HomeMy WebLinkAbout2001-P03647 - add/remodel/repair . PERMIT
C I TY C�F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P03647
Crystal Bay, Minnesota 55323 P2flllit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 4i6�2oo1
SITE ADDRESS: 610 Big Island
EXCELSIOR,MN 55331
P I D: 22-117-23-31-003 3
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: tcesidentiai
Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Eiecu�icai �siaie j
NOTICES/REMARKS:
I
FEE SUMMARY: PermitFee: $ 349.25 Valuation: $ 22,000.00
Plan Review Fee: $ 226.98
State Surcharge Fee: $ 11.00
TOTAL FEE: $ 587.23
APPLICANT: SATHRE THOMAS REMODELING OWNER: KENNETH K PLUNKETT
7226 OLIVER AVE SO 610 BIG ISLAND
RICHFIELD, MN 55423 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 PERMITEE SIGNATURE ISSLTED BY SIGNATURE
Copies: City, Applicant,Assessor, Finance Page 1
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Total �`ee: $ �_���� � ��'�' �' Date Received: _���7 - �� �
Entered By: �' ? Permit#: ,==� � ;�,���T_
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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 O CONTRACT
JOB SIT'E ADDRESS: �� l �� �r �, -1.-S � a-� � ZIP:
NAI�IE OF OWNER: � o'� ��p P � "-O `� PHONE: (home) � 1 � � � � �l �I I � �
� (work) ��- ` �- (� - 1 �l L�
MAILI�t 1G ADDRESS: gc3U0 r ; ��S �Q-�- CITY: `oo,��-{�ZIP:
CO\TRACTOR: � r.�-s G •�a��� -e- ��"`o o�pH01�'E:. (�f� � c�6 R —S( 2 �-
COr�'TACT PERSON: NIOBILE/PAGER:
1vLAII.�1G ADDRESS: �a-�-� G rt��c- S� CITY: (��t e-f.�� d ZIP: �s-�r a 3
ST�TE LICENSE: # OU tn�l `l
ARCHIT'ECTlENGINEER: PHO�TE:
MALI.ING ADDRESS: CITY: ZIP:
N��IE; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detain: 2e-� Izc e t,�,�c � �o-k.� s� � �.v �� r� � N�'�''
<"�e z f�o � k /l1� S't�L ,�
STORIES: � SQ. FEET OF EACH FLOOR: c(' � ��
NO. OF BEDROOMS: � GARAGE STALLS: ATT. �_ DET.
EST�IATED CONSTRUCTION VALUATION (excluding land): � ��, d 4 �
I hereby apply for a buildin� 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 Buildin� Code; that I understand this is not a pemut and work is not to start without a
permit; and that the work wiR be in accordance with the approved plan.
APPLICANT'S SIGNATURE: � DATE: 3 `� � D
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 SUB.TECTS 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 secdon.
Subd.2. Infocmation required to be given individual. An individual asked ro supply private or confidendal data concerning himself
shall be informed of: (a)che purpose and intended use of the requested data within the collecting state agency,polidcal 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
refusing co supply private or confidendal dara;and(d)the idenrity of other persons or endaes aurhorized by srate or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pur5uant to secdon 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav olace the norice reauired under this subdivision in the individual income taz or orooerrv tax refund
insrrucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whether he is the
subject of stored data on individua(s,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 dara on individuals shall be shown[he data without any charge to him and, if he desires,shall be informed
of the content and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning, [he data need not be
disclosed to him for six months thereaher unless a dispute or acaon punuant to this secaon is pending or addiaonal data on the individual has been
coltecced or created. The responsible authoriry shail provide copies of the private or public data upon request by the individual subject of the data.
The responsible au[hority may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant to chis subdivision,or within five days
of the date of the cequest,excluding Saeurdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with
che request within that cime, he shall so inform the individual, and may have an addirional 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 conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the nature of the
d'uagreement. The responsible authoriry shall within 30 days either: (a)correct the dara found to be inaccurate or incomplece and attempt to nocify
past recipienrs of inaccurate or incomplece dara,including recipients named by the individual; or(b)nocify the individual that he believes the data
to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
"Ihe detzrminadon of the resporuible authoriry may be appealed pursuant to the provisions of the adminisffaave procedure act relatin�
to contested cases.
DATA PRIVACY ADVISORY
In accordance with N1.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 certai.n
private or confidential information.
You are notified that:
l. 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 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.
L 1-+o�nr S � �:--q ,� S a'�- � r �
Firsc Mid le < Last
� t�- c1 � � � l✓c�;` I�-t1�J
Address ,
`Z : �,I��'�e. � oL NI. � S`5���� 3 � � a - �-6� - � � a�
C��Y State Zip Phone
I understand my rights as stated above.
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s�gnature
6
� � CHECK OFF LIST FOR ISSU�'vCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: {��(� (,3�(� S S��
PID:
DESCRIPTION OF WORK: W��.,�ow z,/�od�.s� sH-�LTd��f s/+'J,��
-----------_---------------------- ----- - --------------------------------- •
ZONING REVIEW BY: DATE APPROVED• � /(I//�
BUILDING REV�W BY: DATE APPROVED: �{- 2. -o c
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
pLAN REVIEW Yes !� No SEWER CONNECTION
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZOti�G CHECK LIST Zoning Disuict: /V O G�-N4r��
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Widch Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
� Adjacent Structures: We and:
Buildin� Hei�ht: Def. Ho[. Pe �Hgt.
Lo[ Covera�e:
Gradin�: Staff Approval Date: y: Council Approval Date:
Septic: Staff Approval Date: y.
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Av�. Setback: Bluff Setbac : L.ot Coverage:
Existin� Proposed
a
Hardcover: 0-75'
75-2�0'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RE�IARKS (in house):
BUILDII�TG REVIEW CHECK LIST
�C� �' � CONSTRUCTION TYPE: V^�
Sq Foocage $ Per Sq Ftg
Basement R =
lst Floor R =
2nd Floor R =
Garage z =
R -
TOTAL
Estimated Construction Value: $ Z 2.,Ooa°'
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)
_�F�� Grading/Filling _�Electrical (State Permit)
Other
RE�IARKS(IN HOUSE): __________
----------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: ExistinQ New
Access Approval: Date gy:
--------------------------
RENIARKS (TO BE NOTED ON PERI�II1�:
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44" 6VlAX. SlLL I-���G}-iT FOR 5i'v�nl�. �e-ct.—�o�2
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DAT TI E
CITY OF ORONO CALLED IN �'l� " �� ` ��
INSPECTION N ICE SCHEDULED ' ; o�
PERMIT NO. d � � co PLETED � �� ��
ADDRESS ��� � ,�
OWNER . CONTR.��'r� �Q�h�e h P a��/P/
TELEPHONE NO. � ��0���—`��s
� ., 7G'v�)
� DESCRIPTION ��vCQit.�.-O-�� �a�C-�i q ~�� ���
lL 01 F 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/N/ETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
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
Q
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
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d ;�WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
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� �'[, CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,- PHOTOTAKEN
INSPECTOR WILL RETURN
I CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. 249-46�0
OwnerlContractor site:
Inspector. � ��� �
White Copyllnspector's File Canary CopylSite Notice