HomeMy WebLinkAbout2005-P09100 - attached deck � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P09100
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued:
9/6/2005
SITE ADDRESS: 1453 North Arm Dr Unit#
Mound,MN 55364
PID: 07-117-23-44-0071
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 111.25 Valuation: $ 4,600.00
Plan Review Fee: $ 72.31
State Surcharge Fee: $ 2.30
TOTAL FEE: $ 185.86
APPLICANT: Tristar Builders OWNER: Vera L Brown
2500 Cedar Crown Dr 1453 North Ami Dr
Minnetonka,MN 55305 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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APPLICANT PERMITEE SIGNATURE ��SSUED BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, l-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1
t
Total Fee: $ :/��J ��' Date Received: ?� r`Z3 f U S
Entered By: �,v'v�'� Permit#: j��;-�� (c�G
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please priiit all informatio�z)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (ci��cle o��e) OWNER OR CONTRACTOR
JOB SITE ADDRESS: i 5/�� ;l� ry!'I �`Z�- � ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �NO Ifyes, n special event permit is required ivith Police Deparbnent and City Council appr•ova/
60 days p�•ior to the event. Slzirttle bus service W�ill be regz�ir•ed zmless applicant dei7:orzstrates
si�cient o�a-site parking is available. �'or�-per�nitted events will not be alloi�vec�.
NAME OF OWNER: �t?I'G� ��^�9c'-v :'1 PHONE: (honze)9'�a - �7�>�3(
(work)l�rS� <��1��'��
MAILING ADDRESS: i° J� CITY: v'G� ZIP:
CONTRACTOR: •��'� ��r ��, �����s PHONE: ��i� �'-��'�' �-�v��7
CONTACT PERSON: `�j'jvy, ��,,,�,r� MOBILE/PAGER: �a<rne ,
MAILINGADDRESS: ���^� L'�rr�rn�.v,y ��� CITY: y��,�/� . ZIP: ' S
STATE LICENSE: # ��'�8� EXPIRATION DATE: 3 -�i — a!P
ARCHITECT/ENGINEER: --�-- PHONE: —^
MAILING ADDRESS: -� CITY: —��:
NAME: �----- REGISTRATION: # ----
TYPE OF WORK: New Addition Accessory Structure
Move Home Remodel/Alteration �_ �Pc,�
PROPOSED WORK(describe iia detcri�:
STOI2��S: 5Q.F��'d'OF EACH FLOOIt:
NO. OF BEDROOMS: GARAGE STALLS: AT'I'ACI�ED DETAC�IEI�
ES'TIMA�'ED CONS�'RiJC'�'ION VAI�LJA�'IOI�1(excludirag land): � ��ofc9 `�
I hereby apply for a buildin�pennit and I acknowledge that the information above is complete and accurate;
that the���ork�vill 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 wi II be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: � DATE: ��a.�1.s
;1
,
Sec13.Od RIGHTS OF SUBJECTS OF DATA
Subd. l. Type of data. The rights of individual on whom the data is stored or to Ue 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 dataconcerning 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 shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a la�v enforcement officer.
The commissioner of revenue mayplace the notice required under this subdivision in the individual income tax or propertv taa reftu�d
instructions instead of on those forms.
Subd.3. Access to da[a by individual. Upon request to a responsible authority,an individual shall be informed�vhether he is d�e 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 individuais shall be shown the data without any char�e to him and,if he desires,shall be infonned of the content and
meaning of that data. AYter an individual has been shown the private data and informed 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 crea[ed. The
responsible authoriry shall provide copies of the private or public data upon request by die individual subject of the data. The responsible authorit��
may require the requesting person to pay the achial costs of making,certifying,and compifing the copies.
The responsible authoriry shall comply immediately,ifpossible,with any reques[made pursuant to this subdivision,or�vitltin five days of
the date oY the request,exciuding Saturdays,Sundays and legal hol idays,if immediate compliance is not possible. [f he cannot comply with the request
�vithin that time,he shall so inform the individual,and may have an additional five days within which to comply with die request,excluding Saturdays,
Sundays and legal holidays.
Subd.d. Procedure when data is not accurate or complete. An individual inay contest the accuracy or completeness of public or private data
concerning himself To ezercise this right,an individual shall notify in writing the responsible authoriry describing the nature ofthe disagreement. The
responsible authority shall within 30 days eithec (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[he 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 pennit 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 t6at:
1. The inforniation you furnish will be used to determine your qualification for the permit or license
rec�uested.
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 pennit or license rec�uires Cowlcil action to approve, some information may become
public.
5. You liave certain riglits 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 pennit.
��""v1-�_ — -
First �Iiddlc Last
Address
Cih State Zip Phone
� understand my rights as stated�bove.
Signatur
�2
CHECK OFF LIST FOR ISSUAI�ICE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ��tS 3 No 2�� Mi cz.w� {�R
PID:
DESCRIPTION OF WORK: �pE�,�c
ZO�.vI�1i G REVIEW BY: DATE APPROVED: �-t- o s
BUII�DII\G REVIE`V BY: DATE APPROVED: c,_�_o s'
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ,/ No
PLAN REVIEW � Yes �/ No SEWF�t CONNECTION
STATE SURCHARGE Yes ✓ No WATERCONNECZTON
INVESTIGATION FEE Yes No PARK FEE �
SAC Yes No SIT'EINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. 1�I.9 4 3 Acres . 3`f Width 7 y.�d 5 Depth 19�.b'3
Survey Submitted: Yes �C No Date of Survey: $-8•05
Proposed Setbacks:
Front(Lake): _ S S��'f Right Side: ��' ?'
Reaz(Street): I ZO' t Left Side: ���
Adjacent Structures: �o'+e s H�» Wetland: N I IA
Building Heioht: Def. Hgt. rV�,�1 Peal:Hgt.
Lot Coverage: �0•�t
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # "' Resolution: # Resolution Date:
Shoreland District: v�es
Av�. Setbac� �/��F Bluff Setback: �►//�l L.otCoverage: I 0� `(
Existing Proposed
Hazdcover: 0-75'
7�-250'
2�0-500'
500-1000' ,[ 1 S�70
Hardcover Variance Required: Yes No�_ Date of Council Approval:
REI�LARKS (in house):
�
BUII,DING REV�W CHECK LIST
U�C� - �2' 3 CONSTRUCTTON TYPE: �L I�J
� Sq Footage $Per Sq Ftg
Basement . x _
lst Floor x _
2nd Floor x _
Garage x _
R -
TOTAL
Estimated Construction Value: $ '-1,b 0 p o=
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
�_Footing ' Septic Sewer Connection
c Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (11�Ifg.) Well (State Permit)
�� F�� Grading/Filling Electrical (State Permit)
Other
RENIARK.S(IN HOUSE): .
-------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
RENIARKS (TO BE N01'ED ON PERMI'1�; ------------------------------------------------------------
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CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED �S�
PERMIT NO. DD COMPLETED � ° �
ADDRESS �7 5 . �r/Yl
OWNER CONTR. T l� C�'Q'.+�' �Q%J."S'
TELEPHONE NO. � (o/L �9'� /a/7
� DESCRIPTION I,�' �rah'11 n
� 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 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
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑WORK SATISFACTORY:PROCEED ❑ PROJECI�COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O�CORRECT WORK,CALL FOR REINSPECTION�,-y�y� TEMPORARY
V �� F��~L �" "'I� PERMANENT
OCORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL�NSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on ite•
Inspector.
White Copyll�spector's File Canary CopylSfte Notice
� (� D�jT� / TIME �/
CITY OF ORONO CALLED IN � /v
INSPECTION N TI E�y 7"� SCHEDULED - ��%-��
PERMIT NO. �/ �/ COMPLETED � 'i Gv
ADDRESS �!7'�J�.3 /��JY� 7`C� hR �L1/�
OWNER CONTR. T✓/ S��C.- — dl��
TELEPHONENO. ��la ��v . �7`a�
� DESCRIPTION �
� 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
J 10 PLUMBING FINAL 36 FOUNOATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
Owner/Contractor on�te: ��
Inspector. �(l �
White Copyllnspector's File Canary CopylSite Notice
� � , ATE TIME �
CITY OF ORONO LL D IN /d 3
INSPECTION�OTICE SCHEDULED � �_
PERMIT NO.��`j / C�C� COMPLETED
ADDRESS / ��S� N � �m ,D�
OWNER CONTR. �/�/ S�r /J/c1f S
TELEPHONE N0. �`.T�' ��� �S � � S��-1"1
� DESCRIPTION d </?�l `��
Ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOILOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YE NO
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the nex inspection 24 hours in advance. (J52� 249-4600
OwnerlContrac i e:
Inspector. ..
White Copyllnspector's Fi Canary CopylSite Notice
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CERTIFICATE OF SURVEY FOR
VERA BROWN
IN LOTS 86 AND 87, HIGHWOOD LAKE MINNETONKA
HENNEPIN COUNTY, MINNESOTA
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DAT�______._ q' �' �5 _ �
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I N 87°10' 28" E 199. 2 1.67 �
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S g7 13 26 W 199.54 MEAS.
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I 200 HIGHWOOD LAKE MINNETONKA i
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LEGAL DESCRIPTION OF PREMISES
Lot 86, and the Southerly 25 feet of Lot 87. HIGHWOOD LAKE MINNETONKA
o : denotes iron marker set
• : denotes iron marker found
This survery shows the boundaries of the above described
property and the location of an existing house, garage, and
shed. It does not purport to show any encroachments or improvements.
GRONBERG 8�ASSOCIATES INC. �hereby certify that this survey was prepared by me or under my direct super- SCALE
CONSULTING ENGINEERS,LAND�SURVEYORS, vision,and that I am a duly registered Civil Engineer and Land Surveyor under 1"= 40,
the laws of the State of Minnesota.
SITE PLANNERS
DATE
445 N.WILLOW DRIVE S�$�O�J
LONG LAKE,MN.55356
��!f-�L-�iC'"..4 �.c'.�-�c.7 JOB NO.
952-473-4141 05-263
Mark S.Gronberg Minnesota License Number 12755
05-263