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HomeMy WebLinkAbout2005-P09362 - addn/remodel/repair ` � � � - PERMIT CITY OF ORONO 2750 Kelley Parkw�y- PO Box 66 Permit Number: Po9362 Crystal Bay, Minnesota 55323 Permlt Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 11/10/2005 SITE ADDRESS: 1379 Park Dr unit# Mound,MN 55364 PID: 07-117-23-42-0038 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Pernvt Class: Building Pernut T e: Addirion/RemodeURepair Pemvt Sub-type(s): Addn/RemodeURepair YP DETAILS: Approved per resolution#: Separate permits required: Electrical(state) NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 349.25 valuation: $ 22,000.00 Plan Review Fee: $ 227.01 State Surcharge Fee: $ 11.00 TOTAL FEE: $ 587.26 APPLICANT: Danberry Company OWNER: Sean&Melissa Wambold 4410 Shoreline Dr 1379 Park Dr Spring Park,MN 55384 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 UIREMENTS. U � i/ 1 L1_�i( �-�'/'L- C.V►''�.' P CANT EE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing(If Septic, 1-Septic) Page 1 , �' L�C f Q � c��e 5 i 7L� �Jlc4.. �'a � �S `� ��r�►t �- 4 � ��o� , Total Fee: � �g�• Z� 1� Date Received: �C� �7-Q Sr Entered By: �� — Permit#: ��`,�-s'_"�p � CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print alf iizformatio�z) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O CONTRACTOR� / � JOB SITE ADDRESS: � ?j ��'j �C� ✓!C Ot� . � _ w.—ZIP: _�,�3 S Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS ❑ NO If yes, a special ei�eir�permit is r•eqtured ivith Polrce Depar•tmej�t and City Cozrr�cil npproval 60 dcays pr•io�'to the evefzt. Shzrttle btrs sei•vice tivill be reqi�ired unless applicant dernonstrates suff cieat on-site parkrng is avai(able. �Von-per�mitted events wi!!t�ot be allorved. NAMEOFOWNER: �j�A.� �pti✓�j /� PHONE: (home) �� Zr�/�«- -�!0 t� (work) MAILING ADDRESS: �� CITY: ZIP: CONTRACTOR: �t- � PHONE: ��� ��3 Z CONTACTPERSON: , MOBILE/PAGER: tt/2 Z,ra 7d�7 MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ,/fr(�� EXPIRATION DATE: ARCHI7['EC'T/ENGINEEI2: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition �'� � A�ory Structtu�e Move Home Remodel/Alteration PROPOSED WORK(describe in detai�: /�a[d 3�"aC 7�� ' �`'f 40'��-- -j- rv..SS�"S , ST'OgtIES: r� SQrI'�ET OI+EACI-I I,I�O�: , . 1e1�. OF B�B�tOOIWIS: GARAGE S'I'ALL�: AT'I'ACHE13 �ETA�I�E�3 �STIIV�A'I'EI➢C'ONS'T1�IJCT'ION VAL,LiA'I'ION(excluding land): � Z' Z Qdd O �i I hereby apply for a building permit and 1 acknowiedge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the Cin� and with the State B�iildinQ Code;that I understand this is not a permit and work is t�ot to sta��t without a permit;and that the work will be � in accordance with the approved plan. EIPPLICAN'I''�SIGI�'A'I'URE: � / I)ATE: �� �`T �,� , 31 . . . , . • �« }•,'-.� `�`_. y � �.:. ,,,�I��i � .. `i" 1 � ' °_�" - . � .+ `r � t� 1 , s. � ., � � . , . r , �` �,�` � Sec13.04 RIGHTS OF SUBJECTS OF DATA . • � Subd. I. 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. [nformation required to be given individual.An individual asked to supply private or confidential data conceming himselfshall 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 o�cer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax or p,�oerty 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 thedata without any charge to him and,if he desires,shall be informed of the content and meaning�of tba4 d�ta. ft�r an individual has been sho�vn tha privateda,�and�formed of its fneaqing,the data need not be disclosed to him for six months dierea�'Ret unl�adispute or action pursuant to thiaseation is pending M add'Nional dat2 on the ir�clividual has been collected or created. The responsible authority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authority may require the requesting person to pay the actual costs of making,ceRifying,and compiling the copies. The responsible authority shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe request,excluding Saturdays,Swidays 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 publ ic or private data ��' �,;`�.;•aonce�ing hi�'se�t7�dexercise this right,an individual shall notifj�,in�vritin the��ponsible�authority d c[ibing the nature of the disagreemenL The responsib(e authority shall within 30 days either. (a)correct the c�ata'fou YO iaaccurate or incd�lete�idattempt 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 th iscles �d+ata. The determination of the responsible authority may be appealed pursuant to die provis'ons of t administrative procedure act relating to contested cases. �. � � �� ,�. .: '�.� ` .*'. s �,� '� `. �' � ' DATA PRIVACY AI�VI�OIt�'�3 � - .•r,r . . � . J .. . �. ° 'R� ,� I� /� 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 departmen��iayt tquire you to furnish certain private or confidential information. You are notified that: l. The information you furnish will be used to determine your qualification for the permit or license requested. � 2. You may refuse to�ir�'p�y�da���sal may require that the City deny the permit or license. 3. The information may be share(i with dther local, state or federal agencies to the extent necessary to process the permit or license. 4. r; If your,reque�sted permit or license requires Council action to approve,some information may become c t�� �„ public.` M,y.� ,.' •.. �i; ^,!.'"� 5. You have certain rights under M.S. 13.04(available upon request)to review private d�s,,o+}�jpp�.@�f...� .� 6. Your full name is required to ess this application or permit. � ..�. irs � Middle Lnsf �: �' s • . , M.��• f Address . Ciq� State Zip Phone I understand my rights as stated above. . � . �.�.. . • � , f ,; Signature , ' 32 CI3ECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 1379 P�4Msz 02 PID: DESCRIPTION OF WORK: (',,,�n,4��� �AD i rc o i.l ZOYIi�TG RE'VIEW BY: DATE APPROVED: I I •$-oS BUII�DIl`G REVIEW BY: DATE APPROVED: �� -c� -6 S FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ,/ No PLAN REVIEW � Yes i/ No SEWF.R CONNECI'ION STATE SURCHARGE Yes ✓ No WATERCONNECTION INVESTIGATION FEE Yes No ,/ PARK FEE SAC Yes No ✓ SITEINSPECTION Number of SAC�Units OTHER (specify) ZONII�IG CHE.CK LIST Zoning District: G/L-I/3 Fire Department: Post Office: School District: Lot Area: Sc,B. 5 6, �`{'S Acres �.3 Width /y5 Depch Survey Submitted: Yes No Date of Survey: 6 •ZZ�bS Proposed Setbacks: Front(Lake): 1`77`"r Right Side: 1c16' �' Rear(Street): �2� �� Lef[Side: Z6� '–i Adjacent Structures: /v/il- Wetland: N�/4 Building Height: Def. Hgt. o ��l Feal:Hgt, a �� Lot Covera�e: °I.Z Grading: Staff Approval Date: NJ G�.�.r�,,� By: — Council Approval Date: Septic: Staff Approval Date: /�/1,A By: Zoning File: # � Resolution: # Resolution Date: Shoreland District: �� Av?. Setback: c9.L�. Bluff Setback: N�� L,ot Coveraje: 9•Z Ezistin� Proposed Hardcover: 0-75' �/G ,�./� 75-250' 2y.Z 2y•b 1 2�0-500' NY G 500-1000' Hardcover Variance Required: Yes No�_ Date of Council Approval: REMARKS(in house): � BUILDING REV�W CHECK LIST �C� IZ • 3 CONSTRUCTION TYPE: V� Sq Footage $Per Sq Ftg Basement x = 1st Floor x — 2nd Floor x _ Garage R = z — TOTAL Estimated Construction Value: $ Z2,o00 `�^ Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal Mechanical Water Connection oc Footing ` Septic Sewer Connection � �_Frami.ng Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Boazd (Mfg.) Wetl (State Permit) °� F�� Grading/Filling _�Electrical (State Permit) Other REMARKS (IN HOUSE): . REVIE`V BY OTHERS: DATE: Access: Existing New � Access Approval: Date By; RENIARKS (TO BE NOTED ON PERi�; 8 �� w` �� �// D T�{ TIME � �CITY OF ORONO CALLED IN `�(�_��✓j��' INSPECTIONN IC SCHEDULED ,7�.S�GZ % �i?� PERMIT N0. COMPLETED � I �" 3C�"'�� '"� ADDRESS �37� �(�i � OWNER CONTR. /�/�,�I�P�� TELEPHONE NO. �O�Z. Z �"l�0"! � DESCRIPTION �'���� � l� 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 � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a 0 �r- �'�y -�, C� _ �' f�1l� K�c�•�"%.t ��-- � p� �r C� D 1� T`� ��X-• ���""_i^ � f'v�n� • O � � �� j,.�� ,�� v� � 2 W � W � � d W� �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �� pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. 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