HomeMy WebLinkAbout2008 - 00087 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2008-00087
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 08/06/2008
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 1099 WILLOW DR S
PIN : 10-117-23-24-0016
LEGAL DESC : UNPLATTED 10 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 5,000.00
NOTE: THIS PROPERTY IS CONSIDERED LAKESHORE TO FRENCH LAKE. ANY ADDITIONAL CONSTRUCTION ON PROPERTY
WILL
REQUIRE TOPOGRAPHY AND HARDCOVER CALCULATIONS.
NEW 10'X 24'CEDAR DECK WITH STEPS.
APPLICANT PERMIT FEE SCHEDULE 118.00
ALBERT KESTNER SR PLAN REVIEW 76.70
6436 BRIGHTON AVE S E
MONTROSE,MN 55363- STATE SURCHARGE(VALUATION) 2.50
(952)224-6648 TOTAL 197.20
OWNER
RODER,ROGER&GLORIA
1099 WILLOW DR S
WAYZATA,MN 55391
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any ti e�for due c. se Q / o'
E't e)(a/ CY
Applicant Permitee Signature Date I f ed BySignature r g LAX
Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Total Fee: $ /�I /' �U Date Received: ' c `o
Entered By: Permit#: r-,?O !! ('Q/ ,•7
74 / A.?\54f
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) OWNER OR CONTRACTOR
JOB SITE ADDRESS: /0 q9 tL).L ixL ZIP: 5-5,533
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
Yes SJ N I If yes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: Cy 611,cGU �769d0t44 PHONE: (home)
(work)
MAILING ADDRESS: tog g( (oi ) SALte,s0. CITY: di(mp ZIP: S—S'3 2,3
CONTRACTOR: a�P a : c.� �L, PHONE: zz,F-6 6 0
CONTACT PERSON: fie... MOBILE/PAGER:
MAILING ADDRESS:6413e,13A iU�ilky�. 5 5, CITY:134Cm J1ij . ZIP:$5: 23
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may requ re MCWD review and permits!
PROPOSED WORK(describe in detail): ` ) e
xaki
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
aD
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 500u
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:
31
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 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 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 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 ,4 thet- A g-)Qo 0 1(e,5-+Al f ,5R i
iddle Last
��� i) �
3r1 Yq (Nue_ s. E
Address
V°k)'QlP,_ 5e__. `A, i A/4, .5-3-3 .__3
City State Zip Phone
I understand my rights as staled abov
' i /4-• -(L ..=... _ ,
Sig ature
°i t{
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 10 91 L(J-/1 c, �-
PID:
DESCRIPTION OF WORK: dcc.K YvAynctuuS�
ZONING REVIEW BY:: DATEAPPROVED: 7/Z 5f7Of
BUILDING REVIEW BY: ,--1-511:„ _ DATE APPROVED: -7 - -c�c
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ,/ No
PLAN REVIEW Yes t/ No SEWER CONNECTION
STATE SURCHARGE Yes ✓ No WATER CONNECTION
INVESTIGATION FEE Yes No s-" PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (spec)
ZONING CHECK LIST Zoning District: - I
Fire Department: Post Office: School District:
Lot Area: Sq ft. • Acres Width Z OS- Depth 3' 7
Survey Submitted: Yes 1,/ No Date of Survey: l q g/3
cap,r ham;/1-kr ha
Proposed Setbacks:
Front(Lake): 47��
-fit Side:
Rear(Street): t%Y1 b/acl(a`6c1Le ft Side: 78 P YOpe-ff tcf
Adjacent Structures: S m A.4.47 /S /4-/�she. -
Wetland: , �i
Building Height: Def Hgt. /?/-3• Peak Hgt
F �-A"
Lot Coverage:
Grading: Staff Approval Date: n a
By: Council Approval Date:
Septic: Staff Approval Date: IU,4 By: W G'
Zoning File: # Resolution: # Resolution Date:
Shoreland District: 1/ MCWD Permit:
Avg. Setback: Bluff Setback. Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500' O /
500-1000'
Hardcover Variance Required: Yes No V Date of Council Approval:
REMARKS(in house):
33
I
BUILDING REVIEW CHECK LIST
UBC: 12 . 3 CONSTRUCTION TYPE: •1"..)
Sq Footage $Per Sq Ftg
Basement x
1st Floor x _
2nd Floor
Garage x =
x =
TOTAL •
Estimated Construction Value: $ S ok5v
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)
pC� 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):
7E6 prof e, is ecrrsired �,q-kaSkre -fo 5-eiieh 141(0 _
Add'bowl n ci d&
red
by cGI on �popeirty Aid) IvQvire � Y
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34
08/05/2008 11:48 IFAX -* EFAX IJ002/002
AUG-05-2008 11:41 REED REALTY 715 779 9523 P.02/02
HUG-01-2008 15;13 From:CB BURET WYZ 9524733932 To;715 779 9523 P.2
1 U"t't k-kr-,.ti -r ra - •
BUILDING PERMIT APPLICANT: PROPERTY OWNER
,understand that the State of Minnesota requires
that all residential building contractors,reinodelers and roofers obtain a state license
- unless they qualify for a specific exemption from the licensing requirements. This license
requirement applies to owners of residential real estate who build or improve such
. property for purposes of speculation or resale.
By signing this document,I attest to the fact that I am improving this house for my own
use and am not building or improving this house for the purpose of reselling it. I hereby
claim to be exempt from the state licensing requirements because I am not in the business
of building or remodeling on speculation or for reside and that the house for which I am
applying for this permit,located at I D 5 q %A., ,. DA_ s ,Orono,is the first
residential structure I have built or improved in the past 24 months. I also acknowledge
that because 1 do not have a state license,I forfeit any mechanic's Hen rights to which I
may otherwise have been entitled under Kinn.Stat. §514.01.
Furthermore,I acknowledge that 1 may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minnesota.I
understand that unlicensed residential contracting,remodeling,andlor roofing activity is a
misdemeanor under Minn.Stat. §326B.082,subd. 16 and can also result in a fine of up to
$10,0(0. I further state that I understand that the filing of a false statement with the City
of Orono may also result in criminal prosecution and/or civil penalties pursuant to
applicable city ordinances and/or state statutes.
I have also been informed and acknowledge that by listing myself as the contractor for
this project,I alone will be responsible to the City of Orono for compliance with all
applicable building codes and city ordinances in connection with the work being
performed on this property. _�
y •e#
Name
Date
•
For questions or information on contractor licensing,or to cheek the licensing status and
enforcement history of a particular contractor,call the Minnesota Department of Labor
and Industry,Construction Codes and Licensing Division,at(651)284-5069. The Web
site is:www.doli.state.mn.us/contractor
TOTAL P.02
TOTAL P.02
0TIMEDAT
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED —7—D 9:30
PERMIT NO.o200.5/—000(5'7 COMPLETED
ADDRESS iDgei (.0111 17(A) Dr 5 •
OWNER '/ Y/O- 1=-0 &" CONTR.
TELEPHONE NO. 7403 acc2 7 37/0 e IIGe__
DESCRIPTION Deck- Roo-Fin
n
LU ❑ FOOTING ❑ MECHANICAL RI CAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL 0 SEWER HOOK-UP ❑ PROGRESS
Z
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
sI
Lu ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
v 01PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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2 WORK SATISFACTORY:PROCEED CIPROJECT COMPLETE
W CIRRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ElCORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. El PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP 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 site: LAJ �, 6��
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
\fel- DAT g, TIME
CITY OF ORONO - CALLED IN "
INSPECTION NOTIC SCHEDULED ,r d /p .31
PERMIT NO. 67/3 O COMPLETED
ADDRESS /r A `L4O 1/2 S-
OWNER CONTR./� /
TELEPHONE NO. /LG� 7493 -?)62 77./
DESCRIPTION lZ'G
uj El FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
h ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
zy[e..2._Ai.6L.L BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
FINAL ❑ SEWER HOOK-UP 0 PROGRESS
.. ❑ DEMO-SITE ❑ SEPTIC MAINT. 0 COMPLAINT
❑ DEMO-FINAL ❑ SEPTIC INSTALL. 0 FOLLOW-UP
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
El PLUMBING FINAL 0 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
CC
CC
O
CC
O
U-
W
CC
W
W
CC
O
WCC ❑WORK SATISFACTORY:PROCEED elK PROJECT COMPLETE
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 111 PHOTO TAKEN
INSPECTOR WILL RETURN
171 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/Contractor on site: 8 .0s..-Inspector.
White Copy/Inspector's File Canary Copy/Site Notice