HomeMy WebLinkAbout2003-P06159 - addn/remodel/repair PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po6is9
Crystal Bay, Minnesota 55323 P21'llllt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: ��ii2oo3
SITE ADDRESS: 1410 Cherry Pl
Mound,MN 55364
PID: 08-117-23-33-0081
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Buildin Census Code 434
Pernut Class: g
Perrrut Type: Addition/Remodel/Repair Pernut Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
A �1"�"__' _"_ 1______ T _".�_"__ ____�l_ �l _a_"__
a�uu���v��v����vuvv iu��w���� r�u��a. u vru
FEE SUMMARY: Perniit Fee: $ g3•25 Valuation: $ 2,800.00
Plan Review Fee: $ 54.08
State Surcharge Fee: $ 1.90
TOTAL FEE: $ 139.23
APPLICANT: T.R.Anderson Construction,Inc. OWNER: Mr. &Mrs.Wilbur
4501 Robin Circle 1410 Cherry Pl
Robbinsdale,MN 55422 Mound MN 55364
THE UI�IDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
�..` �- �� ��� � ,�c= -����--
LICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Covies: 1-File(Si2nitures Repuired), 1-Anvlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
�
� � .� � '
Total Fee: $ � � � � Date Received: � (i ;�5`� �
Entered By: �x I '��� / �� Permit#: �' �'
CITY OF ORONO - BUII..DING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information) �
----------------------------------------------------------------------------------------------------------------
.._________
THE APPLICANT IS: (circle one) OWNER OR CONTRACTO�
JOB SITE ADDRESS: � /C�' �� •1� �. �'�� ZIP: Lj.Sj(,�
NAI�fE OF OWNER:
C�e I )(.� � PHONE: (home)�7/�����
/� (work)
MAILING ADDRESS: `�/U P�'� 0 � CITY:l,�i��rc� ZIP:,�"`S3E> `
763
CO\�RACTOR: I , �, ��Q�Sc,�-'� �n St � PHONE:��,_����
COti�TACT PERSON:1� r� ��.^ 1VIOBILE/PAGE�:E��- -��� �����
NLAII.ING ADDRESS: Z�/ t;, ,.r C, � CITY: -��b,:� c � ZIP:��2
ST�,TE LICENSE: # 3`�3�Z
ARCHITECTlENGINEER: PHONE:
MAILI�i 1G ADDRESS: CITY: Z�:
�,T���; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: ��.,��;�� �- 5���S
STORIES: �� SQ. FEET OF EACH F'LOOR:
1\'O. OF BEDROOviS: � GARAGE STALLS: ATT. DET.
-'�
EST�IATED CONSTRUCTION VALUATION (excluding land): $ � �C��
I hereby apply for a building pernut 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 Buildin� Code; that I understand this is not a permit and work is not to start without a
permit; and that the work wi�be in accordance with the approved plan.
APPLTCANT'S SIGNATURE•�.�.�' �..�--�- DATE: `� 7`�-�
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
— �
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 chis secdon.
Subd.2. Information required to be given individual. An individual asked to supply private or confidenaal data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecang state agency,polirical subdivision,or stacewide
rystem;(b)whether he may refuse or is legally required to supply the requested data; (c)any Imown consequence arising from his supplying or
refiuing to supply privace or confidenaal data;and(d)the identiry of other persons or enddes 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 secdon 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue ma lace ihe notice 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 individual. Upon tequest to a responsibie 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 confidendal. 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[he content and meanin�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 six months thereafter unless a dispute or acaon pursuant to this section is pending or addirional data on the individual has been
collected or created. The responsible authoriry shali provide copies of the private or public data upon request by the individual subject of the data.
The responsible authority may require the requesring person to pay the actual cosu 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 five days
of the dace 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 data concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiece and attempt to notify
past recipients of inaccurate or incompiece data,including recipients named by the individual;or(b)notify the individual that he believes the data
to be correct. Data in dispute sha11 be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appeated pursuant to the provisions of the adminisffaave 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 pemut or license.
4. If your requested pemut or license requires Council action to approve, some information may become
public.
5. You have certain rights under N1.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process [his application or permit.
First Middlt Last
Address
C�ry State Zip Phone
I understand my rights as stated above.
Signature
6
� �
CHECK OFF LIST FOR ISSUAI�ICE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �yl� C I-1 E2�ZY �L�C�
PID:
DESCRIPTION OF WORK: � c,lc
ZO�TING REVIEW BY: DATE APPROVED: �/•��/-03
BUILDING REVIEW BY: DATE APPROVED: Y Z Y -0 3
F'EES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes r�' No
pLAN REVIEW Yes �/' No SEWF�t CONNECTION
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify)
----------------------------------------------------------------------------------------------------------------
ZOti�1G CHECK LIST Zoning Districr.
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Wid[h Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (�e�: I i b� � Right Side: 3 2-� y
Rear (S[reet): 1 p�' � Left Side: �� �
Adjacent Structures: — Wetland: —
Building Hei�ht: Def. Hgt. � Peak Hgt.—
Lot Covera�e: —
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: — By�
Zoning File: # — Resolution: # Resolution Date: . .
Shoreland District: 4��
Av�. Setback:n� Bluff Setback: �J //} L.otCoverage: —
Existin� Proposed
a
Hardcover: 0-75'
75-250' Z 3•�
250-500'
500-1000'
Hardcover Variance Required: Yes No K- Date of Council Approval:
RENIARKS (in house):
7
- � j .
BUILDING REVIEW CHECK LIST
UBC: /2' 3 CONSTRUCTION TYPE: �/�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Gazage x =
R -
TOTAL
Estimated Construction Value: $�`0?°o
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 (Mfg.) Well (State Permit)
�Final Grading/Filling Electrical (State Permit)
Other
RENIARKS(IN HOUSE): -----w
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By;
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REMARKS (TO BE NOTED ON PERMII�:
8
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✓
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. t'�OC� �S`� COMPLETED ��- �- �S �--
ADDRESS /�r U CK�-t. /��
OWNER CONTR.
TELEPHONE NO.
1
� DESCRIPTION
� �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
Z04 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
0.
�
J
O
�
�
O
�
W
�
Q
�
2
W
�
W
�
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� �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContract n
Inspector. da(v��
White Copy/lnspector's File Canary Copy/Site Notice
C � ✓
�"- � D T TIME
CITY OF ORONO CALLED IN �`��f'�
INSPECTION NOT CE SCHEDULED ��2� �C �
PERMIT N0. c� COMPLETED
ADDRESS_ /� l C �1�..��'4iL.-�-� /`"� -
OWNER CONTR. 7--.E� ��'/L 9C��'J
TELEPHONE N0. �J?_�� � ��� �S�G-� -�
� DESCRIPTION ���� � C'��--�
ty Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti
O 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
`� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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W� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑C RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE COND�TION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
�CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe n t inspection 24 hours in advance. (952� 249-46��
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White Copyllnspector's ile Canary CopylSite Notice
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The only easements shown are from plats of record or informa;ion provided �y ` � -�
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V4e hereby certify that this is a true�and correct representation of a survey of tre �
boundaries of the above described►and and the location of all buildings and vis- N� ��� "�
ib�q encroachmenis,if any,from or on said land. � 4 �
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� Suveyed by us this qth_day of flrfinhPr � ,%' ,
19 92.
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Signed I-L`� �%�� /
.�aymond A. Prasch, Minn. Reg. No. 6743
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� • REGIST'ERED F. B. NO._ 5���
UNDER LAi�S OF STATE OF MINNESOTA - SCALE I"_?�
� 760I - ?3rd Avenue North � 0— DENOTES !RO
� 560-3093 �
. Minneapolis, A�in��o� 55428 -
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�e hereby certify that this is a true and correct representation of a survey of the �
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above described land and the location of all buildings and vis- � �
�bie encroachmenis, if any�from or on said land. N-` ��j0
Survey�by us this
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—�_day of 19 92 �� �
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� :�aymond A. Prasch, Minn. Reg. No. 6743
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