HomeMy WebLinkAbout2004-P07277 � • PERMIT
C I TY O F O RO N O Permit Nu ber:
2750 Kelley Parkway - PO Box 66 po72��
Crystal Bay, Minnesota 55323 P2fClllt Typ : Addition/Remodel/Repair
(952) 249-4600 Date Issue : 3ii ii2ooa
SITE ADDRESS: 4375 Bayside Rd
Maple Plain,MN 55359 I
PID: 06-117-23-12-0008
DESCRIPTION: BC occupancy R3
onstrucrion Type VN
Proposed Use: Residential
Permit Class: Building � ensus Code 434
Permit Type: Addition/RemodeURepair ermit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Yiumoing iviecnanicai niec;uicai�sia e�
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NOTICES/REMARKS: I
FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00
Plan Review Fee: $ 208.78
State Surcharge Fee: $ 10.50
TOTAL FEE: $ 540.53 I
APPLICANT: Scherf Construcrion LLC OW�E : Steven&Patricia White
5308 Glengarry Pkwy. 4375 Bayside Rd
Edina,MN 55436 Maple Plain MN 55359
TNE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE RE L IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CI OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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� APPLICAI�F 1C'iNt�Ti?RE ISSUED BY SIGNATURE
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Copies: 1-File(SiQnitures Requirecl), 1-Applicant, 1-Monthlv Reports. 1-Asses3in�. -Finance Page 1
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Total Fee: $ r � ��C `- � �'> Date Received: '� �-U`"!
Entered By: r<' �_�� Permit #: , . � 7Z �
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CITY OF ORONO - BUILDINIi P RMIT APPLICATION
All information must be submitted in full be ore plan review will be started.
(please prinf aU info matron) f
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THE APPLICANT IS: (circ% one) �OWNER `J ONTRACTOR �'.
JOB SITE ADDRESS: ""1� � �(� ZIP:
NAME OF OWNER: c�T�V�. �1�1 I� � PHONE: home s ��
( )9��l
5�it cs. l —(work) 'tplZ. �',�fi 5�"L/(�+T�oel� ��� .
MAILING ADDRESS: �►�'� � �t,.�1'�... C TY: ZIP: r�
CONTRACTOR: �LRF�.UIV�'. PHONE: �p�Z-�Z'��
CONTACT PERSON: 1f�t. }I�RF MOB LE/PAGER: 'SaM`s�. •
MAILING ADDRESS: 3D C�,�NGARR � C TY: _�plNf�.. ZIP: ����
STATE LICENSE: # -Z�17
ARCHITECT/ENGINEER: �`�fll��� PHONE:
MAILING ADDRESS: . C TY:'ST�L ZIP: U�,.
NAME: ��'1n UST R GISTRATION # �
TYPE OF WORK: New Addition Accessory Structure
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Move Remodel/Alterati Land Alteration
PROPOSED WORK (describe in detai�: ���Y.L.s �IC �Rtl�?qp
l�l�flpR �Pc({{ +qS frlc s�. C�"il "Rao�� IDp E�4eC.CAl1Sfi
s�� � y�E0.��.►�w�ZuSt'hLL. H Fcx�� uhr+ ha vHs� LXRt�j f.X rSTs]
STORIES: '�. SQ. FEET OF EACH FLO R: �Q�'T' .
N0. OF BEDROOMS: 3 GARAGE STALLS: ATT. '� DET.
ESTIMATED CONSTRUCTION VALUATION (excludi g land): $ 2�����
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 o inances and codes of the City and with the
State Building Code; that I understand this is not a perm' and work is not to start without a permit;
and that the work will be in accordance with the approved pl n.
APPLICANT'S SIGNATURE: I • DATE: ��;I� .`�
_ _ L�
NOTE.� Parade of Homes evetrts require separate pe ' approva/by Police Department and City
Counci160 days prior to fhe e vent. Non permitted e ve ts wi//not be allo wed.
Sec.l 3.04 RIGHTS OF SUBJECTS OF DATA
Subd. I. 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 legaliy 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 oi other persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an indi�idual is asked to supply investigative data,pursuant to section I 3.82,subdivision 5,to a law enforcement officer. '
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propertv 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 ind"niduals, and whether it is classified as pubiic, private or contidential. 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. Aker 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 shail comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the
date of the request, ercluding 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 notity in writing the responsible authority describing the nature of the disagreement.
The responsible authority shall within 30 days either. (a) correct the data iound 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 PRNACY ADVISORY
In accordance ���th NI.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.
'� _
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First Middle Last
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Address
1� ,�' . : •
City State Zip Phone
1 understand my rights as stated above.
Sigttature
CHECK OFF LIST FOR ISSU NCE OF PERMITS
FOR OFFICE US ONLY
ADDRESS OR LEGAL: �/ �S /3�4 Y s i�� i /��
PID:
DESCRIPTION OF WORK: �'�iv�si-� r� e`r► —
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ZONING REVIEW BY: � DATE APPROVED: .3-5 -o H .
BUILDING REVIEW BY: DATE APPROVED: 3-�,-a y
FEES TO BE CHARGED: Misc. Fees C Iculated By:
PERMIT Yes f No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes _b� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: o c� Q
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Widt Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Le Side:
Adjacent Structures: etland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
A�•g. Setback: Bluff Setback: L o t C o v e r a g e :
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
BUILDING REVIEW CHECK LIST
UBC: (Z� � CONSTRUCTION TYPE: �(iV
Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 2�,� o o�
Inspections Required: Work Requiring Separate Permits:
Site �Plumbing Fire
Hardcover Removal �_Mechanical Water Connection
Footing Septic Sewer Connection
�C Framing Fireplace Lawn Irrigation
�_[nsulation (Masonry) Other
_�Wall Board (Mfg.) Well (State Permit)
�Final Grading/Filling _�Electrical (State Permit)
Other
REMARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMIT):
DATrc TIME
CITY OF ORONO 7 7 CALLED IN pC I
INSPECTION N SCHEDULED a- 7-05 3:e-D
PERMIT NO. COMPLETED
ADDRESS L3 75'
OWNER / CONTR. Lk7JR.5cit-P4 (-4-11441
TELEPHONE NO. to�o� aoa .5T9 7
DESCRIPTION //1.5 a-fah an
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
U..• 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
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 REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:LYES_NO
o COMMENTS:
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k( 4-0 CAV &V--
CC
CC
CC
CC
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2 WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED Ell ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
El CITATION ISSUED
El STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance. (952) 249-4600
Owner/Contr. • .jam. si e:
Inspector. / QL,IA
White Copy/Inspector's Flick Canary Copy/Site Notice