HomeMy WebLinkAbout2008-00172 - attached deck ti
CITY OF ORONO PERMIT NO.: 2008-00172
' 2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE IssUEu: 09/03/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 1180 ELMWOOD AVE
PIN : 07-117-23-14-0033
LEGAL DESC : SKARP&LINDQUISTS FERNHILL LA
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DECK ATTACHED
ACTIV[TY : 434-RESIDENTIAL
VALUATI01�1 : $ 2,500.00
NOTE: MUST BE EXACT REPLACEMENT OF EXISTING DECK-NO LARGER. RA[LING MAY BE ALTERED AS NECESSARY TO
COMPLY WITH CURRENT CODE. STEPS MAY BE ADDED.
APPLICANT PERMIT FEE SCHEDULE 88.50
ALL SEASONS BUILDING COMPANY PLAN REVIEW 57.53
14209 EWING AVE S
BURNSVILLE, MN 55306- STATE SURCHARGE(VALUATION) 1.25
(952)736-3308 TOTAL 147.28
Minnesota State License#: 20570015
OWNER
WELSH,JENNIFER
ll80 ELMWOOD AVE
MOUND,MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved 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 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
-requested in conformance with the State Building Code.This permit may be
revoked at an�time fo ue cause. � �
� ��..�� , �l i `� ��cc� � ,�. ,� �� ��� ��
_ _.,. 1;. ,.'YY?�i��I � �
Applicant Permitee Sig ur Date Issued By Signature Date
PARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
. � �- �
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Total Fee: $ ��� �� Date Received: �/a� o g
Entered By: Permit#:a�Q�- 00 /7�-
CITY OF ORONO - BUILDING PERMIT APPLICATION
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: t 6P,U E.c..l�v.=C���� �v�: ZIP: j5 3i��
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ I�es � NO If yes, a special event permit is required with Police Department and City Council app�roval
60 days prior[o the event. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non-permitted events will�aot be allowed.
NAME OF OWNER: j�NN it=�F' ' JC>F�r� A�MS PHONE: (home)
�
(work)
MAILING ADDRESS: 1��� ��mw�o� �v� CITY: �-�(a�jJ J ZIP: SS acsry
CONTRACTOR: L�(,� SEt�SoaS gu�c,�iNe� ���, , PHONE: ���2- �3to - �?.�
CONTACT PERSON: , )vS N / 5(=c�TT MOBILE/PAGER:
MAILINGADDRESS: �� 'L��! �wr,-�c� a�c`� CITY: p�Ra.t������ ZIP: S53C��o
STATE LICENSE: # ZC>.'> �r�C�i S EXPIRATIOI�'DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition � Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may require MCWD review and permits !
PROPOSED WORK(describe in detai�: TZ� Cx i 5;�,•�c. Z�t;LC .
f al��r r
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ Z��U
I hereby apply far 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 is not a pennit and work is not to start without a permit;and that the work will be
in accordance with the approved plan. _
APPLICANT'S SIGNATURE: `. �� -� DATE: � Z C9 ' Z��
__ _- /
�
31
,� I
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 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 ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legal ly required[o 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 entities authorized by state or federal 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 c_ommissioner of revenue mav 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,ifhe desires,shall be informed ofthe 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 dispu[e 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 of the private or public data upon request by the individual s�bject of the data. The responsible authority
may require the requesting person to pay the actual costs of making certifying,and compiling the copies.
The responsible authority sha11 comply immediately,if possible;with any request made pursuant to this subdivision,or within five days of
the date ofthe request,excluding Saturdays,Sundays and legal holidays,ifimmediate 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,
Sunda}�s and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness ofpublic or private data
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing[he na[ure ofthe disagreement The
responsible authority shall within 30 days either. (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 corzect. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with[he 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 PRNACY 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. ]3.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
! _��'����L F ('��r��1
First Middle Last
I�1Z0�+ �i.J�N�'i L��Jt 5
Address
�3�;�zti::,�; ��c �-t�.S �5�� `iSZ- � 3�� - �"3c�
Cit�� State Zip Phone
��-nndQ,rstand my right stated above.
�-_ � _ ���t� Zc�
Signature
Reset Form 32
. CHECg OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I( � C:' �1�-��w oc:;I
PID:
DESCRIPTION OF WORK.• /kk.. L�c�s`7 r�c L �
ZONING REVIEW BY.• , n�,1- DATEAPPRO I�ED: � ��/'U�
BUILDING REi�IEW BY.•
� '`"i- ; ` L..�,-- DATEAPPROVED: 9-3- o f3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes �/ No N�ATER CONNECTION
INVESTIGATION FEE Yes No�_ p�g FEE --
S�1C Yes No �/ SITEINSPECTION
Number of SAC Units OTHER s eci
— (P .fY)
ZONING CHECK LIST Zoning District: t...� - �,�j
Fire Departmerit: Post Office:
School District.•
Lot Area: Sq.ft. • Acres Width
Depth
Survey Submitted.• Yes No
Date of Survey:
Proposed Setbacks:
Fronz(Lake): Right Side:
�xr►c�--
Rear(Street): Left Side: �����"'�
G?�- eXI S�1 Vt C:�
.4djacenl Structures: Wetland: Q`2L�` -
Building Height.• Def. Hgt. Peak Hg2.
Lot Coverage:
Grading.• Staff,4pproval Date: By: Councilflpproval Date:
Septic: Staf�,4pproval Date: ' ��g By: w�
Zoni�zg File:- # Resolution: #__ Resolution Date:
Shoreland District.•
Avg. Setback: MCWD Permit:
Bluff Setback: Lot Coverage:
Ea isting Pro osed
Hardcover: 0-75' p
75-250'
250-500'
SDO-1000' �
Hardcover Variance Required.• 3'es No
Date of Council.4pproval:
IZE11'IARFiS(in house): :�j� us� �,t� � �,� ���i .� �",��, 1 h ��
U�' � .�+� "' .�- W 1�p,v(M 1 1 t,�;�
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�'w►�n � .
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B UILDING REVIEW CHECg LIST
UBC: lZ- 3 CONSTRUCTIONTYPE: �I N
Sg Footage ,�Per Sq Ftg
Basement x =
Ist Floor x =
Znd Floor x =
Garage x =
x =
TOTAL -
Estimated Construction Value: S
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Remaval Mechanical Waier Connection
✓Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
YY'all Board (Mfg.) i�'ell(State Permit)
✓ Final Grading/Filling Electrical(State Permit)
Other
REIKARKS(INHOZTSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access flpproval: Dafe By:
REMA.RIiS(TD BE NOTED ONPERMIT):
M�-':� � t7� C%XF'1� (�D�l1t,zMw-Yl�' C�� ��1`�-,11�1 � fCC..� — (�l'i (/�'1'�.Qi{�'sT�
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/r�/g� �.l���� ���" CITY OF ORONO
/'10�n`n, Y�N SS36y BUILDING P M{T PLAN REVIEW
INSPECTQR
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in full complianca w�,a1 all ;:�p!ic»bie b;�i;��rg ;�d zcni;�:c�Y1e.
Reqwrements ir,ciudtng iisms no;spaci;ica!!y.�oted in 6his rQv�ew.
IC�fiP THIS PLAN SET ON Sl7E AT ALL Tl�vt�5
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INSPECTION NOTICE SCHEDULED -Z-� /D=�
PERMIT NO.oZG����Z- COMPLETED
ADDRESS �/ �
OWNER CONTR. ��Q�
TELEPHONE NO. � �a �� — ` 4 �7 0
� DESCRIPTION ��� �D��
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION ,
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
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❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-460�
OwnerlContractor on ite:
Inspector._v ! 'J �
White Copyllnspector's File Canary Copy/Site Notice
� r Ci'�-�"� ` DATE TIME �
CITY OF OR NO � CALLED IN �
INSPECTION OT CHEDU EL� `� �/(�',3U
PERMIT NO. � '�d���oMP TED
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Call for the next inspection 24 hours in advance. �95Z� 249-46QQ
OwnerlContractor on sit�
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White Copyllnspector's File Canary Copy/Site Notice
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CITY OF ORONO CALLE�ti� -� �i—j•7—�
INSPECTION NOTICE (` �� �`� SCHEDULED , _�.0.� —I C
PERMIT NO. \ COMPLETED
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Ca11 tor the next inspection 24 hours in advance. (952� 249-4600
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