HomeMy WebLinkAbout2001-P04702 - addn/remodel/repair CITY OF ORONPERMIT
O Permit Number:
2750 Kelley Parkway- PO Box 66 P04702
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 12/31/2001
SITE ADDRESS: 4510 North Shore Dr
Mound,MN 55364
PID: 07-117-23-31-0029
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential Construction Type VN
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: Plumbing Other-0
NOTICESIREMARKS:
FEE SUMMARY: Permit Fee: $ 562.95 Valuation: $42,000.00
Plan Review Fee: $ 365.97
State Surcharge Fee: $ 21.00
TOTAL FEE: $ 949.92
APPLICANT: Heritage Builders(See Comments) OWNER: Pete&Kathy Sawicki
5020 Minnetonka Blvd 4510 North Shore Dr
St.Louis Park,MN 55416 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.
ALVCANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Sienitures Reauired),1-Applicant, 1-Monthly Reports,I-Assessine, I-Finance Page 1
Total Fee: $ l?y9 9 Date Received: 1,q6 t -702
Entered By: F0 Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
------------------------------------------------------------------------- -s.___-< ---------------------------
THE APPLICANT IS: (circle one) OWNER CONTRALTO
JOB SITE ADDRESS: 4!S o N , S oi`� `b� , ZIP: S (e
NAMEOF OWNER: VE—\G °t-ykNku S w\Ck PHONE: (home) -
(work) i ,1 a- -;t-7ov o
MAILING ADDRESS: t�S t c7 s,; , �:�yz NCITY: to apt c, o ZIP:--5 G,3
CONTRACTOR: PHONE:
CONTACT PERSON: skE y ��� ,u�A l MOBILE/PAGER: &\a
MAILING ADDRESS: Spap ZIP: -5.S 41 i,v
STATE LICENSE: # Lf3 i 4
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: --- CITY: ZIP:
NAME: REGISTRATION# -�
TYPE OF WORK: New Addition Accessory Structure
Move �Re��l Land Alteration
PROPOSED WORK(describe in detail): gS rrn� �►- T{�,n., F�ti�s�1�N�
jZVECTt+z g{�Trl 4 0 was .T
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. — 4 DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ L ;a ,QCDC5
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 wthe approved plan.
APPLICANT'S SIGNATURE: DATE: d j
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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 require 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 rbav place the notice required under this subdivision in the individual income tax or oronertv 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 die 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 Worm 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 including recipients named by the individual;or(b)notify the individual that he believes the data
to be correct. Data in dispute shall be ' closed only if the individual's statement of disagreement is included with the disclosed data.
Tbe determination of the respohtsffile 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 toi 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
SC-1&-0 MkNNT--�t^- MN-v9
Address
city State Zip Phone
I understand my ri is as stated above.
Signature
6
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: -+s; 10 NORTH
PID:
DESCRIPTION OF WORK: lywc���c_ � i'►N+Si-i Iry
----------------------------------------------------------------------------------------------------------------------
ZONING REVIEW BY: ( , DATE APPROVED: yui o
BUILDING REVIEW BY: DATE APPROVED:
---------------------------------------------- ----------------------------------------------------- ---------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes f No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: A)o
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: Wed d:
Building Height: Def. Hgt. Peak gt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: iZ 3 CONSTRUCTION TYPE: giv
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ `i Z,000°0
Inspections Required: Work Requiring Separate Permits:
Site X Plumbing Fire
Hardcover Removal Water Connection
Footing Septic Sewer Connection
X Framing Fireplace Lawn Irrigation
�( Insulation (Masonry) Other
_ Wall Board (Mfg.) Well (State Permit)
Final Grading/Filling c),< Electrical (State Permit)
Other
REMARKS(IN HOUSE):
------------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT):
8
CITY OF ORONOCALLED IN DATE TIME
INSPECTION NOT CE SCHEDULED —
PERMIT NO. y 0 COMPLETED -�
ADDRESS Y_S/d tide S'A_U� C�i2
OWNER // CONTR. 1-12 IL_Ci
TELEPHONE NO. l2 �� SS_ 72-3 9
DESCRIPTION L- G✓(
4 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/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 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
Lul 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_VINO
COMMENTS:
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W//WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑"""CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
C3STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
a
Inspector. .
White Copy/Inspector's File Canary Copy/Site Notice
CITY OF ORONOIN DATE TIME
INSPECTION TIC CALLEDL
SCHEDULED
PERMIT N0. N COMPLETED
ADDRESS
OWNER S 4 c K' CONTR. az:��
TELEPHONE NO.
DESCRIPTION
U4 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING
yMING 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
w09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
fel N S:
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ORKSATISFACTORY:PROCEED ❑PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 El CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
El CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Conor tpr on site-
Inspector.) l
G White Copy/Inspector's File Canary Copy/Site Notice
rV/ DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI ^' SCHEDULED
PERMIT NO. COMPLETED Y
ADDRESS N - S h n D_
OWNER CONTR. ll -- t roI[�
TELEPHONE NO. a r U��S ^ -7 a S
DESCRIPTION LA-
01
A-01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/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 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
09 PLUMBING RI 23 SEP IC INAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
O MENTS:
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0
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GWWORK SATISFACTORY.PROCEED ❑ PROJECT COMPLETE
W
ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C1 BEFORE 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/Con for on site:
Inspector.
White Copy/inspector's File Canary Copy/Site Notice
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ORONO COPY
SPECIAL MOTE
SF.E ATTACHED SHEET
FOR --5Vy"0e . 4
CODE REQUIREMENTS
- - 21'-p"
EXISTING EXTERIOR WALL
a w EXI57IN6 b FOOT DOOR
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"- DRYWALL REPAIRS ONLY IN TH15 ROOM
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4 QD rn
X
U- w EXISTING MASTER BEDROOM
w z
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Z X
-j CARPET m
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`X NEW WALL
r N
? 2-4 b
Z N �
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W P'1/ Z
Q - - CARPET
); 2-4
cl) MASTER BATH
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EXH.FAN � � LD
J to X =
a CERAMIC FLOOR > LU
iv Z .( >
JU
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NEW MARVIN CASEMENT WINDOWS EXISTING WINDOW
TEMPERED SAFETY OLA55
CITE OF ORO46
BUILDING PF,q I PLAN REVIEW
-11VM NOIN31X3 9NI1SIX3 INSPECTOR
DATA � Z'(7 O J PERMIT NO.
D APPROVED AS SUE101 T TED
MASTER SUITE REMODEL ',ErAp ROVEDW1'Igc°;;lE''TIONSASNOTM
III NOT APPROVED•--CC)FiR:CT&RESUSM1T
The-.a cornmcnts aro for your Infom?a'ion. AI!work sha!l be dote
in ft--1 cor,�W;ante v:i.. all anplica'-,!a huildimg and zoning coo.
Retjt r?. 3"io inC'Ud5?g it.rs net spec i c:?!fy noted in tins review.
SCOPE OF WORK:
KEEP THIS PLAN SET ON SITE AT AAA;TIMES
* ALL WORK 15 WITHIN EXISTING WALLS OF EXISTING OFFICE, MASTER BATH & MASTER BEDROOM
* REMOVE EXISTING MASTER BATHROOM AND REPLACE & REMODEL TO PLAN
* EX15TINO OFFIGE 15 REPLACED BY WALK-IN CLOSET TO PLAN
* NO STRUCTURAL GHANGES TO BE MADE -ALL INTERIOR WALL CHANGES ARE UNDER EXISTING CLEAR SPAN TRU55ES
ONNERS: HERITAGE BUILDER5 ING.
PETER & KATHY SAYqIGKI 5020 MINNETONKA BOULEVARD .k
4510 NORTH SHORE DRIVE ST. LOUIS PARK, MN 55416 °I
ORONO., MN 55364 952-927-6585
MN LIG. # 4314 -
EXISTING EXTERIOR WALL
Lu
Q EXISTING 8 FOOT DOOR i
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G u-
•z• FAMILY ROOM
W
,11
19
f
w DRYWALL YVALL5&GEILING5 rn O
/ X
� Z i
Z pit vmTREATED PLATES WHEN �
10 LAYER ON CONCRETE a J
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NET BAR WITH UPPER GABINETEMOVE BEARING ALL INSTALL LVL ENG.BEAM O
- BEAM CALC5.TO BE ON 5ITE FOR FRAMING INSPECTION -
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BATH �Q� \ rn X
X �71� �
�� Xr lP 111
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EXH.FAN u'
w DRYWALL WALL5&CEILING- :I
�pw to
4PE! toWJ 70
5 R xw w rn
12'-11"— - --- -
��'dM�lOIb31X3 9NIlSIX3
LOWER LEVEL REMODEL
SCOPE OF WORK:
" EXISTING 5PACE 15 UNFINISHED
" LOWER LEVEL HVAC 15 EXISTING AND COMPLETE
" PLUMBING WA5TE 15 ROUGHED IN & EXISTING
FIN15H FAMILY ROOM & BATHROOM PER PLAN
OWNERS: HERITAGE BUILDERS INC.
PETER & KATHY 5AWICKI 5020 MINNETONKA BOULEVARD
4510 NORTH SHORE DRIVE 5T. LOU15 PARK, MN 55416
ORONO., MN 55364 q52-q2l-6585
MN LIG. # 4314