HomeMy WebLinkAbout2003-06791 - entrance monument CITY OF ORONO PERMIT NO.: 2003-06791
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 09/30/2003
952 249-4600 FAX: 952 249-4616
REPRINTED ON 10/14/2010
ADDRESS : 270 NORTH SHORE DR W
PIN : 06-117-23-23-0019
LEGAL DESC IDYLLVALE FARM
LOT 002 BLOCK 001
PERMIT TYPE ACCESSORY STRUCTURE
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ENTRANCE MONUMENTS
ACTIVITY O/S BUILDING-UNDEFINED
NOTE: P06791-THIS PERMIT WAS APPLIED FOR AND KEYED INTO WRONG ADDRESS(270 NORTH SHORE DR W),DISCOVERED
ON 9/23/10 BY PLANNING&ZONING. ASKED TO CHANGE TO CORRECT ADDRESS(210 NORTH SHORE DR W).
APPLICANT PERMIT FEE SCHEDULE 181.25
LUNDGREN BROTHERS CONST. PLAN REVIEW 117.78
545 E.INDIAN MOUND
WAYZATA,MN 55391 STATE SURCHARGE(VALUATION) 5.50
TOTAL 304.53
OWNER
TASTAD,JOHN M&KIMBERLEY
210 NORTH SHORE DR W
MOUND,MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the �.
State Building Code. This permit is for only the work described and does e
not grant permission for additional or related work which requires separate (y'
permits. All provisions of laws and ordinances governing this type of work '`
shall be compied with whether or not specified herein.This permit will `�
expire and become null and void if construction authorized is not U
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: P06791
Crystal Bay, Minnesota 55323 Permit Type: Accessory structures
(952) 249-4600 �() Date Issued: 9/30/2003
SITE ADDRESS: 0 North Shore Dr W
/Mound,MN 55364
PID: 06-117-23-23-0018
DESCRIPTION:
Proposed Use: Residential
Census Code O/S-Building
Permit Class: Building
Permit Type: Accessory Structures Permit Sub-type(s): Entrance Monuments
DETAILS:
Approved per resolution#:
Separate permits required: Eiecmcai(state)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00
Plan Review Fee: $ 117.78
State Surcharge Fee: $ 5.50
TOTAL FEE: $ 304.53
APPLICANT: Lundgren Brothers Const. OWNER: Bradley Pass
545 Indian Maland E 2536 18th Avenue S
Wayzata,MN 55391 Minneapolis,MN 55404
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.
APPLICANT PERMITEE S ATURE SSUED BY SIGNATURE
Conies: 1-File 0-unitures Required), 1-Annlicant 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
` Total Fee: $ .53 Date Received: �- `� t
Entered By: Permit#:
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 CONTRALTO
JOB SITE ADDRESS: Z/® 11cr7 Y1- St,,c ...P+-, ZIP:
NAME OF OWNER: 0/1 r�,�,�-a s • boa-C,/-• PHONE: (home)
(work)6/z - 5,e-7- as 73
MAILING ADDRESS: CITY: (,t1 -2 ZIP: 7
CONTRACTOR: z6w5 , / res. ��5+` PHONE:
CONTACT PERSON: 41- MOBILE/PAGER: Gjz - F19- a3 73
MAILING ADDRESS: g�. rte- .c,.;. eco- " CITY: ZIP: S's 3 g/
STATE LICENSE: # a y1 3
ARCHITECT/ENGINEER: 16-A05-, PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New /K Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): (�Oy►S�r�-� .�r �e /l'�n�
STORIES: �1A SQ. FEET OF EACH FLOOR: '`J 4
NO. OF BEDROOMS: ,*/i4 GARAGE STALLS: ATT. -'1114- DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /v, &.o U
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: I��� 43
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.
' a
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 stoned shall be as set forth in this section.
Subd.2. Information required 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 of is legally required to supply the requested data;(c)any(mown 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 may place the notice rewired under this subdivision in the individual income tax or property 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 the 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 inform 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 ire 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 data,including recipients named by the individual;or(b)notify the individual that he believes the darn 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 the responsible 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 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 and land my rights as stated above.
S' cure
• CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
'ADDRESS OR LEGAL: 2%o AJ o R;n-A s t-to rtc rJ 2 w��
PID:
DESCRIPTION OF WORK: Ciy 7nAN d,C, rYia K . ry7S
ZONING REVIEW BY: DATE APPROVED: 4•Z&-o j
BUELDItii TG REVIEW BY: DATE APPROVED: 9
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNEC HON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes_, No Date of Survey: 03
Proposed Setbacks:
Front(Lake): 5+ Right Side:
Rear(Street): I f t Left Side:
Adjacent Structures: N /,4 Wetland: N 14
Building Height: Def. Hgt. Peak Hgt. —
Lot Coverage: 1-r fA
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Se ack: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMAR .S (in house):
7
o
BUILDING REVIEW CHECK LIST
UBC: i CONSTRUCTION'TYPE:'
Sq Footage $Per Sq Ftg
Basement x _
1st Floor x _
2nd Floor x
Garage x =
x
TOTAL
Estimated Construction Value: $_[ U, UO
Inspections Required: Work Requiring Separate Permits:
Site. Plumbing Fire
Hardcover_Removal Mechanical Water Connection
—X_ Footing Septic Sewer Connection
Framing Insulation Fireplace Lawn Irrigation
Wall Board (Masonry) Other
_Final (Mfg.) Well(State Permit)
Grading/FMing -- Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMHI):
8
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED
PERMIT N0. fffi6 it COMPLETED !G ! '�► /:(/O
ADDRESW7O 14�A, 4"V --f#MO V*—' .
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION �
FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIWNG
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
2 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
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNEWCONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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0
0
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Q
W
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ATISFACTORY:PROCEED ❑PROJECT COMPLETE
VZ W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN p CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Con or ite•
Inspect
WhRe Copyllnspectoes File Canary Copy/She Notice
LIGi4IT FIXTURE
LIGHT FIXTURE
STONE CAP
ADDRESS STONE
TAPERED STORE COLUMN
N
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in
STONE CAP
9 TAPERED STONE WALL
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GRADE
TAPERED STONE WALL ' 2.-w
4 COLUMN W/STONE CAP
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5-0" a. I'I r�
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L-----_-------------___L----------____----J l--_-_-------------J_-___-_________________J ------
FfRONT ELEV,4TION 2 SIDLV,4Tf ON
SCALE: 1/4" 1'- 0" I SCALE: 1/4" 1'- 0"
CONG.FOOTINGS BELOW
r_— ----_ ----_� STONE CAP
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----------- I I I ;. i 1 I --- TAPERED STONE WALL
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I /� CITY OF ORONO
3
FLAN VIEW BUILDING4P �illI FLAN REVIEW 4 CjECTION
SCALE: 1/4" . I'- 0" INSPECTOR SCALE: 1/4" I'- 0'1DA? 2 _P'-'.R'JiT NO.
11 A7PROVED V.i!FH CC: .v r,�,r.S AS r 7 D
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Kc�rJ i rtlS PLAN SE i Cori sl TE AT ALL TIMES O u
0 R 0 NO PROPERTY ENTRANCE MO NUMEI NT
70 N • S/rcore_ - ORONO COPY
SURVEY FOR: LUNDGREN BROS. 64000-074 624/22
(126-17)
SCHOELL & MADSON, INC. ( (� .
ENGINEERS * SURVEYORS * PLANNERS
SOIL T * ENVIRONMENTAL SERVICES ENTRANCE MONUMENT EXHIBIT
105800 WA WAYZATA BOULEVARD, SUITE 1
MINNETONKA, MN 55305
952-548-7801 FAX: 952-548-9085
www.ac-hoolimadmon.com
WEST
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— PROPOSED
ENTRANCE
5.0 MONUMENT 0 10 20
AS STAKED
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Outlot A, IDYLLVALE FARM,
Hennepin County, Minnesota.
W
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LEGEND
= 5.0 • Denotes found iron monument
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CITY OF ORONO
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SITE FLAN
GRADING, PLAN
APPRO V ErJ
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z ❑ APPROVED WITH REVISIONS
Q ❑ DI;APP'-` � D
U BY
DATE - z�_
This drawing has been checked and
reviewed this /S 7-14 day of
0 e,. 20 Q 3 .
by
SW. CORNER OF OUTLOT A,
3 ^�.,..•. / IDYLLVALE FARM I hereby certify that this exhibit was prepared
under my supervision and that I am a Licensed
Land Surveyor under the laws of the State of
Minnes
S89047'00"W
534.30--- ,
Daniel takols
LL Date: Se,p+ 15, zoo License No. 19839