HomeMy WebLinkAbout2007-P11002 - addn/remodel/repair ` -� � PERMIT
CI�Y OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P11oo2
Crystal Bay, Minnesota 55323 Permit Type:
Addition/RemodeURepair
(952) 249-4600 Date Issued:
6/28/2007
SITE ADDRESS: 1030 Loma Linda Ave Unit#
Mound,MN 55364
P��� 07-117-23-14-0056
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:
Remodel Bath,Bedrooms,Raise Roof,Finish 2 Bedrooms,Hall&Bath 2nd Floor
FEE SUMMARY: Pernut Fee: $ 888�75 valuation: $ 85,000.00
Plan Review Fee: $ 577.69
State Surcharge Fee: $ 42.50
TOTAL FEE: $ 1,508.94
APPLICANT: Benjamin Construction Co. OWNER: Lori Huinker&Gary Wollner
6600 Woodedge Rd 1030 Loma Linda Ave
Minnetrista,MN 55364 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.
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APPLICANT PER. ITEE SIGNATURE ISSUED BY SIGNATURE
� Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, l-Assessing,(If Septic, 1-Septic) Page 1
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Total Fee: $ j ��''-� C�� DateReceived: ��/� S /°��
Entered By: __ /� E'� Permit#: ,/�J/�1�'�2--
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR
JOB SITE ADDRESS: � b -� 0 4 ZIP: `�S`��y
Witl this be a Parade of Homes, Remoctelers Showcase Home or othec•Display Home?
❑ Yes �No If yes, a specia!event per•rnit is r•eqt�ir•ed with Police Department m�d City Coarncil approna!
60 days prior to the event. Shirttle bus servrce wil!be reqaiired unless applicant demonslrates
sufficient on-site parking is available. Non-permitted ei�ents rvi(1 not be allowed.
NAME OF OWNER: /�i` C�c�� er` PHONE: (home) ���" �r� ��
� , (work) ''
MAILING ADDRESS: �� � v'd n a `��� �ITY: ���v -• ZIP: ,SS�
CONTRACTOR: J C^- `�rn•-� - ^ � � PHONE: ��'a-SG ��/,��
CONTACT PERSON: a.--�- �/ �� MOBILE/PAGE • �` ^ �
MAILING ADDRESS: � �� c CITY: n v�: - ZIP: 5..� �
STATE LICENSE: # �7 EXPIRATION DATE:��
�r, ,:/t�— - Q a—�"'J��e ��% —D�'.�`
�: �/� � Du CJ P ONE: �G.� �
MAILING ADDRESS: y/rs� •�P CITY: �v s- ZIP: �'S� d.3
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windowsl _�_
Any earth moveme may�requir1e CWD�e/view and per its !
P PO ED W RK(describe�n detai�: Q m��f�. �/ �6C rf�o-v��f ^ B� �
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2- '�` °"•� �"� � ��, ,�,
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STORIES: / /SQ.FEET OF EACH FLOOR: ��� ���
NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED O DETACHED�
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ,�SU'`'�' �-
I hereby apply for a building pecmit and I acknowledge that the information above is complete and accurate;
that the�vork will be in conformance witll the ordinances and codes of the City and with the State Building
Code; that I understand this is not a permit d work is not to start without a permit;and that the work will be
in accordance with the approved plan.
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APPLICANT S SIGNATURE: DAT�. � .1 O �
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. , �• �
. . .
Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all infoYination)
-----------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ZIP:
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes ❑ No If yes, a special event per•mit is required with Police Department and Ciry Council appr•oval
60 days prioi•to the event. Shuttle bus service wil!be required unless applicant demonstrates
su�cient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: PHONE: (home)
(work)
MAILING ADDRE�S: CITY:. - ZIP:
CONTRACTOR: � PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
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 review and permits!
PROPOSED WORK(c�escribe in detain:
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): S - -
I hereby apply for a building permit and I acknowledge that the information above is co�nplete and accurate;
that the work will be in conformance with the ordinances and codes of the City and with the State Building
Code;that[undzrstand this is not a pern�it 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 suppiy private or confidential dataconcerning himselfshall be
informed ot (a)die purpose and intended use of the requested data within the col lecting 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 contidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data.This requirement shal I
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a la�v enforcement o�cer.
The commissioner of revenue may_place the notice req�ired 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 shall be shown the data without any charge to him and,if he desires,shall be informed of the content and
mea�iing 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 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 authoriry 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 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 tive days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. I£he cannot comply with the request
within d�at time,he shall so inform the individual,and may have an additional five days within which to comply with the request,ercluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest Uie accuracy or completeness of public or private data
concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement.The
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipieiits 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 ifthe individual's statement of disagreement is included with the disclosed data,
The detertnination 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 pritcate 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
pubtic.
5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6.��Y9ur full nanie is required to pro ss this application or permit.�� � �
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Address
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City StNte Zip Phone
I understand rights a above.
Sig ure
Reset Form 3� �
�CHEC�K pFF i,IST FOR TSSUANCE OF' �E��TS
FOR OFFICE USE ONLY
p,DDRESS aR LE�AL: L o w�
p�; ,S ,•� ui¢.✓ � �/�✓� c wS�c-
�E5CRIPTXO�T OF WORK Gx��.nd_� � ( c,nd
-------------
_---------- -------------------- pATE Al'PROVED: e -ts-0-7
ZOY.T�G REVIE�V BY: , DA.TE APPROVED; 0"9.
BUII�DING REVTE`V EY. � �
�EES TO BE C�-TARGEA: ^ Misc. Fees Calculated By:
PERNLIT Yes ,/� No
PLAN REVIEtiV � Yes —� No S�VER COi�NECTlON
� No _____ ��A�CONNECTION
STATE SURCHAR.GE �-'eS ,�o � p�K FEE
INVESTIGATION FEE Z'eS No _� STTEINSPECTION
SAC �Ces
� OTHER (specify)
Number of SAC�Units ______________________________
-----------------------------------------
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ZO! .1 CY CT�CK. LIST Zoaing District: �_�� .
Post Office: Schaot District: �
Fire Depart.meat: . s�
Acres Width � Depth 3J3
I,,oc Area; Sq.ft. .
Survey Submicted: Yes � ��
Date of Survey: �
Proposed Setbacks: �� �t Side: �5S� �
Front��): _ ��o� '
ao� •
Re ar (St�:�at): (ZS� � -La€t S ide: 75-�
�g�r Crn n r ,; ti�1?r1a.�r�j;
Ad;a ��-1-z ,
Z �� �-� Pealc Hot. 3 d�
Buil�lin� Hei�t: DeF. Hgt, � � _
Lot Ccvera�e: �lL
Gcadin�: Scaff Apgroval Date:
By; CouncL Approval Date: '
Szp[ic: StafE Aporoval Dace: �y�
Zoe�n� F� � �__. Resolutioa�. r____.__ RP`atu�ion Dz:e:
�l_:
� LS 350 � 7C90� �,r� �aka.��nv s►dd�hcro►1 4wrdcsat.i �+rapos�d
Sherela�:d Distric�: �P L,;,�Coverz��• A+�d iar*Std eM
B�,uf�:Setback: �"
Av�. Settiac`:�:. Proposed eo�nn�(`s obltQut�
�,�sc�c� latv�ls��'lo.�dco►�-v
-
a�(�.�cco��Pr�. G-i5 -------- ls h0�l.ldt.SSlkf..
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SUII�DING REVLE�V CHECK LIST
UBC: IZ• '3 ' CONST�tUCTION TYPE: �/�1
�
Sq Faatage $ Per Sq Ftg � ,.
Baseasent . .. x = .
lst Floor ' z = . � ,
2nd Flaor x = � •
Garaoe x =
x =
TOTAL
Estimated Co�structioa VaIue: $ �$,Doa �
Inspections Required: tiYork Requiring Separate Permi�s:
5 ice _�Plumbing Fire
Hardcover Removal _�Mechaaical Water Coaaectioa
Dc Footing ` Sepcic 5ewer Caanection �
� o� Framing Fireplace Lawn Irrigation
_ r�! L:sutatioa ' (Nlasonry) Other
�Val1 8oard (Mfg.} Wei1 (Stace Perm.it)
_�F�� � Grading/Filling _�C Eleccrical (S�ate Permic)
Other
RENIARK� (INHOUSE): �
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REVIE�V SY OTFiERS: ���;
Access: Ez.isting New
Access Approval: �atz gy;
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TIME �/
I Y OF ORONO CALLED IN �'S'- � �
INSPECTION NOTICE A SCHEDULED ' � '
PERMIT NO.�I I. ��llZ-- COMPLETED
ADDRESS I O �C� C C�� t f
OWNER CONTR. \ !I �{
TELEPHONE NO. � � � 4` '" �
� DESCRIPTION '—
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING R� 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU: ' YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
p ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the n xt inspection 2a hours in advance. (952� 24J-460O
Owner/Contrac r �te:
Inspector. �
White Copyllnspector's File Canary Copy/Site Notice
D u TIM E "
CITY OF ORONO CALLED IN '�3
INSPECTION NO ICE SCHEDULED ' 'b7 �+�-'-3�
PERMIT NO. �0O� COMPLETED
ADDRESS �D�D L� G��IGLQ �
OWNER CONTR. ` �� �-���
TELEPHONENO. /�Z � �l z"'
� DESCRIPTION /�S�Q���
ty 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
Q 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 06 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
��., COMMENTS:
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� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (952) 249-4600
OwnerlCon ite:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice
"'�� /� TIME �
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❑ 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
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
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White Copyllnspector's File Canary Copy/Site Notice
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ 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
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONW�THIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe nex 'nspection 24 hours in advance. (952� 249-4600
Owner►Contr n 't :
Inspector. "�°
White Copy/lnspector's File Canary Copy/Site Notice