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Home My WebLink About2003-P06195 - add/remodel/repair PERMIT CITY OF ORONO Permit Numb r: 2750 Keiiey Parkway - PO Box 66 P06195 Cry`�tal Bay, Minnesota 55323 P21"fTllt Typ2: Addition/RemodeURepair (952) 249-4600 Date Issued: ai2s�2oo3 SITE ADDRESS: 4105 Bayside Rd Maple Plain,MN 55359 P I D: 06-117-23-14-0023 DESCRIPTION: U C Occupancy R1 Proposed Use: Residential onstruction Type VN ensus Code 434 Permit Class: Building Permit Type: Addition/Remodel/Repair ermit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: riumoing iviecnanicai Eiecmcai�siaiej NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 1,721.75 Valuation: $ 230,000.00 Plan Review Fee: $ 1,119.23 State Surcharge Fee: $ 115.50 TOTAL FEE: $ 2,956.48 APPLICANT: Anderson Woodcraft Inc. OWN R: Nick&Sue Burke 1438 85th St NW 4105 Bayside Rd Buffalo,MN 55313 Maple Plain MN 55359 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE AL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL ITY OF ORONO ORDINANCES AND STATE OF M ILDING CODE REQUIREMENTS. � � ��- ��22�-� /�� L A ITE GNA RE ISSUED BY S[GNATURE Copies: 1-File(Sienitures Required), 1-Apnlicant, 1-Monthlv Reports, 1-Assess e, 1-Finance Page 1 �� ' j �� Total Fee: $ �� G` �� I � �`� � �i Date Received: � --' Er�tered By: '"��> >� ��'`� Pernut#: �j -/(,, �'_5 � � , s CITY OF ORONO - BUILDING PE T APPLICATION All information must be submitted in full befo e plan review will be started. (please print all inform tion) � -------------------------------------------------------------------- -- --------------------------- THE APPLICANT IS: (circle one) OWNER O CTOR � � JOB SITE ADDRESS: � S1✓� ZIP: �� ?J� I NAME OF OWNER: (�L�-�V1� PHONE: (home) . � ork) MAII..ING ADDRESS: ��-rn� ITY: LI�}� ZIP: fi�� CO\"T'RA.CTOR: � 1 PHONE:_�Dl t �� Z�� COr�TACT PERS N: M BILE/P GER: ��C NL4II.ING ADDRESS: � . 1'v.� CITY: Z�:� � ST�iTE LICENSE: # ZDZZG��qP� ' ARCHIT'ECT/ENGINEER: PH0�1E: MAII.ING ADDRESS: CITY: Z�: N�`�; REGISTRATION# TYPE OF `VORK: New Addition Accessory Structure Move Remodel/Altera ion Land Alteration T PROPOSED WORK(describe in detai�: '�}�j 1 � �a� �� 1►� � STORIES: SQ. FEET OF EACH OOR: NO. OF BEDROOviS: � GARAGE ST LS: ATT. DET. �� EST�IATED CONSTRUCTION VALUATION (e cluding land): $�.�..�,o� I hereby apply for a buildinJ permit and I acknowledg that the information above is complete and accurate; that the work will be in conformance with e ordinances and codes of the City and with the State Building Code; that I understa is is not a permit and work is not to start without a perm.it; and that the work wiII be in ordan e wit the approved plan. APPLICANT'S SIGNAT DATE: l�' NOTE! Parade of Homes events require separate ermit approval by Police Department and City Council 60 days prior to the event. Non pe itted events will not be allowed. 5 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 secdon. • Subd.2. Informadon required to be given individual. An individua!asked to supply privace or co�den[ial dara concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecring state agency,polidcal subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested data; (c)any lmown consequence arising from his supplying or reCusing to supply privar�or coof"idenoal data;and(d)the idendty of o[her persons or entiaes authorized by smte or federat law to receive the data. This requirement shal( not apply when an individual is asked to supply invesrigative data, pursuant to secuon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav lace the norice re uired under this subdivision in the individual income taz or ro ertv tax refund instrucrions instead of on those forms. Subd. 3. Access to data by indiridual. Upon request to a responsible authoriry,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 individua]who is the subject of stored private or public data on individuals shall be shown the data without any char�e to him and, if he desires,shall be informed of the content and meanin�of tha[data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed co him for six months thereafter unless a dispute or action pursuant to this secdon is pending or addirional data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesrin�person to pay the actual coscs of making,certifying, and compiling the copies. The responsible authoriry shall comply'vnmediately,if possib(e,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 addidonal 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 dara conceming himself. To exercise this right,an individua]shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplece and attempt to nodfy past recipiencs of inaccurate or incomplete dara,including recipienu named by the individual;or(b)nocify thz individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's sratement of disagreement is included with the disclosed data. The determinadon of the responsible authority may be appealed pursuant to the provisions of the adminis�aave procedure act relating r 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 Middle Last Address Ciry Stace Zip Phone I under my rights a stat d ve. Signature 6 . � CHECK OFF LIST FOR ISSUANC OF PERMITS FOR OFFICE USE ON Y AI�DRESS OR LEGAL: �l I o S (3Ay si�J� /20 ' PID: DESCRIPTION OF WORK: /�,p ,�,�► . � ----- -------------- -----------------------� y--y-- ZO.vI�1i G REV�W BY• DATE APPROVED• 2 cr3 BUILD�TG REV�`V BY: DATE APPROVID; �l-2y-a 3 FEES TO BE CHARGED: Misc. Fees C lculated By: PERNSIT Yes ✓ No , PLAi�1 REVIEW Yes ✓ No SEWF.R CONNECITON STATE SURCHARGE Yes �/ No WATERCONNECITON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPEC"TION Number of SAC�Units OTHER (specify) -- -------------------__--- _------------------+--------------------------------------- --- ZONING CH�CK LIST zoning Districc: i Fire Department: Post Office: School District: � Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes�_ No Date f Survey: o�.► (-'►u`'- Proposed Setbacks'. � � ' � � Front (Lake): 1�i�� Right Side: � �S __ . Rear(Street): 3� � Left Side: I�7 Adjacent Structures: Arn4c.t�,�-� �Vetland: N(�R' Building Height: Def. Hgt. p.l� Peal:Hgt. _i � Lot Coverage: N (/'� I Gradina: Staff Approval Date: U•(,C By: � Council Approval Date: Septic: Staff Approval Date: �j( �� BY: Zoning File: # — Resolution: # Res ution Date: Shoreland District: No 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: RE1�IARKS (in house): 7 BUII,DING REVIEW CHECK LIST ' UBC: �� 3 CONSTRUCTION TYPE: �//� _ Sq Footage $Per Sq Ftg Basement x _ lst Floor x _ 2nd Floor x _ Garage x _ . z = TOTAL Estimated Construction Value: $ Z�Q,�j�- Inspections Required: `Vork Requiring Separate Permits: Site �_Plumbing Fire Hazdcover Removal �C Mechanical Water Connection �C Footing ` Septic Sewer Connection —�Framing Fireplace Lawn Irrigation ____�_Insulation (Masonry) Other �_Wall Board (Mfg.) Well (State Permit) —�F�� Grading/Filling k- Electrical (State Permit) Other REI�IARKS(1N HOUSE): '--------- - ------------------------------------------------- REV�W BY OT�[ERS: DATE: ------ Access: E�cisting New Access Approval: Date gY: �w------------ ------------------------------------------------------- REMAR��S (TO BE NOTED ON PERivIIT�: 8 �� DA E TI E V CITY OF ORONO CALLED IN �'�' INSPECTION OTICE, SCHEDULED � '� � � PERMIT N0. COMPLETED ADDRESS `�� OWNER CONTR. /1.��1-�J� � TELEPHONE NO. �'�Z 3��7�— ��ESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/ ILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WET NDS 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 � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER RE OVAL J 10 PLUMBING FINAL 36 FOUNDATION/RE VAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � a o� o�t,�' � J O � � O � W � Q � 2 W � W � � d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OC PANCY W � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �QSZ� 249- 60� OwnerlContract �ite: Inspector. White Copy/lnspector's ile Canary Copy/Site Notice � i V DATE TIM CITY OF ORONO CALLED IN b . � INSPECTION NOTI SCHEDULED �T � � � : f� PERMIT N0. l COMPLETED " ADDRESS C� �'� �� i S i OWNER CONTR. 'l EYS TELEPHONENO. " �� ?� C�� 'cr�tF� � DESCRIPTION �l� S G.�f� f/ �'� � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/F LING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WET NDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REM VAL v 10 PLUMBING FINAL 36 FOUNDATION/REM VAL � OWNERICONTRACTORTOMEETYOU: YES_NO � COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � d ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCC PANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952� 249- 60� OwnedContracto Inspector. White Copyllnspector's File Canary CopylSNe Notice - - � DATE TI E CITY OF ORONO CALLED IN "?�� INSPECTION NO ICE SCHEDULED � •� d PERMIT NO. � COMPLETED ADDRESS � � U� lf" �S,�c OWNER CONTR. � ��`��' TELEPHONENO. ��` ��c� �� DESCRIPTION � � ��'��-- W G 11 MECHANICAL RI 18 EXCAV/GRADING/FI LING 02 fRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WET NDS Q 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 REM VAL J 10 PLUMBING FINAL 36 FOUNDATIOWREM VAL � OWNERICONTRACTOFi TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q � 2 W � W � � d W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUP NCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECOND�TIONWITHIN HOURS. � pHOTOTAKEN ! INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe ne t inspection 24 hours in advance. (952� 249-46 0 Owner/Contrac ite: Inspector. White Copyllnspector's File Canary Copy/Site Notice