HomeMy WebLinkAbout2000-P02676 - addn/remodel/repair PERMIT
C��T`Y-O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P02676
Crystal Bay, Minnesota 55323 P@f1711t Typ@: Addition/Remodel/Repair
(612) 249-4600 Date Issued: ��2�i2oo
SITE ADDRESS: 2765 Pheasant Rd
EXCELSIOR,MN 55331
P I D: 21-117-23-23-002 5
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Single Family
DETAILS:
Approved per resolution#:
Separate permits required: Eiecuicai(siaie j
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00
Plan Review Fee: $ 117.78
State Surcharge Fee: $ 5.00
TOTAL FEE: $ 304.03
APPLICANT: STEPHEN BAKKE OWNER: STEPHEN L BAKKE ETAL
2765 PHEASANT RD 2765 PHEASANT RD
ORONO, MN 55331 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.
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APP ANT PERM TEE I NATUR ISS BY SIGNATURE
Copies: City,Applicant, Assessor, Finance Page 1
Te�l Fee: $ �L' .�� Date Received: �JJ7��
. � .
Entered By: Perm.it#: �,�a��(�o
CITY OF ORONO - BITII�DING PERII�IIT APPLICATION
All information must be submitted in full before plan revie � will be started.
(please print all information)
THE APPLICAN'T IS: (circle one ��� OWNER�R CONTRACTOR
�
JOB SITE ADDRESS: ��7� S �' •���c� ��� z�: �� � �
. ��CE:=
NA1�TE OF OWNER �� C..� � � PHONE: (home) �f 7l-70��i�
� (work) �� ;,z. - �� l � C��Fc�j
1�IAII�ING ADDRESS• :-7�5 ������.�:r v� f" ;�� CITY: �% _,�(� �c �_ ZIP: - `SS 3;�/
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C0�1'�RACTOR: G � 2��./c �,1=' '�-�� G �� i� H0�1E:
C0�1'I'ACT PERSON: = � i.: ; 1�� iOBILE/PAGER: .
MAII.,ING ADD CTTY: ZIP• � ..
STATE LICF.�S'�E: #•
`-1�-���� �`t
ARCHITECT/ENGPi tEER: �"�7 i t? �C�7S h-��� PFiO�tE: //,� -�'.3�1-7S�YG
l�1AILI�i'G ADDRESS: ��„ , ,. 7 g �'Sf=..��,�: ,�i�; CITY:��,-,.,,f�;s�r�„ ZIP: �-�- ,.
N��,�: �,� �e _REGISTRATION#
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
C � � �r�✓i � L''V� !i'K��L l/1 �
PROPOSED`�ORK(describe in detai�: }�C'-��Gl_ E --� J
i,��"�-� i% �z� r' ' ��r'�.�
STORIES: SQ.FEET OF EACH FL44R: _
NO. OF BEDROO�IS: GARAGE STALLS: ATT. DET.
EST11,i LAT`ED CONSTRUCTION VALUAT'ION (excludi.ng lancn: $ / �', ��'° —
I hereby apply for a buildin�permit and I acknowled�e that the information above is complete and
accurate; chat 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 perm.it and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
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APPLICA.NT'S SIGNATURE:,�-�`-��-- Y2� k/Q%'�'�
DATE: � �� -UG
1�'OTE! P ra ade Q Homes events require separate permit approval by Poliee Department and
Ciiy Council 60 days prior to the event. Non permitted events will not be allowed.
. �
Sec.13.0�2 RIGFi'LS OF SUBJEC'TS OF DAT?►
Subd. 1. Type of data. The righ�s oi icdividual an whom che daei is r•or:d ar o�be srnred shalI be as sec forrh in chis secrion.
Subd.2. Infocmaaoa req�ssred m be�vm iadividual. a.n individual uked w suppiy private or confidendal data coacerniag himself sfiall
be informed oF (a)ehe pucpase and ia�nded use of the cequested dam wichin ehe collecdng 3ci�agenry,polirical subdivision,oc satewide rystem;
�b)whether he may�fuse or is(egaIIy requitzd m supply the[equesud data:(c)any I�owa coasequeace arising from his supplyiag or refusing to supply
pcivarr oc confidendai dara;and(d)che idenriry of a�er pecsoas or enddes au�hariz:d bY scar.or federsl law to re:eive[he daes. Ttiis tequirement stiall
noc apply when an individual is�sked to suppiy in�arigadve dam.Qursuaat co sec�on 13.82,subdivision 5,m a taw enforteaeac officer.
The eommissioner of rvenue mav oli:e che nodce r:auired under ehis subdivision in the individua! income tix or orooem mz cefur.d
insmccrions insttad of on chose forms.
Subd.3. ?iccess to data b.individual. Lipon requesc te a�zspansibte auchoriry,aa individual shall be informed whecher he is the subjecc
of scncod dara on individuals,and whe:her it is classified u public,privau-.or con::dendal. L;gon 6is furcher request,aa individuai who is the subjecc
of stor.d privace or public data on indir•iduals shall be shown�he dan wichout aay cau3e tn him and:if he desires,shall be iniocmed af the concenc
ar:d meaning of diat dars. Aher an individual h3s been shown the priva�e dara and iaforsaed of its mesning,[he data need noc be d'uclosed to him for
six mondu diecrafrer unless a dispuu or acdon pursuanc w ehis secdoa is pending or addiaoaa.t dan oa the individual has beea collecud or creared.
The respacuible auehoriry shall pravide copies of dit privace or public data upon requesc by[he icdividual subjecc of che dac�. Tne responsible authoriry
may �:quire che requesring peaan to pay ehe acmal cases of maScing.cerrifying.ar.d compiIing che copies.
The responsible authoriry shall compty immediacety,if passible,wich a:y 2quest�de pursuant to this subdivision,or within five days oP
the dar.of che requesG e�ciuding Samrdays.Sundays and legal halidays,if immed'uc�campliance is noc possible. If he cannoc comply wich rhe requesc
w{chin d�ac dme,he shall so infarm the individual,and may have an addidoaal five days wichia which w comply wic'�the requess,ezciuding Saeurdays.
5undays and legsl holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may concest the accuracy or complaeaess of public or private'
dara eonceming himself. To ezeccise�is righc,an individual shall nadfy in wridcg�:e respansble aurhoriry dascribing�tte aaeu:e of[he d'uagreemaat. ..
The cesponsibla auehoriry shall wichin 30 days eia`er. (a)corrnct�he dara found m te inaccLrit or incomplete and aaempc co nodfy pasc recipiencs of
inaccurace oc incomplete dact, inciuding recipiena named by che individuai:or(b)coafy cl:e individual chac he believes rhe data to be corcecc Data
in d'upuce shsll be disc'.osed only if ehe individuai's sta�emenc of disagreemenc is�.cluded aich[he disclosed dara.
The decerminadon of ehe responsibte au�horiry may be appealed purssa-c to the provisions of[ha adminis�rive pro.edure act reladng to
conmsced cues.
DATA PRIVACY �D`'ISORY
In accordance wich M.S. 13.04, Subd.2, "Righcs oE subjeca oi data", �c•e would like to inform you that your requesc
for a perm.it or license from the Ciry of Orono or any of ics depz:ments may require you to furnish cercain private or
confiden[ial information.
You are notified that: .
1. The informatioa you furnish will be used to determine your qualification for the perm.it or license requested.
?. You may refuse to supply daca, buc refusal may require that the Ciry deay the perm.ic or license.
;. The information may be shared with ocher local, stace or federal agencies to the extent necessary to process
. the permit or license.
4. If your requested permit ar license requires Council action to approve, some information may become
public.
5. You have cenain righcs under i1�1.S. 13.04 (available upon reQuest) to review private data on yourself.
6, Your full name is required to process this application or permi[.
Firsc l�tiddla Lasc
addr.ss �
Cicy Smr� Zip Phane
I understand my ri�hcs as staced above. .
Signatu
CHECK OFF LIST FOR ISSUANCE OF PERiI�ITS
r ' FOR OFFICE USE ONLY �
ADDRESS OR LEGAL: 2�7 6 S PH�1A5�1N-r (Zoa-�
PID:
DESCRIPTION OF WORK: 12�P lAt� cr N'TY1.y
,
ZOrZ\G REVIEW BY: DATE APPROVED: 7• Z Y-v�
BUII..DI�i TG REVIEW BY: DATE APPROVED: �7- z.s"~�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/' No ;
PLAN REVIEW Yes v' No SEWER CONNECTION
STATE SURCHARGE Yes � No WATF1tCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZO�'G CHE.CK LIST Zoning District: /t!o G t�n/� N, _ .
Fire Depaztment: Post Office: School District: �
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: �
Front(Lake): Right Side:
Rear(Streei): Left Side:
Adjacent Structures: Wetl d: .
Building Height: Def. Hgt. Peal: gt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Eusting Proposed
Hazdcover: 0-75'
75-250'
250-50�'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
REMARI�S(in house):
7
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BUII,DING REVIEW CHECK LIST
�C� ��3 CONSTRUCTION TYPE: \/N
Sq Footage $Per Sq Ftg
Bastment . x =
lst Floor x _
2nd Floor x =
Garage z =
� _ A
TOTAL
Estimated Construction Value: $_� p�(�Ov°n
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechaaical Water Connection
_�Footing ' Septic Sewer Connection _ �
�r�S Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
_�F�� Grading/Filling � Electrical (State Permit)
Other
RE�ZARKS(IN HOUSE): .
REVIE`V BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gy;
RE�IARKS (TO BE NOTED ON PERiI�II'1�:
8
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CITY OF ORONO CALLED IN �
INSPECTION .. TICE SCHEDULED D �
PERMIT NO. � COMPLETED Z 7� .�%dv
ADDRESS
OWNER ./��v CONTR.
TELEPHONE NO. — �
� DES TION
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 OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �-CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContractor on site:
Inspector. //I��G� S
DATE TIME
CITY OF ORONO CALLED IN �_`�'I� �'- 33
INSPECTION NOTICE ;��0 � SCHEDULED —� �' 3'p
PERMIT NO. COMPLETED �-��� � �
ADDRESS �7�� ����'��'I"" �O�
OWNER R�'�KrK�- CONTR.
TELEPHONENO. �7�" 7��`f
� DESCRIPTION C�i'1 �'�'✓�-i w�-�i
l� 01 F 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
SULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 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
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
J
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� MENTS:
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� ❑WORK SATISFACTORY:PROCEED pROJECT COMPLETE
W
� �CORRECT WORK 8 PROCEED C; ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. . pHOTO TAKEN
INSPECTOR WILL REfURN
O STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContr or on site:
Inspector. � 2 �
White Copyllnspector's File Canary CopylSite Notice