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Home My WebLink About2008-P12185 - addn/remodel/repair PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p12185 Crystal Bay, h�innesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 6/24/2008 SITE ADDRESS: 2755 Kelly Ave Unit# Excelsior,MN 55331 PID: 21-117-23-23-0026 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: Connect 2 bathrooms to one on main floor&completely remodel basement bath, &i FEE SUMMARY: Pernut Fee: $ 563.50 valuation: $ 38,500.00 Plan Review Fee: $ 366.28 State Surcharge Fee: $ 19.25 TOTAL FEE: $ 949.03 APPLICANT: Filla Designers Builders&Remodlers OWNER: Karen Kaverman 3317 Breconwood Cr 2755 Kelly Ave Wayzata,MN 55391 Excelsior,MN 55331 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. l � �� '�.- ' �i��— _-� �j�GC_. �I�,/�� APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNA CURE � ,//%/�i' Copies: I-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1 � �� . � . � � �� Total Fee. $ 9 y9.o Date Received. � 2' � Entered By: Permit#: �- ) `�. ��j CITY OF ORONO - BUILDING PERMIT APPLICATION Alt information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: , ��-- / - � ZIP: -J��r� Will this be a P rade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ��10 If yes, a special event permit is required with Police Department and Ciry Council approva/ 60 days prior to the eveni. Shuttle bus service will be reguired unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed NAME OF OWNER: �}��,� (��J�l��r2 N(l�� PHONE: (home) (work) MAILING ADDRESS:� ' "� ` _E� CITY: ZIP: CONTRACTOR: / /IC1�61� t��sa�,�u�v ��[`L�w r�y�ONE: "�ISr�'��L-�`t S/ CONTACT PERSON: ��Tyrr �;`�,{,� MOBILE/PAGER: y�L-�/�--�3C g� MAILING ADDRESS:,��7_��?j?�.��.i, CITY: ZIP: r� STATE LICENSE: # rj'j/Q EXPIRATION D �/_' f ' `C� � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) �_ " Any earth movement may require MCWD ,xeview an permits ! PROPOSED WORK(describe in detain: •.v� � �, ,y � i iU� G.L+9��t .�+.Rt�2--- � �` � � �Z��/ �7 / � �'�' � �-u.��'�,U::: .� ,�3�e.�izt,*a � �r �f,� STORIES: S!.FEET OF ACH FLOOR: ' ��.ca� �C-�;�� , NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ,Q �---� ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �J; `J�� ,, I hereby apply for a building permit and I acknowledge that tlle 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 permit;and that the work will be in accordance with the approved plan. � APPLICANT'S SIGNATURE: �� DATE: � � �� 31 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 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 concerning himself shall be informed of: (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence azising 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 shal] 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 reauired under this subdivision in the individual income tax or pro�e,rty tax refund instructions mstead of on those forms. 9ubd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infortned 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 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 tothi5 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 of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. 1'he 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,iFimmediate 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 rwt accurate or complete.An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise this right,an individual shall notify in writing the responsible au�ority describing the nature of the disagreement. The responsible authority shall within 30 days either. (a)conect the data found to be inaccurate or`incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipienu 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 of disagreement is included with the disclosed data. The determination 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 l�cense from the C.ity 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. N� ��v7�� F'�.�� , . First Middl Last ♦ �� .�Z Ql�iv�u� aQ � Addres e T • � �9` C�tY State Zip Phone I understand r' s s stated above. "C ' Signature � � 32 CHECK OFF LIST FOR ISSUANCE OF PERII�ITS ' FOR OFFICE USE ONLY . ADDRESS OR LEGAL: 2?5S 4�E-�.� Av� PID: DESCRIPTION OF WORK: Qp� f ,c3 As��,�,.r. i?,�-,�,,,�p Z ZONING REVIEW BY.• (r�1 DATEAPPROVED: � SUILDINGREVIEWBY.• DATEAPPROVED: �,• 33-0� FEES TO BE CHARGED: / Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes �/ No SEWER CONNECTION STATE SURCHARGE Yes� No WATER CONNECTION INVESTIGATION FEE Yes No c/' PARK FEE SAC Yes No � SITEINSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning District: /vV C��rq� � Fire Department: Post�ce: 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. Pea Hgt. Lot Coverage: Grading: Staff Approval Date: By. Council Approval Date: Septic: StafJ'Approval Date: By.• Zoning File: # Resolution: # Resolution Date: Shoreland District: MCWD Permit: Avg. Setback.• Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 2.i 0-500' 500-1000' Hardcover variance Required.• Yes No Date of Council Approval.• REMARKS(in house): 33 BUILDING REVIEW CHECg LIST UBC: �� '3 CONSTRUCTION TYPE: 'V� Sq Footage $Per Sg Ftg Basement z = 1 st Floor � x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ 3,�,500 � Inspections Required: Work Requiring Separate Permits: Site ,�Plumbing Fire Hardcover Removal �Mechanical Water Connection Footing Septic Sewer Connection _�Framing Fireplace Lawn Irrigation �_Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) _�Final Grading/Filling �_Electrical(State Permif) Other REMARKS(INHOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS(TO BE NOTED ON PERMIT�: 34 '� � �� lS��1Nc, ��t� r�b�m � ,€ t�l�Y �,i.�l f '� • ' )/ . � �a, y.�� x � ' C��IV �� i . -- . �...,__ �� ..�.._..,,- �� . . `-�A�.-. . t -. . f � `> � i � .�_�.1_..._.u.._..___�_ .__ l��.-� _�._ : _ __� _ _.�_ _ ._ _ _ _ �_ _ � — — — �-_- I _..___.__..�_.._.,..�. ____� � t7� _�� _--_--i � _� . — — �_�� --� �� E �" '�—� - � , , . � , G� ( _ ` � o � . . � �_ � � -.�,_ a_ � . ,.-a�- J � � 1 , --�_ _ . i �oA� k + �� o�� l . ._ . � ,�,�:,��,- ��_�.� r��v,Ew C��!/ � ��U. : � ��`� �'• �3-J� ^4,��n �� t• i ' ... ..'�i`. f��"i �:�.� 'n i�!�l��C �'.� Ti�.�-i�� ',-; t _ . ��....r .r� `..�. ,r ',.�„_:'.!";'�1iT ,�!, ... ;gu.a + ' . ,... ,�iii I:e dcrs � � �} � , �r,� : �«de. ,�, •��.� ��f��=/f � _ ._ , «. ,� .., ,, r.�,�. '" r. .., ..t`.�! .�Er s.�(n 31 i r..<4 'E�S / ,. , _ . f _�� . � i , � _ � � o� �a � � I° � I — �--.--� ` � � � � � � (� � . � c-�'� � ^ �� -- � � M l �p �:. - I 4 � , �._/ �- �� C �'� ``.. 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( � � �- � � � _ � �� --- ___ � �� 1� � � � � � �t�� ;��,��-�.��uf:_ . � ., I � �4�-�` "' ' �:-,<.�,� . {{:. :_; ��i�« t E . u �: ,,�,.�„ . r '4,�. ° ' • <� r. � ' ` {. � I � k,. � � ' ; ,.�+ �� a ; .�� ' �i�.� � � . � . E .� • � 1 �.-ir � " °` _.. f„ n,r ?'''� t ` .- . / �, ;�:; . ; . . . - �� , � � .� � 4-��'. ��,�� 4i--� �"i�::,t � � (� 1� �� „� ' \� �o I � � 1 � , _� a� ;�._ a� ,_ � , �� _ �, �� c�Q�' , , � � � . � �. � .� � C� . , o N� � �j- - - � ' t �, O SPEC[AL NOTE � SEE ATTACHED SHEET FO R �r�SS C��c.c.s . CODE RE�Ut��i4/rE�iT� � � ��r�-�� //� � � � �--` � . . f � � r� � � ��J DAT TIME� / CITY OF ORONO CALLED IN �� b� � v INSPECTION TICE SCHEDULED / � b � PERMIT N0. l � COMPLETED ADDRESS � � / v! Gt� OWNER CONTR.� Q- TELEPHONENO. , �L,�L�j - �lSv��oZ �� DESCRIPTION ` ry ��f ly ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q��RAMING ❑ MECHANICAL FINAL ❑ LAKESHOREM/ETLANDS 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 ❑ WARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a j O � � O � W � Q � 2 W � W � � d W��WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPL.EfE � \ W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Ca11 for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContracto on si : Inspector. White Copylinspector's File Canary Copy/Site Notice �� ✓ DATE TIME CITY OF ORONO CALLED IN �C �I�"� INSPECTION NOTICE scHE�u�E� r' ! % � ' �L� PERMIT N0. � /�� 5`7 COMPLETED ADDRESS ��`�� l�"� � L/ 1�L'� OWNER CONTR. —�T'1 C/�'Ct S t—� I I� TELEPHONE NO. �� '� - � � �' —G' � 0 I � s'rv�c d�f`S J � DESCRIPTION �t--�� -- ��F"��'{ ��I �)l'�C � � ❑ 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 Z OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W a � �rv�o�'� �-F�' �o� S'/l1 0 '' � � �JeT `TD,� �=. r��l� � � �o �-1- o $ /D-�3S�1� W � Q � z W � W � � d W� ❑WORKSATISFACTORY:PROCEED ROJECT COMPLETE W C]CORRECT WORK&PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED O INSPECTION REQUiRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�0 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice