HomeMy WebLinkAbout2005-P09153 - addn/remodel/repair r F :* : PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: po9153
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued:
10/12/2005
SITE ADDRESS: 1379 Park Dr Uuit#
Mound,MN 55364
P��� 07-117-23-42-0038
DESCRIPTION: UBC Occupancy R3
Construcrion Type VN
Proposed Use: Residenrial
Census Code 434
Permit Class: Building
Permit T e: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
YP
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
2nd Story Addition&Screen Porch
FEE SUMMARY: PermitFee: $ 3,121.75 valuation: $ 480,000.00
Plan Review Fee: $ 2,029.14
State Surcharge Fee: $ 240.00
TOTAL FEE: $ 5,390.89
APPLICANT: The Danbury 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 REQUIREMENTS.
� a
P ANT P G ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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TotalFee: $ �.39�� � / DateReceived: ,��� �'� �rJ�
Entered By: Permit#: <=j f G � 0 j
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 o��e) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ZIP: % ;'
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑fi10 lf yes, n special event pernut is regarired�vith Police Depar�tmeiat and City Cotrncil appr•oval
60 clays prior to the event. Shz�ttle bus service tinill be reqzcired unless applicant demonsb�ates
si�f cient on-site parking is m�ailable. iVon permitted events tivill not be allotived.
NAME OF OWNER: " • PHONE: (home) ``�' � " � `H �'
(work)
MAILING ADDRESS: � CITY: � - � ZIP: �.
CONTRA.CTOR: � PHONE: � s �'
CONTACT PERSON: MOBILE/PAGER: - t m d7 Js Y
MAILING ADDRESS: CITY: ZIP: �.: ��;
STATE LICENSE: # EXPIRATION DATE: �
ARCHITECT/ENGINEER: PHONE:
MAILING ADDR�SS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition Accessory Structure
Move Home Remodel/Alteration :--�'
:;�
PROPOSED WORK(describe in tletai�: � ��` t' L- � '� ���'� r
�'I'ORIES: ��.�'EE'I'O�'EACY��'I,OOR:
NO. O�'BEDROOMS: GARAGE STALLS: ATTACHED DE'�ACHED
ESTIIVIATEI)CONST12iJCTION VALUA�'ION(excluding land): � �° ', `'�' � �
I hereby apply for a building permit and I ackno�vledge 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 pennit and work is not to start without a permit;and that the work wiii be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE:
31
� • Y .
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individuai on whom the data is stored or to be stored shall be as set forth in this section.
SuUd.2. Information required to be given individual.An individual asked to supply private or contidential data conceming 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 suppiy invesNgative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or prooertv 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 infonned whether he is the subject of
stored data on individuals,and whether it is classified as public,private or contidential. Upon his further request,an individual who is the subject of
stored private or publ ic data on individuals shal I be sho�vn the data without any charge to him and,if he desires,shall be informed of the content and
meaning of diat data. After an individual has been shown the private data and infonned of i[s meaning,the data need not be disclosed to him for six
months thereafter uniess a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible au[hority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within Yive days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannotcomply�vith the request
within that time,he shall so inform the individual,and may have an additional tive days within which to comply with the request,excl uding 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 notity in writing the responsible authority describing the nature ofthe disagreement. The
responsible aufhority 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 ifthe individual's statement ofdisagreement 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 fike to inform you that your request
for a perniit 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 inforn�ation 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 a�encies 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. ]3.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit. �
C.t � ��_n�^ y -L"�.,,`, `r� �/�rY �� '��~ ��
First Ntiddle Lxst
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Address �
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Cit�• State Zip Phone
I understand my rights as stated aheve.
l _ _ ��,
Signaturc
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I ��`i �f�RK t�P.
PID:
DESCRIPTION OF WORK: q p o , ,—, on�s
-------------------------------------------------------------
ZO��TG REVIEW BY: � DATE APPROVED: � • 27-os'
BUILDING REVIEW BY: DATE APPROVED: S • Z7 -�S
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW � Yes _� No SERTER CONNECI'ION
STATE SURCHARGE Yes ✓ No WATERCONNECTTON
INVESTIGATION FEE Yes No _� PARK FEE
SAC Yes No ✓ � STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONI�TG CHECK LIST Zoning District: (.2- �f3
Fire Department: Post Office: School District:
LotArea: Sc.ft. S�.B45 Acres i•3 Width �y�5 Depth
Survey Submitted: Yes �c No Date of Survey: b- 2'Z-0 5
Proposed Setbacks: AeA•n�•► su�.M.4.Rc�l. �
Front(Lake): i�l �� 1`3�l Right Side: � � 9Z �
2�►�9 S'ra� 14` i.. S i�
Rear(Street): ►Zf�� � 3`��' Left Side: 6Y� * y Y�
Adjacent Structures: prr�nc�+�� Wetland: N�A
Building Height: Def. Hgt. v. k- Peal:Hgt. —
Lot Covera;e: (o.S°��
Grading: Staff Approval Date: N� CH+4r�i,! By: — Council Approval Date:
Septic: Staff Approval Date: N/A BY�
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: V�P S
Av�. Setback� 0.k Bluff Setback: N I/� LotCoverage: (,.S
Existing Proposed
Hardcover: 0-75' � N/G
75-250' 2-�.'Z z3•7
2�0-500' N� Ci�
500-1000'
Hardcover Vuiance Required: Yes No ac Date of Council Approval:
REMARKS (in house):
�
. ; �.
BUILDING REVIE`V CHECK LIST
UBC: R• 3 CONSTRUCTION TYPE: �l�►
Sq Footage $ Per Sq Ftg
Basement x _
1st Floor x _
2nd F1oor x _ �
Garage x =
z =
TOTAL
F,stimated Construction Value: $ �b(��p p� �_"
Inspections Required: Work Requiring Separate Permits:
Site __�Plumbing Fire
_�Hazdcover Removal _�Mechanical Water Connection
o� Footing ' Septic Sewer Connection
_�(_Framing Fireplace Lawn Irrigation
_�Insulation (Masonry) Other
_�o Wall Board (Mfg.) Well (State Permit)
—�F�� Grading/Filling _�Electrical (State Permit)
Other
REMARI�.S(IN HOUSE): . . .
- ----------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
---------------------------------------------------------------------
RENIARKS (TO BE NOTED ON PERIVII'T):
8
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CITY OF ORONO CALLEO IN l� ��`�
INSPECTION NOTICE,., _ SCHEDULED ��
PERMIT NO. ���I!�� � COMPLETED
ADDRESS � ���l'j �(.t � � ��� •
OWNER CONTR. � � rL
TELEPHONE NO. ��c� ` • `" �` �C� f�
�9
� DESCRIPTION `
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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
? 09 PLUMBING RI 23 SEPTIC FINAL 35 WARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO M ET YOU: YES_NO '
c�., COMMENTS: � C
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Ca11 for the next inspection 2a hours in advance. (J52� 249-4f)�0
OwnerlCon
Inspector.
White Copylinspector's File Canary CopylSite Notice
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y 7 � �� DATE TIME
CITY OF ORONO , CALLED IN � - �-G(�' �°�,�,
INSPECTION NQTIC ���3 SCHEDULED 1-II-D!o ���_
PERMIT NO. �� COMPLETED
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ADDRESS �.��� � �i��C ,j�� _
OWNER CONTR. l l' -<�`L/
TELEPHONE N0. �Sc� ��� C� 3c�'
� DESCRIPTION �l�-+'��� �� /
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAMING 13 MECHANICAL FINAL 19 IAKESHORE/WETLANDS
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O 03 I LATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL{NSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor o
Inspector.
White Copy/lnspector's File Canary CopylSite Notice
� DATE TIME �
�
CITY OF ORONO CALLED IN / `��'
INSPECTION,�VOTICE SCHEDULED �.� ��
PERMIT NO.��% 5 � COMPLETED
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ADDRESS -/�
OWNER CONTR. ' �
TELEPHONE NO. �S � L� �� G � 3�
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�- DESCRIPTION �C,.�!./J�'L'�Z��•
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l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
�FB,� 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 OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUJv16fNG FI 36 FOUNDATION/REMOVAL
� OWI�fRICONTRACT TO MEET YOU:�YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
Owner/Contract i e:
Inspector.
White Copylinspector's File Canary CopylSite Notice
6 � . D'AT/E TIME �
CITY OF ORONO CALLED IN - `'� �6
INSPECTION NOTICE 2 SCHEDULED �-�U� •�
PERMIT NO. JG��j "J COMPLETED
ADDRESS 3 � �
OWNER CONTR. '�� >
TELEPHONE NO. �S � �7� Gj� .3 �
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� DESCRIPTION I <--� " /�G
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADfNG/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q INAL 14 SEWER HOOK-UP 06 PROGRESS
� O-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� CO MENTS:
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O ❑CI�RRECT WORK,CALL FOR REINSPECTION X TEMPORARY �(�J-OIp
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� 249-46��
Owner/Contrac r site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice