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Home My WebLink About2001-P03601 - addn/remodel/repair PERMIT CITY OF OR,�N� Permit Number: 2750 Kelley Par.kway - PO Box 66 P03601 Crystal Bay, Minnesota 55323 P@f1711t Typ@: Addition/Remodel/Repair (952) 249-4600 Date Issued: 3ii3i2oo1 SITE ADDRESS: 4300 North Shore Dr MOLIND,MN 55364 P I D: 07-117-23-42-0023 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Kesidentiai Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Eiectricai(siaie j NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 111.25 Valuation: $ 4,217.00 Plan Review Fee: $ 72.28 State Surcharge Fee: $ 2.15 TOTAL FEE: $ 185.68 APPLICANT: STEPHEN&JENNIFER PAIDOSH OWNER: STEPHEN&JENNIFER PAIDOSH 4300 NORTH SHORE DR 4300 NORTH SHORE DR MOLJND,MN 55364 MOLJND,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. G _ ��;,� �'' ,� � ,;� � �. AP T PERMITEE SI NATURE [SS 'D BY SIGNATURE Copies: City,Applicant,Assessor,Finance Page 1 Total Fee: � � ��7 � �� Date Received: .3 � �� Entered �y: ,i2/' Permit#: ;.�LL�j,�.`,,.,,� �`v,-..:�<� :��-"��' /� Cl �(n(J � 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�ze) WNER R CONTRACTOR JOB SITE ADDRESS: y�O v j� . � �{p['Z��U� ZIP: �S 3 6 �� NAME OF OWNER: J��;�_r. �'�,� �� .. PHONE: (home)��-�7� -�i!� (wark) 7��• �j��/ -5�i'�3 MAILING ADDRESS: y3vG IU� SEJv,QF d�iU�= CITY: Q ROlU G Z�: �S 3�� CONTRACTOR: N�� PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGIl�TEER: jU/p PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition�_ Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK (describe in detain: �,o-,$�'� ;�,�� n�,(o�� yt � r -U i,,�C.�1, („� � � 1�..� ►%L � � r r�r„t �2 0 o-F_ �. n c:e �=c�t�� f i o 'n- STORIES: � SQ. FEET OF EACH FLOOR: � � NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION �:�I.UATION (excluding land): $ � ; �7. O O 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: �--�- c i NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the eti•ent. Non permitted events will not be allowed. 9 . 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 secrian. Subd.2. Information reqwlred 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 stateande system;(b) whether he may refuse or is legally required to supply the requested data;(c)any l�own wnsequence arising from his supplying or refusing W supply private or confidential data;and(d)the idendty of other persons or end6es 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 W section 13.82,subdivision 5,W a law enforcement officer. The commissioner of reve�e mav nlace the notice iequired under this subdivision in the individual income tax or nronertv tax refund instcuctions instead of on those forms. S�bd.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 swred 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 siz months theceafter unless a dispuoe or action pursvant W this secdon is pending or addiflonal data on the individual has been collected or created. The responsible audioriry shall provide copies of the private or public data upon request by the individua(subject of the data. The responsible authoriry may reqaire the requesting person to pay the actual costs of making,cerdfying,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,encluding Sawtdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within d�at time,he shall so infocm die 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 camplete. An mdividual may contest the accuracy or completeness of public or private data co�eming hunself. To exercise this right,an individual shall norify in writing the responsible authoriry descnbing the nature of the disagreement The �nsisible awhoriry shall wid�m 30 days either. (a)corc�t the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete dara,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 deoemtination of the cesponsible authoriry may be appealefl 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 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. S�.�.,��.e,ra ��e.��,� r� Q��-o.�� First Middle Last �3�� N o r�.T � � Et o n.� 0 R o �� ' Aaare� D t�o�� (�t� SS�6y /U, �63-��-��3� Ciry State Zip Phone I understand my rights as stated above. lN� �(�a'�?a'��7 � � �� signamre 10 � CHECb OFF LIST FOR ISSUAI�TCE OF PER1ti1ITS _ � FOR OFFICE USE ONLY . ' . ADDRESS ORLEGAL: � 3U O I`J o 2T'!-4 st-to�'z� �R • PID: DES CR�'I'ION OF'�ORK: c..�•.,�c,o s�.� �-N-r�rt,�, vN��. �.�c s r�� /W�r= . ZO�SLIG REYIEti'Y BY: D�TE APPROV�D: 3 -I Z-o� BUILDIri TG REYIE�BY: , DATE APPROYED: 3 -t i-o t FEES TO BE CHAItGED: biisc. Fees Calculated By: pERMIT Yes_� No �• pI,AN REVIEW Yes r/' No SE�FR CONNECTiON STATE SURCHARGE Yes� No WATERCONNECTION . INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECITON Number of SAC-Units OTHER(specify) _ ZOtiZ�i G CH�CS LIST Zoning Districc: /UC� G�� _ . Fire Department: Post OfFlce: School D'utrict: • ' • Lot Area: Sq.ft. Acres � Width Depth Surve;Suba:itted: Yes No Date of Survey: Proposed Setbacks: � Front(I.a.ke): Right Side: ' Rear(Street): I.efr Side: Adjacent Structures: �Vetlaad: • Buildia;Heiaht: Def. H�t. Peal:Hot. Lot Coverage: Grading: ScafF Approval Date: By: Couacil Approval Date: _ Sepdc: Staff Approval Dace: By: Zoaing File: # Resolution: � Resolutioa Date: . Shoreland District: Av?. Setback: Blufc Setback: LotCocera�e: E��, Proposed a Hardcover: 0 75' ------- . 75-250' 2�0.500' 500-1OQ0' Hazdcover Variance Required: Yes No Date of Couacil Approval: �o�n/✓>A—� � �0 0 rf REsI�LA�iS (inhouse): DIv � rs s�6 a� un�-� �xrs 7 f . � BUII�DING REVIEW CHECK LIST UBC: R' 3 - CONSTRUCTION TYPE: v� Sq Footage $ Per Sq Ftg . 8asement x = lst Floor z = 2nd Floor x = Garage x = x = TOTAL Estimated Construction value: $ �, 'Z 17 , C�c'� Inspections Required: Work Requiring Separate Permits: Site • Plumbing ' Fire Hazdcover Removal Mechanical Water Connection Footing Septic Sewer Connection DC Framing Fireplace Lawn Irrigadon —b�Insulation (Masonry) Other �_Wall Board (Mfg.) Well(State Permit) �C Final Grading/Filling oc Electrical(State Peraut) Other RE1•IARKS(IN HOUSE): � REVIEW BY OTHERS: ' DATE: Access: Existing New Access Approval: Date By: REILARKS (TO BE NOTED ON PERNIIT�: 8 DAIE TIME CITY OF ORONO CALLED IN o'�- INSPECTION NOTICE / SCHEDULED 3 '• D , PERMIT NO. P�,�[Y��I COMPLETED � �� 5 3� ADDRESS ��C�Q /V-��l,eE �� . OWNER �-e.��_ �C.L�'CfoS'l� CONTR. �'1/Lt O�/he.�^ TELEPHONE NO. ��p 3 �g� � ��3`� � DESCRIPTION -�-✓IJ!/Ic��D � � 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 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � J O �. � O � W � Q � 2 W � W � j � �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal1 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContr on site: Inspector.��r-�—��i(� White Copyllnspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN �� INSPECTION N TICE SCHEDULED oZ Ul q�3o.�¢M PERMIT NO. COMPLETED ADDRESS ��DO /�l127-f-f �S%�U/Z E l�ie 1T��'E OWNER ��/l�D.si-� CONTR. .��Z � TELEPHONE NO. �K �COJ �� y.3 � 4S Z 72 Y2i7 � DESCRIPTION �iQ.�-�cit/h�Cs� W 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 F MIN 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 OS 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 FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � J O � � O � W � Q � Z W � W � � d 4�WnRK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE �� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCI;PANCY W Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT O CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDEF POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�0 OwnerlContractor on site: Inspector.�/ .�f�1�J2� White Copyll�spector's File Canary Copy/Sfte Notice