HomeMy WebLinkAbout2007-P10618 - addn/remodel/repair PERMIT
CITY O� ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P10618
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: 1/12/2007
SITE ADDRESS: 1027 Linden La Unit#
Mound,MN 55364
P��� 07-117-23-13-0094
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Pemut Type: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Electrical(state)
NOTICES/REMARKS:
Add Master Bathroom
FEE SUMMARY: Pemut Fee: $ 181.25 vatuation: $ 10,000.00
Plan Review Fee: $ 117.81
State Surcharge Fee: $ 5.00
TOTAL FEE: $ 304.06
APPLICANT: Pleasant Valley Homes,Inc. OWNER: Troy&Traci Peterson
243 Revere Lane 1027 Linden La
Champlin,MN 55316 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
MINNESOTA BUILDING CODE REQUIREMENTS.
� v �'�/j
�`��(_�../' d�f���'7 %��
APPLICANT PERM E SI ATURE ISS D BY SIGNATURE � r
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
i
Total Fee: $ �L� � ` U� �G Date Received: ��–a�—l��o
Entered By: �� L_y;�'=�`� /��/ Permit#: _�/f>�/8
�.
CITY OF ORONO - BUILDING P�RMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please p�•int a/l informatiort)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR�
__._�.�
JOB SITE ADDI2ESS: I � Z � L �rvcQ.-c'n Lc.��-� ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ 1'eS ❑ �I O If yes, a specta!evenl pern�it is required Z�vith Police Depcu•l�rrent arid City Cozmcil appr•oval
60 days pi•ior to the event. Sh�uttle Gi�s service 1�vil!be requir��ed iu�less applicant de�nonstrates
sc�rficreni on-site parkir�g is nvnilable. No��-per��ritted events rvill not be allowecf.
I`1AlVIE OF OWNER: ,�(�'I tJ b G�t � t`�j(y�e� PK�NE; (home)
(work)
MAILING ADDRESS: � O Z� L;r,��C„ Ll�t CITY: U�v�� L ZIP:
CONTRACTOF: �e v�sa.� ct e �DY�� PHONE: ��Z-Zb�-Z!I�
CONTACTPERSON: ,,� � MOBILE/PAGER:
MAILING ADDRESS: Zy 3 ��-�,-{ C� �v CITY: CL,��,m,�l,:� ZIP: ��3 ��
STATE LICENSE: # Z O l 3 I �Z i� EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
NiAILING ADDRESS: CI�Y: ZIP:
NAME: REGISTgtATION: #
TYPE OF WORK: New Home Addition Accessory Structuee
Move Home Remodel/Altecation (ie: Siding, Windows) �_
Any earth movement may require MCWD review and permits !
PROPOSED WORK(desc�•ibe in cletai�:
c� ��� ���- b�t�,
S'I'ORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHEI) DETACHED
ESTIMATED CONSTRUCTION VALUATION(e�tcluding land): $ 1O,�6�1, G �'
I hereby apply for a buildin�permit and I acknowledge that the information above is complete and accurate;
that the work�-vill be in confonnance with the ordinances and codes of the City and�vith the State Building
Code;that I understand this is not a permit and«�ork is not to start without a permit;and that the�vork�vill be
in accordance with the approved plan.
a��i,�carrr�s s�c�;a��r�� f a��� ----_ �a��: �� � � Z�a�
��
r
�
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.l. 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 dataconcerning himselfshall be
informed of: (a)the purpose and intended use of the 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 arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by shate or federal law to receive the data.This requirement sha(l
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 ma�place the notice reauired under this subdivision in the individual income tax or properri 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 shall be shown the data without any charge to him and,if he desires,shal I be informed of the content and
meaning of that data. After an individual has been shown the private data and infonned of its meaning,the data need not be disclosed to him for six
months thereatter 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 privaCe 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.
The responsible authoriry shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within tive 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�vithin 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
concerning himsel£ To exercise this right,an individual shal I notify in writing the responsible authority describing the nature of the disagreement.The
responsible authority shall within 30 days either: (a)corcect 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 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 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 required to process this application or permit.
C`,n�.C�� ( �P ro n-�� ��G��S �C�
First Middlc Last
z Y3 R-����.� �w ,,�
Address
('� lnC1�.�,-./� ��.� �ti� �3 � �
City State Zip Phone
I und n y rights as stated above. 1
Signaturc
Reset Form 32
� �CFiE�� Ok'F iJIST FOR ISSUANCE O�F i'E�t►.'ViITS
FOR OFFICE USE ONL1Y� . .
ADD�tESS ORLEGAL: �oz� �i��� c�wc=
PID:
DESCRTPTIO�T OF WORI�: (NV4s'R=.2 4��-4 -
ZOYI�l'G REVIE'4V BY: r--N!______�__ DATE APPROYED:
gUII�DING REV]EtiV BY: � ' . . DA.TE APPROVED; iz -i9-
. .-- ----- ----- -----------------------------------------------------6----
FEES TO BE CHA.RGED: Misc. Fees Calculated By:
pgg�T Yes �/ No
PLAN REVIBtiV ' Yes ✓ No SE�VER COiYI�TECTION
STATE SURCHARGE Yes —� No �VA'I�RCONNECI'IOi�I
INVESTIGATION FEE Yes No �/ PARK FEE
SAC Yes No �/ SITEINSPECTTON
Number of SAC�Units OTHER (specify}
ZOYI,IG CHE.CK LIST Zaning Discrict: N� cN�^' .
Fire Department: Past Office: School Discrict: • '
L,ot Area: Sq.ft. Acres � Width DeP�
Survey Submitted:� Yes No Date of Survey:
Proposed Setbacks: • ;
Front(Lake): Right Side: ,
Reaz(Streec}; Lcft 5ide:
Adjacent Structures: W tland:
Suilclin�Hei�.t: Def, Hgt, P �`Hg��
Lot Covera�e:
Gradin�: Scaff Approval Date: y: Council Approval Date: '
Szptic: S�aff Approval Date: �. '
Zoaing File: � Resolutioa: � Resolution Date:
Shorelznd District: ��Coverage:
Av�. Setback: Bluff Secback:
Euscing Proposed
H2dcover: 0-75'
75-250'
2�0-560'
�00-1 G`C�'
`[-'lar�!COt�" �;'"c_i2IlC� .rt�.^1L'!i��.: ,25 �;0 D3r_ n��'p��C� ?��z^.:OVZ:
F.E�L�S (in house):
Bu�nnY� z�vrEtiv cx�c�LIST�
UBC: �2' 3 ' CONSTRUCTTON TYPE: V/J .
Sq Footaae $Per Sq Ftg
� Basement • . .. x _ . .
lst Floor ' x . , . . . ' .
2nd Floor x _ � .
Garaoe X = .
x =
TOTAL
Fstimated Construction Yaiue: $ � t�,�o0 0�
Insgections Requirec�: VVark Requiring Separate Permits:
S'tte _�Plumbing Fire
� Hardcover Removal Mechanical Water Coaaectio❑
Footing ' Septic Sewer Connection ��
K Fr�o • Fireplace Lawn Irrigation
K Insulatioa (Masonry) Other
_��Vall Board (Mfg.) Well (State Perm.it)
� F�� Grading/Filling _�Electrical (State Permit)
Other
REMARK� (IN HOUSE): � � � ��
--- ---------------------------------------------------
REVIE�V SY OTHERS: DA�E:
Access: Existing New •
Access Approval: Date gy; '
-- ------------------------------
REVLARb'S (TO BE NOTED Qv PEF.�I�II�:
8
� 1• ' ,
� �
G �
Z. �
� - -._--____ _.�...-----...._�...�`�J_`� L (� �1 (A
. � G � ��r.i,., ���.�,... .,.,.._�,.�..'_'..� ;_�-.�......e....�_.�i,.�.. _�I ��� p /�J 1•1 V f
� � ,� � _.,.,�.;�p, v� --� V� � � �
�, � � � �----, v 1 � �, ,�
� � � , � �
�b � ;, ;.�.�.,,_.,,.�, �: c�� y�
' �4'� �, �-�, �
� E,.�:. �
� V� � .f ' %� ' e � � �.: „1: �
� - � � ; , ` � � d f��
1� �� � � � � � �� �� � �
� � ��� � �..�� � z ._
�' .�. .�^1• ` , ` `� ,
�; � .,.�; �,,,i ' �,� .7`� ? ` `� � �
� �-..� ���� , �� � �� � m
'�^l �,�; �.. � �.�, -� -� �
� � ~�'� J � �1`� � `� �
� � � '�k l,���-�, ^� `"P�� ,, ; � � ."f
,^ ti �
V) , �� ���A��� � _� _ y�i��'.
i �
i ` L' �' ��a
� j �'� �� �i \
� � �
�` ` `i �
�`f i � ���FI . ''� i .�S ,�o �! `'�tr
� , ; ' i . i ri � ��'^.} j
(� �- i ..� 4 k ( 1
`'?f� ' k �—�--- ���Y ._.,,...—__—__�; iif k �� � ,
' ' '' � -1 c C
�...� ,.,: ; ; , �
�`� ` �,,, ; --_....j; �T r k C'>
�, t ��1 f �''�.,�„ `� +� �.�......._.�,� I �
r 4 � ��� { �
+, '� � `,� I k, � ' �'�'`��
" ' �V �� � � " � 4 �
.��,�.� � '�� ��� � � �9_ t � , ��i
C�. ° � �',� � ` 'R p �
� � � � ° ► .
,, !i f � "�`',
�� � ;
...� �, � ` "'�1 ..�—�. G � `'��
�',;t �:+ ?� ( �; ,'� i "�t`'"^'
a�--� 4 Z �,. "'.r•i i' '� 1 i ' '�
� ' ;:•'� �-3�C� ;r, m `� fi., j� I i; �y � ! �,'��.
c � � �-*^ �y
� i r .. �� � {I`q _V� :� �! . S'--1'
ro a � . .._ �� � � ,1 k` o 'j � �� �''n"`i
� �' r j �!N 37 n _ � . " ��� r";,,^'_-
� , I' �t� �'i„() � ,,,�� .... . ... . .., ...............,.,.. S (,x-tis �� �, �,
_ . �,►, � �, r_ �._.. _��.,..�..-...��..�� �. �...
2 -;�`C j� ``�--_.__.._.._....,__ .... ..., _.....__....�_�_. .... r �f..r1'e'�....a }
� ' _,�1t � O -�� >.,_ _`
�.0 r: � ' � ��1
Z ; _ B ,�r.. � :
�
� . : i Q �,
�" � ' � � ? ���� �
�„ y ,� � � ��
i � � �
...�C ., � l.' ' t � Z �c'
�m .:, �y • .�, � �
`-:. :- �: , :�, � � o
�� � ,:,- � � --. � mC� �
-{1. . �•: ��-j G
a. _l.:: . :-1
N�n � -� � I �
�� )
m �
�
,� ✓
` DAT TIME
CITY OF ORONO����/7 CALLED� ��
INSPECTION NO ICE s H ULED l,�7 —D7 ��
PERMIT NO. � ���TED
ADDRESS l�d 7
OWNER CONTR. O ��
TELEPHONE N0. lo�Z Z�9 Zll �
� DESCRIPTION ��� ���1'�'�. ���/h(
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADIN I �ING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
� -- �� t�.s�Pi
a
� --
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
d , /
� WORK SATISFACTORY:PROCEED ROJECT COMPLETE V
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call for th next inspection 24 hours in advance. (952� 249-4600
Owner/Co n site:
Inspector. v""q
White Copyllnspector's File Canary CopylSite Notice