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Home My WebLink About2005-P08831 - addn/remodel/repair � � PERMIT � CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Numbe : po8831 Crystal Bay, Minnesota 55323 Permit Typ2: Addition/Remodel/Repair (952) 249-4600 Date Issue�d: 8/17/2005 SITE ADDRESS: 4465 Bayside Rd Unit# Maple Plain,MN 55359 PID: 06-117-23-21-0006 DESCRIPTION: i BC Occupancy R3 onstruction Type VN Proposed Use: Residential ensus Code 434 Permit Class: Building i Permit T e: Addition/RemodeURepair ermit Sub-type(s): Addn/Remodel/Repair YP DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Electrical(stat�e) NOTICES/REMARKS: Add dining area, entry and covered porch,deck-resubmitted FEE SUMMARY: Pernut Fee: $ 593.25 Valuation: $ 45,000.00 Plan Review Fee: $ 385.61 State Surcharge Fee: $ 22.50 � TOTAL FEE: $ 1,001.36 APPLICANT: Terry Built OWNE : Robert Carlson 340 Leaf Street 4465 Bayside Rd Long Lake,MN 55356 Maple Plain,MN 55359 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE R 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. � I � � � __ _ __ �.____ I - � APPLI .ANT PERMj�$E SIGNATURE ISSUED BY SIGNATUR � I Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessin ,(If Septic, 1-Septic) Page 1 � . � 6_ DS �'��-`� Total Fee: $ bC�. 3� DateReceived: - - � Entered By: Q �:r�rrr, 7/�3 Permit#: �- � CITY OF ORONO - BUILDING I�E T APPLICATION All information must be submitted in full befor plan review will be started. (please print all infornT tion) ------------------------------------------------------------------------ ----------------------------------------------- THE APPLICANT IS: (circle one) O`VNER O CONTRACTOR JOB SITE ADDRESS: �'�s�'`-;� � SiD� �t . ZIP: SS 3� % � � Will this be a Parade of Homes, Remodelers Show�ase ome or other Display Home? ❑ Yes ,�NO If yes,a special event per�mit is require witl Police Department and Cr.ty Council approval 60 davs prior to the e•vent. Slzzrttle bzrs servic will be required unless applicant demo��strates st ff cient orz-srte parkii�g is available. �'Jor�- e��nzitted events wi11 not be allotived. NAME OF OWNER: �r�i- �3 .��.�� I PHO�TE: (hon�e) �S� � L/7.�2- y�> � (work) '� MA.II�ING ADDRESS: L��'-�'(�� S /�i¢�'��0� �C TY: /�� ,,r I]P: SS"3S�/ coNTUACTox: �� - �?��° �� , �� ,> �� Pxo�: �S� y�6 d� �� CONTACT PERSON: T,�vt ` '�'r�'t y M BILE/PAGER: �,/� - gS o-Odz�i � MAILING ADDRESS: 3��- ��r= 5 r� CITY: ;;��.� �'�,:= ZIP: �S3Sc STATE LICENSE: # � t S E I TION D��TE: � - 3/ — U,� ARCHITECT/ENGINEER: - o T/-�'� e T PHONE: �i�._ �� -,�S'3 S MAILING ADDRESS: 3� �� / �v . S CITY: i�j/'�5 ZIP: �SYo g NA'_VIE: GISTRATION: # TYPE OF WORK: New Addition � Accessory Structure Move Home Remo el/Alteration � pROPOSED WORK(descr•ibe in detai�: /�� /� r� �,�� c��i �rr ��'�' �9 rt� � ,� _ f� �. ., ,f -7m , �_ STORIES: � SQ.FEET OF EACH FLO R: d2�i-' �'' ��✓�n �ZSD � �r� l� NO. (aF BEDROOMS: � GARAGE STALLS: TTACHED x�.� D TACHED �� ESTIMATED CONSTRUCTION VALUATION(e�cclu ing land}: $ �� Cv t� A��A-D 4�`" �'��'� � %.�n�z � i �� rr�!"�c.� S, ,D�n� �� Tc� . I hereby apply for a building pernut and I acknowledge that�he' formation above is complete and accurate; that the work wi11 be in conformance with the ordinances a d co es of the City and with the State Building Code;that I understand this is not a permit and work is not ta st without a permit;and that the work will be in accordance with the approved p1a�_ A.PPLICAi�1T'S SIGNATURE: - DATE: � - /.,� ` � ,� � 31� � � � � Sec.13.04 RIGHTS OF SUBSECTS OF DATA Subd. 1. Type of data. The rights of individua!on whom the d1[a is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individua(.An individual asked to supply private or confidential data conceming himselfshall be infortned 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 legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential daca;and(d)the identiry of other persons or entities authorized by state or federal law co receive the data.This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcemen[officer. The commissioner of revenue mav piace the notice required under this subdivision in the individual income tax orgro�ertv tax refund instructions instead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authority,an individuzl shall be informed�vhether he is the subject of stored data on individuals,.and whe[her 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 snown the data without any charge to him and,if he desires,shall be informed of the content and meaning of that daca. After an individual has been shown the pnvate data and informed of its meaning,the data need not be disclosed to him for six months thereafrer 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 reques[by the individual subject of the data. The responsible authority may require the requesting person to pay the accual costr of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within fve days ef the date of the request,e�cluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comp!y with the request within that time,he sha11 so infomt the individual,and may have an additional five days widlin which to comply with the request,excluding SaCsrdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contes[the accuracy orcompleteness ofpublic orprivate da[a conceming himself. To exercise chis right,an individual shall no:ify in wiiting the responsible authority describing the nature of the disagreemen[.The responsible authority shall within 30 days either. (a)con�ect the data found[o be inaccurate or incompleie and attempt to notify past recipients of inaccura[e or incomplete data,including recipients named by the individual;or(6)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statemen[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 rela!ing to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subj ects 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 fumish certain private or confidential information. You are notified that: 1. The information you furnish will be used to deternline your qualification for the pernlit or license requested. 2. You may refuse to supply data,but refusai 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 pernlit or license. 4. If,your aequested permit or license requires Council actior.to approve, some inforniation may becume 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. ��J-e e. � �1 c�� re✓� �C��-�� First Middle Last "'� ( l.C' ) �(�v/ S�!vlX ��C:JCCL,� Address City - '"�� .�=-��! State Zip Phone �' I unders�arnd m}�rights as st d ab,ove�. i %� / � 5igna 32 , � , • . CHECK OFF LIST FOR ISSUANC OF PERMITS FOR OFFICE USE O Y ADDRESS ORLEGAL: �Y65 Ay.SiD� ✓20 PID: DESCRIPTION OF WORK: �r� ,n�N /�a/�-c�f+ � ------- ----------------___-------------------------- ZO.�i TG REVIEW BY: ��„� (Qiv�...r— DATE APPROVED: �B �- i 3 -o�"� BUILDING REVIEW BY: �,Q� (Q�„�— DATE APPROVED: -� -► 3 -aS FEES TO BE CHARGED: Misc. Fees C lculated By: PERMIT Yes �/' No PLAN REVIEW Yes � No SEWER CO�TNECTTON STATE SURCHARGE Yes � No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ---------------------------------------------------------------------- ----------------------------------------------- ZO�tI�G CH�CK LIST Zoning District: Fire Departmeat: Post O�ce: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes_� No Date Survey: `j -'Z'1- oS Proposed Setbacks: Fron[ (L-e�e): 25 I � +' Righc Side: i Z c� Rear (SEreet): I 21 � � Left Side: 6 Z Adjacent Structures: j� etland: �l 1A- � Building Hei�ht: Def. Hgt. C�• �-- Peak Hgt. Lot Covera�e: /�1 I� Grading: Staff Approval Date: — By: Council Approval Date: Septic: Staff Approval Date: — By: Zonin� File: # — Resolution: # Reso tion Date: Shoreland District: �u Av�. Setback: Bluff Setback: L,otCovera�e: Existina Proposed O Hardcover: 0-75' 7�-2�0' 2�0-�Ca' � 50C-1000' Hardcover Variance Required: Yes No Dace of Council Approval: REVL4RKS (in house): . , , BUILDI�i 1G REVIE`V CHECK LIST �C� 2'3 CONSTRUCTION TYPE: Y� • Sq Foo[age $ Per Sq Ftg Basement z = lst Flaor x _ 2nd Floor x = Garage x _ R = TOTAL Estimated Construction Value: $ y,5r c��0 � Inspections Required: `Vork Requiring Separate Permits: Site __�Plumbing Fire Hardcover Removal _�Mechanical Water Connection __� Footing ` Septic Sewer Connection _�Framing Fireplace Lawn Irrigation _�Insulation (Masonry) Other _�Wall Board (Mfo,) Well (State Permit) ---�_F�� Grading/Filling _�.Electrical (State Perinit) Other REMARKS (Pi 1 HOUSE): � � ----------------------------------------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date gy: --------------------------------------------------------------------------------------------------- REI�IARKS (TO BE NOTED ON PERi�II'I�: 8 � � � � �� DATE TI E "CITY OF ORONO CALLED IN U P INSPECTION NOTIC SCHEDULED � ' v PERMIT NO. �� COMPLETED �� ! ADDRESS ` � � OWNER CONTR. � c/% TELEPHONE NO. � �a o�� ' � � DESCRIPTION �� 1 l� O1 FOOTING 11 MECHANICAL RI 18 CAV/GR DING ILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOR /WET NDS � O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REM VAL ' Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPE TION Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS� � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAIN J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-U i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COV�R RE OVAL J 10 PLUMBING FINAL 36 FOUNDATI N/RE OVAL Z OWNERICONTRACTOR TO MEET YOU�YES_NO � COMMENTS: � W � � J O � � O � W � Q � 2 W � W � j d W �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W �CORRECT WORK&PROCEED !- ISSUE CERTIFICATE F OC UPANCY O ❑Ct�RRECT WORK,CALI FOR REINSPECTION TEMPORA Y V BEFORECOVERING PERMANE T ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR WILL RETURN ❑ CITAT�ON ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� �49- 6�� OwnerlContractor q�(1 s' . �' Inspector. � >L---� White Copyllnspector's File Canary Copy/Site Noti�e _ __ ___ __ ___ _ � ��Y�=1 DA E TI E � CI OF ORONO CALLED IN I/ � D S INSPECTION NOT � - � SCHEDULED � �� ;r_ PERMIT NO. � COMPL� � �� ADDRESS � � � � S i qC-� � OWNER CONTR. /��o7,�t � �-- TELEPHONE NO. - � � �� / I1� � DESCRIPTION � � �� I l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/ ILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOR�/WET NDS h O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REM�VAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPE TION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAIN � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-U = 09 PLUMBING RI 23 SEPT C INAL 35 HARD COV�R RE OVAL J 10 PLUMBING FINAL 36 FOUNDATI N/RE OVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W C o • "�� L}�lJ cJ� ,f,,, a � O � W � Q � Z W � W � � d � WORKSATISFACTORY:PROCEED Ci PROJECTCOMPLETEI W ❑ RRECT WORK&PROCEED � ISSUE CERTIFICATE C}F OC UPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORA Y V BEFORECOVERING PERMANE T ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN 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. �952� �49 6QQ OwnerlContractor on site• Inspector. � �r �J White Copyllnspector's File Canary CopylSite Noti�e i�� '� �i� . � �� D TE TI E ITY OF ORONO CALLED IN v" �� INSPECTION NOTICE SCHEDULED �� PERMIT NO. ,��i COMPLETED n-I 7-t7� - `4 i ADDRESS ��" � �� - OWNER CONTR. � � ��'�� TELEPHONE N0. ' � � �- � 8 � DESCRIPTION ��r i�� S l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRApING/ ILLING � 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHOR ET NDS ti Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMO AL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPE TION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAIN � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-U = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER RE OVAL � 10 PLUMBING FINAL 36 FOUNDATIO�1/RE OVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO ' � COMMENTS: � W a o ), l� v'�/ n J C�IKA 'i �� C�c.��' � � �' o = � ,�� ,� Q - j" � I �E't�� '� � Z w � w � � � ��WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE O OCC PANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORA V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION W�THIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ' ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z 9- 6QQ OwnerlContractor on site: Inspector. � �� White Copyllnspector's File Canary CopylSite Notic