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Home My WebLink About2008-00442 - addition CITY OF ORONO PERMIT NO.: 2008-00442 e� " 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 12/15/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 2420 DUNWOODY AVE PIIY : 20-117-23-21-0018 LEGAL DESC : TOWNSITE OF LANGDON PARK : LOT 001 BLOCK 007 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RELIGIOUS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENT[AL&NONHOUSEKEEPIN VALUATION : $ 4,000.00 NOTG: ADDITIONAI.PERMI"I�S REQUIRED: EI,ECTRICAL PERMIT(STATE) EXPANSION OF PLA'I'FORM APPLICAIVT PERMIT FEE SCHEDULE 103.25 THE CARPENTER'S CONTRACTING, INC. PLAN REVIEW 67.1 1 1085 COUNTY ROAD 19 MOUND, MN 55364 STATE SURCHARGE(VALUATION) 2.00 (952)472-5715 TOTAL 172.36 Minnesota State License#: 3622 OWIVER CHURCH, CALVARY MEMORIAL 2420 DUNWOODY AVE WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT The work for which[his permit is issued shall be performed accordii�g to the approvcd plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of I 80 days at any time atter work has commenced. The applicant is responsible for assuring all required inspec[ions are requested in conformance with the State Building Code."Chis permit may bc rev.n�ed at any time for due cause. r� SC.�;,� . ,`a��.��.; t Z / 1� / / / Applicant Permilee Signature' Date ]ssued By i nature �- Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIB ABOVE. f " d � � (� � Total Fee: $ �` , Date Received: ��!�/� Entered By: Permit#: 0�-DO CITY OF RONO - BUILDING PERMIT APP�ICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: a.ya.0 L-�;, �.tiG<;�,� 1�\�}�i ZIP: >>��( Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes, a special event permit is required with Police Departmenl and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is availab[e. Non-per�mitted events will not be allowed. NAME OF OWNER: (�,��,,,,T��u eMb,ro�:�AU ��'�� PHONE: (home)�(�j��c.{�( -SSI� (work) MAILING ADDRESS: �..�2'C -�vN wc,��y IQu v CITY: 5�,2,,^,t�t ZIP: 5S3cj� CONTRACTOR: TN� ��c��(�2� C�J��vb . iv,ii, PHONE: 9��-�G?L -�:71� CONTACT PERSON: �y� ��,�.; MOBILE/PAGER: (�c L-��hS�ak,c-I ti MAILING ADDRESS: �p�,c�,��y�;� t� CITY: V�L�.;.� ZIP: �S3E�'� STATE LICENSE: # �(,Lti EXPIRATION llATE: 3's�-•r°� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Ho�ne Remodel/Alteration (ie: Siding, Windows)�_ Any earth movement may require MCWD review and permits ! PROPOSED WORK(describe in detai�: F-;��'��ov� �� i�Fc�'� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � oe�! �� I hereby apply for a building permit and I acknowledge that the information above is coinplete 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'SSIGNATURE: � �,�r� DATE: L�-` �"��'�' 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The righu 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 conceming himselfshall be informed of.� (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewidc 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 identity of other persons or entities authorized by state or federal law to receive the data.This requirement shal I 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 revenue may place the notice reauired under this subdivision in the individual income tax or prooerty tax refund instructions 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 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 ofthe content and meaning of that data. Afrer 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 or additional data on the individual has been collected or created. The responsible authority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authority may require the requesting person to pay the actual costs of making;certifying,and compiling the copies. The responsible authority shafl comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe 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 writing the responsible authority describing the nature ofthe disagreement. The responsible authority shall within 30 days eithec (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. Data in dispute shall be disclosed only if the individual's sYatement 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 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. �—��J i;.i �,d l.b� First Middle Last \0�i CS��;C"` �� I� Address ��v'�c;�� uti�,r> 5��6`� �52-�1?Z.-S-?f� C��J' State Zip Phone I underst my rights as stated above. � Signaturc Reset Porm 32 � CHECK OFF LIST FOR ISS U.qNCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: Z,�l ZO �vNwOoD v Av c PID: DESCRIPTION OF WORIi: EXg4•vsi u� Dr P�.4 r,=pR�t-� ZONING REVIEW BY:• I � DATEAPPROI�ED: �L iZ�O� BUILDING REG7Ei�'BY.• DATEAPPROT�ED: [2-�z-v b FEES TO BE CHARGED: Misc. Fees Calculated Bv: ��Y �~� —____ PERMIT I'es ✓' No y PL_AN REVIEt�Tt Yes ✓ 1Vo SENlER CO.NNECTION STATE SURCHARGE �es ✓ No Yi'ATER CONNECTION INVESTIGATION FEE �es No ./ PARK FEE SAC Yes No_��; SITEINSPECTION Number of SAC Units OTHER (spec�) ZONING CHECK LIST Zoning District: N vMG/fAN` e� y ' N �' '� �' Fir�e Department: Post Off ce: School District: Lot Area: Sq.ft. Acres 'idth Depth Survey Submitted: 3'es No D te of Su�vey: Proposed Setbacks: Fron1(Lake): Right Side: Rear(Street): Left Side: � ,9ajacenl Structures: N�etla d: Building Height: Def Hgt. p�ak g� Lot Coverage: Grading. Slaff Approval Date: By�: Council Appr-aval Date: Septic: StaffApproval Date: B�,: Zoning File: # Resolutioiz: # esolution Date Shoreland District: CYiD Pe��nait: .Avg. Setback: BIa�Setback: LotCoverage: E�-isting Pr•oposed Har•dcover: 0-;.i' ?S-_'.i 0' ,so-sno� �00-1000' Hardcover t�ariance Reqz�ired: 7'es N'o Date of Coznvcil.9pproval: REIYLAKfiS(in house): 33 BUILDING REVIEN'CHECK LIST UBC: i�� A'3 CONSTR IJCTION TYPE: VN � Sq Footage $Per Sg Ftg Basement x = • 1 st Floor x = 2nd Floor z = Garage x = x = TOTAL Estimated Construction f�alue: $ y�(9CC7 �-'� Inspections Required: W'ork Requiring Separ�zte Permits: Site Plumbing Fire Hardcover Removal MeChanica! Gi'ater Connection Footing Septic Sewe�-Connection �f Framing Fireplace Lawn Irrigation 1»sulation (Masonry) Other T�"all Board (�t1fg.) TG"ell(State Permit) �Final Grading/Filling �_Electrica!(State Permit) Other REM.qRKS(IN HD USE): REVIEW BY OTHERS: DATE: Access: Faisting IJew Access Approval: Date B��: REMARKS (TO BE NOTED ON PERMIT): 34 d"�' aD TIME V CITY OF ORONO CALLED IN �"` '�� INSPECTION NOTICE !L SCHEDULED � '� "� � PERMITNO.�OD�-� ` ��COMPLETED <:' � ��C`; ` ADDRESS Gi�Y'o�D �GL��a�i � OWNER CONTR.CO�.CJ��x�4 C��i: TELEPHONE NO. 9�J2'`�7Z`" S7( S� � DESCRIPTION � � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � ��ORK SATISFACTORY:PROCEED C� PROJECT COMPLETE W ❑'CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: � Inspector. ` White Copyllnspector's File Canary CopylSite Notice