HomeMy WebLinkAbout2008-00219 - addn/remodel/repair ' CITY OF ORONO PERMIT NO.: 2008-00219
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE 1SSUEn: 06/03/2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 3486 NY PL
PIN : 20-117-23-42-0031
LEGAL DESC : SPRING PARK
: LOT 007 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 25,000.00
NOTE: SEPERATE PERMITS REQUIRED: NONE
REFRAME BACK DECK AND NEW DECK BOARDS,FRONT STOOP AND STAIRS.
APPLICANT PERMIT FEE SCHEDULE 413.00
HAUGO CONSTRUCTION CO. PLAN REVIEW 268.45
8696 STANLEY TRAIL
EDEN PRAIRIE, MN 55344- STATE SURCHARGE(VALUATION) 12.50
(952)401-9303 TOTAL 693.95
Minnesota State License#: 20338377
OWNER
OWEN, DAVID&KAY
3486 IVY PL
WAYZATA, MN 55391
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 ditional or related work which requires separate
permi[s. All provisio o laws and ordinances governing this type of work
shall be compied di ether or not spe ed herein.This permi[will
expire and beco e nu and void if ruction authorized is not
commenced w hin 0 days of ate of issuance,or if consvuction is
suspended f a p iod of 1 s at any time after work has commenced.
The applic t i espons or assuring all required inspections are
requested n nform with the State Building Code.This permit may be
revoked ny ti r due cause.
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Appli ermrtee Signature Date ]ssued Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OT R THAN DESCRIBED ABOVE.
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Total Fee: $ 1%� • �S Date Received: q�,� Q�S
Entered By: Permit#: o�DO " dC�� `f'
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CIT�' OF ORONO - BUILDING PERMIT APPLICATION
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All inyformation 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:�y�� (U�(��1C4C.-�_ ZIP: �S3 lI
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Y0S � No If yes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
su�cient on-site parking is available. Non pernzitted events will not be allowed
N� PHONE: (home)
(work)
N i',�,, I e., ��-a ZIP:�3��
""t l �{Dl -
� ' �l'I'IfQ �Z�� �j � � ( �.�.. PHONE�v,-. �-o� 1�3a �
� �Q �'� i t�Cl .E/PAGER: /02- 799- �/F�
r �,f� �� Y�ek���t�LIP: �3��
` � ��m� �- TON DATE:s�-- /--lS y
` ��w�..(e�r c �,v►�� �, -
I �P� �Gv PHONE:
��{�I r 9 ��C� J�'I IS CY: ZIP:
��� '" 0�� ISTRATION: #
SI��� � �
• �/G� _ Accessory Structure �
� ��C��G� ( {� S�S�,� ation (ie: Siding, Windows)
� re MCWD review and permits !
_ °�S'ti'� '� 6/< �D ( � c —� ���
Sc� ��h ' SS� r1�
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�,a� � I'TACHED DETACHED_
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�"-� ing land): $023' lj 6 C��
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6 i4 5 N a n��„�, �/}--� �T-
CCyy�,�� � �rmation above is complete and accurate;
� � �des of the City and with the State Building
_ ,Q � � � �. p t without a permit;and that the work will be
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DATE: �/��- d�
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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 sha11 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 of the requested data within the collecting state agency,pol itical subdivision,or statewide 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 confidential data;and(d)the identity 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 commissioner of revenue mav place 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 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 shail be shown the data without any charge to him and,if he desires,shal l be informed of the content ar�d
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. The
responsible authority shall provide copies of the private ocpublic data upon request by the individual subjeet 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 shall 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,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 additional five days within 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 himsel£ To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The
responsible authoriry 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 thathe believes[he 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 determination of the responsible authority may be appcaled 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 pem�it 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:
l. 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. � Y'ou/r full name is required to process this application or permit.
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,�, �� Reset Form 32
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CHECS OFFLIST FOR ISS'UANCE OFPERMITS
FOR FICE USE ONLY
ADDRESS OR LEGAL: ��Q
PID:
DESCRIPTIONOFWORg• e s -t- p- �
ZONING REVIEW BY.• DATEAPPROT�ED: 9•zb-�8
BUILDINGREi�lEy�BY.• DATEAPPROVED:_
s-t�-n�
FEES TO BE CHARGED: Misc. Fees Calculated By.•
PERMIT Yes No
PLAN REVIEW Yes� No SEWER
STATE SURCHARGE YeS--�' No CONNECTION
INVESTIGATIONFEE YeS R'A�RCONNECTION
No �/ PARK FEE
SAC Yes No_ v SITEWSPECTION
IVumber of SAC Units O T H E R (spec�)
ZOMNG CKECS LIST Zaning District:
Fire Department: Post O�ce:
School District:
Lot Area: Sq.fi. • Acres Width
_ Depth
Survey Submitted.• Yes�_ No Date of Survey;
Proposed Setbacks:
_ ... ,.
�"���)� - ���� Right Side: G Z
liaav�(Street): 4 7 Left Side: �8' .�-. . _ _
Adjacent Structures: I¢lTy�tlicJ Weilarui.• — _
Building Height: Def.Hgt. N//� Peak Hgr.
Lot Coverage:_ �.rc,. �
Grading: Sta„�"Approval Date: �I'/�1. ^
BY� Counci!Approvc�l Date:
Septic: StafjApproval Date: gy. �
Zoning Fi1e:- # -' Resolution: #___ Resolution Date: -
Shoreland District: �,�S
.4vg.Setback. � ��,�L MCWD Permit:
BZuffSetback.• LotCrn,er,age.
Existing Proposed
Hardcover: 0-75'
75-250' 2 3.6!�
250-SDO' � °
500-1000' �
Hardcover Yariance Required.• Yes No
�_ Date of Council Approval.•
REMARSS('jn house):�1tw /L�u� i s ,�{e��.�.J ,4.� � awJ �.��. �s
n.l-�IA C e� I/U IG'�rV✓J �r��
33
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BUILDING REVIEW CHECS LIST
UBC: !2 • 7 CONSTRUCTION TYPE: Vi�l
� Sq Footage $Per Sg Ftg
BdsemenE x = .
IsrFloar x — � '
2nd FZoor x =
Garage x =
x =
TOTAL
Estiniated Construction Value: S Z S d o0 ��
Inspec�ions Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Cnnnection
� Footing Septic Sewer Connection
rc Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other --_
Wall Board (Mfg.) Well(State Permit) _
�� Final Grading/Filling Electrical(State Permit)
Other _
RE1iYlARKS(INHOI7SE): '
REVIEW BY OTFIERS: DATE: ` . : . .
Access: Existing New ' .
.4ccess Approval: Date By:
,
� REMARBS(TO BE NOTED ONPERM77?:
34
� � f D E TIME
CITY OF ORONO CALLED IN ��1��
INSPECTION NOTICE �sCHEDULED 7�� �s�-
PERMIT N0.�2�������`7 OMPLETED
ADDRESS t�/��
OWNER CONTR. v
TELEPHONE NO-^ ~ ��� ✓ /G�" 7 oZ/ � '
� DESCRIPTION ��.���-�`–� %�Z��
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FR,4MING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z �ALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YO�ES_NO
� COMMENTS:
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� .�ORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� � �£FORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITfON WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
�
OwnerlContractor on sit :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
��` c� I(�
ATE TIME
CITY OF ORONO CALLED IN C ��M` " I p �/�
INSPECTION SCHEDULED !�2�1�'"� --�1�—
PERMIT NO. COMPLETED
ADDRESS � ' � i ��
�
OWNER CONTR. � - ��� �-
TELEPHONE N0. � � �� -� �� - �'�� �Cl
� DESCRIPTION ���Y�� �� �lJ•�-Q �-'F—
� ❑ 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
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS: �L ��Y�� (C�C+C f�.� t-L;l I�
a ��'� L.�� C,� �'l�# 2_ �.
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� Z49-460�
OwnerlContractor on site:
Inspector. �!']i�
White Copyllnspector's File Canary CopylSite Notice
DATE TIME v
CITY OF ORONO CALLED iN
INSPECTION OTICE SCHEDULED - ��-/
PERMITNO. OD$ - b0°?l� COMPLETED
ADDRESS 3'1��� �V�'1 /'"�
OWNER TELEPHONE NO.
CONTRACTOR
>; DESCRIPTION
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITH�N HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContractor on site:
Inspector. � ^ �
White Copyllnspector's File Canary Copy/Site Notice
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