HomeMy WebLinkAbout2005-P08379 (add./remod./repair) CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Pog3�9
Crystal Bay, Minr�esota 55323 P2rf111t Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: zi�i2oos
SITE ADDRESS: 3265 Carman Rd
Excelsior,MN55331
PID: 2o-i i�-23-ia-ooi i
DESCRIPTION:
Proposed Use: Residential
Buildin Census Code 434
Permit Class: S
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#: 3065
Separate pernuts required:
NOTICES/REMARKS:
n_______ r�__t_ ri__t"' �i�ir_.__.__`_ n_`._ o n_`_t_..__ �i�_it
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FEE SUMMARY: PermitFee: $ 643.75 Valuation: $ 50,000.00
Plan Review Fee: $ 418.53
State Surcharge Fee: $ 25.50
TOTAL FEE: $ 1,087.78
APPLICANT: Owner/Self OWNER: Mark&Bonnie Hector
� 3265 Carman Rd
Excelsior,MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
;� � ___ , �__ r� �,%�C� c:_ il %� �
APPLICANT PERMITEE SIGNATU ISS _D BY SIG'�fATURG //`'l' ✓
Cooies: 1-File(Si�nitures Repuired), 1-Apvlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 2 �
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. �1 � ��'� �,�� ��
Total Fee: $ �r�``�;� �` �Date Received: ��`� �
—�' ' �C-�
Entered By: 1 ^� � ,��-, � � �,�ermit#: 1 �Z�j � �
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CITY OF OROfNO - BUILDING IPERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all i�ifori�:atio�z)
--------------------------------------------------------- ----------------------------------------------------------
THE APPLICANT IS: (circle o�ie) OWNE OR CONTRACTOR
JOB SITE ADDRESS: �;���� �)��2�77 ;%��'Q ZIP: ���
Will this be a Par�ade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes [� No If yes, a speciczl everrt pe��mit is requii�ed with Police Department and City
Courtcil approval 60 dc�ys prior to tlie event. Non perrnitted eveizts wi�ll not
be allowed.
::%���.�-C�'�i
NAME OF OWNER: �.1�/� %��,�C�� � PIIONE: (home) ,7a- � 5- 3r�'Ic�
(work)
MAILING ADDRESS: ���� � o��ITY: ('�/LCiY7,�� ZIP:�S,j.�
CONTRACTOR: C�� ����'v.t�l� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Accessory Structure
Addition Move
Remodel/Alteration � Land Alteration
PROPOSED WORK(describe i�z detai�: - "
(',lJC
��,C ' - �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �C� C?UU
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: i���� �-�L��� 1 �—
�_ � DATE: ,/ C �
3ec.13.04 RIGHTS OF SUBJECTS 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 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 Icgally required to supply the requested data;(c)any knorvn consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity oCother persons or entities authorized by state or federal law to receive the data. This requirement shall
not appty 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 tnav place the notice required under this subdivision in the individual income taz or oronerfY tax re(und
instructions instcad of on those fonns.
Subd.3. Access to data by�ndividuaL Upon request to a responsible authority,an individual shall be informed whethen c�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 sho�vn the data without any charge to him and,if he desires,shall be i�formed of the content and
�neaning of that data. After an individual has becn shown thc private data and informed of its mcaning,the data need not be disclosed to I�im for six
months thercafter 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 requcst by the individual subject of the data. The responsible autliority may
requirc the requesting person to pay the actual costs of malcing,certifying,and compiling the copies.
The responsiblc authority shall comply immediatcly,if possible,with any requcst made pursuant to this subdivision,or within eve days of the
date of thc request,excluding Saturdays,Sundays and legal holidays,if immediate compliancc is not possible.If he cannot comply with thc request within
that time,hc shall so inform the individual,and may 6avc an additional Gvc days within which to comply with the request,cxcluding Saturdays,Su��days
and Icgal holidays.
Subd.4. Proccdure when data is not accurate or co�nplete. An individual may contest H�e accuracy or completeness of public or private data
concerning himself. To exercise this right,an individual shall notify in writing the responsible authm•ity describing the nature of the disagreement. The
responsible authority sha►1 within 30 days eithe�: (a)correct the data found to be inaccurate or incompletc and attempt to notiCy past rccipients of
inaccurate or incomplete data,including recipie��ts named by the individual;or(b)noti(y the individual that he bclicves the data lo be correcL 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 procedw�e act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance�vith 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 deternune your qualification for tl�e pernut 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 pernut 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.
✓��. � �r�.�,� ��� ��� ,�.
First Middle �� Last
� �:�� �5 l���-/'YI/��2�
:�Cddress
C� �v�U �2�f2/ 5��3.�/ �����-��9s
City State Zip Phone �
I understand my rights as stated above.
� -
Signature
�
� CHECK OFF LIST FOR ISSUAIV�CE OF PER�tiIITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 3Z.(�S C�R�A�l ���✓�
PID: '
DESCR.IPTIONOFY�ORK: - nri� c�►AI( T-� `I-` f�P`Au �.c'`' �- 'p-eWC
-- - ------------------------------------- ------- ---------
7_OtVItVGRET�IEGVBY: .D.ATEAPPROVED: 2• 3 , b5�
BUILDIIYGREVIEYVBY: .DATEAPPR06'ED: 2• 3• bs
---------------------------
FEES TO BE CHARGED: .tL'Iisc. Fees Calcc�frcted By:
PERNIIT Yes � !tio
PLA�V RE I/IE GV Yes ✓ No SEYVER CONNECTION
STf1TE SURCH.4RGE Yes �/ t�Io tiVATER GOtWECTIOIV
I�VVESTIGATION FEE Yes No PARK FEE
S.�!C Y"es No SITE NSPECTIOtV
Nuntbey of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------ -
2'O�VI[YG CHE Ch�L.�ST Zor�i�t;District: C�2-�3
Fire Deparhrierrt: Post Office: Scl�ool Disti•ict: __.
Lor.�(�-ea: Sq.fr. ►'S,b'7`� Acr•es . 3� 6�idtli �i5� Deptli
Scc�vey Su6rnitted: Yes�_ No Date of Scuvey:
Proposed Setbad:s:
Fror�c(Lal.e): Right Side:
Rear(Sb•eei): Left Side:
Adjacent Str•uct�u•es: Wetlancf: /VO GN�4N�-Q
Building Height: Def. Hgt. Peak Kgt.
Got Coverage: �22• �
G�•adirig: Staff,4pprovcll Date: �- 3 - O S By: � Coc�nci!Appr�oval Date: —
Septic: Stnff,�lpproval Date: N �/4 BY�
Zortirtg Fife: # oY-3U�S Resolutia2: # Resoli�tio�i Dnte: I-I o-o�
Slioreland Dish•ict: �a��_
Avg. Setback: N�A Bluff Setbacic: /v / Lat Coverage:
Elisting Proposed
Hm•dcover: 0-7�' s.83 S��3
75-Z 5 0' s K.��
250-Sb0' '
500-1000'
Hardcover Variatice Reqc�ired: Yes,1� No Date of Co�utci!�Ipproval: i- �o -a�
RE1I�IARKS(irt house):
31
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`••�75' SETBACK L1NE
REMOVE 0
Approved Hardcover: W
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0-75'Total-412 s.f.or 5.83% � POOL i o�
Concrete pad 8 s.f. � � �p +
Patio/Deck 5 s.f. ti o � � I
Pool Deck 210 s.f. S,�o e�'� � � I
,..�enrw[xK� �
Steps 24 s.f. A�,
Walis 165 s.f. �� 2�,, � � � I
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75'-250'=4,708 s.f.or 54.68% �bV_,�� � I
House 1,990 s.f. 1����` ��
� Driveway 1,212 s.f.
Sidewalk 90 s.f. �� \ o I
Open porches 114 s.f. p'Q o �
PatiolDeck 176 s.f. � .\ � gzg.4 coi
Pool Deck&Pool 956 s.f. I
Walls 170 s.f.
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�EGAL DESCRIPTION OF PREMISES :
Lot 5, 81od< 1, CARMAN COVE '
� ( � DATE TIME �
CITY OF ORONO CALLED IN `'i-�G "��
INSPECTION NO IC,� , G� SCHEDULED �-�?.'-+�- /��/S.�►M
PERMIT NO. � COMPLETED
ADDRESS��o.� C��(/"/Y(Ct s'� /=-�.-� _
. , c:.�"n
OWNER /-�.r'C�f7>/� CONTR. L��_�r—�—" ' �
,
TELEPHONENO. l�'�� �/���L� ��/(1-> 7�7 �/% �
� DESCRIPTION ��'�--i/i/lI9 G'��c�.�`—
l� 01 FOOTING 11 MECHANICAL I 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK&PROCEED !� ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CAIL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContr n� ite:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
�' DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. ��� COMPLETED
ADDRESS S
OWNER CONTR.
TELEPHONE NO.
� 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
��LLBD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
QS AL Q� 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 FINA� 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next in ection 24 hours in advance. (J52� 249-46��
OwnerlContractor
Inspector. _
White Copyllnspector's File Canary CopylSite Notice
� l � DATE �. TIME
" CITY OF ORONO CALLED IN ����
INSPECTION NOJ.���3�� SCHEDULED �'2 ~—�� �
PERMIT NO. �-J COMPLETED S J /,�/S
ADDRESS �� ' /
OWNER/�"�C�''� CONTR. �G��-�
TELEPHONE NO. G��llfd�G ll'/�I ��� 7���
� DESCRIPTION .1- G�`�l
� 01 FOOTING 11 MECHANICAL 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 Q�ITE 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 Rt 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46�0
OwnedContractor on site:
Inspector. ./� _ /��� �
White Copyllnspector's File Canary CopylSite Notice