HomeMy WebLinkAbout2000-P02071 - addn/remodel/repair -
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-- PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: �r pozo��
Crystal Bay, Minnesota 55323 Permit Type: additio��emodel�epair
(612) 249-4600 Date Issued: 1/�y����
SITE ADDRESS: 433o Nortn snore Dr
MOUND,MN 5�364
P��: 07-117-23-42-0024
DESCRIPTION:
Proposed Use: Residential UBC Occupancy. R3
Permit Class: Building
Construction Type: �
Permit Type: Addition/Remodel/Rep�ir
Census Code: 434
Pernut Sub-type: Single Fainily
DETAILS:
Resolution#: N/A
Separate permits required fo
NOTICES:
FEE SUMMARY: permit Fee: $ 54���� Valuation: $ 1,500.00
Plan Review Fee: $ 35.08
State Surcharge Fee: $ 0.75
SAC Fee: $ 0.00
Misc. Fees: $-(�-H6'.:%'`f C��
TOTAL FEE: $ 143.83
APPLICANT: A1lstar OWNER: Eric�,opeZ
8401 North Share Dr 4330 North Shore Dr
Minneapolis,MN 55428 Mound, MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AUR�ES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANC�S AND
STATE OF'NIINNESOTABUILDINU CODE REQUIREMENTS.
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APP� �'T�P1iRMITEE SIGNATU � D BY SIGNATURE ����(
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Today's Date: 1/19/00 Page 1
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Total Fee: $ /�3. a .� Date Received:
Entered By: ��, . Permit#: �
t'(y`'.;�C."�C''i
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 OR CONTRACTOR
JOB SITE ADDRESS: '7`.�.-3 O Nc�-��►s �i�✓r ��, ZIP:
NAME OF OWNER: PHONE: (home)
(work)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: �1�5 T�K _ PHONE: S� '� 7��0
CONTACT PERSON: �,� ��`� 4� OBILE/ AGER: �`�0 !/7;�
MAILING ADDRESS: $`ffl( 7 3 t�l _.CITY: !'I'1�I��- ZIP: )"�2 �
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZII':
NAME: REGISTRATION#
TYPE OF WORK: N�w Addition X� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK (describe in detai�: ��� f"r-r-�- � ��f4�1 � �� �- �r�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
r-C-
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � ��C!
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: �� /r``'� DAT'E: �` r�—O�
NOTE! Parade of Homes events require separate perntit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of i�ividual on whom the data is stored or to be stored shall be as set forth in this serrion
Subd.2. Information reqwired to be�iven individual. An individual asked to supply private or confidential data concernmg himself
shall be informed of: (a)the purpose and iatended use of the requested data withict the collecting state agency,poli6cal subdivision,or staoewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any lrnown consequence arising from his supplying or
refusing to supply private or confide�ial data;ami(d)the ide�iry 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,m a law
enfarcement officer.
The commissioner of revem►e mav olace the notice reauired under this subdivision in the individual income taz or nronertv iaz 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 die subject of stor�private or public data on individuals shall be shown the data without arry charge to him and,if he desires,shall be mformed
of the content and meaning of that data. After an individual has lreen 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 addidonal 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 che data.
The responsible authoriry may require the requesting person to pay the acWal costs of making,certifying,and compiling the copies.
The respons�ffile authority shall comply immediately,if possible,with any request made pursuant to ttus subdivision,or within five days
of the date of the request,excluding Sadudays,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 ari addidonal five days within which to comply with the cequest,
excluding Saturdays,Sundays and legal holidays.
S�bd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of�blic or
private data concerning himself. To exencise this right,an individual shall notify in writing the responsible authority describing the aamre of the
disagreement The responsible audwriry shall withia 30 days either: (a)correct die data fourni to be inaccucate or incomplete and attempt oo notify
past recipientc of inaccuiate or incomplete data,including recipients named by the u�dividual;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 ihe responsible authoriry may be appealed pursuant to the provisioas of die admiaistra6ve procedure act relating
to contested cases.
AATA 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 depaztments may require you to furnish certain
private or confidenrial 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.
First Middle Last
Address
City State Zip Phone
I understand my rights as stated above.
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6
' • � CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �i 33 o tU d 2 i�� �N o tt� �0 2�u�.
PID:
DESCRIPTION OF WORK: �oF�c��- ("2-no�r ou� �c,sn�� �c�
---------------------------------------------- -----------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: 1 - i S- b�
BUILDING REVIEW BY: DATE APPROVED: ( -i q -o u
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/' No
PLAN REVIEW Yes '�' No SEWER CONNECTION
STATE SURCHARGE Yes � No WATERCONNECTION
�INVESTIGATION FEE Yes � No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: /U U C (-f-��Q
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wet and:
Building Height: Def. Hgt. Pe Hgt.
Lot Coverage:
Grading: Staff Approval Date: B : Council Approval Date:
Septic: Staff Approval Date: By
Zoning File: /t Resolution: #{ Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: I.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):�- �,��n 2 k s 7'A iZ.�Y� (�r �-(c� u � �`P/ln'''�� l
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BUII..DING REVIEW �I�ECK LIST '
UBC: �Z.-3 CONSTRUCTION TYPE: V N
. Sq Footage $Per Sq Ftg �
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ !,S�() �"�
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InspecNons Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
( Footing `Septic Sewer Connection
oL 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: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT):
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DATE TIME
CITY OF ORONO l��p �� CALLED IN
INSPECTION NOT r SCHEDULED �� �
PERMIT NO. conn LETED �/s� 9°�� G'
ADDRESS (��� �������'-� �` "
OWNER CONTR.�""�l Siuv' �QYl'I' .
TELEPHONE NO. ��`>S ���� Ce.�\ L� 5�-1-a-I�L I
� DESCRIPTION �r1 �GC� �
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 RAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
= 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
14 SEWER HOOK-UP 06 PROGRESS
� DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR T MEEf YOU:_YES_NO
c�,� COMMENTS: E'PG' /`�-L'i� `-r'-�
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4 ,rY.c:ORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. , pHOTOTAKEN
INSPECTOR WILL RETURN
❑ STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContractor on site:
Inspector� CG��-�'.r��
White Copyllnspector's File Canary CopylSite Notice
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