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Home My WebLink About2007-P11731 - addn/remodel/repair PERMIT CITY OF ORONO 27�a Kelley Parkway- PO Box 66 Permit Number: p11731 Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 12/l0/2007 SITE ADDRESS: 1205 North Arm Dr Unit# Mound,MN 55364 P�� 07-117-23-41-0013 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Addition/Remodel/Re air Permit Sub-type(s): Addn/Remodel/Repair Permit Type: P DETAILS: Approved per resolution#: Separate permits required: Plumbing Electrical(state) NOTICES/REMARKS: Ext bathrm wall, sheetrock&insulate vapor barrier, Work Started w/o Permit FEE SUMMARY: PermitFee: $ 9�.25 valuation: $ 3,500.00 Plan Review Fee: $ 63.21 State Surcharge Fee: $ 1.75 Misc. Fee: $ 97.25 TOTAL FEE: $ 259.46 APPLICANT: R W CONSTRUCTION OWNER: Paul Skageberg 5456 BLAISDELL AVE S 1205 North Arm Dr MINNEAPOLIS,MN 55419 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. C_ -- . , � �� ,_.� APPLICAN�C PE�t I'I'I�,G SIGNA'1'URE 1 ED BY S[GNATURE Copies: I-File(Sig�iatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 c�o� � �2,� Total Fee: $ z�. `�"�P DateReceived: / � ,3 07 Entered By: Permit#: ��7�� 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�ONTRACTOR JOB SITE ADDRESS: � �(:�� J��-I� �,�„� � ZIp; Will this be a�ade 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 approva! 60 days prior to lhe event. Shuttle bus service will be required unless applicant demonstrates suff cient on-site parking is available. Non-permitted events will not be al(owed. NAME OF OWNER:��„Q �� PHONE: (home)�la - 3a�- �a�3 (work) MAILING ADDRESS: G�(jp-� CITY: ZIP: CONTRACTOR: �-I �� (' , �i�r��,� PHONE: �� -I-b1 -C��(-j CONTACT PERSON: � c.�= • MOBILE/PAGER: G �,,.� MAILING ADDRESS: S<-�-5'� �Rl�,t�i► , �� S . CITY: �'�P�S ZIP: S 5�i-r� STATE LICENSE: # 6�cz,a ��-}q EXPIRATION DATE: Z� � j dg ARCHITECT/ENGINEER: V� �_. PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) x Any earth movement may require MCWD review and permits ! PROPO ED WORK(describe in detai�• �L �o�}�, Nc�H., �,Jc�2Q� * � t�� VJ (/� Lvt C3�Q. �� ci' � G. 1�'1 S c.�.�cr (/` �U,�n .�. STORIES: I� SQ.FEET OF EACH FLOOR: (� _S� �� NO. OF BEDROOMS: __� GARAGE STALLS: ATTACHED � DETACHED c� _ ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �j�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 wark will be in accordance with the approved plan. �_. _ APPLICANT'SSIGNATURE: y�Qr- DATE: Ia � �3 • U'� 31 r � Sec.13.04 RIGHTS OF SUBJECI'S 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 himselfshall be informed of: (a)the purpose and intended use ofthe 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 corrimissioner of revenue may place the notice required under this subdivision in the individual income tax or pro�erty tax refund instructions mstead 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 infortned 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 si�c 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 shal I 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 shal l 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 compl iance 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 conceming himsel£ To exercise this right,an individual shall notify in writing the responsible authoriry describing ihe nature ofthe disagreement.The responsible authoriry 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 statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions ofthe 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. The information may be shared with other local, state or federal agencies to the extent necessary to pmcess 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. ��c�� v�.p l�r—`� First Middle Last ��S(o ��c�tcrQ�ll �� S . Address _ �'1 r`-'c�� vI � �Y' / �'t ��'�-��1'�� C�tY State Zip Phone I understand my rights as stated above. � Signature 32 � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: !Z o S UU 0 R�t-1 ✓-�Q� PID: DESCRIPTIONOF WORK: Q y�,,� �Z,�;�,n o,p�.� ZONING REVIEW BY.• N I A �MY� W DATEAPPROilED:~ �� BUILDING REVIEW BY.• � _ . �,_. DATEAPPROVED: I z•S- 07 ------------------------------ FEES TO BE CHARGED: Misc. Fees Calculated By.• PERMIT Yes � No PLAN REVIEW Yes ,/ No SEWER CONNECTION STATE SURCHARGE Yes ✓� 1ye WATER CONNECTION INVESTIGATION FEE Yes ✓41�`�Vo PARK FEE SAC Yes No ✓ SITEINSPECTION Number of SAC Units OTHER (specify)_ ----------------------------------- ZONING CHECK LIST Zoning District: N o � Fire Department: Post Office: School District: Lot Area: Sg.ft. Acres idth Depth Survey Submitted: Yes No te of Survey: Proposed Setbacks: Fron�(Lake): Right Side: Rear(Street): Left Side: Adjacent Structures: Wetla d: Building Height.• Def. Hgt. Peak t. Lot Coverage: Grading: StaffApproval Date: By: Council Approval Date: Septic: StaffApproval Date: By; � Zoning File: # Resolution: # �Resolution Date: Shoreland District: �I�ICWD Permit: Avg. Setback: Bluff Setback: i Lot Coverage Existing Proposed Hardcover: 0-75' ''� 75-250' ' 250-�00' 500-1000' Hardcover 1 ariance Required: Yes No � Date of Council Approval: REMARKS(in house): 't,l1v C Sn4�'C-1Z-� • ` v '�.� T' 33 BUILDING REVIEW CHECK LIST UBC: �2�3 CONSTRUCTION TYPE: '�l�I Sq Footage $Per Sq Ftg Basement x � _ 1 st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ 3.S 0(7 00 Inspections Required: Work Requiring Separate Permits: Site � Plumbing Fire Hardcover Removal Mechanical W'ater Connection Footing Septic Sewer Connection �Framing Fireplace Lawn Irrigation _.Zc Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) _�[ Final Grading/Filling �Electrical(State Permit) Other REMARKS(INHOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ONPERMIT): 34 DATE TIME ✓ CITY OF ORONO CALLED IN INSPECTION N TICE 'I SCHEDULED PERMITNO. �� jC�OMPLETED �� ADDRESS Ic�� k �!�'r�� OWNER CONTR. TELEPHONE NO. � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAI 19 LAKESHORE/WETLANDS O INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 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 � COMMENTS: � W � J � ` 7� f �J . O a � O 1��- �l C.�l U • ,��L � W � Q � 2 w � W � � d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � �CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ;� pHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTIOIV REQUIRED.CALLTO ARRANGE ACCESS. Call for the ne�t inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContr c or�s�te: Inspector. v'L White Copyllnspector's le Canary Copy/Site Notice