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HomeMy WebLinkAbout2007-P11165 - addn/remodel/repair PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P11165 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 6/27/2007 SITE ADDRESS: 4017 North Shore Dr Unit# Mound,MN 55364 PID: 07-117-23-44-0005 DESCRIPTION: Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Mechanical Electrical(state) NOTICES/REMARKS: Storage over garage/living space FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00 Plan Review Fee: $ 117.81 State Surcharge Fee: $ 5.00 TOTAL FEE: $ 304.06 APPLICANT: Owner/Self OWNER: Fred Johnson MN 4017 North Shore Dr. 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. ,jp 01(1/411/17A1 APPL d v I EE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 • C-4°1 Total Fee: $ 304.© Date Received: [p 25 07 Entered By: I,/ Permit#: A 1 i tl CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) -- 1 THE APPLICANT IS: (circle one) (OWNER OOR CONTRACTOR JOB SITE ADDRESS: th Jl,. C �� ---Nik7 ZIP: 0/1". 4 t°4 Will this be a Par a of Homes, Remodelers Showcase Home or other Display Home? nYes o 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 sufficient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: tZ � �� PHONE: (home)/e3-z70f Sic/ (work) `?‘6 3 7,eo J O MAILING ADDRESS: c1-4 S 'L CO CITY: rt.k 1\ , ZIP: CONTRACTOR: PHONE: D skiSNC( CONTACT PERSON: 5 A ,i-- MOBILE/PAGER: MAILING ADDRESS: Sq {'� CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: (2A6 k pJ,31 � PHONE: ,61- SO DO \(== S MAILING ADDRESS: N 1, 3r4 S CIT c:IS ZIP: 45-s- NAME: --R., 41) ketA i S cps 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 detail): CD oeccZ qQg Li�rJ��SQAc� STORIES: � SQ.FEET OF EACH FLOOR: 677 ":1-- NO. - NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ I 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. Oki APPLICANTS SIGNATURE: 4 � DATE: 0 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 confidential data concerning 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 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 commissioner of revenue may place the notice required under this subdivision in the individual income tax or property 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 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 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 the date of the 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 of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the 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 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 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 rocess this application or permit. 5--(\__, ilk__ 4\ 1— Middle Last Address City State Zip Phone I under' . rk lights as stated above. fit.it Sig , Ire 32 r • CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 1-101"1. /'vorzT S itt OR. PID: DESCRIPTION OF WORK: _ .i ► - a. 0 v ‘,Altkox «_______ vpAU. ZONING REVIEW BY:: en P DATEAPPROVED: 4.- BUILDING -BUILDING REVIEW BY: Ge_4 ----- DATEAPPROVED: 4,• ZG- o7 ------------«�__««.« , ------------------------------------«-«---------------------------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes ,/ No SEWER CONNECTION STATE SURCHARGE Yes V/ No WATER CONNECTION INVESTIGATION FEE Yes No t/ PARK FEE SAC Yes No ,/ SITE INSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning District: Ny C Hean�.�0 Fire Department: Post Office School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Righ Side: Rear(Street): Left Side: Adjacent Structures: Wetland: t-41)a4.9 .'1 t Building Height: Def Hgt. 6 44109e. 2.0` Peak Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: Shoreland District: MCWD Permit: Avg. Setback: Bluf5fSetback: Lot Coverage: Eris ing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS(in house): 33 BUILDING REVIEW CHECK LIST UBC: earsV CONSTRUCTION TYPE: \JtJ Sq Footage $Per Sq Ftg Basement x = 1st Floor x = 2nd Floor x = Garage x = x = TOTAL ea Estimated Construction Value: $ (010 O a Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal 14. Mechanical Water Connection Footing Septic Sewer Connection _ p . Framing Fireplace Lawn Irrigation oc. Insulation (Masonry) Other X Wall Board (Mfg.) Well(State Permit) Final Grading/Filling ►L Electrical(State Permit) Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: • Access: Existing New Access Approval: Date By: REMARKS(TO BE NOTED ON PERMIT): • 34 I DATE�/ TIME C TY OF ORONO CALLED IN -1.26 "! q IO AM INSPECTION N iv - SCHEDULED 1 2.4 O7 I.3d -Ai PERMIT NO. I '(bD �}�,, COMPLETED ADDRESS 4011 North I► L LSKOK-- yO'�, OWNER �� z CONTR.Z �M i L z Lir.c1 ' t TELEPHONE NO. a�fit- gL37 — �� t7cif DESCRIPTION fvZvY\( LU 01 FOOTING 11 MECHA • L RI 18 EXCAV/GRADING/FILLING FRAMING 13 MECHA 'L FINAL 19 LAKESHORE/WETLANDS y 3 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL • 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP LLJ 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES NO o COMMENTS: cz Lit CC 0 CC 0 W Q W W 0 W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY CI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U BEFORE COVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the ne t inspection 24 hours in advance. (952) 249-4600 Owner/Con c te: Inspector. White Copy/Inspector's Fil Canary Copy/Site Notice F7DAT E, TIME / CITY OF ORONO p�//65-- CALLED IN - INSPECTION NO IC SCHEDULED /0-/O-0 7 o?"do PERMIT NO. �� COMPLETED, �' J ADDRESS fD/7 Ailr/K 01 �1�� �� `_---" OWNER CONTR. a:4 oe, L'/o,4 TELEPHONE NO./Z Za-.4-01-sevt/-95,1—937 — 3339 DESCRIPTION hiati a.747 072 D FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING ❑ FRAMING 0 MECHANICAL FINAL ❑ LAKESHORE/WETLANDS C/) 0 INSULATION 0 WOOD BURNER/FIREPLACE ❑ TREE REMOVAL • ❑ WALL BD. 0 WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL 0 SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP LU ❑ PLUMBING RI 0 SEPTIC FINAL ❑ HARD COVER REMOVAL ❑ PLUMBING FINAL 0 FOUNDATION/REMOVAL • OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc W Q. cc O cc O U- W CC toW CC WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY tJ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for then t inspection 24 hours in advance. (952) 249-4600 Owner/Co• t act. •n • "-: Inspector.c- �/ White Copy/Inspector's -Ie Canary Copy/Site Notice cl• DATE TIME CITY OF ORONO I.W65--' CALLED IN 7/x-'7 INSPECTION NOTicg SCHEDULED //- f-Z)7 d- PERMIT NO. [/., 06-7$ COMPLETED ADDRESS '7 `4 Jh Z;;IL. OWNER CONTR. ,= _ 6 / g TELEPHONE NO. 92-- 3S3 `t/7c? a- E DESCRIPTION FIrta-eia ▪ ❑ FOOTING ❑ MECHANICAL RI EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE 0 TREE REMOVAL Z 0 WALL BD. 0 WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. 0 COMPLAINT ✓ ❑ DEMO-FINAL ❑ SEPTIC INSTALL. 0 FOLLOW-UP ct ❑ PLUMBING RI ❑ SEPTIC FINAL 0 HARD COVER REMOVAL v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES NO 2 W p COMMENTS: S�rV IGe- play -ovk-J -pl � - c - Q. r ` eds aa a b c� el . 47c.: 1c %ac- ? 3 `1b oIt"- 0 u W cc co W Z W cc d W 0 WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CCW 0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CZ /CORRECT WORK,CALL FOR REINSPECTION TEMPORARY • Gnor COV[flSr_ PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN 0 CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR 0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the xt inspection 24 hours in advance. (952) 249-4600 Owner/Contra site: Inspector. White Copy/inspecto s File Canary Copy/Site Notice A E �//loS N O''7 OCITY OF ORONO Pf CALLED I �c I INSPECTION NO � ; JA SCHEDULED I• 160.61_ 1(:,30 PERMIT NO. �fl ► �k n )COMPLETED /(`-� � ADDRESS � I`) SJ I v OWNER G� CONTR. V A-7 I N�, -�-�� TELEPHONE NO. 052 —b3 `"�122- DESCRIPTION 'F liJJ V{k- IQ ❑ FOOTING ❑ MECHANICAL RI ❑ XCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS C1) ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP 0 SITE INSPECTION ❑ FINAL 0 SEWER HOOK-UP 0 PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. 0 COMPLAINT Q ❑ DEMO-FINAL 0 SEPTIC INSTALL. 0 FOLLOW-UP LU D PLUMBING RI 0 SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COM k ENTS: tar V\I ()pm . cc0 1• S-rA r r Kti).i 5-7" /4 Aue ette 5o L ( e 614 Lis/A-1-1;:, Lu cc (2) 5-7w-4e G C. �,J� i Afe&ci e_c( z ez 0 W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O,<CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U EFORE 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. (952) 249-4600 Owner/Contractor on site: Inspector. 6-7ri3eS White Copy/Inspector's File Canary Copy/Site Notice F-7TIME/ �� 1D /�` CITY OF ORONO � CALLED IN / INSPECTIO CE SCHEDULED //-.30-07 .1.'.� PERMIT NO. // COMPLETED ADDRESS 4/01 7 Aly-'1"6 SA-e2.(2 OWNER Fred jO ONTR. // TELEPHONE NO. a/ oZ 76/ Jr/ `//7 DESCRIPTION '"/le uj ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION 0 WOOD BURNER/FIREPLACE ❑ TREE REMOVAL ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP 0 PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ P iIQAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: ES NO yo COMMENTS: cc W CC 1VeL4-4©uc VK O cc O cc z ccWORK SATISFACTORY:PROCEED PROJECT COMPLETE CC W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CO ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY (..) BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. El PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED Cl STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the n t inspection 24 hours in advance. (952) 249-4600 Owner/Contract n ite: Inspector. • White Copyllnspe ttor's ile Canary Copy/Site Notice NVId 3'1LIL-NVId al C rtIfIA GC i z. NN 1i iL9 IMF -••••••••• 111.71-- . i �`I L I, ` , :ON I3tH5 i 1 it 1 4'11[91. 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