HomeMy WebLinkAbout2003-P06178 - porch PERMIT
CITi( OF ORONO Permit Number:
27�0 Kelley Parkway - PO Box 66 P06178
Crystal Bay, Minnesota 55323 Per-mit Type: Addition/RemodevRepair
(952) 249-4600 Date Issued: 4�2i�2oo3
SITE ADDRESS: 1115 Cox Farm Rd
I.ong I.ake,MN 55356
P I D: 27-118-23-3 2-0016
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential Consriuction Type VN
Census Code 434
Pernut Class: Building
Permit Sub-type(s): Porch-Residential
Pernut Type: Addition/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: Eiecuicai�siaiej
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 279•�S Valuation: $ 16,500.00
Plan Review Fee: $ 181.48
State Surcharge Fee: $ 8.75
TOTAL FEE: $ 469.48
APPLICANT: Aspen Builders Remodelers Inc. QWNER: Christopher&Joylynn Gardner
4844 Island View Drive 1115 Cox Farm Rd
Mound,MN 55364 Long Lake MN 55356
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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� AP ICANT PERMITEE SIG�ATU� IS UED BY SIGNATURE
Copies: 1-File(Sienitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
Recelved: 4/ 7/03 70:42AM; +9622494676 -> ASPEN BUILDERS; Page 6
Apr-07-2003 09:25am From-CITY OF � +9522494616 T-219 P.006/007 F-198
Total Fee: $ ��/q 7 � bate Received: ��-//-G � _
Entered By: �_ f� Permit�: r� '�,?�''
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, �, � CITY IJ�' ORONO - BYJII-.DXNG 1'ERIVLTT APPLYCATIQN
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�� All information must be submittec� in Pull before plan review will be started.
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__ ____________________.._____�_
________________________________________ _
THE APPLICAN''C IS: (circle one) OWN�R O CONTRACTOR
JOB SYTE AriDRESS: I r 'o I� r �Rc� ZIP: S� 3 S(�
NAIVIE OF O�VN]�R: C�t�i C i T�: ' in�n ,i�tir�-�v� ��' PHONE: (home) a�SL- ��- i��r
c�r Fa� ��Z- �+�� -3z��
MAILlNG AT)DRESS: . CIT'Y: ZIP:�
CONTRACT0�2: �1�t��rJ ;3ct���F�?.S t iZE��DFi�l�pHONE: ���- ��C' - ��
CONTACTP�I2SON: �TcR� �yA�- MOBILE/pAGETt:
iv1AILYNG ADDRESS: 4��+y i s�4�%� �;i t�.� ��CITY: _ m i r�ti�� _ZIP: s_s3 k�
STATE T.ICENS�: # c��l
ARC�iITECT/ENG�INEE12:_/v`�� PY10NE:
MAILING ADD�.ESS: � C�T�': ZIP:
N��; REGISTX2ATI4N�t
T'YP� OF WORJK: New Addition � Accessory Structure��
Move Remodel/Alteration Land Alteration
P�tOPOSED W4��tK(describe in detai�: _ �✓'c �t r��•�l��i� �
STO�S: C SQ. �EET 4F EACT�F�..00R: 3U D
NO. O�' BEDROOMS: -�— GAR.AGE STAT,T.S: ATT. _� DET.t9-
ESTTMATED C���1STlt�(JCT�ON VAL�(.1ATI4N (excluding land):' $ /(�,SUD. -
Z hereby apply for a building permi[ and I acknowledge that the information above is complete and
accura[e; that the work will be in conformanc;e with[he ordinances and codes of the Ciry and with
che Scate Buildin�; Code; that I understand this is not a permit and work is noi to statt without a
permi�; and that the work will be in accordance with the.approved plan.
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APPLTCANT''S SIGrNATI1R�: f�� � f'�` � DATE: ' 0 3
_ �
NOTL�'.' ��� of Hom� events require separate permit approval by Police Depqrtment ar�d
City Counci160 days prior to the event. Non permitted events will not be allowed.
5
' CHECK OFF LIST FOR ISSUANCE OF PER.�I�IITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ���s c-c>x 1=A Z� R-o�A�
PID:
DESCRIPTION OF WORK: (�o(Lu� ,� nv� � r� o�
------------_______________-------------------------
ZO�TING REVIEW BY: DATE APPROVED: �/-/� �0 3
BUILDING REVIEW BY: ,,,� DATE APPROVED: y-r�t `a�2
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes _� No
pL� g��EW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes c/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify)
ZO�'Il�1G CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes�` No Date of Survey: 9•Z-g -'� 5
Proposed Setbacks: �
Front (v�< �to' r Right Side: �Yo�
Rear (��): `l�`� Left Side: 135' �
Adjacent Structures: h�'��v.� Wetland: ill�-
Building Hei�ht: Def. Hgt. �- Peal:Hgt. ---
Lot Covera�e: �
Grading: Staff Approval Date: _ By: Council Approval Date:
Septic: Staff Approval Date: -- BY�
Zoning File: # — Resolution: # Resolution Date: . .
Shoreland District: /U�
Av�. Setback: Bluff Setback: L.ot Coverage:
ExistinQ Proposed
a
H ardcove r: 0-75'
75-2�0'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: �Z'-3 CONSTRUCTION TYPE: VN
Sq Footage $ Per Sq Ftg
Basement R =
ls[ Floor R =
2nd Floor x =
Garage R _
R =
TOTAL
Estimated Construction Value: $ I�,S'o J`�'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_ZC Footing Septic Sewer Connection
_�Framing Fireplace Lawn Irrigation
_e�Insulation (Masonry) Other
_�Wall Boazd (Mfg.) Well (State Permit)
'� F�� Grading/Filling _�c Electrical(State Permit)
Other
REMARKS (IN HOUSE): ---------�-
----------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existin; New
Access Approval: Date By:
-----------------------------------------------------------------------------------
REMARKS (TO BE NOTED ON PER�'�IIT�:
8
. ..� � .
.
. 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 sha11 be as set forth in this section.
Subd.2. InFormation required to be given individual. An individual asked to supply private or confidenrial data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the coilecdng state agency,poliacal subdivision,or sratewide
system;(b)whether he may refuse or is legatly required to suppiy the requested dara;(c)any Irnown consequence arising from his supplying or
refusing to supply private or confidenaal dara;and(d)the idenoty of other persons or entides authorized by sate or federat 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 revern�e mav lace the notice re uired under this subdivision in the individual income taz or ro rtv tax refund
instrucrions instead of on those forms.
Subd. 3. Access to data by indiridual. 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 co�denrial. 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 dzsires,shall be informed
of the 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 thereafrer unless a dispute or acaon pursuant to this secdon is pending or addidonal data on the individual has been
coUected or created. The responsible authoriry shall provide copies of the privace or public data upon request by the individual subject of the data.
The responsible au�horiry may require the requesring person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediate(y,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 wi[hin that cime, 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 complete�ess of public or
private dara conceming himself. To exercise this right,an individual shall nocify in writing the responsible authoriry describing the nacure of the
disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nocify
past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)noafy the individual that he believes the data
co be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the adminisa�aove procedure act relacing
to contested cases.
D�►TA PRIVACY ADVISORY
In accordance wi[h 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 pemut 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.
..�oR7 /�y� Z
First Middle ��dN r�AL��✓�)
Last
f(IS C�'nF/�Zivl ��A-i�
Address
(;I:C�I�J�� ���1�i `at7.�S(c� ('n(Z (�,��� �{`���
C�ry State Zip Phone
I understand my rights �s stated abqve.
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Total Fee: $ Date Received: '
Entered By: Permit#: � .
_ CITY OF ORONO - BUILDING PERMIT APPLICA ON
All information must be submitted in full before plan revie will be started.
(please print all information)
------------------------------------------------------------------------------- --------------------------------
THE APPLICANT IS: (circle one) OWNER OR CON CTOR
JOB SIT'E ADDRESS: ZIP�_
�
NA1�iE OF OWNER: / PHONE: (home)
. `• (work)
MAILING ADDRESS: � / CITY: ZIP:
�
�;
CO\�'RACTOR: PHONE:_
COr�T'ACT PERSON: NIOBILE/PAGER:
1VL4II,ING ADDRESS: CITY: ZIP:
ST�T'E LICENSE: #
ARCHITECT/ENGINEER: PHO�tE:
MAII,ING ADDRESS: CIT ZIP:
N�Z�; � REGIS TION#
TYPE OF WORK: New Addition Access Structure
Move Remodel/Alteration Land teration
PROPOSED WORK(describe in detain:
STORIES: SQ.FEET OF EACH FLOOR:
I�'O. OF BEDROO�iS: � � GARAGE STALLS: ATT. DET.
ESTL1-IATED CONSTRUCTION VALUATION (excluding land): $
I hereby apply,for a building permit and I acknowledje 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 wilI be in accordance with the approved plan.
APPLIC�NT'S SIGNATURE: DATE:
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.
5
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`�. " DATE TIME
CITY OF ORONO CALLED IN '� �� �
INSPECTION N TICE _ v SCHEDULED E Z -L�� �`�---
PERMIT NO. D COMPLETED 4-z� • �3 �`
ADDRESS ���-� Cc�i �4�/� ��
OWNER CONTR. nJ�n ���r-5
TELEPHONE N0. �SZ `�9 y / 7(�Z C'u��-�C ��v�Z-�?U�-���1�'T
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� DESCRIPTION
Cy �FOOTING t i MECHANICAL RI 16 EXCAV/GRADING/FILLING
y�2 MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WA�L 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
v 10 PLUMBING FINAL � 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
�NSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR � CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail forthe next inspection 24 hours in advance. (g52) 249-46��
OwnerlConUactpr on 'te:
'-�spector. ��
White Copyllnspector's File Canary CopylSite Notice
DATE TIME �
CITY OF ORONO CALLED IN �� '�'-�
INSPECTION NOTIC� SCHEDULED �'I`� U� ': �.;�.
PERMIT NO. �( 7�� COMPLEfED
ADDRESS I I I`7 �,�;X -� c;, :r j �c-l'�
OWNER CONTR. � ) L �
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TELEPHONE NO. (11 I-.� - (f� �C.> �-{ �j�f�7 �-c:c,;��--�-
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� DESCRIPTION
l� 01 FOOTING i t MECHANICAL RI 18 EXCAV/GRADING/FILLING
�02 F�R��A�M�ING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O ��"1�a5vCAT�UN 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
J 10 PLUMBING FINAL �� 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_' NO
� COMMENTS:
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W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� O CORRECT WORK,CALL FOR PEINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerlContract 'q�site:
Inspector U
White Copyllnspector's File Canary Copy/Site Notice
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AT � TIME
CITY OF ORONO �CALLED IN � � =-� �" -��
INSPECTION N IC� —1 SCHEDULED _�> •��_
PERMIT NO. � I COMPLETED
ADDRESS � �� �� ���X �C�-.Il %�}�1 �
OWNER CONTR. _ A�'� F� � �
TELEPHONE N0. �� � �' �' � C- - Lj C'l�'C�
� DESCRIPTION �C�'� � � F�' ��'�
� 01 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
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 PLUM8ING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
O CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe nex inspection 24 hours in advance. (952� 249-4600
OwnedContractor ' e:
Inspecto�
White Copyllnspector's Fi Canary Copy/Site Notice
✓
DATE TIME
CITY OF ORONO CALLED IN `�(Z� I �'�3
INSPECTION NOTI E �� .�cl SCHEDULED ����
PERMIT N0. r� COMPLETED
ADDRESS � I I �_l ��V �--1'�_�'" �_Z��
OWNER CONTR. '����V� I�Ic1 i�
TELEPHONE NO. � �a � �C� � -- ��i��1
� DESCRIPTION �\ V�C�_� - `-t �ZG�SC n �.
� 01 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 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 OEMO-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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
�INSPECTION REOUIRED.CALLTO ARRANGE ACCESS.
Cail forthe next'nspection 24 hours in advance. (g52) 249-46��
OwnerlContra n i :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
b83571
CERTIFICATE OF SURVEY FOR � �
FEATU�E BUIL�:Ef�� �
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LEGAL DESCRIPTION OF PREMISES :
Lot 4', B 1 ock 1 , SHADOWOOD FARM . , so,
o : denotes iron marker �
(►00�.9� : denotes existing spot elevation , mean sea level datum N
,004.2 ; denotes proposed spot elevation , mean sea level datum �
Bearin9s shown are based upon an assumed datum .
,
�of Are4 = 94�/72 rJQ.FT. � �!<c /.v Sat,-�000' lErB�rCK Zo.vF, ,
This survey intends to show the boundaries of the above
described property , and the proposed, loc�tio,n. of a proposed ,
house thereon . It does not purport to show any ,other ,
improvements or encroachments . � •.- � - �- . �
A�
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, I hereby certify that this survey �vas prepared b�� me or uncier mV direct's�iper- �A"I�F 9-29-95
� � � � � � � vision, and that I am a duly registered Ciyil Engineer and L�nd Sur��e��or undcr
„� the laws of�the Statc of Minnesota. - ' sca�E ���_$D'
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Mark S. Gronber� Minnesota License Number 12755 �v��� QS-354
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