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Home My WebLink About2008-00168 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2oos-oo�6s 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUED: 09/12/2008 ` 952 249-4600 FAX: 952 249-4616 ADDRESS : 1030 LOMA LINDA AVE PIN : 07-117-23-14-0056 LEGAL DESC : LINPLATTED 07 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 9,500.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) MOVE FRONT ENTRY-ADD FIREPLACE TO GREAT ROOM-ENTRY PORCH-MOVE EXISTING WINDOWS AND DOORS. � APPLICANT pERMIT FEE SCHEDULE 191.75 BENJAMIN CONSTRUCTION CO. PLAN REVIEW 124.64 6600 WOODEDGE RD MINNETRISTA, MN 55364- STATE SURCHARGE(VALUATION) 4.75 (952)250-7132 TOTAL 321.14 Minnesota State License#: 3287 OWNER WOLLNER, LORI HUINKER&GARY 1030 LOMA LINDA AVE MOL7ND, MN 55364- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permi[is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applic responsible for assuring all required inspections are requested i�j� nfo ance with the ate Building Code.This permit may be �revo d Can rhe d � ��,� � � � f ,� � i�%F�/f�, � � �� -� , , Appl�cant Permitee Signature Date '� �� `�2�L / Issued By Sig ture Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. I Total Fee: $�v�/, /� Date Received: $�o3(%�J�B Entered By: Permit#: �ODB- DD/�pg CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in ful► before plan review will be started. (please print all infor�nation) ------------------------------------------------------------------------------------------------------------------------ -- .—�-- THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR JOB SITE ADDRESS: G� ��C� ��h�� ZIP: '�� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes, a special event permit is reguired with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: /1^ C�'�� ,^ PHONE: (home) �1�J � �;� �' / „ / � (work) MAILINGADDRESS: `�Sv `� 'r+� G,_`�CITY: ��-� ZIP�1'� j � � � ��s'� CONTRACTOR: ��'ti �-�.-� -.� � �� PHONE: ��- �— CONTACT PERSON: �`/ /�/r�,(;.,— MOBILE/PAGER: �-.�� - �/s'�- MAILING ADDRESS: �Ga-,� ��/��_CITY: ��, - ZIP: .S.Y,J� STATE LICENSE: # �� ,'� EXPIRATION DATE: �„G./ ,�� -�'j � � 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 W�RK describe in detain: /�v�c ��1 �� „ -, � �--c �� C � /� '^�° o� — r ' ` v��ov.� � STORIES: /f/.� SQ.FEET OF EACH FLOOR:�"� NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �,��„ �' I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the wark will be in conformance with the ardinances 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: � � � G�� 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 conceming himself shall 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 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 olace the notice required under this subdivision in the individual income tax or r�operty 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 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 ofthe 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 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,if immediate compliance is not possible. Ifhe 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 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 shal I 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 bel ieves 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 PRNACY ADVISORY In accordance with M.S. l 3.04,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: 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 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. First Middle Last Address City State Zip Phone I under a d m ri ts as ted above. � v�__� gnature Reset Form 32 , • ' CHECK OFFLIST FOR ISSUANCE OFPERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: �� 0.3 d ( �t�. �,InC/�} PID: DESCRIPTIONOFWORK: o' �- ,qvc�/ � S � r�1�� ZONING RET�IEW BY.• ` DATEAPPROVED: � 2(o G'�' BUILDING REI�IEW BY.• DATEAPPROVED: ct-Z - p� 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 ,/' PARK FEE SAC Yes No �SITEINSPECTION Number of SAC Units OTHER (spec�) ZONING CHECg LIST Zoning District: � - Fire Department: Post�ce: School District.• LotArea: Sq.ft. Acres �, 2.�( Width 3 �,q' Depth 3 �� Survey Submitted.• Yes No Date of Survey: (,�'�� s.,,�,.�.� �� Proposed Setbacks: � Front(�): � SG Right Side: f� /�r _E�� Rear(Street): �l(/�- LeftSide: V11�- Adjacent Structures: ��' Wetland: Building Height.• Def.Hgt. �� Peak Hgt. Lot Coverage: �d �P� Grading: Staff Approval Date: By: Council Approval Date: Septic: StaffApproval Date: By; � Zoning File: # Resolution: # Resolution Date: Shoreland District.• MCWD Permit: Avg. Setback: Blu,f,J`'Setback: Lot Coverage: F�isting Proposed Hardcover: 0-75' 75-250' 250-500' 500-]000' Hardcover Variance Reguired: Yes No Date of Council Approval.• REMARK.�(in house� A,d t S �rj�}� tv �Q�j� ��,N„ � �, � wt�h�wvk( f�ecd�h�w� � tcc�a-,� �„�,�zjs-eG �c� loa� a a� c cw�l�-�� _ a h I t Q,ue. A 2,v v�l s l��*'.�l C�xr�v '�s �c�- Q�cc�s s��. 33 BUILDING REVIEW CHEC%LIST UBC: 12` 3 CONSTRUCTION TYPE: �l�J Sq Footage $Per Sq Ftg Baseme»i x - Ist Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ �!, '�ZX� �^� —� Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection QC' Footing Septic Sewer Connection D� Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) _�c Final Grading/Filling p( Electrical(State Permit) Other nE�Rx.s�nv�rovsE�: REVIEW BY OTHERS: DATE: Access: Existing New .4ccess Approval: Date By: REMARKS(TO BE NOTED ON PERMIT): 34 ��'' ATE TIME �/ CI�F RONO CALLED�N � D INSPECTION TIC SCHEDULED / 0 ��: PERMIT NO - c PLETED ADDRESS OWNER CONTR. t TELEPHONE NO. � � ^ � DESCRIPTION �-:��lI��- f��1�� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVA� Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION QQ�FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PIUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � �- �d � W � o �c'r�.<�.c-d-e � � � ° �P� , l�i�� . {�� ;�e c� Q ��-'� t 1 �4 �c c..� A �� f��z �f-�� e �J z c�?�1' �� C�,� S W � W � j d W� ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE W�CORRECT WORK&PROCEED ❑ I UE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP OFiDER POSTED.CALL INSPECTOR O CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952) 249-4600 OwnedContractor on site: Inspector. �,� 1�� White Copyllnspector's File Canary Copy/Site Notice a - � � DA TIME CITY OF ORONO CALLED IN INSPECTION TIC Q SCHEDULED l•z� PERMIT NO.�� U COMPLETED ^ �` ADDRESS � � � Q- OWNER CONTR �(1'I TELEPHONE NO. Q ' � DESCRIPTION ��_ ��'FOOTING ❑ MECHANICAL RI EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O a � O � W � Q � Z W � W � � � VORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W �CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED ❑ INSPECTfON REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContra o si Inspector. White Copyllnspector's File Canary CopylSite Notice �r � ATE TIME V CITY OF O ONO CALLED IN lD D INSPECTION OTICE SCHEDULED /;� PERMIT NO � S COMPLETED ADDRESS � �-l�1�1-�- ��-�'�- � OWNER CONTR. TELEPHONE NO. — � �' �1�� DESCRIPTION �/Y1 /��D � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q�RAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-S�TE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO c� COMMENTS: � W a 0 1 ��Mt�g �,� � � 0 � Q ��T ��Zr„�° /o- -��'s z ��r .�v.r� �r��,��.� W � W � � ��VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.GALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Catl forthe next inspection 2a hours in advance. (952) 249-4600 OwnerlContractor on ite: Inspector. ' White Copyllnspector's Flle Canary CopylSite Notice