HomeMy WebLinkAbout2007-P11058 - re-finish basement PERMIT
CITY �F ORONO
Permit Number:
2750 Kzlley Parkway- PO Box 66 P11058
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued:
6/12/2007
SITE ADDRESS: 1199 Elmwood Ave Unit#
Mound,MN 55364
PID: 07-117-23-14-0059
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit T e: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
YP
DETAILS:
Approved per resolution#:
Separate permits required: Electrical(state)
NOTICES/REMARKS:
Re-Finishing Basement
FEE SUMMARY: Permit Fee: $ 363.25 Valuation: $ 23,000.00
Plan Review Fee: $ 236.11
State Surcharge Fee: $ 11.50
TOTAL FEE: $ 610.86
APPLICANT: Metro Prairie Homes OWNER: Mr. &Mrs.Harvey
80 W 78th St. Suite 240 1199 Elmwood Ave
Chanhassen,MN 55317 Mound MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL fMPROVEMENTS 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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APPL[CANT E ITEE SIG ATURE I SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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Total Fee: $ � ���o Date Received:
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Entered By: �� Permit#: � i � C���
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print a[I ii�iformcrtion)
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THE APPLICANT IS: (circle one) OWNER OR�CONTRACTOR�
JOB SITE ADDRESS: �% �� ��,��o-�G —�.e��i.��z- ZIP: ��3� `�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �NO /f yes, a specral event per•mit is�•eqarired lvith Po/ice Departme�zt and City Coa�nci(approvn(
60 dnys prior to the event. S/nrttle birs service will be reguired un/ess app/icant demonstrates
sa fficient on-site parking is available. ��'on-permitted events�vill not be aflotived.
NAME OF OWNER: SGOT d�Z15 S�t �An U�y PHONE: (home) ��'y�,�,�-1�y�
(work)
MAILINGADDRESS: 1�9y GL/�1��,p�i yQv�. CITY: /I�Dr�t�� ZIP: 553(�y
CONTRACTOR: �f1�/�D �i('6'�1 RI 6 �il o �v1zS PHONE: `�5�'�`1'3�i"����—
CONTACT PERSON: �p�ri'�Z j�I>F[_�/ �,i" MOBILE/PAGER: �;5',2 -;t7� , S7�
MAILINGADDRESS: �3b %�'�S� �7`�'t�i `��, CITY:�=JJ��+��1y�55�n� ZIP: 5�3�i �
STATE LICENSE: # �7 y( EXPIRATION DATE: �P2l� U 3
,U� k�i' ' .
AA���fi��ER L�Q�vER�-o.v2 �Cv�>r��� n�>,�-yv PHONE: �,f�� ���0 . L�(d.`7
NIAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Re►nodel/Alteration (ie: Siding, Windows) ✓---�
Any earth movement may require MCWD review and permits !
PROPOSEDWORK(describeindetcri�: �rj'�p��� - �t2j',�.'��� LIz�Lt+v`�-- d-V,�a��L�r�fr �—
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�J-�f�ti ST�'� r�IL LUA.c/ A�^'/� �Q�? 3;Ya%�,��j�.' _ ��d�0 � �YI3A/L �4ND �A /3�ivETS- f4t� � sc���
`� (�� 7(�j�^L%r j= )Q�1�L:��.F' . ��G*%i�Z- �B�`9ADD -�h�rss ZrG-i.�I`i�t:��Nr'''�i�/LS/�✓�L` J. ��9 /rt/f .
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land j: $ ��,���•' �
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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 is not a permit and���ork is not to start without a permit;and that the���ork�vill be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: , DATE: .5 -� �j --p �
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Sec.13.04 R[GHTS OF SUBJECTS OF DATA
Subd. l. Type of data The rights of individual on whom the data is s[ored or to be stored shall be as set forth in this section.
Subd.2 Infonnation required to be given individual. An individual asked to supply private or confidential data concerning himselfshall be
infonned of: (a)[he purpose and intended use of the requested data within the collecting state agency,political subdivision,or state�vide 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 contidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data. This requirement shall
no[apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision i,to a law enforcement officer.
The commissioner of revenue mayplace the notice required under this subdivision in the individual income tax or property 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 infonned whether he is the subject of
srored data on individuals,and whether it is classitied as public,private or contidentiaL Upon his further request,an individual who is dte subject of
stored private or public data on individuals shall Ue shown the data without any charge to him and,if he desires,shall be informed ofthe content and
meanine 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 ro this section is pending or addi[ional data on the individual has been collected or created. The
responsible authoriry shall provide copies of the privare or public data upon request by the individual subject 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 authoriN shal I compfy immediatelv,if possible,with any request made pursuant to this subdivision,or within tive days of
the date of the request,e�ciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [fhe cannot comply wid�the request
within that time,he shalf so inform the individual,and may have an additional five days�vithin 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
conceming himself. To exercise this right,an individual shall notily in wTiting the responsible authority describing the nature 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 correct. Data in
dispu[e shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible aud�ority 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 infonn you that your request
for a pennit or license from the City of Orono or auy 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 detennine 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 a�encies 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 ri;hts under M.S. 13.04(available upon request)to review private data on yourself.
6. Your fut(name is required to process this application or permit.
(�'o(�-Q l�� �I�FC(,(C.�
First �iiddlc Last
�C� i�1�s��i 7�'f1�1 �T 2��%
Address
C' N',�5,'��. ;M n�, �S3y-�� `��,z���3�,--�,6� -�
City State Zip Phonc
i understand mv rights as stated above.
4
ignat rc
Resef Form 32
.
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I 1`►�t L.C.Mw o c�vJ ,q v,t
PID:
DESCRIPTION OF�I�ORK: (A,,,�c� 'uc� �..r.^1-��ec...
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ZONING REVIEW BY: � DATEAPPROVED:
B UILDING RE[rIEW BY: DATEAPPROVED: 5-3 0-0�
FEES TO BE CHARGED: / Nlisc. Fees Calca�lated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes� No SEWER CONNECTION
STATE SURCHARGE Yes� No WATER CONNECTION
INVESTIGATION FEE Y'es No�� PARK FEE
SAC Yes No�� SITE INSPECTION
Nzu�zber of SAC Units OTHER (specify)
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ZONING CHECK LIST 7o�7ii�g Drslr ict: N� C/tA/`r!o 2.
Fire Department: Post Office: School District:
Lot:lrea: Sg.ft. .4cres I�idth Depth
Scu�vey Submitted: 3'es No Date af Susvey:
Proposed Setbacks:
Front(Lake): Right Sid :
Reai•(Sh•eel); Left S' e:
Adjncent Structaeres: G['etlancf: �
Bui/di��g Neight: Def. Hgt. Peak Hgt.
Lot Cove�•age:
Grnding: Stnff.dpp��oval Date: 1�: Council,�Lppr•oti�a!Da�e:
Septic: Stnff.=lpprova!Dnle: 1�y
7_o��ing File: � Resohrtion: = Resolutian Da(e:
Sl��orelnnd District. � AlCGVD Per�rrit:
:ltig. Setback.• Bla�ffS'etback: LotCoverage:
Ezistiiig Proposecf
Hn�•dcover: 0-%.i'
7 i-?i�' -- -
zsn-�on�
;on-�ono�
Flardcover [�'ariance Required� �'es �Vo D�ue.of Coln�cil.�tpprovnl:
RE:�I4RICS(in house):
3�
B UILDING REVIEW CHECK LIST
UBC: R•3 CONSTRUCTIONTYPE: �lAI
Sq Footnge �'Per Sq Ftg
Basement Y —
Ist Floor Y —
?nd Floor t —
Garage r —
s =
TOT.d L
0
Estintated Co�tstr�ictiolt Value: $ 23,(�OO ¢
Irispectiats Required: 6�'or•k Regrtiri�rg Sepnr�ate Periatits:
Site Phunbing Fire
Hnrdcover Removal tllechnnicnl Y�ater Co�inection
I'ooting Seplic Setiver Ca�nection
pC F'rQirii��g Fireplace Lmvti Ir•rigation
�_I��sarlatior� (�1�Iasoniy) Ot{aer
�_Yi�all Boc�rd (�i-lfg.) YVell(State Permit)
_�Final Gradrng.'Filling _�Electr•icnl(State Permit)
Othef•
REMARKS(INHOUSE):
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RE vIEW BY OTHERS: DATE:
Access: Exisli��g �'erv
Access.9pproval: Dale By'
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REt�14RKS (TO BE NOTED ON PE.RMIT):
3a
[ / DATE TIME ✓
t� ITY OF ORONO CALIED IN _�21�
INSPECTION N IC SCHEDULED �3� 3'C�o
PERMIT NO. � � COMPLET o
ADDRESS I (
OWNER CONTR. — �QI►'�
TELEPHONE NO. `'1�..J�- ��I � I�� �CJ ���
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� DESCRIPTION �� � V � —
� 01 FOOTING 11 MECHA ICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 M ICAL 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 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
� OWNERICONTRACTOFi TO MEET YOU:_YES_NO
� COMM NTS:
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W ORK SATISFACTORY:PROCEED fl PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ;_� pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CfTATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next i spection 24 hours in advance. (952� 24J-460O
OwnerlContract s te
Inspector.
White Copyllnspector's File Canary CopylSite Notice
� DATE TIME �
�� ITY OF ORONO C LLED IN � �. 1��I-3 �1�'1
INSPECTION N T E s�HEDULED � ' Z� 2:��M
PERMIT NO. � COMPLETED
ADDRESS I t �l� �I��'��C.'1,��
OWNER CONTR. Y��-IMPTfG �Iu�YI.Q-
TELEPHONE NO._���- ZZI ��I �G ���
� DESCRIPTION �-Sl,� �� l'�'
� 01 FOOTING 11 MECHANICAL RI 18 XCAV/GRADING/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 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i 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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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
��CORRECT WORK&PROCEED '7 ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN � CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for ihe next inspection 24 hours in advance. �95Z� Z49-46�0
OwnerlContractor on ite: �
Inspector. lol / `
White Copylinspector's File Canary Copy/Site Notice
�� � RD TIME "
�� CITY OF ORONO �CALLED IN v'
INSPECTION N CE r, SCHEDULED 'D cZ;D-a
PERMIT NO. �Sb COMPLETED
ADDRESS �/�I q .��t-uJ7l� C�
OWNER CONTR. 7
TELEPHONE N0. ! �� � � SI�o
� DESCRIPTION ���'(� r���
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 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-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
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� f�N/ORK SATISFACTORY:PROCEED PROJECT COMPLETE
W �L�CORRECT WORK&PROCEED ^ ISSUE CERTIFICATE OF OCCUPANCY
� C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �� pHOTOTAKEN
INSPECTOR WILL RETURN I
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne�t inspection 24 hours in advance. �952� 24Q-46QQ
OwnerlCon�or or�s�e:
Inspector.� 1*-���}��
White Copy/lnspector's File� Canary CopylSite Notice