HomeMy WebLinkAbout2004-P07734 - shed CIT OF ORONO PERMIT
� Permit Number:
2750 Kelley Parkway- PO Box 66 P07734
Crystal Bay, Minnesota 55323 Permit Type: Accessory smx��es
(952) 249-4600 Date Issued: 8/5/2004
SITE ADDRESS: 340 North Arm La
Mound,MN 55364
P I D: 06-117-23-24-0013
DESCRIPTION: UBC Occupancy U1
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 328
Permit Type: Accessory Structures Permit Sub-type(s): Shed
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 38.75 Valuation• $ 1,000.00
Plan Review Fee: $ 25.18
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 64.93
APPLICANT: Owner/Self OWNER: 7ames&Adrienne Neilson
MN 340 North Arm La
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.
t
APPLICANT E ITEE SIGNATURE ISSUED BY SIGNATURE G��
Covies: 1-File(SiQnitures Required), 1-Atmlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
Total Fee: $ Date Received: 7'�"��
Entered By: Permit#: AU 77�3
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 o OWNER O CONTRACTOR
JOB SITE ADDRESS: 3yfl �pKT� T�iVI 1•A�t ZIP: SS,3�o
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes �TO If yes,a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
su�cient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: ���M Nt 1 l�Sa 1►.� PHONE: (home)��2- •l 7 Z•��L�
� �l (work) 2.. 7 , O�
MAILING ADDRESS: 3�'I'� �(�'l'{ �M `-+�ITY: ,N�� ZIP: 6
CONTRACTOR: �.1 PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition Accessory Structure �
Move Home RemodeUAlteration
� � �•
PROPOSED WORK(describe in detai�: I�O X 11 (� �j 1'�'1�1�
STORIES: � SQ.FEET OF EACH FLOOR: ��S
NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �,�.
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 p it 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: 1 O�
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. l. Type of data. The rights of individua whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. [nformation required to be given individual.An individual asked to supply private or confidential data conceming himself shall be
infonned of: (a)the purpose and intended use of the requested data within[he collecting sta[e 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[o 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 commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or propertv tax refund
instructions instead of on those forms.
Subd.3. Access ro 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 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 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 of the data. The responsible authority
may require the requesting person to pay[he 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,exduding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [fhe 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[he accuracy or completeness ofpublic or private data
concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreemen[. The
responsible authority shall within 30 days either. (a)corzect 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
dispu[e shall be disclosed only if the individuaPs statement 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 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
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.
��N� N�I��,.l
First Middle Last
�� 1�'C7�'� � 1 lTl�� V��G
Address
o��o M►� S'�'3 6`( �S Z.�(�Z . e�� �
City Sta[e Zip Phone
I understa m�rights as stated above.
Signature
32
• CHECK OFF LIST FOR ISSUANCE OF PERMITS
, FOR OFFICE USE ONLY
A.DDRESS OR LEGAL: 34 0 No 2Z"1-1 �2v►� �wN�
PID:
DESCRIPTION OF WORK: �S1�=t�
ZO�NG REVIE�V BY: � DATE APPROYED: g�-�y
BUII.DI�IG REYIE'�V BY: DATE APPROVED; S�•3:o,,
FEES TO BE CHA.RGED: Misc. Fees Calculated By:
PER1ti1IT Yes � No
PLAl�t REVIEW Yes No SEWER CO�]NECITON
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No SI'TEINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CH�CK LIST Zoaing District:
Fire Department: Post O�ce: School District: �
L.ot Area: Sq.fr. Acres ' Width Depth
Survey Submitted: Yes_ c No Date of Survey: oh, �h��e
Proposed Setbacks: �
F�oat(Lake): (p 0l � = Right Side: `tU� t
B.ee.r(Street): yU ` f Left Side: ZoD� �
Adjacent Structures: I 0 � 'z `Vetland: �•(L
Building Height: Def. Hgt. � ��,L. Peak Hgt. �-
Lot Coverage: N/�I
Gradino: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # -- Resolution: !# Resolution Date: �
Shoreland District: � ��
Avg. Setbac ��� Bluff Setback: � I.ot Coverage: �
Eusting Proposed
Hazdcover: 0-75'
75-250' � �
250-500' I D` �'
500-1000'
i
Hardcover Variance Required: Yes No Date of Council Approval:
RE1I�IARI�S(iIl hOitSe):
7
BUILDING REVIEW CI�CK LIST
�C� �� � CONSTRUCTTON TYPE: �1/`�
_ Sq Footage $Per Sq Ftg
Basement . x _
ls[Floor x � � _ .
2nd floor z =
Garage x = �
x =
TOTAL
Fstimated Construction VaIue: $ I,OoO °n
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbiag Fire
Hazdcover Removal Mechanical Water Connection
Footing ' Septic Sewer Connection •
' Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd • (Mfg.) Well (State Permit)
—�.F�� Grading/Filling Electrical(State Permit)
Other .
RE1�Z4RKS(IN HOUSE): .
------- -------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New .
Access Approval: Date gy;
--------------------------------------------------------------
REIVZARKS (TO BE NOTED ON PER1vII7�:
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Our most popular model with wide opening double doors.
•Big rafter-free space accommodates larger lawn and garden equipment.
•Classic gable roof style complements any home's architecture.
•Window and flower box may be added to enhance decor.
i •A great place to store bicycles and sports equipment.
•Rugged 4-panel doors are 6 feet high and can be painted to coordinate
, with home.
i •Vents included.
•Shed Base System Model B001 makes installation even easier.
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION ICE SCHEDULED _S�� 'B�
PERMIT N0. COMPLETED
ADDRESS ��� ��'� �f"►'��'�'l. L/'L�
OWNER p�L1'►�l/V�eL Srd'Y� CONTR.
TELEPHONE NO. 9�7 Z �7 3 ��� 3
� DESCRIPTION �s1'�c-GC. — �l�X
� 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
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 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 FINA 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOFi TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CQRRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Ca11 tor the nex 'nspection 24 hours in advance. (952) 249-4600
OwnerlContra 't :
Inspector.
White Copyllnspector's Fil Canary CopylSlte Notice