HomeMy WebLinkAbout2008-P11847 - addn/remodel/repair PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Pa.kway- PO Box 66 P11847
Crystal Bay, Minnesota 55323 Permit Type:
Addition/RemodeURepair
(952) 249-4600 �___.. ..
Date Issued: 2/1/2008
SITE ADDRESS: 1120 North Shore Dr W Unit#
Mound,MN 55364
PID: 07-117-23-23-0005
DESCRIPTION:
Proposed Use: Residential Census Code 434
Permit Class: Building
Addition/Remodel/Re air Permit Sub-type(s)�' Addn/RemodeURepair
Permit Type: p
DETAILS:
Approved per resolution#:
Separate permits required: Other-0
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 25.00 Valuation: $ 450.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 25.50
APPLICANT: Home Improvement Specialists OWNER: Jay A Lezer
6700 Woodedge Rd 1120 North Shore Dr.W.
Minnetrista,MN 55331 Mound,MN 55364
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANC&TH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
01
APPLICANT PERMITEE SIGNATURE V1 ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
CITY OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: P11847
Crystal Bay, Minnesota 55323 Permit Type:
Minor Alterations
(952)249-4600 Date Issued: 2/1/2008
SITE ADDRESS: 1120 North Shore Dr W Unit#
Mound,MN 55364
PID: 07-117-23-23-0005
DESCRIPTION:
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Replace load bearing girder(interior)
FEE SUMMARY: Permit Fee: $ 25.00 Valuation: $ 450.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 25.50
APPLICANT: Home Improvement Specialists OWNER: Jay A Lezer
6700 Woodedge Rd 1120 North Shore Dr.W.
Minnetrista,MN 55331 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.
APPLIC PERMITEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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Total Fee: $ Date Received: "I`�,36��
Entered By: Permit#: — 119*7
CITY OF ORONO - BUILDING 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 O CONTRAC OR
JOB SITE ADDRESS: /U. ,Sl ®k ZIP.
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes o If yes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non permitted events will not be allowed
NAMEOF OWNER: TAY LE L 20, PHONE: (home) S2 - Y 7z_7a 3�
(work)
MAILINGADDRESS: ABOVE- CITY: 0P0,k) p ZIP:
CONTRACTOR: D M t- //''f PRo 1I E M 7- SPEC( PHONE: 0
CONTACT PERSON: til�Q�� f3 _ MOBILE/PAGER: T 5 i2 —q7 z-- 410 9.2
MAILING ADDRESS: Ko760 [yooh>i9DCITY: 1j6j,V D ZIP: 57 3 6
STATE LICENSE: # 2n / 7607 EXPIRATION DATE: 0Z3 t 10 F,
ARCHITECT/ENGINEER: Lf ..-• 5 , (49 C-, PHONE: t 5 vZ -q 7-3 - VC)7 -2
MAILING ADDRESS: � 7o 0 Umof-a CITY: �Q p 04)2 ZIP: 5 36 5/
NAME: REGISTRATION: # 9
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration(ie: Siding,Windows)
Any earth movement may require MCWD review and permits!
PROPOSED WORK(describe in detail): /�S�'.4LL
7 v O/N A) 0 Ll V? R,Lt k I 7-C-M EAJ
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $
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: l
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.1. Type ofIlata. 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 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 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 may place the notice required under this subdivision in the individual income tax or property tax refund
instructions instead of on those forams.
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 arty 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 ofpublic 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 data,including recipients named by the individual;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 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 understand my rights as stated above.
i
Signature
keset!! � 32
s
• CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL:
PID:
DESCRIPTION OF WORK
ZONING REVIEW BE — VOL DATEAPPR 0VED:����
BUILDING REVIEW BDATEAPPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes_ No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE—
SA C Yes No SITEINSPECTION
Number of SAC Units OTHER (spec)
ZONING CHECKLIST Zoning District. �-
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acr Width Depth
Survey Submitted: Yes No Date of S ey:
Proposed Setbacks:
Front(Lake): Ri Side:
Rear(Street): Left Si
Adjacent Structures: and:
Building Height: Def.Hgt. Peak t.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By.
Zoning File: # Resolution: # Resolution ate:
Shoreland District. MCWD Permz
Avg. Setback: Bluff Setback: Lot Coverage:
Existing roposed
Hardcover: D-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council roval:
REMARKS(in house):
33
BUILDING REVIEW CHECKLIST
O�00 6 IRC,C, CONSTRUCTION TYPE:
Sq Footage $Per Sq Fig
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: S Sy
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover moval Mechanical Water Connection
Footing i�h eae� Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
Final Grading/Filling Electrical(State Permit)
Other
REMARKS(INHOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
34
TIME V
'CI;OF ORONO CALLED IN
INSPECTION NqT,10ESCHEDULED
PERMIT NO. -7 COMPLETED �- �!/IA
ADDRESS I 1 �o i�J
A) - n 1-',,:7 AA2 t&L
OWNER CONTR. n—I
TELEPHONE NO.
DESCRIPTION beam
tU El FOOTING El RI EXCAV/GRADING/FILLIN
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
h ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
v ❑ PLUMBINGFINAL ❑ FOUNDATIOWREMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS: L,2j zeg,
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Uj ❑WORK SATISFACTORY:PROCEED kPROJECT COMPLETE
W ❑CORRECT WORK&PROCEED UE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
ElSTOP 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:
Inspector.
White CopyMspectoes File Canary Copy/Site Notice