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Home My WebLink About2007-P10976 - interior remodel PERMIT CIT� �Y ORONO 2750 �elley Parkway - PO Box 66 Permit Number: p10976 Crystal Bay, Minnesota 55323 Permit Type: (952) 249-4600 Addition/RemodeURepair Date Issued: 5/8/2007 SITE ADDRESS: 4225 Forest Lake Dr Unit# Mound,MN 55364 PID: 07-117-23-12-0025 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residenrial Census Code 434 Permit Class: Building Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: Interior Remodel: Move Laundry Room Into Existing Library,Relocate 2 Windows FEE SUMMARY: Permit Fee: $ 818•75 Valuation: $ 75,000.00 Plan Review Fee: State Surcharge Fee: $ 37.50 TOTAL FEE: $ 856.25 APPLICANT: Owner/Self OWNER: Kenneth Anderson MN 4225 Forst Lake Dr 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 BUILDING CODE REQUIREMENTS. _ � , � t�-,�Q ��'I CP-�"1 �/� APPLI T PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � Total Fee: $ Date Received: Entered By: Permit#: 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) ��:][�OR CONTRACTOR JOB SITE ADDRESS: �-�ZZ�� Yt°`jfi L�� I�v � ZIP: »�lo `I Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � �TO !f yes, a specia!event per��rit is reqirir•ed ivith Police Department and City Cotrf�cil approvnl 60 days�rioi•to tl7e eve��t. Shuttle bzrs ser•vice tivi!!be required im/ess applicar�t clemonstrates siG�cient on-site parking is m�ailable. Non-pernritted events��vi!!not be allowed. NAME OF OWNER: C,`;�14�%<��/1 l\V V�� D l/517� PHONE: (home)� L-�7Z`�7� (work)(r 1 Z��l��(-�(G( MAILING ADDRESS: '�� '(�7Y�j� � .�L 1�v CITY: O��;D ZIP: �'�p� CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: 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 require MCwD review and permits ! , , PROPOSED WQRK(describe in detai�: i� ` � C.�/� �. =-3 �.�,�:. f 1 C y ' ,., ,�,.��i°' ' ',- � �, „-�.S�. . `CG', .,:�, .�. r' y ��+� � �. � ��(�� STORIES: � �L SQ.FEET OF EACH FLOOR: Z�OC� NO. OF BEDROOMS: `1 GARAGE STALLS: ATTACHED� DETACHED_ , . ESTIMATED CONSTRUCTION VALUATION(excluding land): � � I�j,(`�C�� I hereby apply for a buildin;permit and I acknowledge that the infonnation above is complete and accurate; that the�i�ork will be in conformance �vith the ordinances and codes of the City and with the State Bui(ding Code; that[ understand this is not a permit and work is not to start without a permit;and that the��-ork�vill be in accordance with the approved plan. w �1 �.�1 DATE: �- APPLICANT'S SIGNATUR�: � � � l �� 3t • _ , Scc.l3.Od RIGHTS OF SUB3ECTS OF DATA Subd. L 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 contidential data concerning himselfshall be ' infonned of: (a)the purpose and intended use ot the requested data within the collecting state agency,political subdivision,or state�vide system;(b) whether he may refuse or is legally required to supply the requested data;(c)aip�known consequence arising from his supplying or refusin�to supply pri��ate or contTdential data:and(d)the identiry of other persons or entities authorized by state or federal Ia�v to receive the data. This requirement shal I not apply when an individual is asked to supply investieative data,pursuant to section 13.82,subdivision 5,to a la��enforcement officer. The commissioner of revenue ma_y_place the notice required under this subdivision in the individual income ta�or orooerri tax refund instnictions instead of on those fonns. 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 ciassitied as public,private or contidential. Upon his further request,an individual�vho 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 infonned of the content and meaning of diat 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 thereaPter 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,certifr'ing,and compiling the copies. The responsible aud�ority shal I comply immediately,if possibie,with any request made pursuant to this subdivision,or within tive days ot' the date ofthe 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 addi[ional tive days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure 4vhen 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 notity in writing the responsible authority describing the nature of the disagreemenL The responsiblc 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)notity the individual that he believes N�e data to be correct. Daca in dispute shall be disclosed only if the individuaPs sta[ement of disagreement is included with the disclosed data. The determination of the responsible authority ma}'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 pennit or license from the City of Orono or any of its departrnents 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 infarmation may be shared with other local, state or federal agencies to the extent necessary to process the perntit or license. 4. If your requested permit or license requires Council action to approve, some information may become pubiic. 5. You have certain rights wlder NI.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. � ��-��d �Z�y� First J[iddlc LHst �ZZ� �� iP�"��e A�a��ss ' �.�v�.o ��n �� 3��f ��2 - �I�Z�� Citv State Zip Phone I understand my rights as stated above. �1 ��_�'�'� � s��;,t�r� _ Reset Form �'- " ��-IEC� p�`F i.�IST FOR ISSUA.I�iCE 4F �'E��'IITS ' FOR OFFICE USE ONLY AbDRESS OR LEGAL: �12Z S �lL�$r-"!�� 'O2 PID: I�ESCI-�T70� OF WORK: �2-��^AV��Z ZOY�YG REV�E�ti BY: ----� I v�__ —. D�.TE APPROVED: �UTLDII�G REVLEtiti BY. �, � , , DA.1�E APPROVED: 5'-7-�? . FEES TO BE C�-LA,RGED:� Misc. Fees Calculated By: _ pE�T Yes ✓^ No PLAN REVIEtiV Yes No �/' SEti�TER COi�l�t-'ECTION STATE SURCHl�RGE Yes � No �VA"I�RCOi�INECTIO�i INVESTICrATION FEE Yes No PARK FBE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) ZO�G-'C�CK. LIST Zon.ing District: �c� �t-4-/}�� . Fire Depart�ecc: Post Office: School District: � L,oc Area: Sq.f�. 1�cres Width .L�ep�h ! Survey Submitted: Yes No Date of Survey: Proposed Setbacks: � ; Fron:(Lake): Riaht Side� ,�._.._ Left Sid �'CE3['�J�icctj: �djaceot Scn:ctures; �Vettand: Buil�li:.�Hei��: DeT, Hgt, Pea1ti Hgc. Lot Covzra�e: Grading: S�afi F�pprov�t Da�e: B;: Cou_ecil Approval Date: ' Sept;c: Staft Appro�ral D:.te: v: Zoc�ng F;le: R Resolutioe: r P.esolution Da'e: Shorel�.^� Dist�:c�: Av�. Secback: Elu�t Se�bac, : I.o:Cover�Ue: _. v Eciscio P;oposed ��d�o�,-e-. 0-%5' - 7�-2��' %�Q-SC'0' �c�-lcc�� r,.,.� i - - �' - ---•- -- �n�.i�ril _',n� ^�'vZ: �_��,.��.',. �f�,_._..._ . ..��. iC'] - �.r�,��.�.��.� ;L: r:,,,y�c;: � EUII�DING REVIEti� CHECK LIST �C� �• � C�NSTRUCTION TYPE: �� , Sq Foatage $ Per Sq Fto Basemen[ • X _ . ls[ Floor z _ 2nd �1oor x = Garage X _ x — TOTAL Estimated Coastructioa Value; � � J, (� o V `�� J.nspections Requirec�: �Vork Requiring Separate Permits: Site _�c plumbing Fire Hardcover Removal _�Mechar,ical Water Coanectioa Footing ' Sepcic Sewer Coaaectioa _� Fram;ng Fireplace Lawn Iniga[ion _�Insuiatioa (Masoary) Other Wall Board (Mfg.} Well (State Permi�) 'C F�� Grading/Fillin� _� Electrical (State Permit) Other REMA.RKS (IN�-IOUSE): - -- -- --------------------------------------------------------------------------------------- REVLE'�V BY OTHERS: DATE: Access: Existing New Access Approval: Date gy: --------------------------------------------------------------------------�-------------- REI�LA.RT�S (,"['O 13F NC�'r'F'r� ntir n�g�, y� : 4 � � <C/ DAT TIME ✓ �� OITY OF ORONO CALLED IN � INSPECTION N TIC SCHEDULED �7 'oD PERMIT N0. � COMPLETED � ADDRESS �S \ �7"C?'Z�/1-� � � OWNER �j2 ONTR. TELEPHONE NO. C�DN�n�7 �/a� (�7 �� Z d � DESCRIPTION /�� 01 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 Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a J "'� � O � � O � W � Q � Z W � W � � d W ❑ Q1�KSATISFACTORY:PROCEED f� PROJECTCOMPLEfE � CORRECT WORK&PROCEED '- ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR !^' CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the ne t inspection 24 hours in advance. (J52� 249-460� OwnerlContra o s e: Inspector. White Copylinspector's File Canary CopylSite Notice �� DATE TIME � CITY O CALLED IN ��6 �a � � INSPECTION NOTICE SCHEDULED �L_ PERMIT NO. �/ a `I "� � COMPLETED "3� ADDRESS �� yZ'�e21`�_�1 �f'�-e- �i"'t./ OWNER �u'�E'_�.o�c� CONTR. � TELEPHONE NO. �d�vricl+- " �/}_ � 7 7 ../� �� DESCRIPTION -p� ;C�r��l�.�-✓ � � O1 F TING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAI. 19 LAKESHORE/WETLANDS y 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 J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � /��rri./�-C-�v� /'G� — uJ�LQ� � a j ,, ! �y 0 /.l��.tti0 ? C��L.� ✓I�L�-� ,Q �-C` � ��Q�1��-A� /��(.�-Q�/J �iG/�[�.��G,LC-LG<- � �c-r.�.� ��-� vN.��.��.- � W � Q � � ✓� � � ' �/�7 z � �" (` -5 � +',g`� � � ,�l.vt — C> � d � ORK SATISFACTORY:PROCEED f:� PROJECT COMPLETE W ❑ C RECT WORK&PROCEED r: ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � i PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR -� CITATION ISSUED D INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on s'� Inspector. G'f�G�� White Copyllnspector's File Canary CopylSite Notice � �) , / ATE � TIME ✓ CITY OF ORONO �D IN �L' r��` � INSPECTION NOTICE SCHEDULED ��/.�:�`�/1`�7 PERMIT NO. Pl C�J��' COMPLETED ADDRESS �/ �v� � f c-`rP�t L L'_ ./� OWNER��n � �C�!4' I ��TR. TELEPHONE NO. ��/'l � Co �c� - b ��l'f I� � DESCRIPTION ' `��t l� FOOTWG �,� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 2 RAMING ��';� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � O 03 NSULATION � 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 4 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 J 10 PLUMBING FINAL '� / 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:�,[YES_NO � COMMENTS: � � W � � J O � � �L�� , 0 � W � Q � Z W � W � � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W � ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance. (952� 24J-46O0 OwnerlCo c on i : Inspector. White Copyllnspector's File Canary CopylSite Notice