HomeMy WebLinkAbout2006-P10013 (Addition/Remodel) � ' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p10013
Crystal Bay, Minnesota 55323 Permit Type:
Addition/Remodel/Repair
(952) 249-4600 Date Issued:
7/10/2006
SITE ADDRESS: 2180 Abingdon Way Unit#
Long Lake,MN 55356
PID: 03-117-23-24-0007
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
Finishing basement-remove bearing wall
FEE SUMMARY: Permit Fee: $ 181.25
Valuation: $ 9,500.00
Plan Review Fee: $ 117.81
State Surcharge Fee: $ 4.75
TOTAL FEE: $ 303.81
APPLICANT: Hoikka/Fortsie OWNER: Gage
P.O.Box 606 2180 Abingdon Way
Dassel,MN 55321 Long Lake,MN 55356
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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APPLI NT PE E SIGN URE IS UED BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, I-Assessing,(IfSeptic, 1-Septic) Page 1
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Total Fee: $ � �''!i� �� � Date Received: � `� ���
Entered By: Permit#: �j 3
CITY OF ORONO - BUILDING PERMIT APPLICATION
r � �
� ��; All information must be submitted in full before plan review will be started.
t\.�'�`. (please print all information)
' -----------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) `'�OWNER R CONTRACTOR
2180 Abingdon Way 55356
JOB SITE ADDRESS: ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes Q NO If yes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
su�cient on-site parking is available. Non-permitted events will not be allowed.
Richard Gage 9535441061
NAME OF OWNER: PHONE: (home)
2180 Abingdon way orono l•'�nrk�6129161272
MAILING ADDRESS: CITY: ZIP: 55356
CONTRACTOR: Ho�kka/forst;e PHONE: 3202s67o2o
CONTACT PERSON: Dale Hoika MOBILE/PAGER• 6122218038
MAILING ADDRESS: ��X�6 CITY:dassel � 7�p; ss�2i
STATELICENSE: # 4t-�962439 EXPIRATIONDATE: =�i=�lio�
SEG inc. 6123392844
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: �0 washington A�e n CITY� minneapolis ZIp: 55401
NAME: Calvin Lundquist REGISTRATION: # 7535
TYPE OF WORK: New Home Addition Accessory Structure
Move Home RemodeUAlteration(ie: Siding, Windows) ✓
Any earth movement may require MCWD review and permits!
PROPOSED WORK(describe in detain: We are finishing an unfinished section of basement.This
imolves removing a load bearing wall.Structural dnvings done by Rollie Johnson,a certified structural Engineer.are atached.
X�L I�-cJ� �A��4�C, bc,o�� �c;+aG I S Q`�"�:rc� U.P G�f'G.f i",•t:�.� �✓�c � �" fy N/i���.n�.
STORIES: �{� SQ.FEET OF EACH FLOOR: �
NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED DETACHED� _
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ g _
I hereby apply for a building 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 City 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 will be
in accordance with the approved plan.
:
APPLICANT'S SIGNATURE: %� DATE: �.>O �
.
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. Informarion required to be given individual.An individual asked to supply private or confidential 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 identiry of other persons or entities authorizal 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.
TI►e commissioner of revenue may olace the notice reguired under th�s subdivision in the i dividual' come tar or procerty t�refiLnd
instructions mstead of on tho�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 confidenNaL Upon his further request,an individual who is the subject of
stored private or public data on individuals s6a11 be shown the data without siry charge to him and,if he desires,shall be informed ofthe content and
meaning of that data. After an individual has been shown the private data and infornied of its meaning,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. 1'he
responsible suthority 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,certifying,and compiling t6e 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 imtnediate compliance is not possible.If he caonot comply with the request
within that time,he shall so inform the individual,and may have an additional five days within which to comply witt►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 public or private data
conceming himself. To e�rercise this right,an individual shall notify in writing the responsible authority describing the nature of U►e disagreement.The
responsible suthority shall within 30 days either: (a)correct the data found to be inaccurace or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)norify the individual that he believes the data to be correct. Data in
dispute shall be disclosed only if the individuaPs statement of disagreement is included with the disclosed data.
The determination ofthe responsible suthority 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 inform you that your request
for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential informarion.
You are notified that:
1. The information you furnish will be used to deteimine your qualificarion 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 shazed 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 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 permit.
IG.G M1�. f c+ v�Suv� �S 'L_
Firat Middle Iatat
� 1�a Qh:�.�I�,,, (�/�y
Address
or��� � � 5���3�� �/� ,9l ��7�?
C�tY State Zip P6one
I understand my ts as stated bove.
gnatare
RPcrr F�rm ,,,,
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Total Fee: $ � � �" DateReceived: �v'ZD-0(o
Entered By: Permit#: f�/ob/,2,,
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(p[ease print all information)
-----------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one)( OWNER R CONTRACTOR
�
2180 abingdon way �--- 55356
JOB SITE ADDRESS: 7,Ip;
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes Q No Ifyes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
suff cient on-site parking is available. Non permitted events will not be allowed.
Richard Gage
NAME OF OWNER: PHONE: (home) 9s2s�tto6i
2180 abingdon way orono �"'^rk�6129161272
MAILING ADDRESS: CITY: ZIp; ss3s6
CONTRACTOR• hoikkalforstie pH��, 32o��oso
�_ _ _--- -- ___ --- _ _ _- —- _ _ __ _. _ .
CONTACT PERSON: Dale hoikka MOBILE/PAGER• 6�22isgo3s
MAILING ADDRESS: ��X� CITY•dassel � ZIp• ss32�
STATE LICENSE: # �-20391605 EXPIRATION DATE• 3i31im �
SEG 6123392844
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: ��'ashington ave n. CITY: minneapolis Zjp. 55401
NAME: Calvin Lundquist REGISTRATION: # �s3s
TYPE OF WORK: New Home /-� Addition � Accessory Structure
Move Home Remodel/Alteranon(ie: Siding, Windows) ✓
Any earth movement may re,quire MCWD review and permits!
PROPOSED WORK(describe in detain; Removing a partition wall and installing cabinetry for a bar/
counter top.
STORIES: °�a SQ.FEET OF EACH FLOOR: "�a
NO. OF BEDROOMS: °�a GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ lsoo
I hereby apply for a building 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 City and with the State Building
Code;that I understand this is not a permit an work is not to start without a permit;and that the work will be
in accordance with the approved plan.
t
APPLICANT'S SIGNATURE: DATE: (� �0 �
.
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 shaU be as set ford►in this section.
Subd.2. Infortnation required to be given individual.An individual asked to supply private or confidentisl data conceming himself sl�ll be
infom�ed of: (a)the purpose and intended use of the requested data within the collecting state agency,polirical subdivision,or statewide system;(b)
whether he may refuse or is legally required to suppty the requested data;(c)eny known consequence arising&om his supplying or refusiag to supply
private or confidenrial data;and(d)the identity of other persons or entities suthorized by state or federal law to receive the data.This requirement shall
not apply when an individual is asked to supply investigarive data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue ma�Rlace tl�e notice teauired under this subdivision in the individual income�c or pr��y�c refund
inshuctions instead of on those forms.
Subd.3. Access to data by individual. Upon ra{uest to a responsible authority,an individual shall be infom�ed whether 6e is the subject of
stored dats on individuals,and whether it is classified as public,private or confidential. Upon his fiuther tequest,an individual who is the subject of
stored private or public data on individuals shall be shown the data without azry charge to him and,if he desires,shall be informed ofthe content and
meaning of that data. ARer en individual has been shown the private data and infortned of its meaning,t6e data need not be disclosed to him for six
months thereafter unless a dispute or acdon pursuant to this section is pending or additional data on the individual has beea collected or created. T6e
responsible authority shall provide copies of the private or public daffi upon request by ffie individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of�king,certifying,and compiling the copies.
The responsibte authority shall comply immediately,if possible,with siry request made pursuant to this subdivision,or within five days of
tbe date of the request,excluding Saturdays,Sundays and legal holidays,if immediate complisnce is not possible.If he cannot comply with the request
within that time,he shall so infortn the individual,and�y have an additional five days within which to comply with the tequest,excluding Saturdays,
Sundays and legal holidays.
Subd.4.Procedure when data is not accurate or complete.An individuel may contest the accwacy or completeness ofpublic or private data
concerning himself.To exercise this right,an individual shall notify in writing the respons�ble authoriry describing the nature ofthe disagreement The
responsible suthority shall within 30 days either. (a)correct tl►e data found to be inaccuratc or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify tLe iedividual that he believes tfie data to be correct. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The detemtinarion of the responsible suthority�y be appealed pursuant to the provisions of the administrative procedure act telating to
contested cases.
DATA PRIVACY ADVISORY
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 departments may require you to fumish certain private or
confidenrial information.
You are notified that:
1. The information you furnish will be used to determine your qualificarion for the pennit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. T'he infonnation 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 information may become
public.
5. You have certain rights under M.S. 13.04(available upon request)to review private data on youiself.
6. Your full name is required W process this application or permit.
Qk� ��(lc� Ca��;L, �C��
First Middle Lsst
r
f�dP 38
���� ,�, �� �� 3�^� � � ���'��-.>�
City State Zip Phoue
%
I �erstand my ghts s stated .
ignaterc
Recet Fnrm ..,.
� CHECK OFF LIST FOR ISSUANCE OF PER1v.fITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z+ �� ACS����'^' w�y
PID:
DESCRXPTIO:V OF W�O.RK: 1Z,cvw�oec. (�,aso n�� F-�N�s N
------------------------------------------------------------------------------------------------------------------------
ZONINGREVIEYVBY: DATEAPPROVED: G -Z)-�6
BUILDItVG,REVIEW BY: DATEAPPROI'ED: �•�� - o�
---------------- ---
FEES TO BE CHARGED: Ntisc. Fees Calculated By:
PER1I�IIT Yes� No
PLAN REVIEGV Y"es � tVo SEYVER CONNECTION
STATE SURCH.4RGE Yes � �Vo � tiVATER CON�VECTION
IIVVESTIGATI0IV FEE Yes [Vo PARK FEE
SAC Y"es [Vo SITE NSPECTIO�V
Nlcinber• of SAC Urzits OTHER (specify)
-----------------------------------------------------------------------------------------------------------------------
ZOIYIIYG CHECK LIST Zor�ing Discricr:
Fire Deparhnertt: Post Offcce: Scliool District: ___.
Lot.�(rea: Sq.f't. Acr•es �t�idth Depdt
Su�vey Subncitted: Yes No Date of S�uvey:
Proposed Setbacks:
Fr•oru(Lake): Rig/zt Sicle:
Rear(Street): Geft Side:
Adjaceret Sh'uc[eu•es: Y�edand.•
Buildi�rg Height: Def. Hgt. Peak Hgt.
Lor Cavei•age:
Gracfing: Stczff Approva!Date: By: Coc�ncil Apprroval Dccte:
� ���Septic: Staff,4pprovaf Date: 1 BY�
Zoaing File: � Reso(ution: # Resolt�tion Date:
Shoreland Dish•ict:
Avg. Set6ack: Bl��ffSetback: LotCover•age:
Elisting Praposecf
Harcfcover: 0-7�'
75-?�0'
250-500'
500-1000'
Har•dcover f/nriance Reguired: Yes No Date of Cocuacil�pproval:
R.E�I�IARKS(i�i lzotcse): ��`•�.h.�� A-�v/. �rzN�s - �po-� an�e
3i
,
B U�LDItVG RE VIE t�CHECK LIST
UBC: �- 3 CONSTRUCTIOrYTYPE: V/J
Sg Footage ,�Per 5q Ft,;
Basenierc� � _
Ist Floor x =
?ncf Ffoor x =
Gar•r�e s =
a =
TOT.4L
OJ
Estirrca[ed Construction Vafue: �S "�, �Z'�
I�ispections Required: 6Yark Reqcriri�tg Separate Permits
Site �Plctrnbrng Fire
Hardcaver Rernovc�l { Mechanicnf Yt�ater Connection
Footirtg Septic Sewer Connectiori
_e�Frc�n:ir�g Fir•eplc�ee Lativr� !�•rigRtio�i
� Insulation ('tilason�y) Other
� FT%c�11 Bom•d (Ntfg.) GVell(State Permit)
�c Final Gracfing/Fillin,; _�Elech•ical(State Perntit)
Otlze�•
ItEtYIARh'S(IN HO USE):
REVIEtV BY OTHERS: DATE:
.4ccess: E,ristin„ Netiv
,4ccess Approval: Date By:
,RENIARh'S (TO BE NOTED O�V PERNIIT):
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Job: Gage Residence Steel Code: AISC 9th Ed. �•�--;°
Span information: Transfer Beam at Lower Level
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CITY OF ORONO CALLED IN �^� �
INSPECTION N ICE SCHEDULED _�2�� �
PERMIT NO. � � COMPLETED
ADDRESS ���d 17��h�'� G��7
OWNER Ga- 'SR� CONTR.
TELEPHONE N0. ��4� gl� �a 7 a'—
� DESCRIPTION � �'>'!/�
��01 FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING
Q OAFRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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