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Home My WebLink About2000-P02926 - addn/remodel/repair � , PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po2926 Crystal Bay, Minnesota 55323 P@I'llllt Type: Addition/Remodel/Repair (612) 249-4600 Date Issued: 9��i2000 SITE ADDRESS: 4225 Forest Lake Dr MOUND,MN 55364 P ID: 07-117-23-12-0025 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Buildin Census Code 434 Permit Class: g Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Single Family DETAILS: Approved per resolution #: Separate permits required: r.iectricai(siatej NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 512.45 Valuation: $ 37,000.00 Plan Review Fee: $ 333.12 State Surcharge Fee: $ 18.50 r TOTAL FEE: $ 864.07 '�..'-- �� ,\ _ , � �. F� �..-��--�..�z. . ;,- � .— PPLT�ANT: CLASSIC BUILDERS R�NIODELERS OWNER: KENNETH GERALD ANDERSON 2418 BLACK LAKE Rd 4225 FOREST LAKE DR SPRING PARK, MN 55384 MOUND MN 55364 TI-�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. ,.; ,�__ �. � ° � � _�, ----�----- c �� : ` c --r-..r..__ti s—� —� ��T ANT PERMITEE I NATU SSUED BY SIGNATURE Copies: City, Applicant, Assessor, Finance Page 1 ' � CHECK OFF LIST FOR ISSUAl�TCE OF PER1tiIITS - FOR OFFICE USE Oi�1LY ADDRESS OR LEGAL: 4 ZZS F'0��s� c�r� lu� 1D� PID: DESCR�TION OF`i�ORK: ,� C3 �„�- o/zT1u•J a� ' -____-- �S✓.,.0lYTl�n� ZOrT�i'G REY�`V BY: � DATE APPROVED: BUII.DI�i IG REV�tiV BY: ' DATE APPROVID: FEES TO BE CHARGED: Misc. Fees Calculated By: PERNIIT Yes ✓� No :. PLAN REVIEW Yes �/ No SEWER CONNECTION STATE SURCHARGE Yes _� No WATERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No STI'EINSPECTION Number of SAC�Units OTHER (specify) ZONI.YG CH�CK LIST Zoni.ng Districc: � � Fire Department: Post Office: School District: L,ot Area: Sq.ft. Acres �idth Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks`. Front(Lake): Right Side: Rear (Street): Left Side: Adjacent Structures: �Vetl d: . Buildin; Hei;ht: Def. Hgt. Pe H;t. Lot Covera�e: Grading: Scaff Approval Date: y: Council Approval Date: Septic: Staff Approval Date: y: Zoning File: # Resolution: # Resolution Date: Shoreland District: Av;. Setback: Bluff Setb k: I.otCovera?e: Existing Proposed Hardcover: 0-75' 75-250' ?a0-500' 500-1000' Hardcover Variance Required: Yes Date of Council Approval: RE�L�RKS (in house): 7 BUII,DING REVIEW CHECK LIST UBC: �Z - � CONSTRUCT'ION TYPE: �/J Sq Footage $ Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Garage x = R = TOTAL Estimated Construction Value: $ �-�� '�7�pC�c� �� Inspections Required: Work Requiring Separate Permits: Site Plumbing - Fire Hardcover Removal Mechanical Water Connection _Q�C Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) O[her Wall Board (Mfg.) Well (State Permit) _�C Final Grading/Filling pC Electrical (State Permit) Other REMARKS(IN HOUSE): RE'VIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REVIARKS (TO BE NOTED ON PERMI�: 8 . ��-�c�e �-r �l/3 S�/�c� �/�Q��%� /1 �� Total Fee: $ E��-�� Date Received: '��!r� Entered By: r=!_� Permit#: a- CITY OF ORONO - BUILDING PERNIIT 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: �� Z �j rv r �5� ) K �)�, ZIP: `:�`� 3�;� f � �7z -S�� NAME OF OWNER: �1 C�i1 a I�K��Y"�C r, PHONE: (home)��1�l) � _ -, � (work) �_� � �-� �— - MAII.ING ADDRESS: y�� `��`�S� �Y ��i CITY: T��r,�"�` ZIP: � - ��; . i � � � � C�1\11�Li�1�R: � _ � �'�� I L. ��AJ; ��`�,�� C`,j '�"��t �4-_��I��H��:� ��'��-i �� i ��'� CONTACT PERSON: � �., ��c��r�<�, r� MOBILE/PAGER <;,-�-r._ `L MAILING ADDRESS: ��-i 1�Y �i�j c��,k. �_ �V�1 CITY��;�%��;rk� -'r'��.,•- % ZIP: ��=3��!� STATE LICENSE: # 7�.s�> !%:,�� - � -� , � �� ARCHITECT/ENGINEER: � ��,..:::, �. � �_� �'�� '��. P�`ONE:�-' �% � � �i i ��'�l��_��_1 MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition �,.- Accessory Structure Move Remodel/Alteration�� Land Alteration PROPOSED WORK (describe in detai�: �r�;_-< ,- Cc ��c�r�fL ��,c +- + �-�` c�-;��r� _ � ' - � 1 l ��i\=�,�_a �i � "1 i.' �i\� ? �� ' i C_��,J� � E 4 c`-. C�i� '� 1\ EU._� `4c�s v (�%�vt��-c �F ` �4 c:.P � r-��.-.�o�-r,.�ni �-' c�T't..� r4-r�.s� STORIES: Q. FEET OF EACH FLOOR: ��c- ;-�.-��^ .-- �, ,`�r'�� ` NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ �!`��c ��%� I 2- I hereby apply for a building permit and I acknowledge that the information�bb�eis 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 SIGNATUK�:(� -� ,�-z ��,_ , , � DATE: ,1 - !'-I- �� 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 SLIBJECTS OF DaT� Subd. 1. Type of data. The righcs of individual on whom che data is stored or to be scored shall be as set for[h in this secrion. Subd.'_'. Information required to be given indiridual. An individuai asked to supply private or confidential data concerning hicnself shall be informed of: (a)the purpose and intended use of the requested data within the collecting'state agency, policical subdivision,or statewide system; (b)whether he may refuse oY is legally required to supply the requested data:(c)any Imown consequence arising from his supplying or refusing to suppty privace or confidential data;and(d)rhe iden�ity of other perso�s or enrides auchorized by state or federai law to receive the data. This requiremenc shall not apply when an individual is asked to supply invesdeaave dara, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav plac the norice reauired under this subdivision in the individual income_tax or propercv tax refund instructions instead of on those forms. Subd. 3. Access to data by indi�idual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of scored data on individuals, and whether it is classified as public, priva[e or confidendal. Upon his further request, an individual who is the subject of stored private or public data on individuals shall be shown[he data without any charge to hun 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 ics meaning,the data need not be disclosed to him for six months thereafter unless a dispute or acrion pursuanc to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authoriry shali provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesring person to pay the actual costs of making, certifying;and compiling the copies. The responsible authoriry 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 noc possible. If he cannot comp(y with the request within that time,he shall so inforrtt[he 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 individua(may contest the accuracy or completeness of public or pri�•ate data concerning himself. To exercise this rieht,an individual shall nocify in wridng the responsible authority describing[he nature of the disagreement. The responsible authoriry shall within 30 days ei[her. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy 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 corcect. Data in dispu[e shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. The determination of the rosponsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act reladne to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�h[s 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 deparcments may require you to fumish certain private or confidential information. You are notified that: . 1, The information you furnish will be used to determine your qualification for the pemut or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pemut or license. 3, The information may be shazed with other local, state or federal agencies to the extent necessary to process the pernut or license. � 4. If your requested permic or license requires Council action to approve, some information may become public. 5. You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. (. Your full name is required to process this application or permit. �–i��C j� y �.,�� f�C t �,L i 7�– � � -;'�n c'�„�� First yfiddle Last Z-L-I ( �' 1��c�.c.� 1 �—' I� I � Address "\ —r_ _ � � `"`�;, � / 1 �% � �I C��.�C� C �� , �L � '�'�_l � �'"�� 1 .� � � � �iry State Zip Phone I understand my rights as stated above. C _ _� ,.�/ . —. �_�/ F ( yl/�'C� �t.�!' � i ..Sign�–r�---- DATE TIME� CITY OF ORONO CALLED IN INSPECTION O I�E/ SCHEDULED � PERMIT N0. Lb COMPLETED � `''� �-J� ADDRESS ' �� ?-� G�/�'s�� OWNER CONTR. TELEPHONE NO. � DESCRIPTION � Ot 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 O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 45 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 � MENTS: � � a � � � � a ✓ ' e G"c � S j Q � t%c. �/ �'-c. >. %,L,,�, � r O � W � Q � Z W � W � � d � ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED �INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlCon tor on ' Inspector. White Copyll�spector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN �-7v"L�D �=fyQl�-�. INSPECTIO,�N/OTICE /�� SCHEDULED ��Z.z(�,' �i � 00�'�, PERMITNKT�' ��(C/ COMPLETED C� W ADDRESS `��e�� ''�'S > L /c <�/Z OWNER�� --' CONTR. �!�- ��rc�cf;.� TELEPHON E NO. �7��C� �c".�'T� — ��y� � C&1P_TION ��L,7 i�YC-a 01 FOOTIN 11 ti1ECHANICAL RI 18 EXCAV/GRADING/FILLING � 0 G 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 Z Q 05 FINAL 14 SEWER HOOK-UP O6 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 J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � � � C5 _�G �-� �c��.�c � � O � � O � W � Q � Z W � W � � d W ,l WORKSATISFACTORY:PROCEED PROJECTCOMPLETE W CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT I i CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN INSPECTOR WILL RETURN [1 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED C; INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-46�� OwnerlContrac r on si Inspector. White Copyllnspector's File Canary CopylSite Notice .DID �T� T_<� CITY OF ORONO CALLED IN INSPECTION NO�T I E SCHEDULED �C�-� � -� PERMIT NO. "'��' COMPLETED � `` `'�, ADDRESS �� '� �✓� OWN ER CONTR. C��asS l G �i.� TELEPHONE N0. l�I - �� y�"I � DES TION ��G�I�+dC�✓1 1 F ING 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 Z Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 4Qi 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL = 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL J � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: `�' � ; �� -�z� o �� a � J O a � O � W � Q � Z W � W � j d W _ WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑ CORRECT WORK R PROCEED ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT CI 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. 249-4600 OwnerlContractor ite- Inspector. White Copyl�nspector's File Canary CopylSite Notice Y DA � T� CITY OF ORONO CALLED IN j-��C' INSPECTION OTI. E SCHEDULED �� PERMIT NO. COMPLETED r'� `'�`o� ADDRESS �'�--c�'� ��5� L�--I� ��' OWNER CONTR. e-�q�s� G- TELEPHONE NO. �� `��"I � DESCRIPTION��C�'`�ii��"1?� ly� 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 Z Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 D NA�� 15 SEPTIC INSTALL. 22 FOLLOW-UP W 9 PLUMBW RI —� 23 SEPTIC FINAL 35 HARD COVER REMOVAL -___._�-- J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q NERICONTRACTOR TO MEET YOU:_YES_NO Z � MENTS: � �� ,� , s - � �`� C � J � ' • s J i..�. �.�/ � � �; �� 1u � �, Q � S r G�-C.�-r? �4. �- � z W � W � j d L WORK SATISFACTORY:PROCEED r PROJECT COMPLETE W � �ORRECT WORK R PROCEED L ISSUE CERTIFICATE OF OCCUPANCY W � Cl 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 i; INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-460� OwnerlContr �p r on site: Inspector.�l��/,�_�� 7� While Copyllnspector's File Canary CopylSite Notice