HomeMy WebLinkAbout2006-P09726 - attached deck � PERMIT
C�TY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p09726
Crystal Bay, Minnesota 55323 P2rmit Typ2: Addition/RemodeURepair
(952) 249-4600 Date Issued: 4/7/2006
SITE ADDRESS: 2501 Kelly Ave Unit#
Excelsior,MN 55331
PID: 20-117-23-12-0053
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Addition/Remodel/Re air Permit Sub-type(s): Deck-Attached
Permit Type: P
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 54.00 va�uation: $ 1,500.00
Plan Review Fee: $ 35.10
State Surcharge Fee: $ 0.75
TOTAL FEE: $ 89.85
APPLICANT: Owner/Self OWNER: Brent Lindgren
MN 2501 Kelly Ave
Excelsior,MN 55331
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK [N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE QU REMENTS.
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APPLICAN ERM[TEE SIGNATU [SSUED BY SIGNATURE
Copies: 1-File(Signatui•es Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
s ,
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Total Fee: ,� �� �C� llate I2eceived: b(O
E n t e r e d B y: '� � 1-- `���/O(�- P e r m i t#: �`: '
CITY OF ORONO - BUILDING PERIVIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print a11 informatioix)
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THE APPLICANT IS: (circle one) OWNE OR CONTRACTOR
JOB SITE ADllRESS: �JO � ��' � �/ � I�
�- ZIP: :.��_�_��-
Will this be a Parade of Homes, Remodclers Showcase Home or other Display Home?
❑ Yes �TTO /fyes, a specia!event permit is reqa�i�•ed�vilh Po/ice Departmenl and Cily Coimcil approva!
60 days pr•ior to tl�e event. Shuttle bz�s service tivrll be regaiired a�nless applicant demonstrates
sa fficient on-sile parking is nvnilable. Non-permit/ed enents wr(1 nol be nllowed.
NAN1E OF OWNER: ►r f '� PHONE: (home)�I '�Q—
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(work) -- -O 3 �S
MAILING AllDRESS: 2��� Kel�v ���' CITY: Q y�0 vt.0 ZIP:�
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGiNEER: PHONE:
M?�r ING A���SS: �TT�'. ZI�:
NAM�: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may require M/CW; D re�iew and permits !
PROPOSED WORK(describe in detain: ���,�3��_- /�/��:�'_',./!!�
STORIES: SQ.FEET OF EACA FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHCll DETACHED
ESTIMATCD CONSTRUCTION VALUATION(excluding land): $ �,s��o��
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 pennit and work is not to star �vithout a permit;and that the worh wi(1 be
in accordance with the approved plan. ,,� j
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APPLICANT'S SIGNATURE: �,ry��'F'°� �'. L.�� DATE: �
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Sec.13.04 RIGHTS OF SUBJECfS OF DATA
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 individual asked to supply private orcontidential data concerning himselfshall be
informed of. (a)die purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or siatewide 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 ofticer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or property tax refund
instnactions 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 wheiher it is classified as public,private or confidential. Upon his further request,an individual who is the subject of
stored private or publ ic data on individuals shall be shown the data without any charge to 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 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 or public data upon request by the individual subject ofthe data. The responsible authority
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible suthority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [f 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,
5undays 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,a�i individual shall noti'ty in writingthe responsible authority describingthe nature ofthe disagreement.The
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or i�complete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients na�ned by the individua�;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 of disagreement is included with the disclosed data.
The detertnination of the responsible suthority 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 equired to process this a ication or permit.
First Middle Last
c�a I ��-� � �-� .
Address �
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City Sfate Zip Phonc
I understand ights as state ov
-�..
Signature
_ _ _ _ ___
Reset Form 32
• - Ci-iEC� OFF i�IST FOR ISSUANCE OF �ERMITS
' FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2501 1�t_-Y � -- 1�►.r�
PID:
DESCR�TiON OF WORK: (Lt IP v4C.0 l.—X �s�i�� �L�'��-
---------
-------------------------------------:--------------------
ZO�.�1I�Ii G REVD�W BY: ��--- ______ DATE APPROVED. {,(- 7- 6�
SUILDING RE'VIEti'V BY: DATE APPROVED; � 7-c�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW �� Yes � No SEWER CO�TNECITON
STATE SURCHARGE Yes _� No WA'I'FRCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC�Units OTHER (specify)
ZOYI�1'G CHE.CK LIST Zoning Discrict: No C,✓-f�^�� ,
Firo Department: Post OfFice: School District: � �
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: . .
Front(Lake): Right de: � .
Rear(Street): L,eft ide:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peal:Hgt.
Lot Coverage:
Gradin;: Staff Approval Date: By: Council Approval Date: '
Septic: Staff Approval Date: BY�
Zoning File: # Resolution: # Resolution Date:
Shoreland District;
Avg. Setback: Bluff Setba : I.ot Covenge:
EzistinQ Proposed
D
Hardcover: 0-75'
75-250'
2�0-500'
500-1000'
Hardcover Variance Required: Yes N Dace of Council Approval:
REv1A.RKS (in house):
�
SLTILDING REV]EW CHECK LIST
UBC: 2• 3 � CONSTRUCTION TYPE: ��'�1
Sq Footaoe $Per Sq Ftg
Basemeat � . . , x _ .
lst Floor x • _ .
2nd Floor x _ •
Garaoe z =
x =
TOTAL
Estimated Construction Value: $ 1,5 OD �
Inspections Required: . Work Requ'uing Separate Permits:
S ite Plumbing Fire
� Hazdcover Removal 11�iechanical � Water Conaection
� ' Septic Sewer Connection •
` _�Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_�F�� Grading/Filling Electrical (State Permit}
Other
REMARKS(IN IiOUSE): ,
---------------------------------------------------------
REY�'4V BY OTHERS: DATE:
Access: Eusting New �
Access Approval: Date By; �
- - ---------------------------------
REI�IARKS (TO SE NOTED ON PERi�:
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DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NO C C�� SCHEDULED _Y� �
PERMIT NO. / ��� COMPLETED
ADDRESS � •
OWNER � ��( ��- CONTR. l>'��'
TELEPHONE NO.
� DE ON
� FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILIING
Q 02 G 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
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
v�, COMMENTS:
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W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALI FOR REINSPECTIOIV TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WFLL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Cail for the n t inspection 24 hours in advance. (g52) 249-4600
OwnerlContra ite:
Inspector. '
White Copyllnspector's Fil Canary CopylSite Notice
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DATE TIME
CITY OF ORONO CALLED IN '�7 _��
INSPECTION N TIC,F SCHEDULED � - �'� '�� �
PERMIT NO. D`�7 COMPLETED
ADDRESS ���i l �_��� ���
OWNER �i��`vfi L��u�9/"2�/I CONTR. D�����
TELEPHONE NO. �/�. ��/C' � ��Z
� DESCRIPTION ��•� � �
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 W BD. 12 WATER HOOK-UP � 17 SITE INSPECTION
05 FINAL 14 SEWER HOOK-UP � 06 PROGRESS
� MO-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 P�UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COfu1MENTS:
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. (952� 249-4600
OwnerlContractor ite:
,
Inspector.
White Copyllnspector's ile Canary CopylSite Notice
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