HomeMy WebLinkAbout2008-00052 - tree preservation easement CITY OF ORONO PERMIT NO.: 2008-00052
„ 2750 KELLEY PARKWAY
� ORONO, MN 55356- �ATE IssuEn: 08/OU2008
952 249-4600 FAX: 952 249-4616
ADDRESS : 45 MYRTLEWOOD RD
P1N : 36-I18-23-33-0015
LEGAL DESC : MYRTLEWOOD
: LOT 003 BLOCK 002
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 95,500.00
N01�E: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE)
REMODEL KITCHEN(NEW CABINETS),ADDITION ENCLOSING DECK AREA INTO DINING AND KITCHEN AREA.
TREE PRESERVATION EASEMENT SENT TO OWNERS; MUST BE RETURNED BEFORE PROJECT IS FINALED.
APPLICANT PERMIT FEE SCHEDULE 1,026J5
BUILD IT PLUS LLC PLAN REVIEW 667.39
9037 DARROW AVE SE
DELANO, MN 55328- STATE SURCHARGE(VALUATION) 47J5
(612)910-5425 TOTAL 1,741.89
Minnesota State License#: 20403979
OWNER
BROWN,JESSICA
45 MYRTLEWOOD RD
WAYZATA,MN 55391-
AGREEMENT AND SWORIv 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 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 applicant is responsible for assuring all required inspections are
requested in conformance w th the State Building Code.This permit may be
rev d any t fo d
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pp icant Perm� e 'gnature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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Total Fee: $ � Date Received: 7
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Entered By: Permit#: � —� �1.
CITY OF ORONO - BUILDING PERMIT AP�CA:TI�N
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR ONTRACTO
JOB SITE ADDRESS: �S��lQ'�-�euaoo� R� D�D/UD ZIP:
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes �No Ifyes, a special event permit is reguired with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
st fficient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: �Cssr�cR �/�foWn�//@/i��1 h�s�4rCo�t' pHONE: (home) �Z-�Z �o�S'?S
MAILING A.DDRESS: �CS/�RS/��b'�v aGr �d, CITY: �.OH/D (W�ZIP: `�'S�ql
CONTRACTOR: _�c���d i f��us �,LC PHONE:�Ja,-`j/D�S`t�,�
CONTACT PERSON: '',,{�,n� �i4w7`'ES MOBILE/PAGER 6'lal,-9L0 -v 5/�,S
MAILINGADDRESS: P.O,Igox,Sl� CITY: ��s-/q�vc ZIP: S�'3��
STATE LICENSE: # �O 5�0 39�`j EXPIRATION DATE: 3-3/-O q
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(describe in detai�: CN� �,g�,�
( I �S o��' � ,..J/
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED� DETACHED�¢i
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ c�,�O� ,C'�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 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 SIGNATU DATE ` ��
3
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.l, i'ype 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. Informati.on required to be given individual.An individual asked to supply private or confidential data conceming 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 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 law enforcement officer.
The commissioner of revenue mav place the notice reouired under this subdivision in the individual income tax or prooertv 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 bc 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 infortned 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 ofthe data. The responsible authoriry
may require the requesting person to pay the actual costs 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 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
concerning himsel£ To exercise this right,an individual shall notify in writing the responsible authority describingthe 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 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 sia[ement 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 detetmine 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.
�TO h AJ /�'G!f C�'6/�L�/ �/�i`V�E�
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I understand my rights a ted ab ve.
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B UILDING REVIEW'CHECg LIST
UBC: � '.3 CONSTRUCTION TIPE: Viv
Sq Footage $Per Sg Ftg
Basement x =
Ist Floor x =
2nd Floor x =
Garage x =
x =
TOTAL -
Estimated Construction Value: $ 9 S 5 O v ��
Inspections Required: Work Requiring Separdte Permits:
Site �_Plumbing Fire
Hardcover Removal _�Mechanical N�aier Connection
C Footing Septic Sewer Connection
_�Framing Fireplace Lawn Irrigation
_�Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
_�Final Grading/Filling _�Electrical(State Permit)
_ Other
xENraRxs�nvxousE�:
REVIEW BY OTHERS: DATE: �
Access: F�isting New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
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��.� � � ��_'��r�;�,��� .��/ Street Address: Mailing Address:
��kE$HOg'% 2750 Kelley Parkway . P.O. Box 66
\ _—_= Orono, MN 55356 Crystal Bay, MN 55323-0066
AGREEMENT TO UPGRADE/REPLACE
ON-SITE SEPTIC SYSTEM
UWe,_Jessica Brown/Phil Lusardi do hereby acknowledge
Name of Owner
that the on-site septic system located at_45 Myrtlewood Road
Property Address
must be upgraded or replaced to be in full compliance with Section 12.30, Individual
Sewage Treatment System Standards for the City of Orono. UWe have submitted or will
submit soil borings, perc tests and detailed design.
And further, Uwe agree that such upgrading or replacement will be completed no later
than 12 months from the date of the assigned ageement, except that in the event that at
the end of the 12 months the City has not decided whether the Myrtlewood Sewer will be
constituted or that it will not be, then the septic replacement deadline can be extended
u}�til the process is complete.
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�ner Date Owner Date
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Witne , City of Orono Employee Date Signed
Failure to upgrade or replace the septic system as agreed to above will result in
enforcement action as prescribed in Section 12.30 Individual Sewage Treatment System
Standards for the City of Orono.
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W:\(Forms)�Septic System Agreements�2008�,AGREEMENT 7 �� ��
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Telephone(952)249-4600 • Fax(952)249-4616
www.ci.orono.mn.us
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` CITY OF ORONO CALLED IN g����
INSPECTION NOTICEC' SCHEDULED �� ���
PERMIT NO. ��fY`�A -C�Y�O� COMPLETED
ADDRESS ��J �1l-I I�-� I e i-�-�OC�� S-�
OWNER CONTR. I:.�L�I �I ��I ��S
TELEPHONE NO. ���I/��l ' �S? I�. - "I ( C� � ��� a��
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� DESCRIPTION �� �
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
O ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAI ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours in advance. (952� 249-4600
OwnedContractor on site:
Inspector. . r� /J /,`�
White Copyllnspector's File Canary CopylSite Notice
� D�Tb TIME "
CITY OF ORONO CALLED IN /�g�,'�7
INSPECTION N TIC SCHEDULED ��. �
PERMIT NO. � � �COMPLETED
ADDRESS ?.5 ,�L1/"7L��D� �
OWNER CONTR. �L�G�e� G]� �G�-b
TELEPHONE NO.[P����� � 7`0� l�O���lL���l
� DESCRIPTION �/IS/.l.L�l�YI
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y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
0 ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
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? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
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INSPECTOR WFLL RETURN ❑ CITATION ISSUED
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❑INSPECTION REQUiRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspector. 1 .
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White CopyMspecto�'s File Canary CopylSite Notice
C� TE TIME ✓
CITY OF ORONO CALLED IN
INSPECTION TICE SCHEDULED — - /O.'aD
PERMIT NO. ����DD��OMPLETED
ADDRESS_ �5 d7�� �
OWNER CONTR. ���C�G���
TELEPHONE N0. ��� / /� JrT�� ��-
� DESCRIPTION_��i�'!/_I O � �l� �
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O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WAIL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
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Ca11 for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector. � . 1 � ,
White Copyllnspector's File Canary CopylSite Notice
�� 2�� DATE TIME �
ITY OF ORONO p-GALLED IN —
INSPECTION NOTICE �� SCHEDULED �
PERMIT NO. o2fX� ����7COMPLETED
ADDRESS
OWNER ONTR.--i������T"�
TELEPHONE N0. —���Yf — �� ���� ������ �
� DESCRIPTION �C.1'J'� ` �� ��l/`7Z.��1Q�1
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Z ❑ WAIL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
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Ca11 for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site•
Inspector. _ � r�7/ �
White Copy/lnspector's File Canary Copy/Site Notice
�� DA�T� TIME , /
CITY OF ORONO CALLED IN � `" I/
INSPECTION NOTICE SCHEDULED 'Z "U �
PERMIT NO. ����"000-S� COMPLETED � � '' �
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� DESCRIPTION_ ��'
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INSPECTOR WILL RETURN
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Call forthe next inspection 24 hours in advance. �95Z� Z49-4600
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