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Home My WebLink About2003-P06211 - addn/remodel/repair � PERMIT CITY OF ORONO Permit Number: 2�50 Kelley Parkway - PO Box 66 Po62i i Crystal Bay, Minnesota 55323 PefCTllt Type: Addition/RemodeURepair ky52) 249-4600 Date Issued: 4i3oi2oo3 SITE ADDRESS: 4415 Forest Lake Landing Mound,MN 55364 —P��: 07-117-23-24-0047 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Pernut Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Yiumbing iviecnanicai rirepiace Eiecuicai�siaie� NOTICES/REMARKS: FEE SUMMARY: PernutFee: $ 2,113.75 Vatuation: $ 300,000.00 Plan Review Fee: $ 1,374.03 State Surcharge Fee: $ 150.50 TOTAL FEE: $ 3,638.28 APPLICANT: Keith Waters&Associates OWNER: Timothy&Lori Line 6216 Baker Road -Suite 110 4415 Forest Lake Landing Eden Priaire,MN 55346 Mound,MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � �, APPLICANT YERMITEE SIG TURE ISSUED DY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Aoolicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 � � �� Total Fee: $ �� . is� �'�2� Date Received: f � �' �� Entered By: � h,�/� I Pernut#: _=�`/ j 7 / v � 1�' ., CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) � --------------------------------------------------------------------------- --------------------------- THE A.PPLICANT IS: (circle one) OWNER OR�CO TN�RACTO JOB SIT'E ADDRESS: �'� � S �U('�� ( �� -�tf`��I�IP: NAI�IE OF OWNER: Tm �` ��l�_ L-I�U � PHONE: (home) (work) �1,�,.��-4 7��lh�J� NIAII,ING ADDRESS: ��S �D�'--�5( Cl-�K��ITY: %2�� ZIP:� �� CO\�TRACTOR: k�F4 � -Z'2��v C�. PHONE:_ �� j CO`�'TACT PERSON:�„�� NIOBILE/PAGER: " ` 1�ZAII,I�i 1G ADDRESS: (�:2IG� i�AK�i�+�f� CITY: ;� n� �p�i�ZIP:_<;�4�; � ST�TE LICENSE: #�`�� S� ARC��'I'ECT/ENGINEER: ��.�; PH0�1E: �iAII.I�i 1G ADDRESS: CITY: ZIP: NA�IIE: REGISTR.ATION# TYPE OF WORK: New C�ddition Accessory Structure Move emodel Alteration Land Alteration PROPOSED WORK (describe in detai�: �� /-� ��(, ��L' ��1�� STORIES: �:� SQ. FEET OF EACH FI,OOR: ��Q� C.��1z- ��-'r��• n0. OF BEDROOMS: � GARAGE STALLS: ATT. DET. ESTLIIATED CONSTRUCTION VALUATION (excluding land): $ ?C��, �� I hereby apply for a buildin� 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 work is not to start without a pem�it; and that the work wilI be in accordance with the approved plan. APPLICAl�iT'S SIGNATURE: � ' ATE: C� NOTE! Parade of 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. 5 � 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 co�den[ial data concerning himself �� shall be informed of: (a)the purpose and intended use of the requested data within the collecdng state agency,polidcal subdivision, or stacewide system;(b)whether he may refuse or is legally required to supply the requested data; (c)any laown consequence arising from his supplying or refusing to supply private or confidenaal dara;and(d)the idenriry of o�her persons or enaaes authorized by srate or federai law to receive the dan. This requiremen[ shall not apply when an individual is asked to supply investigative data, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income taz or orocertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsibie 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 confidenrial. Upon his further request,an individual who is the subject of stored private or public dara on individuals shall be shown the data without any char;e[o 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 acdon pursuant to this secoon is pending or addidonal data on the individual has been coflected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible auchoriry may require the requesring person to pay the actual costs of making,cercifying,and compiling the copies. 'Ihe responsible authoriry shall comply immediacely,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays, Sundays and legaf 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 addidonal five days within which to comply wirh the request, excfuding 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 da[a concerning himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the�ature of the disagreement. The responsibfe authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nocify past recipients of inaccurate or incomptete dara,including recipienu named by the individual;or(b)nodfy the individual that he believes the data co be correct. Data in dispute shall be disciosed only if the individual's statement of disagreement is included with the disclosed dara. The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminis�aave procedure act relatin� to contested cases. D�TA 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 m3y 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 riehts 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. � .� , � � i ' First bfiddle _�� Last .�` C l C.,�� ,� i� � t��'��= �� Z� C�ry Srate Zip Phone I understand my rights as stated abov . i� �� `�� si;nature 6 � � CHECK OFF LIST FOR ISSUAI�ICE OF PER.IVIITS FOR OFFICE USE ONLY A.DDRESSORLEGAL: yy �S Fo��% L�+i� �.•�� PID: � DESCRIP'rION OF WORK: w z (��,,o� �=��,,,S,.9 ZO�TING REVIEW BY: DATE APPROVED: y-z� -0 3 BUII.DING REV�W BY: DAT'E APPROVED: y_ z,..{ -v3 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes _� No PLAN REVIEW Yes J� No SEWER CONNECITON STATE SURCHARGE Yes � No WATER CONNECITON INVESTIGATION FEE Yes No v- PARK FEE SAC Yes No � SITEINSPECTION Number of SAC Units OTHER (specify) --------------------------------------------------------------------------------------------------------------------- ZOti"Il�1G CHECK LIST Zoning District: �v v C<fi'+rvc,� 4 Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres � idth Depth Survey Submitted: Yes No ate of Survey: Proposed Setbacks: Front (Lake): Right Side: Rear (Street): Left Side: Adjacent Structures: Wetland: Buildin� HeiQht: Def. Hgt. Peak Hgt. Lo[ Covera�e: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # R olution Date: Shoreland District: Av�. Setback: Bluff Setback: Lot Co��erage: Existing Proposed Hardcover: 0-75' 7�-2�0' 2�0-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: RE�IARKS (in house): 7 BUILDING REVIEW CHECK LIST �C: 2- 3 CONSTRUCTION TYPE: �lN � Sq Foo[age $ Per Sq Ftg Basement R = lst Floor R = 2nd Floor R = Garage R = R - TOTAL Estimated Construction Value: $ 30c�,00� °`� Inspections Required: Work Requiring Separate Permits: Site _�Plumbing Fire Hardcover Removal ,c Mechanical Water Connection _� Footing Septic Sewer Connection �C Framing �_Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board _�(Mfg.) Well (State Permit) Final Grading/Filling � Electrical (State Permit) Other REI�IARKS (Pi 1 HOUSE): ________ ------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existin� New Access Approval: Date By: ----------------------------------------------------------------------------------------------------------------------- RE�VIARIiS (TO BE NOTED ON PERI�II�: 8 ✓ ��j DATE TIME CITY OF ORONO � CALLED IN INSPECTION NOTICE SCHEDULED __��' ;� • �-' PERMIT N0. �'r� Lo Zl I COMPLETED ADDRESS i_l c,/ /� F ��i �. S-f � i� C CT �.Y.��"` .�, OWN ER CONTR.�� i 7' G� C L>Ct% -�__; TELEPHONE N0. L; �� `� �C v� y��% � DESCRIPTION /Ir:� --�� `�i � ( Ca'Y-i c'y'` � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 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 O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 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 � OWNER/CONTRACTORTOMEETYOU• YE , , � COMMENTS: �� ''1�'�� W a � J O � � O � W � Q � 2 W � W � � � d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOfi �CITATION ISSUED ❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (95Z� Z49-4600 OwnerlContractor te: Inspector. White Copyllnspector's File Canary CopylSlte Notice �'�y - �� DAT i TIME CITY OF ORONO CALLED IN . �t � �� - -'�' �, INSPECTION TICE SCHEDUL�U�I G- PERMIT N0. � C% ��z-� � COMPLETED ADDRESS ��{ �-I I �� xr��f L� LC�(;'�7I , OWNER CONTR. �� i`�-�1 �,��,�`'c�Q� TELEPHONE NO. � � �� — `''� ( �'" � �� / � � DESCRIPTION �r�' �- �� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL 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 J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 S i FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU: ES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � � d W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE w ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPOFiARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �g5Z� Z49-4600 OwnerlContrac i e: Inspector. — White Copyllnspector's Fi Canary CopylSite Notice (se�� t/ DAT TIME CITY OF ORONO CALLED IN �"Z INSPECTION N TICE SCHEDULED � �� 3�Q o PERMIT N0. ��Z� I COMPLETED , ADDRESS _. 7�I s F�-� ��F l OWNER CONTR.�� L,�.��J TELEPHONE NO. �O�Z �l O 7`�'�Sq � DESCRIPTION ��YY�� -�� L�cx� � 01 FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING Q�RAMING 13 MECHANICALFINAL 19 LAKESHORE/WETLANDS y 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 O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FI AL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL � 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W � � J O � � O � W � Q � Z W � W � � O W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-46�� OwnerlContra site: Inspector. White Copy/lnspect s File Canary CopylSite Notice �s�-�- � ,/ D� TIME CITY OF ORONO CALLED IN INSPECTION N TI SCHEDULED �-�7-G?� �;.3-�a PERMIT NO. 'i�•�� COMPLEfED ADDRESS �� - ��-- OWNER CONTR. ��-- �'�� TELEPHONE N0. �'l Z /��C - 7�S—`/r � DESCRIPTION �L �� Oi FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL 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 � 10 PLUMBING FINAL ✓ 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O >. � O � W � Q � 2 W � W � � � d W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContr site: Inspector. White Copy/lnspector's File Canary Copy/Site Notice � I; DATE TIME CITY OF ORONO CALLED IN INSPECTION N TICE / SCHEDULED ' ' • � �ERMIT N�. � c�nn�lETE� ADDRESS e OWNER CONTR. TELEPHONE N0.�1� �D 7��9 . � DESCRIPTION �f lilC�Y^ GG L/�l�l�f � 01 FOOTING 11 MECHANICAL RI 18�EXCAV/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 INSPEC710N 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 = 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: � � a � �, o �— �,{�` �,+� � � � � � � � � � rl s V� W Q✓ �59 �fe PD 6353 Fx�-�.� � D 5 � � � `�iLt. � '�5 w � W� O�7VORKSATISFACTORY:PROCEED ROJECTCOMPLETE W O CORRECT WORK&PROCEED �,l ISSUE CERTIFICATE OF OCCUPANCY � G CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 Owner/Contr s te: Inspector. White Copyllnspector's File Canary CopylSite Notice