HomeMy WebLinkAbout2003-P06740 - attached garage � -� PERMIT
CiTY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po6�4o
Crystal Bay, Minnesota 55323 Pel"Illlt Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 9�isi2oo3
SITE ADDRESS: 1496 Park Dr
MOLJND,MN 55364
PID: 07-117-23-43-0013
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential Construction Type VN
Pernut Class: Building Census Code ���7�
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Garage-Attached
DETAILS:
Approved per resolution#:
Separate pernuts required: Eiec;iricai�staiej
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 321.25 Valuation: $ 20,000.00
Plan Review Fee: $ 208.78
State Surcharge Fee: $ 10.50
TOTAL FEE: $ 540.53
APPLICANT: Owner/Self OWNER: F 7 HARDIN III&C A HARDIN
MN 1496 PARK DR
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.
�� ���-��r'���-�y�����--� �-Y(.�t�_ - _
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Renorts. 1-Assessin�, 1-Finance Page 1
. � ' �
Total Fee: $ �j�v� J�% Date Received:��,���U�
Entered By: �'�2_. Permit#: �U�,,7�-((�i
CITY OF ORONO - BUILDING PERIVIIT APPLICATION
�' All information must be submitted in full before plan review will be started.
`
�,� ,� (please print all information) �
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' - ------------------------------------------------------------------------------- -------------------------
�� 1� -- --
�' THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SIT'E A.DDRESS: I�/�i(o �G►�Ic I���v� . �u�wd Z��. 5 � 3 6 "�`
NAME OF OWNER: �. Su�•r•. �-�a.r��w PHONE: (home) G 5 Z �-/72"37 3�I
(work)
1VIAII�ING ADDRESS: ��rq6 f�aY(� ��h�ve CITY: {/Iq J�wc� ZIP: S�'3 6�
CO\�RACTOR: - c�t�►h�r - PIiONE:_
COr�TACT PERSON: NIOBILE/PAGER:
1VL4II..ING ADDRESS: CITY: Z�:
ST�,T`E LICENSE: #
ARCHITECTIENGINEER: PH0�1E:
NL4II.ING ADDRESS: CITY: ZIP:
�,T���; REGISTRATION#
TYPE OF WORK: New Addition_� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: �d� �,i��,l�ec1 �o�YG�S �L
STORIES: I SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: � � GARAGE STALLS: ATT. df. + D�T.
ESTL�IATED CONSTRUCTION VALUATION (excluding land): $ `�U, uOv
I hereby apply for a buildin�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 Ciry 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 wi� be in accordance with the approved plan.
APPLICANT'S SIGNATURE: � DATE: ,s�� �S , Zad3
..
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
� �i , � ' � ;
Sec.13.04 RIGHTS OF SLJBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is�tored or to be stored shall be as set forth in this section.
Subd.2. Information re�uired to be givea individual, qn indiv�dual asked to supply private or confiden[ial data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polirical subdivision,or stauwide
rysum;(b)whether he may refuse or is legally required to supply the requested data;(c)any Irnown consequence arising from his supplying or
refiuing to supply private or coafidendal data;and(d)the identiry of ocher persons or entiaes authorized by srate or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply invesrigadve data, pursuant to secaon 13.82, subdivision 5, to a law
enfoccement o�cer.
The commissioner of revenue mav olace the notice rewired under this subdivision in the individual income taz or oro ertv tax refvnd
'�nst�u�dons mstead of on those forms.
Subd.3. Access to data by individual. Upon request W a responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is class�ed as public,private or co�denaal. Upon his further request,an individual who
is the subject of stored private or public data on i�ividuals shall be shown the data without any charge W him and,if he desires,shall be informed
of�e content and meanin�of that data. After an individual has been shown the private data and informed of its meaaing,the data need not be
disclosed to him for six months�ereafter unless a dispute or acdon pursuant to this secaon is pending or addirional data on the individual has been
coilected 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 che requesdng person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,wirh any request made pursuant to this subdivision,or within five days
of rhe date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with
the request wi[hin[hat time,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,
excludin�Saturdays,Sundays a�legal holidays.
Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or completeness of pubGc or
private data conceraing himself. To exereise this right,an individual sha11 nodfy in wridng the responsible authoriry describing the�nature of the
disagreemenG The responsible authoriry shall within 30 days either: (a)cornct the data found to be inaccurate or incomplete and attempt to noafy
past recipiencs of inaccurate or incomplete data,including recipienu named by the individual;or(b)noafy the individual that he believes the data
to be coaect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaaon of the resQonsible authoriry may be appealed pursuant to the provisions of the adminisu�auve procedure act relating
to contested cases.
DATA PRIVACY ADVI ORY
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 �iry of Orono or any of its departments may require you to furnish certain
private or confidential information.
You aze 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 Ciry deny the permit or license.
3. The information may be shazed with other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested pemut 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 pemut.
First Middle Last
Address
Ciry State Zip Phone
1 understand my rights as stated above.
. � � g,83 �
Signature
6 � �
` ` � CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I y�b PAR1� �Q �
PID: '
DESCRIPTION OF WORK: ,4rny�„-� 6,3,�s�c�s
Z0.�1I�1i G REVIEW BY: DATE APPROVED: 9-��-03
BUILDING REVIEW BY: DATE APPROVID; 9 -i s �0 3 �
FEES TO BE CHARGED: Misc. Fees Calculated By:
pER�1�IIT Yes �/' No
pLAi�T REV�W Yes ,/' No SEWER CONNECTTON
STATE SURCHARGE Yes �/ No WATERCONNECTION
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST zoning Districc: .
Fire Department: � Post Office: School Districr. • �.
Lot Area: Sq�.ft. Acres � Width Depth
Survey Submitted: Yes_� No Date of Survey: i -i�l-��
Proposed Setbacks: � � �
Front(Lake): �'7' Right Side: Z.�g' .
Rear(Street): 2b�d Left Side: ( I S �
Adjacent Structures: A��'nAul>4et.� �Vetland: •— .
Building Height: Def. Hgt. p.l� Peal:Hgt.
Lot Coveraoe: ��
Gradina: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # — Resolution: # Resolution Date: �
Shoreland District: Nv
Avg. Setback: Bluff Setback: LotCoverage:
Eacistmg Proposed
Hazdcover: 0-75' .
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REl�2A.RKS(in house): ��
� . . .
�, �
BUILDING REVIEW CHECK LIST
UBC: 2• 3 � CONSTRUCTION TYPE: 1/N
_ Sq Footage $per Sq Ftg
� Basement �
� � . x . .
lst Floor . � x . . . - . . .
2nd Floor x . ' " . .
Garage x = � .
x �
TOTAL �
F,stimated Construction Value: $ Zp o0 0 on
Inspections Required: , �york Requiring Separate Permits:
Site PIumbing Fire
Hazdcover Removal Mechanical
. __ZC Footing ' Water Connection
� � _�Framing Septic Sewer Connection . �
Insulation Fueplace Lawn Irrigation
WaII Boazd ��0�'� Other
_�c Final ' (�1fg•) Well(State Permit) - -- -__--:...
Other Grading/Filling ��Electrical(State Permit) "
REMMA122K,S(ni T gOUSE): � . .
REVIEW BY OTHERS w'�' --- -�""�"�-----_ __
:
� DAT'E;
Access: Existing New
Access Approval: Date
By: �
REI�ZARKS (TO BE NOTED ON PERA�II1�; -�- _��_�---------- - -------�_��'____
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DATE TIME
CITY OF ORONO CALLED IN `� ` p�
INSPECTION NOTICE SCHEDULED 5� � �
PERMIT NO.,DI�Cr���-� COMPLETED
ADDRESS ��t��r� �C�.���-- /J�
OWNER ��1'�%{`�j� C�C'G� CONTR.
TELEPHONE NO. • =��' ��� � � �
� DESCRIPTION �'�Q-�'t �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/ LING
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 OS FINAL 14 SEWER HOOK-UP O6 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 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU�YES_NO
� COMMENTS:
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�A/�-0� TIME
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
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White Copy/lnspector's File Canary Copy/Sfte Notice
'�� DATE TIME ✓
CITY OF ORONO CALLED IN -4
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
05 FINA 14 SEWER HOOK-UP 06 PROGRESS
� EMO-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
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Call for the ne inspection 24 hours in advance. (952) 249-460�
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White Copyllnspector's File Canary CopylSite Notice