HomeMy WebLinkAbout2008 - P11925 - addn/remodel/repair f '�1
PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P11925
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
3/26/2008
SITE ADDRESS: 997 Wildhurst Tr Unit#
Mound,MN 55364
PID: 07-117-23-21-0004
DESCRIPTION: UBC Occupancy R3
Construction Type V
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/RepairPermit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Electrical(state)
NOTICES/REMARKS:
Remodek bathrooms,some windows
FEE SUMMARY: Permit Fee: $ 339.25 Valuation: $ 20,000.00
State Surcharge Fee: $ 10.00
TOTAL FEE: S 349.25
APPLICANT: Owner/Self OWNER: C&M Boehm
MN 6375 St. Croix Main-#151
Stillwater,MN 55082
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.
'/ 04/Lit.
APPLI ANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, I-Monthly Reports, I-Assessing,(If Septic, 1-Septic) Page 1
ti
0�
Total Fee: $ 31-19. ZS 3-�, Date Received: 3 —/1-
Entered By: Permit#: 119' 25
CITY OF ORONO - 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) OWNE' I R CONTRACTOR
JOB SITE ADDRESS: 77 7 V ) w S r 71 \ ZIP: 5-536)
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ No ,lfyes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will he required unless applicant demonstrates
sufficient on-site parking is available. Non-permitted events will not be allowed.
NAME OF OWNER: gr;'0..,1 Tu.r\,eIA)1& PHONE: (home) 1.1-J75 /3!S
(work) 9 ?77.)6)-03
MAILING ADDRESS: 7/a1 wrA.Vrn 14vc . CITY: ZIP: 5519-3
CONTRACTOR: S PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: Pb YQ — PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration(ie: Siding, Windows) )C
Any earth movement may require MCWD review and permits!
PROPOSED WORK(describe in detail): Re o Z2 f a 'rc 5 r-Sf
lr ;n e r..✓S R e e_fi. T' / n e•,� Filtr,s �►� � r-7'ti 1 epi
Fie orv:e 'rlth-1>o
STORIES: 4.1 SQ.FEET OF EACH FLOOR: S5.s
NO. OF BEDROOMS: 3 GARAGE STALLS: ATTACHED 1 DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): S _471-C.)
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: ..�~//I , �� .� DATE: 3J/,/ f
31
l d 9891 'ON JNIlNI21d1/NOSIHD 'M Wd9l Zl 8002 '6L '�bW
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 ofthc 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 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 t'_esn red under this subdivision in thejnegvidual income tax or propertym refund
instructions instead of on thou forms.
Subd.3.Access to data by individual. Upon request to a responsible authority,en 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 respousibie authority
may require the requesting person to pay the actual costa 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.Ifhe 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 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.
row Lee_
Fir-st Middle Last
997 w: I21—ivrss 7--ra. : i
Address
4^rb`in yy1 t1J 5-53 6/a�7j)3ls—
Cit-y State Zip Phone
I understand my rights as stated ab' .
at- % , ;or
Signature
.yl�p en
; 7 ' `'�{ "J ,,0 "•til�"`4." 32
Z d 9891 'ON JNIINIU1/NOS1 VD 'M Wd9Z Zl 8001
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 71-7 J i c 1'(v r S T -Fr la,-
PID:
DESCRIPTION OF WORK: i Z..L. aZ- 6A-Tv �.)1D „s /so "a.o o t,a 3
ZONING REVIEW BY:: N l oft- DATE APPROVED:
BUILDING REVIEW BY: D _ DATE APPROVED: 3 2—�,g
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓' No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes .' No WATER CONNECTION
INVESTIGATION FEE Yes No —' PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (spec)
ZONING CHECK LIST Zoning District: N
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Well,nd:
Building Height: Def Hgt. Peak •gt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: NA- By:I A Ic--
Zoning File: # Resolution: # Resolution Date:
Shoreland District: MCWD Permit:
Avg. Setback: Bluff Set.•ck: 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):
33
J .
BUILDING REVIEW CHECK LIST
UBC: 2`3 CONSTRUCTION TYPE: ‘I")
Sq Footage $Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 20,O6c) '
4-1
Inspections Required: Work Requiring Separate Permits:
Site pC Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
>( Framing Fireplace Lawn Irrigation
K Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
x Final Grading/Filling oC Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
34
c--- 46:__'^
74:1
A/
CITY OF ORONO CALLED IN -4' ';/35-`7/0e'
ACE`7//e TIME_
c.INSPECTION NOTIC 9i, SCHEDULED �} _ C}
PERMIT NO. .I COMPLETED • _
ADDRESS 9 -1 L u t [ - i .t„-Cr S.i• I _
OWNER CONTR."]] Ei1\. F� 1 ,
Ic" F QST� _ .:) Ic
TELEPHONE NO. _)
DESCRIPTION �r Irl Lk- ( o-f► CYl ' ICc'frrll
4.1
❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
h ❑ INSULATION 0 WOOD BURNER/FIREPLACE
O ❑ TREE REMOVAL
• ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
• ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
IQ ❑ PLUMBING RI ❑ SE 1C FINAL ❑ HARD COVER REMOVAL
v EIPLUMBING FINAL CI FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
o COMMENTS:
cc
W
a
cc
(,),,„ ck octls
0
>. FII oo'S J e €, i.'-t„
✓y S
O
u..W
.,Q
W
Z
W
CC
O
W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC
$CORRECT WORK&PROCEED CI ISSUE CERTIFICATE OF OCCUPANCY
11/
-`
CZ ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
• BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on Ite-
--Tt-s)
Inspector. t
White Copyllnspector's File Canary Copy/Site Notice
4-7 Se;it DATE TI
CITY OF ORONO CALLED IN 7 9 0
INSPECTION NQPI � SCHEDULED Di /. 3D
PERMIT NO. !J COMPLETED
ADDRESS 7 CJ 7 W/�/L4h /4
OWNER 8r/Qr1 f 4f'h ev�II ONTR.
TELEPHONE NO. '/�l- 8 75'/3/�r
E DESCRIPTION fiea
❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
cnkQ -FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
❑ INSULATION ❑ WOOD BURNER/FIREPLACE
0 TREE REMOVAL
• ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
• ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
".t ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
CC 0
0
`TSS 1,�1 -4�
CC
CC
Q
CC
WCC1(VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑C RECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
• ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
OU BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on ite:
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice