HomeMy WebLinkAbout1997-009263 - addition - PERMIT
` CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - =_..:.�=:`;��
Crystal Bay, Minnesota 55323 Permit Number: ;.«,:_�:y;�,:_;
(612)473-7357 Date Issued: �� �- --
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SITE ADDRESS:
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DESCRIPTION:
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APPLICANTiPERMITEE SIGNATURE �� ISSUED BY:SIGNATURE
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Total Fee: $ `-'`� ' `� � Date Received: �-- �i j� �7
Entered By: Permit#: �;t,�; �.,
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�CONTRA�OR
JOB SITE ADDRESS: ����JL���� �C� ZIP: `'r`� ��'� ,
NAME OF OWNER: �1�� ��1����1���� PHONE: (home) l�j-�7 Z
(work) ���j —�v�
MAILING ADDRESS: �� C�/� =t `- ..CITY: �,t,fGfL f � ZIP: �;?��5�
CONTRACTOR: ��V�� �� PHONE: I�ZJ"C�zC��
CONTACT PERSON: - ' ' OBILE/PAGER: �/- �y��
MAII,INGADDRESS: '��G>� �_-�1-�,/.�%�G�. � ,CITY: /2j�L �� ZIP: �-�-- G�
STATE LICENSE: # Z'G��'��:�
ARCHITECT/ENGINEER: ���'`'�� PHONE:
MAILING ADDRESS: CITY: ZIP:
Np�ME; REGISTRATION#
TYPE OF WORK: New Addition� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�• i F� ��a t� U�
,�.��� �'F �/'1�f�,�'C� � ��L��--
STORIES: �_ SQ. FEET OF EACH FLOOR: ���
NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��/�-�`v �'�
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 i not a ermit and work is not to start w' hout a
pernut; and that the work will be in ac da e approved plan.
APPLICANT'S SIGNA DATE:
NOTE! Parade Qt'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.
9
�
Sea 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 forrh 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 supplying or refusing to supply
private or confidential data;and(d)the identiry of other persons or enriries authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrigative data,pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax refund
instrucdons 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 informed of its meaning,the data need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this section is pending c_ additional data on the individual has been collected or created.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs 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 date 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 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 concerning himself. To exercise this right,an individual shall notify in wriang the responsible authority describing the nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy 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. Data
in dispute shall be disclosed only if the individuaPs statement of disagreement is included with the disclosed data.
The determination of the responsible authority 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 pernut 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
Address
City State Zip Phone
I understand my rights as stated above.
Signature
' CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ZS G�l6N GT PcA c.c..�'
PID:
DESCRIP'I'ION OF WORK: l�rJ t� � �n o N
ZONING REVIEW BY: _ DATE APPROVED: g - (�-�i 7
BUII�DING REVIEW BY: � DATE APPROVED: � -(o- ri 7
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/' No
PLAN REVIEW Yes � No SEWER CONNECITON
STATE SUR`HA�G� Yes �/ No WATER CONNECTTON
INVESTIGAZ'ION-F'EE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
�ONING CHECK LIST zoning District: Q2- I(3
Fire Department: � ru= Post O�ce: (�f X-� School District: G/�/v0
Lot Azea: Sq.ft. 3`1�0(0 3 Acres • � � Wid[h Z 2(�!�? v4 Jf Depth 1 5 Y
Survey Submitted: Yes 0� No Date of Survey: 8— °�7
Proposed Setbacks: � � �
Front (L��ee): —j 1 Right Side: 6 3 '}' /V
Rear (Stfaet): (03� �= Left Side: � 17 �� S
Adjacent Structures: 14TT�U�t� Wetland: l��/�}-
Building Height: Def. Hgt. C9•k Peak Hgt. C�+��
Lot Coverage: (�•��
Grading: Staff Approval Date: ('.�L By:��.. Council Approval Date: "'
Septic: Staff Approval Date: N l�- By:
Zoning File: # Resolution: # Resolution Date:
Shoreland Dis�ict:
Avg. Setback: Bluff Setback: Lot Coverage:
� Existing Proposed
�,� • Hazdcover: 0-75'
75-250'
250-500' �
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMA,RKS (in house):
• 26
BUII.,DING REV�W CHECK LIST �
�C� _ /Z• 3 CONSTRUCTION TYpE: �(N
� Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x = �
2nd Floor x =
Gazage x =
x =
TOTAL
Estimated Construction Value: $ 5�,(oO0 �''
Inspections Required: � Work Requiring Separate Permits:
Site .� Plumbing Fire
Hardcover Removal Mechanical Water Connection
_�C Footing Septic Sewer Connection
_�Framing Fireplace Lawn,Irr�gation
� Insulation (Masonry) Other
Wall Board . (Nlfg.) Well (State Permit)
_�,.F�� Grading/Filling _� Electrical (State Perm.it)
Other
---------------------------------------------------------------
REMA.RKS (IN HOUSE):
------------------- ---------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By;
-------- �w�---------------
REMARKS(TO BE NOTED ON PERNIII�: �
27
Home Gallery, Inc.
3001 Hennepin Avenue South
Minneapolis, MN 55408
(612) 823-0294 Fcrx (612) 823-6147
Addition
6/18/97
Remodeling Specifications for:
Dave and Ann Shaughnessy
25 Cygnet Place
Long Lake, MN(612) 933-3042
Job Description: Add a 20'x 36'2 story addition on the back of the existing home
walkout area to include extending the existing kitchen on the upper level into the new
addition as per plan. New addition upper level shall also have the master bedroom/bath
as per plan including a new hallway leading into the new addition from the existing
home. 1 s'level of addition to be framed only, homeoumeY to finish at a later date.
Preliminary: Design is part of a previous agreement, all additional blueprints and fees
are included. Only the items below are included, su�veying, engineering and any
changes because of engineering and/or code compliance are not included. Complete
material selection and design is included.
Demolition: Owner shall remove all personal properry in all affected areas of new
constYuction before the start of the project. Remove and dispose of the existing rear deck
and all concrete slabs existing on the ground level in the same area. Remove existing
steel siding from the back of the home to include removing the overhangs as per plan.
Remove all w�ndows and doors from the back of the home as per plan. Remove kitchen
cabinets,plumbing and electrical as per plan. Home Gallery to place and maintain a 30
yard dumpster for all construction debris during the course of the project.
Carpentry: Frame all new walls, exterior and interior as per plan to include
microlaminate beams as per plan and framing for the roof ng system. Install new casing
and trim as per plan to include installing windows.
Excavation: Excavate as necessary as per plan for the new footings to support the new
addition. Bac�ll and rough grade as per plan after approvals. Landscaping, retaining
walls, sidewalks, sod and soil corrections are not included.
Masonry: Install footings and slab as per plan for the new addition.
Mechanical: Install a new boiler as per plan to include installing new heat registers as
per plan to heat the new addition. (1 of 2)
Plumbing: Provide a oversized bathtub,faucet, sink and toilet as per plan in the new
master bath room to include all necessary waste venting, shut off's, drains and hook up's
as per plan. Fixture and faucet allowance$2,000.00.
Electrical: Homeowner to supply material and provide all labor.
Insulation: Homeowner to supply all material and labor.
Sheetrock: Homeowner to supply all material and labor.
Millwork: Install window and door trim to include base molding as per plan.
Paint and Stain: Homeowner to supply all material and labor.
Cabinetry: None at this time, option for pricing is available upon request.
Counter Tops: None at this time, option for pricing is available upon request.
Windows and Doors: Install exterior windows, doors and interior doors as per plan and
room schedule.
Flooring: Homeowner to supply material and labor.
Lighting: Homeowner to supply all labor and material.
Roofing: Remove existing roof shingles from the complete home and install new class A
asphalt 240 lb. roof shingles to includefelt paper, ice and water shield and all necessary
ventilation.
Exterior Siding: Install new vinyl siding as per plan on the new addition with an option
of re-siding the complete home.
Appliances: Appliances are not included.
CustomerApproval: Date: / /
Home Gallery:
(2 of 2�
DATE 71ME
CITY OF ORONO CALLED IN
INSPECTION NOTICE scr+Eou�Eo Il—17.�? —=6=-�-`�
PERMIT NO. `�^� �' COMPLETED _� V _
ADDRESS S " ��y�
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAVJGRADING/FILLING
y �RAMING 13 MECHANICAL FINAL /9 LAKESHORE/WETL4NDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TfiEE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� BEFORECOVERING PERMANENT
C;CORRECT UNSAFE CONOITION WITHIN HOURS. — pHOTO TAKEN
INSPECTOR WILL RETURN
❑ STOPORDER POSTED.CALL INSPECTOR CITATION ISSUED
�; INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContr r o ite:
Inspector. �
White Copyllnspector's Fi e Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN ����'1.5� / � � G� �
INSPECTION NOTICE SCHEDULED // -:;Z� �"� O
PERMITNO. `!���< _t' COMPLETED �_ �
ADDRESS � � ��� c-�� � ��
OWNE �lt«.-r��.C-��-� CONTR.
TELEPHONE NO. 7`�, % / �'�
� DESCRIPTION
� 01 FOOTING 17 MECHANICAL RI 18 EXCAV/GRADING/FILLING
�Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 03 INSULATION 24l25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
QWALL B� 12 WATER HOOK-UP 17 SITE INSPECTION
= O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
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Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �. CITATION ISSUED
�7 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex inspe tion 24 hours in advance.473-7357
OwnerlContract site:
Inspector. � �
White Copyllnspector's File � Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN '�-3 `9 7
INSPECTION NOTICE SCHEDULED 9 - �_ � % �'�
PERMIT NO. ���'� COMPLETED � _�
ADDRESS a�� �
OWNER /� �2��!sw CONTR. 1!?�c:.��— �'��c�t__o ,
TELEPHONE NO. G9� U "- 3� 7Z�
� DESCRIPTION ��1�"7n Gt:/.+',tcsJ�
� 01 FOOTING � 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
�Q 0 RAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO�ITE 27 SEPTIC MAINT. 21 COMPIAINT
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Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL
35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. – pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR - CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO AFRANGE ACCESS.
Call for the next in�pection 24 hours in advance.473-7357
OwnerlContractor�ri site�i1
Inspector. ��
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White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN // , 3'C, �'z� ��j �"
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INSPECTION NO CE SCHEDULED j/�/% `/ � //"������i
PERMIT N0. �-��3 MPLETED � • � ' � I ��
ADDRESS � C��
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OWNER -�=� t�ct�-,��-�t__/ � NTR.
TELEPHONE NO. __ � ���" �1/D I
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� DESCRIPTION ��-�-�«--�- �
� 01 FOOTING 11 MECHANICAL RI 1 B EXCAV/GRADING/FILLING
�Q 0 13 MECHANICAL FINAL 19 LAKESHORElWETLANDS
� 03 INSULATION 24l25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� p4 WALL . ) 12 WATER HOOK-UP 17 SITE INSPECTION
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_ � 14 SEWER HOOK-UP p6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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�Q 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINd FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
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� BEFORECOVERING PERMANENT
C7 CORRECT UNSAFE CONDITION WITHIN HOURS. -, pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOPORDER POSTED.CALL INSPECTOR -. GTATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContrac
Inspector.
W e Copyllnspector's File Canary CopylSite Notice