HomeMy WebLinkAbout2002-P05834 - addn/remodel/repair '� � PERMIT
CITY OF ORONO permit Number:
2750 Kelley Parkway- PO Box 66 P05834
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: i1�19i2oo2
SITE ADDRESS: 460 North Arm Dr
Mound,MN 55364
P I D: 06-117-2 3-31-0004
DESCRIPTION: UBc occupancy R3
Construction Type VN
Proposed Use: Residenrial
Pernut Class: Building Census Code 438
Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Adcln/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: Eiecmcai�sraie�
NOTICES/REMARKS:
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FEE SUMMARY: Pernut Fee: $ 32.65 Valuation• $ 800.00
Plan Review Fee:
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 33.65
APPLICANT: Owner/Self OWNER: Thomas&Susan Wanner
M� 460 North Arm Dr
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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PLI ANT PE ITE GNATU SSUED BY SIGNATURE
Copies: 1-File(Signitures Required). 1-At7plicant, 1-Monthlv Reports, 1-Assessins, 1-Finance Page 1
. •
Total Fee: $ �� �� Date Received: ;�G� 5���
Entered By: ,�`'� Permit#: ,i _ ���...
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CITY OF ORONO - BUILDING PERIVIIT APPLICATIOI�
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 CONTRACTOR
JOB SITE ADDRESS: '/ ZIP: ,S S �� �`
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NAME OF OWNER: ���� ������o�' PHONE: (home) S - �Z -C����
(work) � l � �
MAII,ING ADDRESS: �� � � �, ��Tm )r. CITY: r�(),���� ZIP: S s p �
CONTRACTOR: Sry;,,�' PHOiVE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHOl�TE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
PROPOSE �WORK(describe in detai�: � r J��' , C< < �u ;��
�, J���� --� ` l-�-��(�------a,
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STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �'�i� G�''
�� .
I hereby apply for a building pernut 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 SIGNATURE: � DATE: ���� �-C��
NOTE! Parade.Qf Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
. �
Sec.13.04 RIGHTS OF S[JBJECTS OF DATA '
Subd. 1. Type of data. The rightc of individual on whom the data is stored or ro be stored shall be as set forth in this secdon. �
Subd.2. lnformation reqirired to be given individual. An individual asked to supply private or confidendal data concerning himself shali
be informed of: (a)�the purpose and in[ended use af the reques�data within[he collecting Stau agency,political subdivision,or statewide rystem;
(b)whether he may refuse ot is legally requ'ued to supply the requesud data;(c)any Imown consequeace arising from his supplying or refusiag W supply
private or coafidential data;and(d)the idendry of other persons or enriues authorized by state or federal law to receive the data. 'Ihis requirement shall
not apply when an individual is asked to supply investigadve dara,pursuanc to secaon 13.82,subdivision 5,to a law enfo�cement officer.
The commissioner of revenue mav alace [he noace rewired under this subdivision in the individual income rax or proaertv taz refund
insnvctions instead of on those forms.
Subd.3. Access to data by individual. Upon request w a respoasible auchoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whe[her it is class�ed as public,private or confidenaal. Upon his further mquest,an individual who is the subject
of stored private or public data on individuals shall be shown the dara widiout any charge to him and,-if he desires,shall be informed of the content
and meaniag of�hat data. After an individual has been shown the private dara and informed of iss meaning,the data need not be disclosed to him for
six months thereafur unless a dispute or acdon pursuanc to this secrion is pending or addidonal data on the individual has been collected or created.
The respansible authority shall provide copies of the private or public data upon request by the individual subjecc of[he data. The responsible authoriry
tnay require the requesdng person to pay the actual costs of making,cerdfying,and compiling the copies.
The responsible authority shall comply immediately,if possible,wich aay 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 nquest
within that tune,he shail so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays,
Su�ays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An mdividual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall nodfy in wridng the responsible suthority describing�he nature of the disagceement.
The cesponsible authoriry shail within 30 days either: (a)correct the data found m be inaccurate or incomplete and aaempt to nodfy past recipients of
inaccurate or incomplete data, including rocipients named by the individual;or(b)notify the iadividual 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 dara.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administraave procedure act relaang to
conasted cases.
DATA PRIVACY ADVISORY
! In accordance with M.S. 13.04, Subd.2, "Rights of subjecu of data", we would like to inform you that your request
for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or
confidential information.
You ue 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 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 ihis application or permit.
�i0�r! �
g�� Middte Last
Addcess
Ci�y Srate Zip Phone
I understand my rights as stated above.
1 D oi A �-II ���7 �
Signatun
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �I bU N p 2TN A;z�n U2_ �
PID:
DESCRIP'TION OF WORK: F�N�1 N �o �4-[�—
ZO.�TI�Ti G REVIEW BY: �U DATE APPROVED:
BUII.DING REVIEW BY: DATE APPROVED; ��- � $ -a 2
FEES TO BE CHARGED: / Misc. Fees Calculated By:
PERNIIT Yes ✓ No
PLAN REVIEW Yes No �� SERjER CONNECTTON
STATE SURCHARGE Yes J� No WATERCONNECTION
IIWESTIGATION FEE � Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CB LIST zoning District: /l,ro C l�� .
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:
Reaz(Street): Left Side:
Adjacent Structures: Wetl d:
Building Height: Def. Hgt. Peal: t.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Sepdc: Staff Approval Date: By:
Zoning File: # Resolution: # esolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Dace of Council Approval:
RE11�iARI�.S(in house):
7
BUILDING REVIEW CHECB LIST
�C� R•3 CONSTRUCTION TYPE: V�1
_ Sq Footage $Per Sq Ftg
Basement x =
lst Floor x _
2nd Floor x =
Garage x = �
x = .
TOTAL
F.stimated Construction Value: $ $pp�=
InspeMions Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing = Septic Sewer Connection
�c Framing Fireplace Lawn Irrigation
_ps Insulation (Masonry) Other
oC Wall Boazd (Mfg.) Well(State Permit)
�F�� Grading/Filling �Electrical(State Permit)
Other
REMARI�.4(IN HOUSE):
REV�W BY OTHERS• DATE: ��____�����____�__
Access: Existing New .
Access Approval: Date By;
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REMARI�S (TO BE NOTED ON PERMII�:
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DATE �
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED /i- 2�Z_c''�
PERMIT NO. ���3� COMPLETED
ADDRESS 4��(� �(�r12Tf�(/�/� /�� .
OWNER 'I�►'� G���G1�'le� CONTR. �l!2� Clv<'�"
TELEPHONE NO. t S�, `7?a C����
� DESCRIPTION (.(��-C � l� �G��c{cyZ.�
W G 11 MECHANICAL I 18 EXCAV/GRADING/FIILING
02 FRAMING 13 MECHANICAL fiNAL 19 LAKESHORE/WETLANDS
y 03 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WAIL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES ' NO o�
� COMMENTS: �C�C �-. r�-e-��.I C��o O}�Z.1�
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call forth next inspection 24 hours in advance. (952� 249-46��
OwnerlCon r n site:
Inspector. �
White Copyllnsp or's File Canary CopylSfte Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI SCHEDULED �2- Z'��-
PERMIT NO. COMPLETED
ADDRESS yl�� ��.��/-/.�7��-�( J��,
OWNER �'��%t�1/1 C'-`'� CONTR. �l f�• CJ�i`�/1�i''
TELEPHONE NO. ��a �7�� ��� �
� DESCRIPTION
l� 01 FOOTING 17 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMI� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O� 03 iNSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 0 . 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 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 FINAI 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTfONREQUIRED.CALLTOARRANGEACCESS.
Cail for the n xt inspection 24 hours in advance. (g52) 249-4600
OwnedContract o ite:
Inspector.
White Copy/lnspector' File Canary CopylSite Notice
�l�� DATE TIME
CITY OF ORONO CALLED IN '
INSPECTION NQ�ICE SCHEDULED �p3___������»
PERMIT N0. � p '�'�{C�� COMPLETED
ADDRESS �I��N -��YVI 1�
OWNER T 1 S U��1Y��ONTR.
TELEPHONE N0. ��� � � �I �� — C.l� ��
� DESCRIPTION ��C�G'�(Z Ck' — �� �"��
� 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
Z04 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
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES�NO
� COMMENTS:
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W� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next i�spection 24 hours in advance. (952) 249-4600
OwnedContra r�i�it�:
Inspector.
White Copyllnspector's File Canary CopylSite Notice