The URL can be used to link to this page

Home My WebLink About2008-00294 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2oos-oo294 - 2750 KELLEY PARKWAY s ORONO,MN 55356- DATE IssuEn: 10/13/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 3675 LYRIC AVE PIN : 17-117-23-34-0040 LEGAL DESC : NAVARRO : LOT 004 BLOCK 003 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 1,500.00 NOTE: DECK STAIR REPLACEMENT(IN KIND)AND RETAINING WALL APPLICANT pERMIT FEE SCHEDULE 57.50 NIELAND,DOUGLAS 3675 LYRIC AVE PLAN REVIEW 37.38 WAYZATA,MN 55391 STATE SURCHARGE(VALUATION) 0.75 TOTAL 95.63 OWNER NIELAND,DOUGLAS 3675 LYRIC AVE WAYZATA,MN 55391 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 permit is for only the work described and does not grant permission for additional or related work which requires sepazate 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 consVuction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State ing Code.This permit may be revok t any time for due au�e. o � i3 �� ;�r�-�c !o� /�� pplicant erm' Signature Date Issued By ' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 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 information) � THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: ��c 7 S �-�/�ir f7'vp ZIP: .S�S� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service widl be required unless applicant demonstrates sufftcient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER DO U. (a � PHONE: (home) - � -�?�� MAILINGADDRESS: �� 7� ��lc (work �S�y� fl CITY: ��n o ZIP: � CONTRACTOR: �p�g /V [e �a/t � PHONE: �p/a-�/g�5�� CONTACT PERSON: ' ( MOBILE/PAGER: MAILING ADDRESS: Z/„� � c��Z ,�J�/e CITY: �y-�„t a ZIP:l�'�.Ss3�'� STATE LICENSE: j ✓� � 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 requi e MCWD review a d permits! P OPOSED WOR (describe in detain: ¢pjt�; �� /�y�7� ��,d S" . � STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��SOD � 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 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. 0 APPLICANT'S SIGNATURE: DATE: ��,3ra00� 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 siate 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 place the notice reouired under this subdivi ion in the individual income tax or prooerty 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 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 ofthe content and meaning of that data. After an individual has been shown the private data and informed of iu 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 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 of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request within that time,he shal(so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal helidays. 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,induding 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 discloscd 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. T'he information may be shazed 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. o la ; �� , - First Middle Last ��P 7 .-�� 'i� �v� Address a/'�no /7'�„ � 9/ �l�-7/8�S/Sr� C�tY Stah Zip Phone I und stand my ri hts as stated above. c Signature � �� " . ,; 32 . � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: '�b-�S �y/i.�� g�,,,� PID: DESCRIPTIONOFWORK ecic s-�-,2 ��J�,q� �,vr<��✓� _ ��v��1�,4c,` =9 ZONING REVIEW BY: DATEAPPROT�ED: �0 �3-�� B UILDING REVIEW BY.• DATEAPPRO[�ED: i o - i 3-o$ FEES TO BE CHARGED: Misc. Fees Calculated By: �� PERMIT Yes r/' 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 CHECK LIST Zoning District: D C ! w�-�+ Fire Department: Post Office: 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: etland: Building Height: Def.Hg2. eak Hgt. Lot Coverage: Grading: StaffApproval Date: � By: Council Approval Date: Septic: StufJ'Approval Date: y; Zoning File: # Resolution: # Resolutaon Date: Shoreland District: MCWD Permit: Avg. Setback: BluffSetb ck: LotCoverage: Fxisting Proposed Hardcover: D-7.i' 75-�50' 250-.i 00' 500-1000' Har•dcover 6�'ariance Required: Yes No Date of Council Approval: REMARKS(in house): 3 • . BUILDING RETVIEW CHECKLIST USC: �• 3 CONSTRUCTION TYPE: Y'`� � Sg Footage $Per Sq Ftg Basement x = 1 st Floor x = lnd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ J,J 4�°O Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection � � Footing Septic Sewer Connection _Zc Framing Fireplace Lawn Irrigation I»sulation (Masonry) Other Wal!Board (Mfg.) Well(State Permit) Final Grading/Filling Electrica!(State Permit) �Other REMARXS(INHOIISE): REVIEW BY OTHERS: � DATE: Access: Existing New Access Approval: Date By: REMARKS(TO BE NOTED ON PERMIT): 34 �� l�f a � DATE Q TIME CITY OF ORONO CALLED IN ( � �v INSPECTION NOTIC (I SCHEDULED '�� PERMIT NO. � '��1 COMPLETED ADDRESS �L� �cJ L �I r'I C A-tI�_ OWNER �� a�'`.��UI e-IO��'2� CONTR. ^ TELEPHONE NO. UG1� U/� d� '� l � � � C�� DESCRIPTION O � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRA NG/F�LLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ 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 Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING Rf ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL '�/ ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�L YES_NO v� � COMMENTS: � W a � J O � � O � W � Q � Z W � W � j d � ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ;� ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDiT�ONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR !�CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� Owner/Contractor on site: . Inspector. —% White Copy/lnspector's File Canary CopylSite Notice