HomeMy WebLinkAbout2004-P07760 - addn/remodel/repair , t
� � PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po��6o
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: s�9�2o04
SITE ADDRESS: 1390 Cherry Pl
Mound,MN 55364
P I D: 08-117-23-32-0023
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Pernut Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: �����di(siaiej
NOTICES/REMARKS:
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FEE SUMMARY: Pernut Fee: $ 209.25 Valuation: $ 12,000.00
Plan Review Fee: $ 135.98
State Surcharge Fee: $ 6.50
TOTAL FEE: $ 351.73
APPLICANT: T.R.Anderson Construction, Inc. OWNER: Mr. &Mrs. Blount
4501 Robin Circle 1390 Cherry Pl
Robbinsdale,MN 55422 Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
r�- � � _� :L/��L'`'_'.C t�
' PPLICANT PERMITEE SIGNATURE [SSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
, � '
Total Fee: $ 3��'3 Date Received: 7-Z9-D�
Entered By: �� Permit#: f�0 77l00
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) QWNER OR CONTRACTOR
/ r
JOB SITE ADDRESS: 1��� 1���� �/ ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �No If yes, a special eve��t permit is requi�•ed wit1� Police DepaYtrnent and City
� Council c�pprovczl 60 days prior to the event. Non perrnitted events will not
be allowed.
_---�
NAME OF OWNER �lf ���1// PHONE: (home)
2 y
(w rk)
MAILING ADDRESS: /J � ��y�/� ✓ / CITY: ��pi7� ZIP:
. �1
�63--5'3 7� 5'"�5�f
CONTRACTOR:�� - �t G�I�U� �i75/ = --�" PHONE. - -
CONTACT PERSON: � � S�N MOBILE/PA��R:C�'Z -�.��- �G3U
MAILING ADDRESS: S�/ %r ;/ CITY:,� ,,r ZIP:.$-'S'�``?�z
STATE LICENSE: # 3.�.3 2
ARCHITECT/ENGINEER: ��D�r� �� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Accessory Structure
Addition / Move
Remodel/Alteration � Land Alteration
PROPO ED WORK(de cribe i�z detai�:�Py✓ f/��� S/P S ���/�v�T I�G,/G���- v )
L ��/�i1�<� r�o�7���ss�s� �.� C�.s •i� - c '�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. `�
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /� C�' ~
I hereby apply for a building permit and I aclrnowledge 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 SIGNATU . � �.��� DATE: �7 7'--�
,
' � ,
Sec.13.04 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 himseif shall be
informed of: (a)the purpose and intended use of the requested data rvithin the coliecting 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 data;and(d)the identity of other persons or entities authorized by state or federal law to 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 enforcement officer.
The commissioner of revenue mav alace 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 individuat. 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 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 shown the data without any chargc to him and,if he desires,shall be informed of the content and
meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for sis
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 shall comply immediately,if possible,with any request made pursuant to this subdivision,or within�ve days o(the
date of thc 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 additiona►[ive 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 o(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(ound to be inaccurate or incomplete and attempt to notify pust recipients ot
inaccurate or incomplete data,induding recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in
dispute shall be dlsclosed only If the individual's statement of disagreement is included with the disclosed data.
The determination of thc responsible authority may 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 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
City State Zip P6one
I understand my rights as stated above.
Signature
CHECK OFF LIST FOR ISSUA.��tCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I 3 g o C.�-�c 2(�y �P�.,c.cs
PID:
DESCRIPTIONOFWORK: CN'r (LooF r , ,,�5 ,a��►.O n.rPw �►ss�f oN c-X?. ,(�4�1�.�F
- -____���— - - -------------------------------------------------------------- U
ZO.V�ii G REV��V BY: DATE AF'PROVED: 8 •3 •o�(
BLTII�DI'i�1G REVLE`Y BY: DATE APPROVED: �g •3 .o K
FEES TO BE CHARGED: Misc. Fees Calculated By:
PER.�ti1IT Yes ,/ No
PLAN REVIEW Yes ,/ No SEWF.R CONNECTION
STATE SURCHARGE Yes � No WATERCO�tNECTION
INVESTIGATION FEE Yes I�to PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
------------------------------------o-------
ZOYING C�iE.CK LIST Zonin� Districc: C.2• ��
Fire Departmen[: Post Office: Schoot District:
Lot Area: Sq.fr. �-�-,`�s� Acres . �Z� Widch Depth
Survey Submitted: Yes_ C� No Date of Survey: 3-�S���(
Proposed Setbacks: 6 Do� 6A,�(q Poa.c.(�.
Front (Lake): 1'l 1Z 3 Right Side: � S`1
Rear (Street): 6� I �a Left Side: l(�•5 3 r•3
� N (A
Adjacent Structures: �Vedand:
Building Height: Def. Hgt. �, k Peal:Hgt. -'
Lot Coveraoe: L�.}�
Grading: Staff Approval Date: �' By: Council Approval Da[e:
Septic: Staff Approval Date: — By:
Zoning File: # '-' Z`�b `► Resolution: (# Resolucion Date: (� • 2�$•�`-/
Shoreland District: y-�5
Avg. Setback: �v�� Bluff Setback: ^/�� Loc Coverage: —
ExistinQ Proposed
0
Hardcover: 0-75'
75-250' 3ar•z S �e"i�
250-SQO'
500-1000'
Hardcover Variance Required: Yes D� No Date of Council Approval: 6 � Z�'�y
RE1��RKS (in house):
7
BUII.,DING REV�W CHECK LIST
��� Q�3 CONSTRUCTION 1'YPE: ��iJ
_ Sq Footage $ Per Sq Ftg
B�semen[ z _
lsc F1oor z _
2nd Floor z =
Garage x _ .
z —
TOTAL
Estimated Construction VaIue: $ �� o�o `�
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
�_F�a��o � Septic Sewer Connec[ion
v� Framing Fireplace Lawn Irrigation
� Insulation (Masonry) Other
�Va11 Boazd (Mfg.) Well (State Permi[)
aC Final Grading/Filling p� Electrical (State Permit)
Other
REi�IA_RKS (I�i 1 HOUSE): ,
------------ --------------------------------------------------------
KEV�W BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gy:
��--------------------------------------------------------------------------------------------------------
RENIA.RKS (TO BE NOTED ON PERivIIT�:
8
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CITY OF ORONO -
SUIIGi�J.'�,, P i�l T LAN R�VIEiN - � �—
IN.9PECTUR �' ---
DAi(�, $• 3-0 P':.�d;11 i N�. -
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RBt;• . : �,:I.,.r j�,n��..��.:t ..,i,�. � �t?:d ir�t��ia r6view, �'-��
•li,ECP THIS PLAN SET UN 91tE AT A�L TIM2'S -
UPP�R LEVEL
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�,����,� TIME
CITY OF ORONO CALLED IN
INSPECTION N ICE SCHEDULED y <<� ____�'��.
PERMIT N0. C� COMPLETED
ADDRESS_�/_� �(.� ���''c_--1?i�-.� /"�� ,
�
OWNER CONTR. � �/��i^�j�
TELEPHONEN0. ���`YI �}/r� - lG' ,�Cr� �" ���a �OY�
� DESCRIPTION � �� ��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAD G/FILLIN 7
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLAN�
��
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 HARO COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED C; PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED CI ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP OFDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContra o s te:
Inspector. � --
White Copyllnspector's File Canary CopylSite Notice
DATE TIME v
CITY OF ORONO CAILED IN
INSPECTION NOTICE SCHEDULED � �M
PERMIT N0. p����� COMPLETED
ADDRESS O C-
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/N/ETLANDS
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
� 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
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❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance. (J52� 249-4600
Owner/Contr� 't :
Inspector. �
White Copyllnspector's File Canary Copy/Site Notice
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DATE, TIME
CITY OF ORONO CALLED IN �
INSPECTION N IC� SCHEDULED a% �
PERMIT NO. cornP�ErEo
ADDRESS �.39D ��
OWNER CONTR. ��, .,
TELEPHONE NO. �c��3 :S.3S 7.3c�3
� DESCRIPTION ��
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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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 COMPIAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
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Call for the next inspection 24 hours in advance. �95Z� Z49-4600
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White Copyllnspector's File Canary CopylSite Notice
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TELEPHONE NO.
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� 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
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Call for th next inspection 24 hours in advance. (952� 249-4600
OwnerlCo r n site:
Inspector.
White Copyllnspect r's File Canary CopylSite Notice
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LEGAL DESCRIPTION OF PREMISES : �
That part of Government Lots 4 and 5 > Section 8 , Townshir� 117 North , Range 23 West of the 5th Principal Meridian ,
described as follows : Beginning at the Southwest corner c�f Lot 7 , Biock 11 , Saga Hill Revised ; thence East afong
4o the South line of said Lot 7 to the shore of North Arm, l._ake Minnetonka ; thence southzrly along the shore of Lake
Minneton�a 57 . 0 feet , more or less to the Northeast �ornt�r of Lot 1 , Bfock 4 , "Crystal Bay View" ; thence West along
the North line of said Lot 1 to the Northwest corner of �;aid Lot 1 ; thence northeriy to the place of beginning ;
AND ALSO Lot 7 > Bloc<< 11 , Saga Hill Revised .