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Home My WebLink About2009-00036 - addn/remodel/repair � � CITY OF ORONO PERMIT NO.: 2009-00036 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISsuEn: 02/13/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 3200 NORTH SHORE DR PIN : 08-117-23-41-0001 LEGAL DESC : UNPLATTED 08 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 46,926.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE PERMIT) APPLICANT pERMIT FEE SCHEDULE 649.50 FIRST STREET CONSTRUCTION INC. PLAN REVIEW 422.18 417 E 1 ST ST. STATE SURCHARGE VALUATION 23.46 WACONIA,MN 55387 � ) (952)442-4602 TOTAL 1,095.14 Minnesota State License#:BC-4141 OWNER HENDRICKSON,RICK&SHIRLEY 3200 NORTH SHORE DR WAYZATA,MN 55391 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shail be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additionai or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revo t any time f d�cause. v l l l �/ �Q pplic ermitee Signatu e Date s d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � `/�0,� � Totat Fee: $ /��/� DateReceived: � 9 09' Entered By: _ Permit#: 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 JOBSITEADDRESS: 3200 N. Shore Dr. Orono ZIP• Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑Yes ❑NO If yes,a special event permit is required with Police Department and Ciry Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non permitted events will not be allowed. NAMEOFOWNER: Barbara Halper PHONE: (home) 760-468-5468 (work) MAILINGADDRESS: same as above CITY: ZIP: CONTRACTOR: First Street Const . , Inc . PHONE: 612-597-8661 CONTACT PERSON: ��.��, MOBILE/PAGER: 9 5 2-4 4 2-4 6 0 2 MAILING ADDRESS: 4 1 7 F'_ 1 �t �t r P P t CITY: wa c n n i a ZIP: 5 5 3 8 7 STATE LICENSE: # 4141 EXPII2ATION DATE: 3-31-0 9 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration(i.e.: Siding,Windows) **.�rti��e�arih mor��i�ncnl ata�-require II�CWD Re��ie�H� unc11'e��f�ail! PROPOSEDWORK(describeindetai�: Finish exi � ; n� bon �s room ov r �arage . STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ $4 6 , 9 2 6. 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 work will be in accordance with the approved plan. �� L .� �� C � � C_ r APPLICANT'S SIGNATURE: � ' � DATE: � � � � �� 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The righu 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 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 known consequence azising from his supplying or refusing to supply private or confidential data;and(d)the identity of o[her 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 commissioner of revenue ma�place the notice required under this subdivision in the individual income tax or property tax refund instructions instead oron 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 informed of the content and meaning of[hat data. Afrer 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 authoriry 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 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 ihe date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance 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 ofpublic or private data conceming himself. To exercise this right,an individual shall notify in wrifing the responsible authority describing the nature ofthe disagreement. The responsible authority 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 correc[. Data in dispute shal]be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible au[hority 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. V G� ��% ��CC� (/ LL� V`� � � l /Ca,.�� C� First Middle Last �/��" f ' � :�� T Address WGt,C;C'.:� ��L �i'�i� �S .j�� C:� �2— J ��—� -�� City State Zip Phone�5� �� [ I understand my rights as stated�ve. �-r��: � ��;�� G'��r-,li Signa[ure . / Reset Forn� 32 , , Total Fee: $ Date Received: Entered By: Permit#: 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 CONTRACTOR JOB SITE ADDRESS: ZIP: Will this be a Parade 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 approval 60 days prior to the event. Shuttle bus service will be reguired unless applicant demonstrates sufftcient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: PHONE: (home) (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: EITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration(ie: Siding, Windows) Any earth movement may require MCWD review and permits! PROPOSED WORK(describe in detai�: STORIES: SQ.FEET OF EACH FLOOR: 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 permit 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: 31 � , � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 3200 �Jp2-ni �,p,�,�; QQ PID: DESCRIPTION OF WORK: �,,,�i S H o..r a+s �Zoe,,.,� q g pv e ('y�_/�c�e ZONING REVIEW BY.• N/A �� DATEAPPROVED: BUILDINGRET�IEWBY.• .�...— DATEAPPROfjED: �-3d•pq FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ,/� No PLAN REVIEW Yes_� No SEWER CONNECTION STATE SURCHARGE Yes �/ No WATER CONNECTION INVESTIGATION FEE Yes No �/' PARK FEE SAC Yes �1Vo - ,r,r': SITEINSPECTION Number of SAC Units OTHER (specify) ZONING CHECIf LIST Zoning District.• O ,yv � Fire Department: Post O�ce: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Fronl(Lake):. Right Side Rear(Street): Left Side: � Adjacent Structures: 4T' tland: • Building Height: Def.Hgt. ak Hgt. Lot Coverage: Grading.• StaffApprovalDate: y: CouncilApprovalDate: Septic: StaffApproval Date: .sewp/� By: Zoning File: # Resolution: # Resolution Date: Shoreland District: MCYY'D Permit: Avg. Setback: BluffSetba : LotCoverage: Existing Proposed Hardcover: D-i�' 75-250' 2.i 0-�00' .i DO-1000' Hardcover 1'ariance Required: I es No Date of Council Approval: REMARKS(in house): 33 • • ( B UILDING REVIEW CHECS LIST UBC: R•"� CONSTRUCTION TYPE:. . VN Sg Footage $Per Sq Ftg Basement` ' • x = ' � . 1 st Floor x = 2nd Floor x = Garage x = � x = TOTAL Estimated Construction Value: $ y(r.9t6 �o Inspections Required: Work Requiring Separ�rte Permits: Site _�Plumbing Fire Hardcover Remova! oC M''echanital Water Connection Footing Septic Sewer Connection rC Framing Fireplace Lawn Irrigafion _�[ Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) �Final Grading/Filling p�Electrica!(State Permit) Other REMARXS(INHOUSE): REVIEW BY OTHERS: � DATE: � Access: Existing New Access Approval: Date By.�" REMARKS (TO BE NOTED ON PERMIT): 34 . �� 2 g��p ,� 6,ro., � � � . . � � . ' • O , � U�' �. � y: • I � /P4.� O . �Q�y" . — � � x , � i � I n � ' � V � � � _ I � � I � � i U ' ' � �I � � � � , � �`�`!o „ � � � � �� - � �y, � e I � ' ?'6 „ � _. _ _ __ _._ _ _ ._. � II .. �� ] ...�i�il�V'�' 'W��„ i. —_ V. + � ...�.�. +...__.. . . .... . .. _... __ {'1• ��.. . . , � .,.. - . � �a L�l�d�'��-r, 1' . <v .... . �i •F�'�� .t, � a .:., . , SE�'e �47 t "' a _ _r. , „ �, "J-ae��s�°c_ ,_.,. ,.' r� � � I � . . ` '^ .. � FC,��:'LQ.'�€?:'��.OE7�c-�-d/L.... . . � ` ., � . r��r s,. .; ' t ,.�- . ( CaaS��'�, b: �6.5�r . a ..: .., ._. _ � ,:,... ,__ . _ . � � � Jx . .._., .... ..-.n-Y.w..r. . . --- _._..._._.._..__..._._ . b � � � � � � � CjTY OF 4RON0 rn � � � � � f' o � � BUiI.AING P IT�LAN REVIEW � �' 3 � � �' n a M!Sl�EGTOR a1�1n•,m,� 1"'f t7 � � � ,a� ti`1 � � Z DATE �'�"��! P�'=?iNl7 IJO. ti �Al'��`�icJ,"�5��:.'�:�,�i�i'�J :% � � � a �c� � � � .,-,��ED �r�+„��cr�i'r:CNS.�S I•d07ET3 � � � j^ �° � �c� � ❑ Fi�1�It`.1Y t,"�� r � f�4T A-'��vL%�D...CC�?rir�CT�:R�S�Jfi��"IT �' �t�y � )— �j�� y -t Theae comm^r.t;4r�fC�your in.'��ap��. k!I wurk st��be done � � [� � ,` N � }—+ in tull ccmp;:anco vailh �I; apptic2,bl2 build�ny antl zcnir�g cocie. � � � � � � � ReGuirerr,en!s+rciudinci itams r.ot specit,callynoted in this review, �� il�EP TNtS Pl.Aflt:i�T UN SfTE AT ALL'fIMES � ` 'V � �' � _ . . - � �� ? �" a o�� TIME CITY OF ORONO CALLED IN =� INSPECTION NOTICE SCHEDULED PERMIT NO. � (`7�� -��peOMPLETED ADDRESS ��.��_� �11�'�P � • OWNER CONTR.�(�fi � \�[�� TELEPHONE NO. �v�y S�7 �� C�� DESCRIPTION ��n � ❑ FOOTING ❑ MECHANIC RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANIC FINAI ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � GW /�'f_I�IlVORK SATISFACTORY:PROCEED f_l PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CAII FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ��CITATION ISSUED � INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�0 OwnerlContractor on site: t ,� Inspector. White Copyllnspector's File Canary Copy/Site Notice �� / D E TIME V CITY OF ORONO CALLED IN �� INSPECTiON NOTICE SCHEDULED �,�� .'BC� PERMIT NO. �D —U� DD3lo COMPLETED ADDRESS ��0��'`� ��P� OWNER CONTR. `�� T��1�� TELEPHONE NO. �Z �g � ��0 � � DESCRIPTION ��r��l� � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUM J ❑ FOUNDATION/REMOVAL � OWNE CONTRACTOR TO MEET YOU:�` Y _NO c�., COMMENTS: � W a � J O � � O � W � Q � Z W � W � � � �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Catl for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. White CopyMspector's File Canary CopylSite Notice �� .� DATE TIME CITY OF ORONO CALLED IN � � INSPECTION NOTICE SCHEDULED ' PERMIT NO. a�� -��lo COMPLETED ADDRESS 3�0 OY �� LZc./ OWNER CONTR. ��` TELEPHONE NO. �o�Z S� 7 ��O�o � � DESCRIPTION ��`L2� — �.�� ❑ FOOTING p MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. O WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO c�n COMMENTS: � W a � � ° �� vr� � ,� � I Pe� .� , a-s �-s � i4 f es � W � Q � y��1�o .�-htl �S�` d/� 'P( ��3 ��► W � � • C� , D rZ-�-Q c-fc�c S 12 C��v t•-/ '�,'� C✓ifc.�� c � v� o F- � �.�a�-c ��c,-�. W� ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE C�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail forthe next inspection 24 hours in advance. (g52) 249-4600 Owner/Contractor on site: Inspector. I�I J J�lr White Copyllnspector's File Canary CopylSite Notice