HomeMy WebLinkAbout2001-P04577 - new structure r
� � ' PERMIT
CITI�' �F ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po4s��
Crystal Bay, Minnesota 55323 Permit Type: NeW strU�ture
(952) 249-4600 Date Issued: t2i�oi2oo�
SITE ADDRESS: 420 Big Island
Excelsior,MN 55331
P I D: 23-117-23-32-0063
DESCRIPTION: UBC Occupancy R3
Construction Type I
Proposed Use: Other
Permit Class: Building Census Code 101
Permit Type: New Structure Permit Sub-type(s): Cabin
DETAILS:
Approved per resolution#:
Separate permits required: ��ecu�icai�s�atej
NOTICES/REMARKS:
i._�'__ r"_c�"_____i ____ __t'
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FEE SUMMARY: Permit Fee: $ 125.25
Valuation: $ 6,000.00
Plan Review Fee: $ 81.38
State Surcharge Fee: $ 3.00
TOTAL FEE: $ 209.63
APPLICANT: Owner/Self OWNER: Donald Swensurd& Mary O'Connor
MN 420 Big [sland
Excelsior, MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERM EE SIGNATURE ISSUGDBYSIGNATUR�
Cooies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reoorts. 1-Assessine. l-Finance Page 1
.
r Total Fee: $ - C (f �'" > Date Received: ��- �` �%'�
Entered By: �.'r� � � r ;� �,� ' �, 1 - , Permit#: � 1 i� �/��7 J
CITY OF ORONO - BUILDING 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 R CONTRACTOR
JOB SITE ADDRESS: ��- C' � �, � �� `,Lr, •� � ; ZIP:
.
NAME OF OWNER: �� PHONE: �om�e)�O --� �
� o na I o� S'w �n s r c,� work) � �, � ,a 6�,y.._ 3 3s�F-
MAILING ADDRESS: ,��- q L�ti �E ���CITY: ZIP: SS�3 Q
CONTRACTOR: Sy� ti�►'l 2- � S l�° �o�✓ � PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
I ;�i.k'�� �
� TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
(, �,�'�"
\� PROPOSED WORK(describe in detai�: S-e S o �, tv-c?��,'���
� 1
STORIES: � � SQ. FEET OF EACH FLOOR: �Q � '� ''�� I � �
NO. OF BEDROOMS: _� GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � � 0 �
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: ����"� � C� ��,.,�,.�% DATE: C � �
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. 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 legally required to supply the requested data; (c)any known consequence arising from his supptying or
refusing ro supply private or confidential data;and(d)the identiry 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 ro supply investigative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav place the notice reouired under this subdivision in the individual income tax or�rooertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible 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 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 charge 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 infornted of its meaning,the data need not be
disdosed to him for six months thereafter unless a dispute or acdon pursuant to this section is pending or additional data on the individual has been
collected or created. The responsible authoriry 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 authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days
of the date of the reques[, 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 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 concernu�g himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authority shall within 30 days either. (a)correct the data found 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. Dara in dispute shall be disclosed only if the individual's statement of disagreement is included with the discfosed data.
The determination of the responsible authoriry 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 y
_S��- `� �_�/ �1 /� � �, A��
A ress
/�/1/ �'S4� .3t� ��-73a-�f?d
Ciry State Zip Phone
I understand my rights as stated above. �
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Signature
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� , �: � ' CITY of ORONO
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\`�, b � f��7 � ti/ Municipal Offices
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�'� ' ' '�"� �¢.� Street Address: Mailing Address:
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`9kEgK0 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
November 8, 2001
Mary G. O'Connor
& Donald Swensrud
5429 Lyndale Ave. N. ����
Brooklyn Center, MN 55430
RE: Building permit Application - 420 Big Island
Dear Ms. O'Connor and Mr. Swensrud,
On November 1, 2001 this office received your Building Permit Application for a
seasonal dwelling at 420 Big Island. The survey submitted shows only a portion of the property.
To properly review your application the City needs a survey of the entire property. Zoning code
requirements are based on total lot size, existing structures, existing hardcover and other items
that would be shown on the survey of the entire property. Review of your application will
recommence upon receiving the entire property survey. If you have any questions please feel
free to contact me or anyone in the zoning department.
Sincerely,
� ����
�
Lyle Oman
Building Official
LO/dml
C.C. Paul Weinberger
Wendy Bottenberg
Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
. CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: y� �/6 r �,Q
PID:
DESCRIPTION OF WORK: Sc�o�vA-C_- G4l�.-�l�
ZO.�tI11i G REVIEW BY: DATE APPROVED: /L• 7-d �
BUII.DING REVIEW BY: DATE APPROVED; � Z - � _o�
FEES TO BE CHA.RGED: Misc. Fees Calculated By:
PER�1i1IT Yes _�' No
PLA1�1 REVIEW Yes � No SEWER CONNECITON
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CH�CK LIST Zoning District: /Z s
Fire Department: Post Office: School District:
I.ot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes�_ No Date of Survey: 5-ZS-�'75
Proposed Setbacks:
F�� ���Fron[(L-aiccj: !00' '-' Righ[Side: ��� i
Rear (S�eet): 1 3�� '� Left Side: (00� =
Adjacent Structures: N I i/a- �Vetland: /�/ ��.
Building Height: Def. Hgt. /S � Peal:Hgt. 17'
L.ot Coverage: N(/�-
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: ^ By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: y�3
Avg. Setback: �.�L Bluff Setback: /� (/�- I.ot Coverage: N /A
Ezisting Proposed
Hardcover: 0-75' 0 2�
75-250' o i•t 0
250-500'
500-1000'
Hardcover Variance Required: Yes No�_ Date of Council Approval:
REMARKS (in house):
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BUILDING REV�W CHECK LIST
�C� �2 ' 3 CONSTRUCTION TYPE: �!/J
' Sq Footage $ Per Sq Ftg
Basement x _
lst Floor x _
2nd Floor x =
Garage x _
R -
TOTAL
Estimated Construction Value: $ (,,000 �
Inspections Required: 1�Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
� Footing ` Septic Sewer Connection
_ C�Framing Fireplace Lawn Irrigation
�Insulation (Masonry) Other
��Wall Boazd (Mfg.) Well (State Permit)
< Final Grading/Filling �Electrical (State Permit)
Ocher
REMARKS(lV HOUSE):
--------------------------------------------
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy:
---------------------------------
RENIARKS (TO BE NOTED ON PERitiII'1�:
8
,�, „F A*,� r.:-n I„� •.
� ��RDCOVER CAI..CLZ�TION �'ORKS�+E'I' �,�r� ;, r �, ; � ;��' �
• ����� �� �� �
' �; � z�o-�oo� , �00-1000�
� SETB�CK ZO�iE: (CIRCLE ONE) 0-%�' %---��
EYI�TItiG ��RDCOVER I`i ZO'�E
- S.r.
,�. Hcuse �
t��ti wic:n
x = S.r.
,� = S.=.
x
- S.r.
= S.F.
B. Garage X
= S.F.
C. Driveway X
= S.F.
x
� = S.F.
D. SidewaLk X
- S.t.
x
� = S.F.
E. Patioi�eck X
- S.F.
x
- S.F.
F. Landscape x _
_ S.F.
Underlain X
- S.F.
By Piastic X
- S.F.
G. Other x
TOTAL HARDCOVER IN ZONE - C� S.F. A
TOTAL PROPERTY AREA IN ZONE - 3'',,?'1 l S.F. B
A �``� - B � � x 100 = �'' %
PROPOSED HARDCOVER IN ZONE _ l��� S.F.
A. House x
Length W idth
x
= S.F.
- S.F.
X = S.F.
x
- S.F.
B. Gaza�e __— X
= S.F.
C. Drivc�vay X _
x
_ S.F.
= S.F.
D. Sidewalk X _
x
_ S.F.
= S.F.
E. Patio/Deck X _
x
_ S.F.
= S.F.
F. Landscape x _
S.F.
Underlain X _
_ S.F.
By Plasric X
= S.F.
G. Other X
TOTAL HARDCOVER IN ZONE " ��� � S'F' `�'
TOTAL PROPERTY ARE.°. rN ZONE - ���� �C S.F. B
— B ����,`, x 100 = �.�1�. %
A ��,'� - '
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� I��RDCOVE�Z C�I.CLZ�TION `�OR:��H��T
. -�
, SETBACK ZOtiE: (CIRCLE ONE) 0-�5' 75-Z=0' ' 2�0-�00' S00-1�00'
EYI�TP�G I��RDCOVER j`i ZO�E
,�. Hcuse x = S.F.
L:n;h R%idth
= S_F.
X — S.F.
Y = S.r.
x
= S.F.
B. Garaga X
= S.r.
C. Driveway X
= S.F.
x
� — S.F.
D. Sidewalk X
= S.F.
x
� = S.F.
E. Patio��ecfc X
- S.F.
x
— S.F.
F. Landscape X _
_ S.F.
Underlain X
= S.F.
By Plastic X —
= S.F.
G. Other X
TOTAL HARDCOVER IN ZONE - C�� S.F. A
TOTAL PROPER"['Y AREA IN ZONE - `,C�Z S.F. B
A _ g x 100 = �. %
PROPOSED HARDCOVER 1N Z�NE _ S.F.
A. House X
Length W idth
= S.F.
X = S.F.
X = S.F.
x
= S.F_
B. Gara�e �-- X
= S.F.
C. DrivEti�•ay X _
x
_ S.F.
= S.F.
D. Sidewalk X _
x
_ S.F.
= S.F.
E. Patio/Deck X _
x
_ S.F.
= S.F.
F. Landscaoe X - _
_ S.F.
Underlain X _
_ S.F.
By Plasric x
= S.F.
G. Other X
TOTAL HARDCOVER IN ZONE - O ' S.F. A
TOTAL PROPERTY AREA iN ZONE - J S �� S.F. B
_ g x 104 = � %
A '
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