HomeMy WebLinkAbout2001-P03834 - pool � �
PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po3s34
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952) 249-4600 Date Issued: si2si2ooi
SITE ADDRESS: 4675 Creekwood Tr
MAPLE PLAIN,MN 55359
PID: 30-118-23-33-0007
DESCRIPTION:
Proposed Use: ftesidentiai
Permit Class: Building Census Code 329
Permit Type: Accessory Structures Permit Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate permits required: Eiectricai (staiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00
Plan Review Fee: $ 117.78
State Surcharge Fee: $ 5.00
TOTAL FEE: $ 304.03
APPLICANT: PooL& sPa coNCEPTs OWNER: D& K sIEK
6415 WAYZATA BLVD 4675 CREEKWOOD TR
ST. LOUIS PARK, MN 55426 MAPLE PLAIN MN 55359
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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APPLI ANT PERM[TEE SIGNATURE ISSUED Y SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
J ` /
Total Fee: $ Date Received: ,�-� /- CU%
Entered By: Permit#: A O 3���
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER O CONTRAC�T R
JOB SITE ADDRESS: �� 75 L-/�'L��K <�.%���t� ��;'��Z ZIP:
NAI�iE OF OWNER: ��v'� �`T�—]� PHONE: (home) �1�Z- `t7�-�-r'1�`-��`
. (work) �i.�'L-7 Y"L - �f7�"�
MAILLIIG ADDRESS: ��'7,,5 ��?���w�'�t%i� CITY: c;'l'Gr,!G ZIP:
T7��.�z-
CO\TRACTOR: ¢�C��. �S!'it- �G�ccy'i S -- PHONE:_ ciS Z- -�S`t��c��Zc
CO��T'ACT PERSON: ,ncS S MOBILE/PAGER: 6'i Z -.���1-.3�i 7
1bLAII.ING ADDRESS: �°�-/.S t✓�1't'Z�h-,C�c..�c� CITY: .�i. c,�-�.s.-3 Pmr'�IP: v�"S�f��
ST�TE LICENSE: #
ARCHI'1'ECT/ENGINEER: PHONE:
vI_AII,ING ADDRESS: CITY: ZIP:
NA_liE: REGISTRATION#
TYPE OF �VORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: pCar' �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOviS: GARAGE STALLS: ATT. DET.
ESTl�IATED CONSTRUCTION VALUATIO�i (excluding land): $ �G�-c'-�- C�� _
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 Buildin; Code; that I understand this is not a permit and wo�c is not to start without a
permit; and that the work wilI be in accordance with the approved plan.
APPLICA:�1T'S SIGNATURE: �'-._"�- DATE: � �% �`-f
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SLTBJECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given indiridual. An individual�sked to supply private or confidential data conceming tumself
shall be informed of: (a)the purpose and intended use of the requested data wi[hin the collecdng state agency,poliacal subdivision,or stacewide
rystem;(b)whe�her he may refuse or is legally required to supply the requested data; (c)any Imown consequence arising from his supplying or
refusing to supply private or confidendal dara;and(d)the idendry of other persons or entides au[horized by snte or federal law to receive the data.
This requiremenc shall not apply when an individual is asked to supply investigative data, pursuant to secrion 13.82, subdivision 5, to a law
enforcement officer.
'I�e commissioner of revenue mav olace the notice reouired under this subdivision in the individual income raz or orocerrv tax refund
instrucrions instead of on those forms.
Subd. 3. Access to data by individual. 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 confidenrial. Upon his further request,an individual who
is the subject of stored private or public data on ir.dividuals shall be shown the data without any char�e to him and, if he desires, shall be informed
of the contenc and meaning of that data. Afrer an individual has been shown the private data and informed of its meaning,the data need not be
disctosed to him for sir months thereafter unless a dispute or acdon pursuant to this sec6on is pending or addidonal data on the individuai has been
collected or created. The responsible authoriry shall provide copies of the private or pubtic data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual cosu of making,certifyin„and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision, or wichin five days
of the date of the request,excluding Saeurdays,Sundays and legal ho(idays, if immediate compliance is noc possible. If he cannot comply with
the request within that time, he shall so inform[he individual, and may have an addirionai five days within which to comply wi[h[he 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 da[a conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing the nature of[he
disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiere and attempt to nodfy
past recipiene�of inaccurate or incomplece dara,including recipients named by the individual;or(b)nodfy the individual that he believes the dsn
[o be correct. Data in dispute shall be disclosed only if the individual's statemen[of disagreement is included with the disclosed data.
The determinaaon of the resporuible authoriry may be appealed pursuant to the provisions of the adminisQadve procedure act celaring
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 Ciry of Orono or any of its departments may require you to furnish certain
private or confidential information.
You are notified [hat:
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 wi[h other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested pernut or licease requires Council action to approve, some information may become
public.
�. You have certain rights under Iv1.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
�G.��` �, t-�?�'.7��.5�f/
First Middle Last
6' �l� vv�y���� �� ��/�.
Address
S 1`- �-C"��'-�.��" �''i'`��� /�i� ��S�Z-�
C��Y State Zip Phone
I understand my rights as stated above.
,__� �-
Signature
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� '� � CHECh' OFF LIST FOR ISSUA.�'�TCE OF PERtirITS
FOR OFFICE USE ONL.Y . � .
p,DDRESS OR LEGAL: y(,� �� GiZ���t�v�/J ��"��— -
PID:
DESCR�ION OF�ORK: oo �
ZOti1\G REY�ti�%BY: D?�TE APPROVED: S • Z�-t -c�)
BUILDli�'G REYIE�BY: D�TE APPROYID: �- 2`�(�-v 1
FEES TO BE CFL4RGED: Niisc. Fees Calcuiated By:
pEg�T Yes � No ��
PLAN REVIEW Yes .�' o SEWF.R C0�INECTION
STATE SURCHARGE Yes _�o �TATERCOiVNECITON
I'�i 1VESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZO`7..-1tG CH�CK LIST zonin�Districc: ��2- 1 � _ .
Fire Departm.ent: yh q�v� nv4,11 Post Ofuce: �pul3 p�� Sc�ool District: �cZON� �
I,ot tlrea: Sq.fr. v C Acres � Widch Depth
Surve;� Sub�itted: Yes p�_ No Date of Survey: �1- ?—t�'9`-( (c�n� r='��
Proposed Setbac!cs:
F.ont (�aL•ej: 3�t� Ri�ht Side: � �2.7�0
. �
Rear (Screet): ��t O Left Side: ) o o _
Adjaceat S[ructures: �` �Vetland: N I� � �
guildin� Hei�hc: Def. Hgt. —' Pea.�:H�t. —'
Lot Covera�e: ----
Gradin�: Scafi Approval Date: — By: Council Approval Date:
Sepcic: Staff Approval Date: ---� By:
Zoning File: R � Resolution: � Resolution Dace: �
Shoceland District: W �
Av�. Setback: Btufc Setback: LotCocera�e:
E���? Proposed
Hardcover: 0-7�' --
7�-250' ---
ti0-500'
500-1OQ0' -
Hardcover Variance Required: Yes No Date of Council Aoproval: ___
gEti� (in house):
7
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BUIZDIl\TG REVIES� CHECK LIST
UBC: — - CONSTRUCTTON TYPE: �
Sq Foota�e S Per Sq Ftg
Sasement x =
lst Floor x =
2od Floor z —
Garage z —
z =
TOTAL
Estimated CorLstruction Value: S �p, OpO °�
Inspections Required: ��'ork Requiring Separate Permits:
Sice Plumbing " Fire
Hardcover Re�ovz? Mechanical Water Connection
_�C Footing Septic Sewer Connection
Framin� Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Wel( (State Pemu[)
_� Final Grading/Filling �_ Electrical (State Permit)
Other
RE`iARI�S (I\'HOUSE): .
REVIEW BY OTHERS: � DATE:
Access: Ezs�ir:� NeW
Access App:oval: Date By:
RE1�IA_RKS (TO BE NOTED ON PERMI'1�:
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V [}4T TIME ,
CITY OF ORONO CALLED IN �p ==-��_S
INSPECTION NOT SCHEDULED
PERMIT NO. - COMPLETED � �
ADDRESS 7 � �� C^�r�E_'l� " ' ' �
OWNER CONTR.
TELEPHONE NO �� ��� � 3(�� "� L
� DESCRIPTION � t/QT I�� �j(,�f L`�
� 01 FOOTING 11 MECHANICAL RI 18 EXCA�//GRR /FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� BdWORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEiE
W��CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for t e next inspection 24 hours in advance. (J52� 249-4600
OwnedContr c ite:
Inspect
White Copyllnspector's File Canary Copy/Site Notice
S6�SY1
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Certificate of Survey for �j; ,v ; j� . � ` � ,
Minnesota Design & Construction `��' '�' `' ` ` ` '
of Lot 5 , alock 1 , PAINTERS 1�100DS
Henne�� in County , P1innesota j
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LEGAL DESCRIPTION OF PREMISES :
Lot 5 , f3lock 1 , P/1INTE12S 1J000S .
This survey intenos to shou� �;he bounclaries of the above described
prop�rty , �n�1 th� proposecl Ioc� Lion o � � proposecl house �ncJ garage �nd driveway .
It cloes not purport to �how any otl�er irnprovements or encro��chments .
o : Iron marker
Bearings shown are based upon an assumed datum .
. • �970.3; • FkiJ/in� P/Pv '
7a.✓ • �:`opola4 P/<v . , .
`P�K°^i�s , r Gv�.�'.ct�'•` �"Mii�;c�irp� ,�.�.ti .�..,,, .
�y �+�C"t�, � a.(��+rt� �'�� ,�� , x�,.l ��
' m3q.:. ''���n S �.�.,- 'rv�Fr 'rti` 4�i - r i r 4 �20 - 94-
� �� ' r ,� .� ,�� � r� -� y�j, 1 hercl,� cerlif� that Ihis sur��r�� ��as E,rcparcci b}� me or undcr m�� direct su�,cr- i�n�rc
`�': ' p � 1 � 0 ' �)��� � ?�'A vision �nd that I �m a dul�� re&islcred Civil 1:n�inccr and L�nd Surve��or under
.
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�`��`,"' � ,� � t�;�u�,� �I�,�,�rlt 4���V the I���vs o( l�he St�lc o( I��iinncs��ta.
�c� '. ��< i�f x�'�n,�"�'�j's�i1T7 '�";T� �(�I���o,'�c�ti� T��{;'1�` / SCni.f> > _ �Q�
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�� r o�K'i'� .��{K��A �}���a�U".s'�.f`L.'y,� v��S��j�,,4Ht 4Y�ea �i�����'�ktift�r�� -- ---- // — -------'— /I C]�
� 5����� "`�"','�?r19 �''� � 9';�`ydid ti��td �Y,f k��, 2 i � i l � ..'..Fn �'` .y•�� � -- . )C�IS NC�. � ..Y • 7
1'7N� �i>l�r�rti�'e� ���J'� )nlf � e�+�",r� �{ia�r� o �il���e � � _. •� t�'(ll��: �. �f0i11)l'f�' I��Tllllll'SO�iI �.ICCIlSI' ��U111 .l'I' ��iJS
�:._.��.��P.�',�+��,�,����kus'tr :�c.�����i!,..:�..`�.r.._�.'�Jr�.�,s.�_,.._��`�''�_'�...,._.vi:.,� _ .. . -^�^:�a�^_.�c.-:�emrrcciz�s�a�n