HomeMy WebLinkAbout2000-P02678 - rebuild attached garage PERMIT
C I TY Ca F O RO N O Permit ►vumber:
2750�Kelley Parkway - PO Box 66 Po26�s
Crystal Bay, Minnesota 55323 P@r1111t Typ2: Addition/Remodel/Repair
(612) 249-4600 Date Issued: ioi3oi2o
SITE ADDRESS: 4455 North Shore Dr
MOUND,MN 55364
P I D: 07-117-23-31-0002
DESCRIPTION: UBC Occupancy U1
Construction Type VN
Proposed Use:
Permit Class: Building Census Code 438
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Garage/Attached
DETAILS:
Approved per resolution#:
Separate pennits required: Eiectricai(siaiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ g3•25 Valuation: $ 3,000.00
Plan Review Fee: $ 54.08
State Surcharge Fee: $ 1.50
TOTAL FEE: $ 138.83
APPLICANT: GREGG KLOHN OWNER: GREGG D KLOHN
4455 NORTH SHORE Dr 4455 NORTH SHORE DR
MOiJND,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 BUII,DING CODE REQUIItEMENTS.
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� A 'P���P� ISS D BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
:al Fee: $ 5.83 Date Received: ��7 � a
e�ed By: Permit#: �}-o �,G`? �_
CITY OF ORONO - BLTII.DING 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: y�/,sS'�/�� ��j�.� C1✓•�— ZIP: sS36�_
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NAME OF OWNER: G���G � /�����1 PHONE: (home) G�2•4��'5����
(work)
MAII.ING ADDRESS: �'��� CITY: ZIP:
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CONTRACTOR: �C� �f��"' C`�wNf�� PHONE: �r� ���Z�
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: Gw���— PHONE:
MAILING ADDRESS: CITY: ZII':
NAME: REGISTRATION#
TYPE OF WORK: New Addition � Acce,ssory Structure
Move �_ Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: fQe/� �� X ���,��� �j���� -
�`ik"f was o�t!�,.,•�� �� J��^ ,
T o -
STORIES: , � � SQ. FEET OF EACH FLOOR: ���
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.�
ESTIlVIATED CONSTRtiCTION VALUATION (�cluding lan�: $ �,�
I hereby apply for a building pemlit 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 Ciry 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 SIGNA _ DATE: �//���
NOTE! Parade o�Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events wi11 not be allowed.
5
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� CHECK OFF LIST FOR ISSUANCE OF PERMITS
, FOR OFFICE USE ONLY
ADDRESS OR LEGAL: y H S 5 /V O R'h� �I�t-d�?�, Q R .
PID:
DESCRIPTION OF WORK: ��Ejnq(,�s
ZONING REV�W BY: DATE APPROVED:
BUII�DING REV�W BY: DATE APPROVED:
FEES TO BE CIiARGED: Misc. Fees Calculated By:
PERMIT Yes ✓' No
PLAN REVIEW Yes ✓' No SEWER CONNECTION
STATE SURCHARGE Yes �,G No WATERCONNEC'TTON
INVESTIGATION FEE Yes Nb , PARK FEE
SAC Yes No � SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECB LIST Zoning District: !.R- �Q �
Fire Department: �'�/(,��,�,�/) Post OfFice: MN��.+�p School District: wt�r-vN�p�
Lot Area: Sq.ft. Z'�. (�.�v Acres .`Z Width �i.�, u v4�n Depth
Survey Submitted: Yes� No Date of Survey: I I-1 L��l'7
Proposed Setbacks:
Front(Lake): 215� '} Right Side: L 0
Reaz(Sueet): f 5 � = Left Side: s•
Adjacent Structures: �� Wetland: /�J��¢
Building Height: Def. Hgt. /2� Peak Hgt. / (s�
Lot Coverage: --
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # 'L� Resolution: # 32Z Resolution Date: 7-Z�, •9�j
Shoreland District: ��
Avg. Setback: p.�C Bluff Setback: Itl.�y, LotCoverage: —
Facisting Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
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B�,nnvG xEv�w c�cx Llsr . .` .e ,
UBC: V � I CONSTRUCTION TYPE:• �� �JN
Sq Footage $Per Sq Ftg ,
Basement x =
lst Floor x � = '�
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ 3,0 c�t� °S
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanic,al � Water Connection
�C Footing Sepric Sewer Connection
oC Framing Firepl�ce Lawn Irrigation
�
�nsulation� `' " ' (MasonrY} � ., y Other , . `
Wall Boazd (Mfg.) Well(State P�rmit)
_�c Final � . `—aading/Filling C'Electrical(State�Perniit)
Other
REMARKS(IN HOUSE): �
_.:_______�__
REV�W BY OTHERS: DATE:
.�2 -', ',
Access: Existing , l�ew .
e . .
Access Approval: Date By:
REI�ZARKS (TO BE NOTED ON PERMII�:
. . . .. ,s ..A a . .. .
•.v ,di .
8
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' Sec.1e3.04 RIGHTS OF SLIBJECTS OF DATA _
� Subd. 1. Type of data. The rights af individual on wttom die data is soored or to be stored shall be as set forth in this section.
Suhd.2. Information required to be given indivitduaL An i�lividual asked to supply priwdoe or coafidendal data co�erning hiaoself
shaa be informed of: (a)the purpose aod ia�nded use of the requested daoi within the collecdng state age�Y�PoGdcal subdivisio0.or statewide
system:(b)whether he may ref�.ce or is legallY�N���PPtY�e�N��:(�)�5'l�own wnsequence arising from his supplying ar
refiuing to supply privaoe or confcdem�l data;and(�the identity of other peisoac or e�ides authorized by state or fedecal law to receive the data.
This requiremem shall not apply whea an individual is asked ro supply imesdgative data,purs�rant to section 13.82.subdivision 5,to a law
enforcement officer. , - . . .
The commissianer_of_c�vem�e mav olace the irotice reauized under this subdivision in the i�rvidual income tax or orooercv taY refiuui
instmctions instead of on those forms.
Subd.3. Access to data bp individual. Upon request to a respoacible audiority,an iadividual shail be informed whemer he is the
subject of stoced data on individuals,and whether it is classified as public,priva�or confidendal. Upon his further request,an individual who ,
is the subject of soored private or public dala on individuals shall be shown the data without any chaige to him and,if he desires,shall be informed
of the content a�meaning of that dara. After an individual has been shown die private dard aad informed of its meaning,the data need not be
disclased to him for six mo�hs diereat�er iml�ss a dispu�or actioa pursvant m this secaon is pending or addiaomdl data on the individual has lreea
collecred 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 requesdng pecson to pay dte acwal wsts of maloag,cerafying,and compiliag die copies.
The responcible awharity shall comply immediately,if possible,with any request made putsvant to this subdivision,or within five days
of die daoe of the requesK.excluding Satuidays,Sundays aad legat holidays.if immediate wmpliaace is�t possible. If he cannot comply with
the request within that time,he shall so iaform the individual,and may have aa addidonal five days within wtuch to comply wi�the request,
excluding Saturdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accuQate or complete. An iadividual may co�st the accuracy oc completeness of public or
priwate data comceming himself. To exen:ise this right,aa iadividual shall notify in writing the respons�le audioriry descnbing the nature of die
d�sagreemr.�3. The mcponsible mtdwrity shall within 30 days either. (a)correct the data faund to be inaccutate or im:omplete and auempt to nodty
past recipie�of i�aoe or i�ompleo�da�a,i�luding recipie�'s named by t�►e individual;or(b)�afy the individuat that he beGeves the da�a
to be correct. Data in dispute shall be disclosed only if the individual's s�teme�of disagreement is included with the disciosed data.
The determimdtion of die�oas►ble authoriry may be appealed pursvant to�te provisioa5 of the adminiso�ative procedure act relaang
to contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, 5uhd. 2, "Rights of subjects of data", we would 1'ke to inform you that your
request for a germit or license from the�iry 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
____ _ _pr�ess the�rmit or license. .. - -_ - -- - � _ -
4. If your requested permit or license requires Conncil action to approve, some information may become
public. .- =- �.. ,
� -- - --__._ _:, . ,:•' � ' ; "
5. You have certain righis under M.S. 13.04(ava�able ugon requestj to review private data on yourself.
6. �Your full name is required W process this application or permit. - . _'`.::-
---�. �a���G._�_: _�/�i£'�'' `,(,iG D�!: ;-. - - . _ -- � � - - --
F� L f Cf,��� /f/i i� ,J�...t O�.r _ �
. �� DrL�.� := ,�,� - s-sP3 s�� 6/a.yys,gad ,
c,cy ' s� z� pho�
I understand my rights as stated above. �
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DATE TIME
CITY OF ORONO CALLED IN l , -C� ���5�
INSPECTION NO�T CE r7 SCHEDULED �� -' '
PERMIT NO. '� !� COMPLETED -��� � - ��
ADDRESS '7�f�� ��(�I"`f'h �OYC' ��..�
OWNER CONTR. ��C'`��'1
TELEPHONE NO. ��� " ��C' � Do�-a�
� DESCRIPTION
�C� ��-� ��.. j�cz -l.� --�S
l� 01 FOOTING 11 tv1ECHANICAL RI 18 EXCAV/GRADING/FIL�ING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION �
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS Q�,�---
= 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT �
Q 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP p�"
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� �WORKSATISFACTORY:PROCEED i PROJECTCOMPLETE
W ❑ CORRECT WORK R PROCEED ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContrac or on site:
Inspector. ` ��� ��-�
White Copyllnspector's File Canary CopylSite Notice
✓
DATE T�IME�/1
CITY OF ORONO CALLED IN __'(�����1� ���
INSPECTION NO CE h SCHEDULED �r-=�/ �
PERMIT NO. � ` � COMPLETED ��
ADDRESS ���5 -�� ,�/ ���Yf C�2
OWNER �C�'��� CONTR. < ? �
TELEPHONE NO. � � � ��
��
� DESCRIPTION j
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 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
J 07 DtMO-FINAL 15 SEPTIC INSTA�L. 22 FOLLOW-UP
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. L' PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR -- CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContrac r on site:
�
Inspector.
White Copyllnspector's File Canary CopylSite Notice