HomeMy WebLinkAbout2000-P02216 - foundation only � PERMIT
•C I TY O F O RO N O permit Number:
2750 Kelle y Parkwa y- PO Box 66 Po22i6
Crystal Bay, Minnesota 55323 P@Pt711t Typ@: Addition/RemodeURepair
(612) 249-4600 Date Issued: 3il�ioo
SITE ADDRESS: 1179 North Arm Dr
MOUND,MN 55364
P ID: 07-117-23-14-0054
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Permit Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Foundation Only
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 153.25 Valuation• $ 8,000.00
State Surcharge Fee: $ 4.00
TOTAL FEE: $ 157.25
APPLICANT: PAUL PAINE MASONARY OWNER: SCOTT L CHRISTIANSON ET AL
6555 CO RD 26 1179 NORTH ARM DR
MINNETRISTA,MN 55364 MOLJND MN 55364
THE UNDERSIGNID HEREBY REQUFSTS PERMISSION TO MAKE'THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMI'LIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUII.DING CODE REQUIREMENTS.
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PL A UED BY SIGNATURE /,`�`
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Copies: City,Applicant,Assessor,Finance Page 1
- Total Fee: $ Date Received:
Entered By: �/ Permit#: ���,Z1(o
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be su6mitted in full before plan review will be started.
(please print all information)
--------------------------------------------------------- -------------______--_----------------------
THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: � ZIP: ��
NAME OF OWNER: �C. ' PHONE: (home) �
/ � J (work) ,$"9 y/,S'
MAII.ING ADDRESS: / �7� /v, C� /t CITY: �,r�r1N� ZIP:
CONTRACTOR: � PHONE: �7 Q -Co ��'y
CONTACT PERSON: M ILE/PAGER:
MAILING ADDRESS: 5 CITY: IP:��
STATE LICENSE: # �'1`- /l.��v�.�/J
"y'�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PR PO ED WORK(describe in detai�:
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIl�IATED CONSTRUCTION VALUATION (excluding land): $ (�J
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 pemut and work is not to start without a
pemut; and that the work will be in ac ordance with the approved plan.
. `'� /
APPLICANT'S SIGNATURE: � DATE: `,J b
NOTE! Parade of 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.
5
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of i�ividual on whom the data is stored or to be stored shall be as set forth in tlus secdon.
Subd.2. Informatioa required to be given individual. An individual asked ro supply private or confidential data concerning 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 lmown consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identiry of other persons or entities auihorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigadve data, pursuant to secaon 13.82, subdivision 5, to a law
enforcement o�cer.
The commissioner of rovemie mav olace the notice reauired under this subdivision in the individual income taz or nronertv 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 irniividuals,and whether it is classified as public,private or confidendal. 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
disc(osed to him for six months thereafter unless a dispute or action pursuant ro this secdon is pe�xling or addidonal data on the individual has been
collected or created. The responsible authoriry shall provide copies of the private or�blic 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 SaUudays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with
the request widvn that time,he shall so inform the individual,and may have an additional five days within which to comply with the requesi,
excluding Saturdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An u►dividual may contest the accuracy or completeness of public or
private data conceming himself. To exercise this right,an individual shall nodfy in wridng the responsible authority describing the nature of the
disagreement. The responsible authority shall within 30 days eidur: (a)correct the data found to be inaccurate or it�complete a�l attempt to notify
past recipients of inaccurate or incomplete data,ic�cluding recipients named by the ic�ividual;or(b)notify the individual that he believes the data
to be correct. Data in dispute st�all be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the administrative prceedure 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 �ity 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 fumish 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 Ciry 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 pemut 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 �S�
Address
Ciry State Zip Phone
I understand m ' ts as above.
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Signamre
6
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. CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: J /7�j /lio 2Th� fJ��w— lJlL
PID:
DESCRIPTION OF WORK: �-�,,.�,�(y�r,�,r►
ZONING REVIEW BY: N��- DATE APPROVED:
BUII�DING REVIEW BY: ,.,�,_ DATE APPROVED: 3 - l7- o�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes No � SEWER CONNECT'ION
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No � SITEINSPECTTON
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District /t-0 Cl�'7�
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 Si e:
Rear(Street): Left Sid :
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Se ack: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Vaziance Required: Yes No Date of Council Approval:
REMARI�S(in house):
7
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.
BUILDING REVIEW CHECK LIST
UBC: 2• � CONSTRUCTION TFPE: �
Sq Footage $Per Sq Ftg
Basement � x =
lst Floor x =
2nd Floor z =
Garage x =
z =
TOTAL
5w--
Estimated Construction Value: $ Q.600
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal 11�echanical Water Connection
�O Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
�p�Final Grading/Filling Elecuical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMI�:
8
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DATE TIME
CITY OF ORONO CALLED IN �r� 'Q� ! 3�
INSPECTION N�TICE SCHEDULED ryv 3 � ' jv
PERMIT NO. G�I la COMPLETED
ADDRESS �I�aL N�-i�h �9-rm ��•
OWNER CONTR.��ul �c�i n�_c��,,-�a�1
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TELEPHONE NO. �I��'L� ��1 ��
� DESCRIPTION �2/YYt�e� {' �,r��t►�
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4 OOTING 7 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
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� ISSUE CERTIFICATE OF OCCUPANCY
W �ORRECT WORK&PROCEED �
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. - pHOTOTAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on site:
Inspector.��L�.2 ��.U-�/1�
White Copyllnspector's File Canary CopylSite Notice
�2�,,./ ,�����s� �y�.P��� -e�c . . .
DATE TIME
CITY OF ORONO CALLED IN T��—���
INSPECTION NOTICE SCHEDULED 3��' `I �-3 d
PERMIT NO. pU � �� �' COMPLETED �"- '�U 9 ' ��
ADDRESS � a`�-� �`-'''''' '�
OWNER 5��7` �7ht,a--�-..�.�� CONTR. � �
TELEPHONE NO. L� 7 �f— � ���
� DESCR ON .�'�-� ��-Q-erne�c�'
�
l� OOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAI
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
J 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
Q OWNERICONTRA OR TO EEr YOU: YES_NO ) c 1�
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� ❑CORRECT WORK&PROCEED �
W - ISSUE CERTIFICATE OF OCCUPANCY
� �OCORRECT WORK,CAL�FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. pH0T0 TAKEN
INSPECTOR WILL RETURN
C7 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
Cl INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContractor on site:
Inspector.l,/�0�✓t �-Ca�.�l
White Copyllnspector's File Canary CopylSite Notice