HomeMy WebLinkAbout2008-00037 - addn/remodel/repair r
� CITY OF ORONO PERMIT NO.: 200&00037
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE �SSUEn: 07/15/2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 1199 ELMWOOD AVE
PIN : 07-117-23-14-0059
LEGAL DESC : SKARP&L[NDQUISTS FERNHILL LA
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 125,000.00
NOTE: SEPERATF.PF;RMITS REQUIRED: PLUMBING,MECHANICAL,AND ELECTRICAL(STATE)
APPLICANT PERMIT FEE SCHEDULE 1,206.75
FRIEDELL ARCHITECTS& BUILDERS PLAN REVIEW 784.39
2238 EDGEWOOD AVE. S
ST. LOUIS PARK, MN 55426 STATE SURCHARGE(VALUATION) 62.50
(952)548-7000 TOTAL 2,053.64
Minnesota State License#: 1772
OWNER
HARVEY, MR. &MRS.
1199 ELMWOOD AVE
MOUND, MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
thc approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
no[grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shaii be compied with whether or not specified herein.This permi[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 timc after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in�onformance with the�tate Building Code.This permit may be
reiqked at any �' for due cause.
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��tCpplicantPer� � e ignat e Date ��
Issued By ' ature � Date ��
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBE A VE.
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Total Fee: • / Date Received: �P`� ��v/'('W Pll�� G/���-
Entered By: Permit#: A �/913�
'0�0 O �-—T 00�3/
CITY OF ORONO - BUILDING PERMIT 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 OR CONTRACTOR
JOB SITE ADDRESS: 1 i99 EtmWooa��e ZIP: 55364
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 Department and Ciry Council approval
60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates
su�cient on-site parking is available. Non-permitted events wil!not be allowed.
NAME OF OWNER: Scot&Lissa}[avey PHONE: (home)_
(work)
MAILING ADDRESS: 1199 Elmwood Ave CITY: Mound Zip: 55364
CQN'j'�C'TQR: Friedell Architects&Builders P�j�j��i: (952)548-7000
CONTACT PERSON: Ro�er Friedell MOBILE/PAGER:
ME�II,IN�`i E���R�+SS: 2238 Gdgewood Avc Cj'j'Y: St Louis Park Zjj�; 55426
STATE LICENSE: # 177z EXPIRATION DATE: o3i3 tro9
ARCHITECT/ENGINEER: Mark Gunstad PHONE: 612.963.9408
MAILING ADDRESS: 2566 Ellis Avc#408 CI'j'Y: St Paul ZjP; 55114
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 !
PR�PD.SE�w�RK(I�BSCYibe ii2 delQl�: kitchen addition into garage,roof overlay
STORIES: 1 SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: 2 GARAGE STALLS: ATTACHED ✓ DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �LS ��
I hereby apply for a building permit and I acknowledge that the information above is complete and accLirate;
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 to start without a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE:
31
_ I
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd I Typc 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 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 reyuested data;(c)any known conscyuence 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 Cederal 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 entbrcement officer.
The commissioner of revenue mayplace the notice required under this subdivision in the individual income tax or prooertv tax refund
instructions instead of on those fonns.
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 dassified 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 intormed 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 dispute or action pursuant to this section is pending or additional data on the individual has been collected or created 'fhe
responsible authority shall provide copies of the private 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 au[hority 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 compl iance is not possible. Ifhe cannot comply with the request
wilhin that time,he shall so inform the individual,and may have an additional five days within which to comply with thc 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 himselY. To exercise this right,an individual shall notity in wTiting the responsible authority describing the nature of the 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 bel ieves the data to be correct. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The detertnination 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.
First Middle Last
Address
C�ty State Zip Phone
1 understand my ' hts as stated above.
S' n.� e
Reset Form 32
,„{
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �t�,5 C(�vv��,�,c�c,,/� �q JL
PID:
DESCRIPTION OF WORK: �c�-r-c�l��.,., t'?–�1,,,�A,�e`
ZONING REVIEW BY.• DATEAPPROVED: (D•z�{-o$ W
BUILDING RE[�IEW BY.• DATEAPPROi�E'D: �-z�i- u�
------___—_____--------------------------
FEES TO BE CHARGED: Misc. Fees Calczrlated B}�:
PERMIT Yes � No
PLA1V REVIEW �es ✓ No SEWER CONNECTION
STATE SURCHARGE �es � No WATER CONT%ECTION
INVESTIGATION FEE �es No_s� PARK FEE
SAC Yes No �/ SITEINSPECTION
Nzrmber of SAC Units OTHER (spec�)
ZONING CHECK LIST Zoning District: �o C�,� �,�,GP� �� -'_____________�__
Fir•e Department: Post Office: School District:
Lot Area: Sq ft. Acres Y�'idth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Fr-ont(Lake): Right Sid :
Rear(Street): Left Sid :
Adjacent Structures: Yi�'etland:
Building Height: Def Hgt. Peak Hgt.
Lot Coverage:
Grading: StaffApproval Date: By�: Council Approval Date:
Septic: StaffApproval Date: $��;
Zoning File: # Resolution: # Resolution Date
Shoreland District: MCY!'D Permit:
Avg. Setback: BlzffSe back: LotCoverage:
Faisting Proposed
Hardcover: 0-'�'
'�-_'�0'
2J O-.i 00'
�00-1000'
Hardcover f"ariance Required: }es No Date of Cozuzcil.9pproval:
REMARKS(in house):
1
33
,.n� � .i��IP:1 �
BUILDING REVIEW CHECKLIST
UBC: /Z- 3 CONSTRUCTIO:ti`TYPE: _ �lK.J
Sq Footage $Per Sg Ftg
Basement x =
Ist Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction f�alue: $ /Z5,d�p o0
Inspections Required: W'ork Requiring Separate Permits:
Site �Plumbing Fire
Hardcove�•Removal �C_iLlechanica! W"ater Connection
Footing _ Septic Seiver Connection
�_Framing Fireplace Lawn Ir•rigation
�( Insulation (Masonry) Other
Wall Board (rl�tfg.) i�Y'ell(State Permit)
oC Final Grading,iFilling �L Electrical(State Permit)
Other
REMARKS(INHOUSE):
REVIEW BY OTHERS: DATE:
Access: E,iisting N'ew
.9ccessApproval: Date By�
REMARKS (TO BE NOTED ONPERMIT):
34
� DATE TIME �
� �
CITY OF ORONO (� CALLED IN
INSPECTION NOTICE SCHEDULED — �_
PERMIT N0. ��� ��.�0��COMPLETED
ADDRESS �
OWNER CONTR. � �
TELEPHONE NO. l�[� �o� -' �.1�'� �� �I
� DESCRIPTION 1�Gt-�'Yl l '� / t �/
/
� ❑ 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
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOH TO MEET YOU: S_NO
� COMMENTS:
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ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CQRRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-460�
OwnerlContractor on site:
Inspector. � �
White Copyll�spector's File Canary CopylSite Notice
1�/ � � ATE TIME v
CITY OF ORONO CALLED IN o6 D 8'09
INSPECTION NOTICE SCHEDULED O /:30
PERMIT NO.�� �bL7O3 7 COMPLETED
ADDRESS �� l`GI ��L�C�d-�'� �.�/�j
OWNER CONT�.�',L1Jal����
TELEPHONE NO. — — D O �
� DESCRIPTION �7(��l_,�-X� —
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED � ROJECTCOMPLETE
ORRECT WORK&PROCEED _ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN
'7 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 2a hours in advance. (952� 249-46�0
OwnerlContractor on site: t
Inspector. �
White Copyllnspector's File Canary CopylSite Notice