HomeMy WebLinkAbout2000-P02607 - addn/remodel/repair � PERMIT
. C��TY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po26o�
Crystal Bay, Minnesota 55323 P@fClllt Type: Addition/Remodel/Repair
(612) 249-4600 Date Issued: s�is/2oo
SITE ADDRESS: 350 North Arm La
MOLJND,MN 55364
P I�: 06-117-23-24-0014
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Buildin Census Code 434
Permit Class: g
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Single Family
DETAILS:
Approved per resolution#:
Separate permits required: iviecnanicai Eiectricai(staiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 542.75 Valuation: $ 40,000.00
Plan Review Fee: $ 352.83
State Surcharge Fee: $ 20.00
TOTAL FEE: $ 915.58
APPLICANT: .►on Pendleton OWNER: JON M PENDLETON
350 North Arm La 350 NORTH ARM LA
Mound,MN 55364 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 BUII,DING CODE REQUIREMENTS.
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� �-�APPL ANT PERMITEE I NATURE SLTED B SIGNATLJRE
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Copies: City,Applicant,Assessor,Finance Page 1
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y `Total Fee: $ /�� � �;� Date Received: ��-z�'�� ��
Entered By: � Permit#: A�: �� G�
CITY OF ORONO - BUILDING PERMIT APPLICATION
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�R CONTRACTOR
JOB SITE ADDRESS: ��U N�V�`��1 �f�`Y1 ��Yle, ZIP� �Vc�►�O ����'
NAME OF OWNER: �o►� � 1 vl � �..`�Ty1 PHONE: (home) �]��,�g�
(work) 7ZCv - '7 45d
MAILING ADDRESS: `j�� (v0 r 1 /�Ywt �.icr� CITY: �v�,ne ZIP: .���jS�(oy'
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATti LICENSE: #
ARC��iTECT/ENGINEER: PHONE:
MAILI�iG ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WO (describe in detai�: � L� X J y- VGt�j}11 �M���� h���
`'-�1 �� �`.��� �' �'l� L�Y1 G ✓l i i ►2 �r I�'le v
STORIES: <� SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: N� GARAGE STALLS: ATT. /�DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �, d(,��.%
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 ' not a permit and work is not to start without a
permit; and that the work will be in a �ordanc wi the approved plan.
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APPLICANT'S SIGNATURE: �� , .� C��� DATE: . j� ' �
NOTE! Parade of Homes events;r�equire separate permit approval by Police Deparlment and
City Couneil 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SUBJECTS 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 confidendal data concerning himself
shall be informed of: (a)the purpose and intended use of the requested daCa within the collecting state agency,political subdivision,or statewide
system;(b)whether he may refuse or is legaUy required to supply the requested data;(c)any known consequence arising from his supplyiwg or
refusing to supply private or confidential data;and(d)the identiry of other persons or entiaes authorized by state or federal law to receive the dara.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivuion 5, to a law
enforcement officer.
The commissioner of revernie mav olace the notice reauired under this subdivision in the individual income tax or orooertv 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 individuals,and whether it is ctass�ed as public,private or confidenaal. Upon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown the dara without any charge to him and,if he desires,sUall be informed
of the content and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be
disclosed to him for six months thereafter unless a dispute or action�rsuant to this section is pending or additional data on the i�ividual has been
collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the uidividual subject of the dara.
Tt►e responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies.
The cesponsible authoriry shall comply immediately,if possible,with any request made pursvant to this subdivision,or within five days
of the date of the request,excluding Samrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with
the request withitt that time,he shall so inform the individual,and may have an additional five days widtin wtuch 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 pubGc or
private data concerning lvmself. To exercise this right,an individual shall nodfy in writing the responsible authority describing the�ature of the
disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccucate or i�xomplete and attempt to notify
past recipienu of inaccurate or incomplete data,i�luding recipients named by the individual;or(b)nodfy the individual that he believes the data
to be correct. Data in dispute shall be disclosed only if the i�ividual's statement of disagreement is included with the disclosed data.
The determinaflon of the responsible authority may be appealed pursuant to the provisions of the administrarive 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�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 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 this application or permit.
First Middle Last
Address
C��y State Zip Phone
I understand right s ated a e.
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s►�c�
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' CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 3S o N o R T1-� A 2v►^ L�,�`
PID:
DESCRIPTION OF WORK: !�o+r� � -r� o
ZONING REVIEW BY: DATE APPROVED: �- � -d�
BUILDING REVIEW BY: DATE APPROVED: 7-6 -oo
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓� No
PLAN REVIEW Yes �/' No SEWER CONNECITON
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC . Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: ^r� �f
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes � No Date of Survey: � �.e
Proposed Setbacks:
Front�t): �/�,j �. Right Side: Q �
.�e�{St�rest): 7S W Left Side: 90 5
Adjacent Structures: A-'7"i�ua PO Wetland: N (r4
Building Height: Def. Hgt. b. �L Peak Hgt. —
Lot Coverage: /v �i'°� �� �
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Grading: Staff Approval Date: B : Council Approval Date:
Septic: Staff Approval Date: B :
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setba : Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes N Date of Council Approval:
REMARKS(in house):
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BUII�DING REVIEW�CHECK LIST
UBC: �' � CONSTRUCT16N TYPE: "V�"J
� Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ H(�,Uc�o�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal �Mechanical Water Connection
�Footing Septic Sewer Connection
o�Framing Fireplace Lawn Irrigation
�Insulation (Masonry) Other
�Wall Board (Mfg.) Well(State Permit)
{- Final Grading/Filling ��Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Eatisting New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT�:
8
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* ��Q�� Men���7to H�i��r�ks, lr1N 55120
P!C]NEE�! � ���� �12 ss� is��•�'�X sa� s488
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,* * Blaine, MN 554�4
�C �- (s�z) �s3-�a�o•FoX �s�-�$$s
Certificate of Survey for: David Wilfiams�_�anstructian
House Address: North Arm Rood. Orono. MN
Mode1 Name:
�, ' � Customer: ...
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4RA�n1orG'{= SWl}�L�s f3`� C.�.. LbT DETNL 5C�►L� tk � 10d Fe�t
N07'�: CONTRACTOR l�UST VERIFY ALL 1�IMENSIONS AiVd Of�IVEWAY DESIGN
Y �oa.a Denotes Existin� Llsvatlan PROPOSEC?__�,OUSE ELEVATION
K e�• Denotes Proposed Elevatfan r
� Drndtes Drainage � utility Ea�ernent Lowest Floor Elevation:���s
� --�--Dendtes Drainage Flow Dir�ctipn Tap Qf �loek Elevattott:L��,��:,
—o-- Denotee Monument Garage 5lab Elevatton:,��,�.��
--�-�r Denate� Offs�t Hub Bearings shown are assumed
La1� 2 , BLOGK 1 MARKQE AC�C� I �IdN
HENNEf'lN CAUNTY. MINNESaTA
I herebY Certi}y that this aurvey,plan nr repOrt was pre ered by me or under my direCi supervision end tflat I am duly RegistBrCd Land 5urveYor
uader the 18Ws of the Stats Of Minnesota,D2ted this�day of_f+UG• ,�,C�.D,19�;•y >
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DATE TIME
CITY OF ORONO CALLED IN �G�� �`�l�-�
INSPECTION NOTIC SCHEDULED � �L} �'LZfh''"
PERMIT NO. ����� COMPLETED -��i�l�` '�,, �
ADDRESS �� ` � - �� yv '
OWNER CONTR. E f �-�
TELEPHONE NO. �'�����7 `�7
� DESCRIPTION -� °��'f�� ��
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l� 01 FOOTING 11 fv1ECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 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 FOLLOW-UP
4�.i 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNOATION/REMOVAL
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� �_ CORRECT WORK&PROCEED ' ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CAIL INSPECTOR CITATION ISSUED
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContr c or on site:
Inspector. �/� /�z vL-S
White Copyllnspector's File Canary CopylSite Notice
DATE qr T
CITY OF ORONO CALLED IN �`����� ' T,_T
INSPECTION TICE SCHEDULED � -
PERMIT NO.I���_ COMPLETED ' � � `���'
ADDRESS ��
OWNER CONTR.
TELEPHONE NO. _��('��9�l �?i�
� DESCRIPTION
W 01 FOOTING 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
05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContr on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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��DAT Tliv(E
CITY OF ORONO CALLED IN C1
INSPECTION NO�CE SCHEDULED � �''�
PERMIT NO. C 1��'c� COMPLETED
ADDRESS ��L �G��� h ��� � �
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OWNER �-I('.{'1C,.� �� CONTR. 'I���[�`c�
TELEPHONE NO. �C�� " �1���
>- DESCRIPTION T �c�/�'� /r�
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ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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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 O6 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
Z OWNER/CONTRACT O ME YOU:� ES_NO
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. _ pHOTOTAKEN
INSPECTOR WILL RETURN
CITATION ISSUED
I�STOP ORDER POSTED.CALL INSPECTOR
[:; INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlCont tor on si .
Inspecton�,��� ���^
White Copyllnspector's File Canary CopylSite Notice
DATE,�7�� TIME
CITY OF ORONO CALLED IN ��a'w � `�3
INSPECTION N TICE SCHEDULED -� �v�
PERMIT NO. COMPLETED � 2.'dv
ADDRESS D _/��'� �� L��-
OWNER CONTR.��G�T/ �Yat�c-�-�-c�
TELEPHONE NO. ��-��T��
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l� 01 FOOTING 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
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Q OS 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
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� �ORK SATISFACTORY:PROCEED f- pROJECT COMPLETE
W ❑CORRECT WORK&PROCEED I ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR ' CITATION�SSUED
C INSPECTIONRE�UIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContr t r on site:
Inspector. �� �
White Copyllnspector's File Canary CopylSite Notice