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Home My WebLink About2005-P08740 - minor alterations � P E RM IT �1�� ' CITY OF ORONO �� . 2750 Kelley Parkway- PO Box 66 Permit Number: po874o Crystal Bay, Minnesota 55323 Permit Type: Minor A ations (952) 249-4600 Date Issued: 5/17/�005 SITE ADDRESS: 2655 Pheasant Rd Excelsior, MN 55331 PID: 21-117-23-23-0005 DESCRIPTION: UBC Occupancy R3 Consh-uction Type VN Proposed Use: Residential Permit Class: Building Census Code 434 Permit Sub-type(s): Addn/Remodel/Repair Permit Type: Minor Alterations DETAILS: Approved per resolution#: Separate permits required: �.iectrical(statej NOTICES/REMARKS: T_.__'_!'�______ T__'__ =viiwaa vu_ubv✓�w-a♦ FEE SUMMARY: Pernut Fee: $ 23.50 valuation: $ 200.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 24.00 APPLICANT: Owner/Self OWNER: James&Cheryl Johnson M� 2655 Pheasant Rd Excelsior,MN 55331 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. _-----. -- 1 \ � � : — � � � �.,.r `�--,- c � L., 1� APPLI NT PERM SIGNATURE I SUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1 ' �c Total Fee: $ �`�• Date Received: ,� ' -��J Entered By: Permit#: `��7�-/G � CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please pj�int all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT iS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: r�� S .� Qu.C r .�� dc w c� ZIP: �� Will this be a Pa��ade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes, a s�ecial event pei•rnit is required with Police Depnrbnent and City Council approval 60 days prior to the event. Slzarttle btrs service will be requir-ed unless applicant demonstrates sirfficrent on-site parkirzg is available. Non pernzitted events will not be allowed. NAME OF OWNER: ��y,r�ei �1 o�S�� PHONE: (home) SZ- 7� " ) �y2 (work) S z- 2y0 -3o r � MAI�,ING ADDRESS: � ��.� � (�Tm� �� CITY: C��O�c� ZIP: ��3 ?� CONTRACTOR: SZ �� PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZI�Y: � STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: �"-�� PHONE: MAYLING ADDRESS: CITY: ZIP: NAME: REGISTRATIOiv: # TYPE OF WORK: New Addition Accessory Structure Move Home RemodellAlteration _� PROPOSED WORK(describe in detai�: �Q p�^�� Ar� p ��.r� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED 0 ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �d � I hereby apply for a building pernut 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 pernut;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNAT DATE: �S- �7"�S` 31 , 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 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 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 officer. '�he commissioner of revenue mayplace the notice required under this subdivision in the individual income taY or�roverty tax refund instructions instead of ort those forms. Subd.3.Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the suhject of stored data on individuals,.and whether it is classified as public,private or confidential. Upon his fiirther 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 no[be disclosed to him for six months thereafter unless a disputo or action pursuant co 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 coscs of making,ceRifying,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. Proceduro when data is not accurate or complete.An individual may contest the accuracy or completeness of public orprivate data concerning himself.To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The responsible authoriry shall within 30 days either: (a)con•ect the data found to be inaccurate or incomplete and attempt to notify past recipients nf inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be conect. Data in dispute shall be disclosed on(y if the individual's scatement of disagreement is included wich 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 infoim you that your request for a permit or license from the City of Orono or any of its departments may require you to fumish 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 infornlation 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. A w�c� First Middle Last Address City State Ztp Phone I understand my rights as stated above. Signa 32 . CFIECK OFF LIST FOR ISSUANCE OF PERMITS ' , FOR OFFICE USE ONLY ADiDRESS OR LEGAL: Z�5� �N��s�,-r (�-�-�� PID: DESCRIPTION OF WORK: ��-r/� �,��nt� d��'�•� ZO.vI�ti G REVIEW BY: �1/� DATE APPROVED: BUII�DING REVIEW BY: DATE APPROVED: S—��--o� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes �/ No PLAN REVIEW � Yes No � SEWF�CO�tNEC?TON STATE SURCHARGE Yes c/ No WATERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) ZO�TIVG CH�CK LIST Zoning District: Nv c'�f� Fire Department: Post O�ce: School District: Lot Area: Sq.ft. Acres Width Dep[h Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Ri Side: Rear(Street): ft Side: Adjacent Structures: Wetland: Building Height: Def. Hgt. Peal:Hgt. Lot Coverage: Grading: Staff Approval Date: Council Approval Date: Septic: Staff Approval Date: y: Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff S tback: Lot Coverage: Eatistin Proposed Hazdcover: 0-75' 75-250' 250-500' SOQ-1000' Hazdcover Variance Required: Yes o Date of Council Approval: RENIARKS(in house): 7 , BUILDING REV�W CHECK LIST ' �C: �� CONSTRUCTION TYPE:_.._��___-_-_. Sq Footage $Per Sq Ftg Basement x _ lst Floor x _ 2nd Floor x _ Garage x = x = TOTAL F.stimated Construction Value: $ 29c�,n p Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal Mechanical Water Connection F��g Septic Sewer Connection � �C, Frami.ng Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Perm.it) �� Grading/Filling O� Electrical (State Permit) Other REMARKS(IN HOUSE): . --------------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Ezisting New Access Approval: Date gy; _________________________-------------__--___--_ ------------------------------------------------------------ RENIA.RKS (TO BE NOTED ON PERMIT�: 8 �I� D E TIME � CITY OF ORONO cn� -- INSPECTION N � SCHEDULED - � PERMIT NO. COMPLETED ADDRESS�� C��UCZ4�" � OWNER�_F,��'�fd��.�-(�CONTR. TELEPHONE N0.�'�'f��' �7�"f l�Z � DESCRIPTION C�� '" G�-L�(��c.��- � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAD /FILUNG Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMUVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z 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 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q ti Z W � W � � d W WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN � CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REOUtRED.CALL TO ARRANGE ACCESS. Call forthe n xt inspection 24 hours in advance. (952� 24J-46O0 OwnerlCo n ite: Inspector. White Copyllnspector's Fil Canary CopylSite Notice