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Home My WebLink About2003-P06227 - addn/remodel/repair � PERMIT �CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P06227 Crystal Bay, Minnesota 55323 Pel"CTllt Typ2: Addition/Remodel/Repair (952) 249-4600 Date Issued: si22�2o03 SITE ADDRESS: 4365 North Shore Dr Mound,MN 55364 P I D: 07-117-23-43-0031 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Buildin Census Code 434 Pernut Class: g Permit Type: Addition/Remodel/Repair Pernut Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate pernuts required: riumoing iviecnanicai Eiecmcai�siaiej NOTICES/REMARKS: wr---`------:�- -��_`:-- r------- ----' ------`- ---�------ ---�� .. ..._.. .. ________.. .r::.:�:i::::-::::a..::::::..::::::.:.::::::b....,i..i.::::. t::aYY'J"'b '.ti.:.:::.:::c::: FEE SUMMARY: Permit Fee: $ 678•75 Valuation: $ 55,000.00 Plan Review Fee: $ 441.28 State Surcharge Fee: $ 28.00 TOTAL FEE: $ 1,148.03 APPLICANT: Stonehearth Custom Homes(See Comment OWNER: Nicholas&Sandra Summers 609 131st Ave N. 4365 North Shore Dr Champlin,MN 55316 Mound,MN 55364 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. Ge-�r��c�r,�v� S��ud �� ,�.� j�t; (�"}�t'l��,�� .�'��',�- APPLICANT PERMITEE SIGNATURE . ' ISSUED BY SIGNATURE Copies: 1-File(Si�nitures Required), 1-Aoplicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1 , � � �Total Fee: $ � � �� " �\,�� Date Received: L �3 b`�' Entered By: �.,1/! j1() Permit#: ��'('p Z�� ; � ` _�� ?�'� ��iLt�i , . CITY OF ORONO - BUILDING PERNIIT 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 ��JOB SITE ADDRESS: �3i��j n ��il�C'e �� ZIP: �." S— .� � NA.�IE OF OWNER: ,C� �,�tY��r� (home) PHONE: �..5� : (w rk) 9_S�- ��,��1r� MAILL�IG ADDRESS: ��c CITY: -�1 ZIP: d � � CO\�TRACTOR: � �`�xo�:_ (0�2 - �19��'��3 � � CO�-TACT PERSON: NIOBILE/P ER: &h�� _ �, S NL4�,I�i'G ADDRESS: � � ��J �,� CITY: +. � ZIP: i��, � ST�TE LICENSE: # ez � S ARCHTI`ECT/ENGINEER: PHOi\TE: � l�I_AII,Ti�tG ADDRESS: TCITY� ZIP: I�'�`IE: �'� �'1 � �b, TYPE OF WOR u � ��,� ��,,\ j� 'J -� -.. s ' � , �� ,�� , � PROPOSI << � � � � � � �� L �� ..� `� �-- � � � � STORIES: _ � '\ � `7 �� '�\� NO. OF BEl " ,��C . �.G� ; ` \ �� L� �.l �� ESTLIIATED ' �A ' I hereby apply fc ' __��auon above is complete and accurate; that the .,.uuiances and codes of the City and with the State Building _..�� is not a permit and work is not to start without a permit; and that tt-� _.. �n a cordan e 'th the ap roved plan. 0. APPLICANT'S SIGNATURE: DATE: Z� -,��_ NOTE! Parade o Homes events require separate permit approval by Police Deparlment and City Counci160 days prior to the event. Non permitted events will not be allowed. 5 r ► � D 1 Sec.I3.04 RIGHTS OF SiJBJECTS 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 reqwired to be given individual. An individual aslced to svpply private or confidential data concerning himself shall be infottned of: (a)the purpose aad intanded use of the requested data within the collecting state agency,polidcal subdivision,or statewide system:(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his yvpplying or refvsing oo supply private or confidenaal data;and(d)the identiry of other persons or entiaes audiorized by state or federal law W receive the data. T6is requirement shall not apply when an individual is asked ro supply investiga6ve data,pursvant to section 13.82, subdivision 5,to a law enfomement o�cer. '�he commissioner of reveriue mav olace the nodce rewired under this svbdivisian in the individual income tax or ro ertv tax refund instrucrions tnstead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or coafidenrial. Upon his further request,an iadividual who is the subject of stored private or public data on individuals shall be shown die data wid�out any charge to hun and,if he desires,shall be informed of die content and meaning of that data. After an individual has been shown the private data and informed of its meaniag,the data need not be disclosed W him for six months thereafter unless a dispute or action parsuant co this sec6on is pending or addidonal data on the individual has been collected or created. The respons�ble authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The resgoasible authoriry may require the requesting person to pay the actual costs of maldng,certifying,and compiling the copies. The responsible authoriry shall comply immediacely,if possible,wit}►any request made pursuant to this subdivision,or wid►in five days of the date of the request,excluding Sadudays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply widi the request within that time,he shall so inform the individuai,and may have aa addidoaai five days within which to comply with the request, excluding Saturdays,Sundays and(egal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeuess af public or priva[e data concerning himsetf. Ta exercise this right,an individual shall notify in writing the responsible authority descn'bing the�nature of the disab�reemecu. The responsible authoriry shall within 30 days either. (a)correct the dare found to be umccurate or incomplete and attempt to nodfy past recipients of inaavrate or incomplete dars,including recipienu named by the individual;or(b)notify the individual ihat he believes the data co be correct Data in dispute shall be disclosed only if the individual's statement af disagreement is iacluded with the disclosed data. The dererminaaon of the responsble authority may be appealed pursuant to the provisions of the adcninistrauve 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 pemut 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 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 I.ast Address Ciry State Zip Pf�one I und d my ' t, s stated ve. S' re 6 . � ' . • CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY . ADDRESS OR LEGAL: V 365 rls o 2rN 5 tto�'r�c. �2. PID• DESCRIPTION OF WORK: Fc ns�sc-t (�o ti�� o r �w� C.c�—u-e.� ZO�TING REVIEW BY: DATE APPROVED: BUII..DING REYIEW BY: DATE APPROVED: y-2�-a3 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes v No PLAN REVIEW Yes ✓' No SEWER CONNECTION STATE SURCHARGE Yes �/ No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No� SITEINSPECTTON. Number of SAC Units OTHER (specify) ZO�'ING CHECK LIST Zoning District: �°�'v �� 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 Sid : Reaz(Street): Left Side: Adjacent Structures: etland: Building Height: Def. Hgt. P ak Hgt. Lot Coverage: Grading: Staff Approval Date: y: Council Approval Date: Septic: Staff Approval Date: y: Zoning File: # Resolution: # Resolution Date: . . . Shoreland District: Avg. Setback: Bluff Setbac : Lot Coverage: Existing Proposed Hazdcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS ('in house): 7 . . , . , . BUII.DING REVIEW CHECK LIST � � �C� 2- � CONSTRUCTION TYPE: v� Sq Footage $Per Sq Ftg Basement R = lst Floor x. _ � 2nd Floor R = Gazage R = R — TOTAL Fstimated Construction Value: $ gg�a oo � Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal �i Mechanical � Water Connection F��g Septic Sewer Connection �Frami.ng Fireplace Lawn Irrigation �Insuladon (Masonry) Other _�_Wall Boazd (Mfg.) Well(State Permit) - --�C F� Grading/Filling _�r Electrical(State Permit) Other RENIARKS(IN HOUSE): � . REVIEW BY OTHERS: DATE: �N��_� Access: Existing New Access Approval: Date gy; � REMARBS (TO BE NOTED ON PERMII�: �,�,o,,,� g.,00„��,r~��,i�'T��,c ��i wrt r .9�Lt !' J�P.��vc � g � V f[� E�� fl� TIME CITY OF ORONO CALLED IN �� ' INSPECTION NOT � ��scHE�u�E� O ' PERMIT NO. COMPLETED ADDRESS � 3�.c� �i S�'1(�YCJ D� OWNER CONTR. S� i�I'l� f-(C.ZD'`F-v� TELEPHONE NO. l� �� L��'� -� rJ�J?� ` � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 XCAV/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 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 � OWNERICONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W a � J O � � O � W � Q � 2 � W � W � � � d W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the ne t inspection 24 hours in advance. (g52) 249-46�� OwnerlContr r 'te: Inspector. White CopyllnspectoPs File Canary CopylSite NoUce Y�-� DATE TIME CITY OF ORONO CALLED IN I�'I 7 INSPECTION NOTICE SCHEDULED ��'Z� �11'- � PERMIT NO. F�U '�?2 � COMPLETED ADDRESS `l��r ✓ �\ " = �'"r�:r< I��L OWNER CONTR. �('r'�"�"�� l C�CL{�9�-� TELEPHONE N0. � C I-� � ��C -�'1 '�� DESCRIPTION t` �r'1tt..-t � 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 Z04 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUM8ING FINAL 36 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a � � � � J � O � � � O � W � Q � 2 W � W � j � , WORKSATISFACTORY:PROCEED ROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL AETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REOUIRED.CALLTO ARRANGE ACCESS. Call forthe n xt inspection 24 hours in advance. (952) 249-4600 OwnerlContr ite: Inspector. White Copyllnspector's Fiie Canary Copy/Site Notice