HomeMy WebLinkAbout2003-P07056 - addn/remodel/repair - R PERMIT
CITY OF ORONO Permit ►vumber:
2750 Kelley Parkway - PO Box 66 Po�os6
Crystal Bay, Minnesota 55323 P2fTTllt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: t2�g�2oo3
SITE ADDRESS: 1485 Green Trees Rd
Wayzata,MN 55391
PID: i i-1 i�-23-23-001 i
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residenrial
Buildin Census Code 434
Permit Class: g
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Eiecuicai�siaiej
NOTICES/REMARKS:
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FEE SUMMARY: Pernut Fee: $ 492.25 Valuation: $ 35,000.00
Plan Review Fee: $ 319.98
State Surcharge Fee: $ 18.00
TOTAL FEE: $ 830.23
APPLICANT: Structural Image OWNER: Charles&7eanette Berg
1405 N. Lilac Dr. #226 1485 Green Trees Rd
Minneapolis,MN 55422 Wayzata,MN 55391
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.
�'� � �`-- ��
APPLICA T PE � ITEE S GNATURE ISSUED BY SIGNATURE
Copies: 1-File(Si�nitures Required). 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
�03 ~
I" ��� `J �
Total Fee: S ��= �• �� Date Received• �2 -z �3
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Entered By: `"r��._ Permit#: �O 70S(o
CITY OF ORONO - BUILDING PERIVIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
--------- • ---------------------------------------------------------------------------
�_..__.. .__.. _,
THE APPLIC?�vT IS• (circle o�te) O`VNER O ONTR�CTOR�
JOB SITE ADDRESS: i`t-C"� `'��1 i�(�=� ,�-C:!�1t-''� ZIP:
`Vill this be a Parade of Homes, Remodelers Sho�vcase Home or other Display Home?
❑ Yes � No If yes, a special event permit is reqi�ired with Police Department and City
Coacncil approval 60 days prior to the event. Non permitted events will not
be allotived.
NAME OF O�V�1ER: �t'�`� �w�='G�_ PHONE: (home)
(work)
1�IAILING ADDRESS: �`��'� v7�'�� ��`''�� ��ITY: C��i�.c„� ZIP:
CONTRACTOR: ��i�%t�ca'Z,"(l.qc� t M,��.� PHO`'E: -7��>�J�f'! J��j
CONTACT PERSON: � j�n,� 1,t�.1�c�2�t� �TOBILE/PAGER:
MAILING ADDRESS: lQ-C`�1�,Z�: �_-�L�c� UtZ.t�Z?�;CITY: =�*(��1 ZIP: ��=��ZZ
STATE LICEtiSE: # ��c�"1Z- �`'i �.
ARCHITECT/ENGINEER: PHOi�TE:
MAILING ADDRESS: CITY: ZIP:
NANIE: REGISTRATION #
TYPE OF�tiORK: New Accessorv Structure
Addidon �_ Nlove r
RemodeVAlteration i�c` Land Alteration
PROPOSED «�ORK(describe in detai�: `�,��p �''itI'..,c�1�9 ��'�Lnc`� f�USj�,.a�1--
.P�2�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIi�IATED CONSTRUCTION VALUATION (excluding land): $ ��;�'�L —
I hereby apply for a building permit and I acl�owledge that the information above is complete and accurate;that the
work w711 be in conformance «zth the ordinances and codes of the City and with the State Building Code; that I
understand this is not a pemut and work is not to start w-ithout a permit; and that the work will be in accordance with
the approved plan.
--,
APPLICANT'S SIGNATURE�_r:c�"�-�-� �- DATE: l2 � 2 '`'' �
r. ' '
Sec.13.04 RIGHTS OF SUBJECTS OF D�TA
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 indi��dual asked to supply private or confidenUal data concerning himself shall be
informed oL• (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide rystem;(b)
whether he may refuse or is legally required to supp)y the requested data;(c)any know n conseque�ce arising from his suppkin;or refusing to supph-
private or confidential data;and(d)the identity oCother persons or entities authorized by state or federal law to receire the data. This requirement shall
not appiy 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 mav lace the notice re uired under this subdivision in the individual income tax or ro ertv tai refund
instructions instead of on those forms.
Subd.3. Access to data by individual. lipon request to a respoosible 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 rnnfidential. Upon 6is further request,an indir•idual N ho is the subject of
stored private or public data on individuais shall be shown the data without any cha se to him and,if he desires,s6a11 be in(ormed of the content and
meaning of that data. After an individual has beeu shown the private data and informed oC its meaning,the data need not be disclosed to him[or 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 shail provide copies of the private or pubiic data upon request b}•the individual subject of the data. T6e responsible wthorih�mav
require the requesting person to pay the actual costs of making,certifying,and compiling the copies. • -
The responsible authority shall comply immediately,if possibie,with any request made pursuant to this subdivision,or w ithin fn•e days of the
date o[the request,excluding Saturdays,Sundays and legal holidays,i[immediate compliance is not possible. If he can�ot compk with the requestNithin
that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,Sundacs
and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeoess of public or private data
concerning himselL To exercise this right,an individual shall notify in writing the responsible aut6ority describing the nature of the disas.reement.The
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete aod attempt to�otify 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 statement oCdisagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrati�e procedure act relating to
contested cases.
D:�TA PRIVACY AD�TSORY
In accordance with 1�I.S.13.04,Subd.2, "Rights of subjects of data",we would like to inform you that�-our request
for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
conFdential information.
You are notified that:
1. The information you furnish will be used to determine�-our 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 estent necessar�-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 i�I.S. 13.04 (a�•ailable upon request) to review private data on�•ourself.
6• Your full name is required to process this application or permit.
First Middle
Last
Address
C�ty State
Z�P Phone
I understand my rights�as stated above.
�
i r �
: ';,?-7`�
,2�J r��
Signature
� � CHECK OFF LIST FOR ISSUANCE OF PERdiITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: /y�S G2E�N riu,=Z S �Y�
PID: .
DESCRIPTION OF WORK ��,,,�,��Jo� ��A ��,��N� ��U�
ZO�'ING REVIEW BY: DATE APPROVED: �Z- y_ 0 3
BUILDING REVIEW BY: DATE APPROVED: ,�r- y-o�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERIIIIT Yes _,� No
PLANREVIEW Yes_1� No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVES77GATION FEE Yes No PARK FEE
SAC Yes No SITE INSPEC770N
Number of SAC Units OTHER (specify)
----------------------------------------------------------------------------------------------------------------------
ZO�VING CHECK LIST Zoning District: �vu c �
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetl nd:
Building Height: Def. Hgt. Pe Hgt.
Lot Coverage:
Grading: Staff Approval Date: Council Approval Date:
Septic: Staff Approval Date: By.
Zoning File: # Resolution: # Resolution Date:
Shorelan.�District:
.-��g. Set6ack: Bluff Setback: Lot Coi�erage:
Ezisting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RE�1�iARKS(in house):
32
. . .
BUILDING REVIEW CHECK LIST
UBC.• �•3 CO�VSTRUCTION TYPE; ynJ
Sq Footage $Per Sq Ftg
Basement X
lst Floor x
2nd Floor X
Garage X =
x
TOTAL
Estimated Construction Value: $_�� U o o �
Inspections Required: Work Requiring Separate Permits:
Site P[umbing Fi�e
Hardcover Removal Mechanical
X Footin Water Connection
g Septic Se�ti•er Connection
_�Framing Fireplace Luxn Irrigarion
Insu[ation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_�( Final Grading/Filling �c Electrical (State Permit)
Other
------�______
�----------------__
REMARKS(INHOUSE): �� ---
------------------------
-------------------------------------------
REVIEW BY OTHERS: DATE: �
Access: Existing ���t,
Access Approval: Dare
BY:
------- -----------------------
-----------------------------------
REAIARKS (TO BE NOTED ON PERMIT):
33
, AUG-04-2003 a8�06 CLOUSER P.02
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�� � � STRUCT L I1V�AGE
DESIGNERS & BUILDERS OF ROOM ADDITIONS • KITCHENS • PORCHES
♦
1�305 N.LILAC DR. #226 GOLUEN VALLEY, MN 55422 763-541-5303 FAX 763-541-5317
June 9, 2004
The following is in reference to the screen porch ai i 4�� Greer� "Trees Ro«d, Orono, Minnesota.
The compression perpendicular to the grain on the horizontal plates is as follows:
Total load per 4 x 4 post equals 1982 pounds. 12.25 square inches per post, 162 pounds per
square inch of post. i`he a�lo;vahle i�► c,�r��pression perpendicular to the grain on horizontal plates
is 375 pc�t�nds p�r squarr� ir�ch of loac�.
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DAT,'E� TI M E
CITY OF ORONO CALLED IN o`
INSPECTION N TICE SCHEDULED �� �°U•
PERMIT NO. f�SZ-P COMPLETED
ADDRESS I��s� :/��C��1 /l�-�C S ��
OWNER CONTR. ✓,�Y Sl�
TELEPHONE NO. � a` ✓� S
� DESCRIPTION S r A�.�,�- ����
� 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
� 4 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 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 Rt 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMB /"� 36 FOUNDATION/REMOVAL
� OWNE /CONTRACTOR T MEET YOU:�YES_NO
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O �CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. L, pHOTO TAKEN
INSPECTOR WILL RETURN
'�CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (g52) 249-460�
Owner/Contractor on s�te:
Inspector.
�
White Copyllnspector's File Canary CopylSite Notice
/ V
DATE TIME
CITY OF ORONO CALLED IN •`'•-�'
INSPECTION NOTICE SCHEDULED 5- -o � ��
PERMIT NO. F�0705�o COMPLETED
ADDRESS � � S
OWNER CONTR.�fY(lL� ti2R�Q_�
TELEPHONENO. ��Z ��� I2D�
� DESCRIPTION Cl��C-� ��• �'I ���
� 07 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 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 HAFD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CAII INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins ction 24 hours in advance. (g52) 249-46��
OwnerlContra o te:
Inspector. '�.L
White Copyllnspector's File Canary Copy/Site Notice
✓
DATE ,�/ TIME
CITY OF ORONO CALLED IN 3'` �-�"� 1
INSPECTION NOTICE SCHEDULED �i —5 ��'`1 C' i�. . �
PERMIT NO. r�' ?C ���' connP��Eo �--
ADDRESS_ l`��(-� �j'E-('6 j I/�t c .5 �L��k '
OWNER CONTR. �f�����'v�f��C� �i`�L�--
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TELEPHONE N0.1,��'� �(� C� � y�' �
� DESCRIPTION _�U�C �� ��c� G�� ��� •
� 01 F<�� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y LATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WAIL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 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
� 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES�NO
� COMMENTS:
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W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑C RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V- EFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContra site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
✓
, � D� TIME
" CITY OF ORONO CALLED IN �
INSPECTION N SCHEDULED �_'O'�
PERMIT NO. DS COMPLETED
ADDRESS ��a 5 ✓�' �-�
OWNER CONTR..����-!!� ��x�
TELEPHONE NO. 7l�� S�� S3Q�
,
� DESCRIPTION ��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 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
J 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:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call far the next inspection 24 hours irt advance. �952� 249-46QQ
OwnerlContrac� ite:
Inspector. �-
White Copyllnspector' File Canary CopylSite Notice
✓
�DATE TIME
CITY OF ORONO CALLED IN �� �-'% �
INSPEC710N NO�ICE SCHEDULED �'- '` '
PERMIT NO. ; /% 7 CSCU COMPLETED O7.OD
ADDRESS '� �' %r i ��-�c c: � �4�' ..2� .SS
OWNER CONTR. � %�� c: r L c:�' '
TELEPHONENO. �7lri� .J ��� �.�:�(�='�
�
� D TION
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
v 07 DEMO-FINAI 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 70 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS: �
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