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Home My WebLink About2002-P04796 - addn/remodel/repair PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P04796 Crystal Bay, Minnesota 55323 PePCYIIt Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: lil�i2oo2 SITE ADDRESS: 405 North Arm Dr Mound,MN 55364 PID: 06-117-23-32-0003 DESCRIPTION: UBC Occupancy R3 Proposed Use: Other Construction Type VN Buildin Census Code 437 Permit Class: g Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 265.25 Valuation: $ 15,340.37 State Surcharge Fee: $ 7.70 TOTAL FEE: $ 272.95 APPLICANT: Lindstrom Cleaning&Construction OWNER: Lakeview Golf Of Minnetonka Inc. 9621 Tenth Ave N 405 North Arm Dr Plymouth, MN 55441 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 MINNESOTAi BUILDING CODE REQUIREMENTS. � 1 � � �;� � , '`A LICANT PERMITEE SIGNATURE I EDBY SIGNATURE v Conies: 1-File(SiQnitures Reauiredl. 1-Apvlicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 , - � , .';=ota1 Fee: $ �� c/-� Date Received: �� l � � Entered By: / �) Permit#: / -- � �/-�� i��> >�-; �-j�� CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information)„__.__. ---------------------------------------------------------------------- - - - --------------=-�------------------- THE APPLICANT IS: (circle one) OWNER R CONTRACTOR -. --- _____----� . JOB SITE ADDRESS: v j 7� �v+ �`'ZIP: ��,��> /, _ NAME OF OWNER �,.-/��U�►/ CL�.� PHONE: (home) (work) �;�,��t7L- �t5 MAILING ADDRESS: ��/'r��2i7��CITY:�� ZIP:�;��-� ,� CONTRACTOR: �°vG15� �� rHONE: �G �-��{ �7�/ CONTACT PERSON: ��'.� 1-�--,�� OBILE/PAGER: �j;--��,f�—�� MAILING ADDRESS: �� < i � �-/�%ov CITY:�� .__ZIP: �j�i STATE LICENSE: # 1�,�'� ' ARCHITECT/ENGINEER: ��.; PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New _Addition Accessory Structure Move <�emodel/Alteration' Land Alteration �--___—___�--�—_ PR OSE �VORK describe in detai : � �=�%p, ( � �-�-` � -' s .� �� _ -�,��_ STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $�S� 3�c ,� � 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 unders and, is is not a permit and work is not to start without a permit; and that the work will be in 'cco � ance�Yvith the approved plan. APPLICANT'S SIGNAT : �li., —�_DATE: l / G��- 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 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 ro supply private or confidenrial data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal 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 idendry of other persons or enudes 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�lace the norice reouired under this subdivision in the individual income tax or nrooertv tax refund instrucrions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,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 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 of the data. The responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision, or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within that rime, 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 himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority 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 that he believes the data ro be correc[. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The detemunadon of the responsible authoriry 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 �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 require o process this application or perm�! �'�a%,'� / ,t/� First Middle Last �� /G� � �-' Addre �" r�'�� r/ �� '� ,j��`�{��6� C�ry � State Zip Phone I understand m i s s state ove. � T Signamre .. 6 _ ' CHECK OFF LIST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: �l C�S N 0 2"� A!a vYl �(J R . . PID: DESCRIPTiON OF WORK: _ ��q-��—�2 ,(��A-rvt��.e (1,C—nn4-�•t ZONING REVIEW BY: N I� DATE APPROVED: BUII.DING REV�W BY: DATE APPROVED: �- i 5 -0 2 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes �/ No PLAN REVIEW Yes No � SEWER CONNECTTON STATE SURCHARGE Yes J No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No STTEINSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning District: �'v'° Ghh�.4 Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Wi Depth Survey Submitted: Yes No ate of Survey: Proposed Setbacks: Front(Lake): Right Side: Reaz(Street): Left Side: Adjacent Structures: Wetl d: Building Height: Def. Hgt. Peak gt. Lot Coverage: Grading: Staff Approval Date: B : Council Approval Date: Septic: Staff Approval Date: B : Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setbac : L.ot Coverage: Eaisting Proposed Hazdcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS(in house): 7 BUII..DING REVIEW CHECK LIST UBC: � ' 3 CONSTRUCTION TYPE: �l�J Sq Footage $Per Sq Ftg Basement x = lst Floor x = 2nd Floor z = Gazage x = R = TOTAL Estimated Construction Value: $ ! S. 3�l�•'3� Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection _�Framing Fireplace Lawn Inigation Insulation (Masonry) Other Wall Board (Mfg.) � Well (State Permit) Final Grading/Filling Electrical (State Permit) • Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMIT�: 8 �RO�� '�� , Lindstrom Cleaning & Construction,Inc. " 9621 TENTH AVENLTENORTH,PLYMOLITH,MN 55441-5098 Phone(763)544-8761 Fax(763)544-8766 MN L.IC#0001087 Client: LakeviewGolf Business: (952)472-3459 Property: 409 North ArmDrive Mound,MN 55364 Operator Info: Operator: MARKV Fstimator: UerSteeg, Mark Business: (763)5448761 Business: 9621 lOth Avenue North Plyrmuth,MN 55441 :r7r,rfA TypeofFstirrrate: Waterdamage ��TY QF ��NQ'.' ' � �' BUiLDING P,FRP iT ¢' f�fJ REVIEW �NSPEGTOR �� Price List: MNMNOSOC ��r� . 1 _►�-�Z--- ,:,.-;��;,i��. Fstirnate: LAKEVIEWGOLF ��,��'��`,''". ".•. �.�„��. .��-f�� C t'.r�'!�?�':-L�)i�:;'i; ��;;��r��:'�:�'IONS AS ti07ED ❑ �:C?T l�,r'P�(',�'ED---C�i-;i?t::CT u i�SL�Bi�?{T Thase SJTi^;3^�S c".;a i�r your itlir?!t�?,,tio�!. f�li o�d�rK sh.u��c^ �Of1B I!7 (U'.i CCf!l'.iil::;?CEi '�1Vi:i1 �il ^(:riiCEt"�2 tUi!Ciifl� nfii� 2UfllftG COdB. Reca';erer�is inch.;d�ng'icri;,�ot s,r,•;�i`cal y not�ii in this r2�.�iew. KEEP TtifS PWiV 5ET�1V SI";E:A1�Ai.L`(lM�S , � Lindstrom Cleaning& Construction,Inc. 9621 TEN'TH AVENUE NORTH,PLYMOLTTH,MN 55441-5098 Phone(763)5448761 Fax(763)544-8766 MN LIC#0001087 IAKEVIEWGOIF Room:Iaclies Restroom I,gWsH 19'4"a 10'10"g 8'0" DFSCRIPTION QNTY UNTT COST TOTAL Remove&Replace Vanity++ 6.00 LF 160.59 963.54 Smk-double-Detach&res et 1.00 EA 80.00 80.00 Smlc faucet-Detach&reset 2.00 EA 27.54 55.08 Apply gemucide,mildewcide,or combination solution 209.44 SF 0.15 31.42 Note: If subIIoor is datr�aged,it will ha�to be replaced Rem�ve&Replace Carpet-(material and labor) 209.44 SF F7r Covering Contents-imve out then reset 1.00 EA 40.49 40.49 Room Stairs Down LxWs�I 12'6"g 2'11"z 8'0" DESCRIPTION QNTY UNTT COST TOTAL Apply germicide,nrildewcide,or combination solution 36.46 SF 0.15 5.47 Reimve&Replace Cacpet-(material and labor) 36.46 SF Fk Covering Room:Mens Restroom I,gWaH 18'1"z 9'6"x 8'0" DESCRIPTION Q1V'I'Y UNTT COST TOTAL Remove&Replace Acoustic ce�ing(popcom)teadure-heavy 171.79 SF 0.98 168.36 Rermve&Replace 5/8"drywall-hung,taped,floated,ready for paint 171J9 SF 1.72 295.48 Recessed light fi�ure-Detach&reset entire unit 6.00 EA 58.14 348.84 Bathroom fan,light,and heater-Detach&res et 1.00 EA 52.77 52.77 Rermve&Replace 1/2"drywall-hung,taped,floated,ready for paint 220.67 SF 1.64 361.89 LakeviewGolf Ol/11/2002 Page: 2 � Lindstrom Cleaning& Construction,Inc. 9621 TIIVTH AVENiJE NORTH,PLYMOUTH,MN 55441-5098 Phone(763)5448761 Fax(763)544-8766 MN LIC#0001087 CONTINUID-Mens Restroom DF�CRIPTION QNTY UN1T COST TOTAL Insulation-Minim�mcharge 1.00 EA 145.01 145.01 Remove&Replace Cerarnic tile 0.00 SF Open SeaUprime the walls 441.33 SF 0.32 141.23 Pamt the walls-two coats 441.33 SF 0.46 203.01 Maskthe walls per square foot 441.33 SF 0.13 5737 Retmve&Replace Carpet-(material and labor) 171.79 SF Flr Covering Contents-nnve out then res et 1.00 EA 40.49 40.49 Room Hallway I.zWzH 19,5,�g 4�1„g 8�U�� Subroom 1:offset LxWaH 3'10"z 3'3"g 8'0" Subroom2:claset LsWgH 3'10"x3'3"x 8'0" DESCRIPTION QNTY UNTT COST TOTAL Remove&Replace Acoustic ceiling(popcorn)te�dure-heavy 104.20 SF 0.98 102.12 Remove&Replace 5/8"drywall-hung,taped,floated,ready for pamt 104.20 SF 1.72 179.23 Recessed light fudure-Detach&reset entire unit 1.00 EA 58.14 58.14 Rermve&Replace Plastic]arrrinate wall fmish 150.67 SF 4.72 711.16 SeaUprime the walls 602.67 SF 0.32 192.85 Paumt the walls -two coats 602.67 SF 0.46 277.23 Mask the walls per square foot 602.67 SF 0.13 78.35 Remove&Replace Cazpet-(material and labor) 104.20 SF Flr Covering Iakeview Golf Ol/11/2002 Page: 3 ' Lindstrom Cleaning & Construction,Inc. 9621 TENT'fi AVENUENORTH,PLYMOUTH,MN 55441-5098 Phone(763)5448761 Fax(763)544-8766 MN LIC#0001087 Room:General Conclitions DESCRIPTION QNTY UN1T COST TOTAL Dumpster load 1.00 EA 323.32 323.32 Pemats&fees(Bid item) 1.00 EA 100.00 100.00 Floor covernigs per scope(Bid iter� 1.00 EA 7239.88 7,239.88 Post conshuction cleanup and cartage 1.00 EA 125.00 125.00 Iakeview Golf Ol/11/2002 Page: 4 . � Lindstrom Cleaning&Construction,Inc. 9621 TENTH AVENUENORTH,PLYMOUTH,NIN 55441-5098 Phone(763)544-8761 Fax(763)544-8766 MN LIC#0001087 Summary for Water damage I�e ItemTotal 12,377.73 Overhead @ 10.0% x 12,377.73 1,237.77 Profit @ 10.0% x 13,615.50 1,361.55 Material Sales Tax @ 6.500% x 5,589.60 36332 (�and Total 15,34037 VerSteeg, Mark Fstirnator Iakeview Golf Ol/11/2002 Page: 5