2O Wetland: N /A wilding Height: Def. Hgt. Peak Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: N Pr" Shoreland District: 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: CONSTRUCTION TYPE: (l/\-) Sq Footage $ Per Sq Ftg Basement x 1st Floor x = 2nd Floor x = Garage x = x TOTAL Estimated Construction Value: $ Z, I Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection ^/ Footing Septic Sewer Connection -jt, Framing Fireplace Lawn Irrigation Insulation Wall Board (Masonry) Other (Mfg.) Well (State Permit) Final Grading/Filling Electrical (State Permit) Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ____ REMARKS (TO BE NOTED ON PERMIT):w 8 _ L----x,,57,,k/c... /VE-,f)g, CJ 4) 1------ ---7jc7:1 T t ... _ ;., ..... , -4-' 0 f ' 1— - Li I -TN - ; , . , , 1 , i 1 .1) . If '%•... I . i - . . i C3 . . . 1 , . at 1 . , „......j , ,1 i . :. ( I . / .- Ilk I ; 1 .._,.. JP A .4 k l 4/- 0 0 - . _ V'i- ii.?•'? 7-1 Ell .---; -r, ' . ro - m ,..) (_, ,..), 1 -i - --'- iif •,- - ::_, 1,__ 0 C 6\ -Z, N ,.,-.__ r- 0 i 0 x p 0 c. --... -.,,'', :`7:- -''..:- --, ;. G) A ;NI .... v. 0 kr --1 i•-• el 0 AP • IrN H Pj _.eCr:" — '3 . --'- ; ! v,.1 n! t 0 1.• 1 -- r---1 0 , TO.. rt, . ,. ) 6 ,i r- iC 1; 0 ,- .. r, r• --X 2. , -4 .I -', i'. c:.: ,:;', - 0 C Ir, IP• ID rs sn -.1, t.1 --..? ,..... DI I , .-- -... .,_ DATE., TIME CITY OF ORONO C LLED IN /a-/ INSPECTION NQTICE SCHEDULED /o244-D5 3.'° PERMIT NO. PO 61316# COMPLETED ADDRESS / &O Wed-14'v L�Gce- OWNER 6P,22/ /C A-4--' CONTR. TELEPHONE NO. 6�� lo8S Piico, (74 • DESCRIPTION F1'—' ,d ec- W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING • 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL • 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 Z OWNER/CONTRACTOR TO MEET YOU:_YES NO o COMMENTS: cc Lu Q. 9CcLU€ cc k. z cc LU• .p WWORK SATISFACTORY:PROCEED ElPROJECT COMPLETE W ❑C RECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ORE COVERING 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 ne4 inspection 24 hours in advance. (952) 249-4600 OwnerlC site: Inspectomut r. r White Copy/Inspector's File Canary Copy/Site Notice (epe/rN DI TE TIME CITY OF ORONO CALLED IN !� INSPECTION NQ1Cjg�4 SCHEDULED '- -'E PERMIT NO. /'(� COMPLETED ADDRESS '$O WeS-4- OWNER CONTR. Se- ' TELEPHONE NO. DESCRIPTION 'PD W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING W 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 OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS:cc Ok< 1 ()bud,. Lti Q. CC cc O cc W CC L9 LU WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE W 0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN INSPECTOR WILL RETURN 0 CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR 0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next i spection 24 hours in advance. (952) 249-4600 Owner/Contract n sit : Inspector. \, _/ a(/ White Copylinspector's File Canary Copy/Site Notice