HomeMy WebLinkAbout2007-P11213 (Building) PERMIT
CiT�Y OF ORONO Permit Number:
�750 Kelley Parkway- PO Box 66 P11213
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952)249-4600 Date Issued: 8/24/2007
SITE ADDRESS: 2180 Abingdon Way Unit#
Long Lake,MN 55356
P��� 03-117-23-24-0007
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential Census Code 434
Permit Class: Building
Pernvt T e: Accessory Struchues Pemut Sub-type(s): Pool-Outdoors-In Ground
YP
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Fireplace Water Connection Electrical(state)
NOTICES/REMARKS:
Pool&Cabana
FEE SUMMARY: Pernut Fee: $ 1,329.75 Valuation: $ 160,000.00
Plan Review Fee: $ 864.34
State Surcharge Fee: $ 80.00
TOTAL FEE: $ 2,274.09
APPLICANT: Hoikka/Fortsie OWNER: Rick&Britt 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.
t�'��"- � C�I�IM
CANT I A I 3LTED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
� Total Fe�: $�2, ���–�� DateReceived: � � � � '��
� Entered By: �� (�/� ._
�.— �.-_ Permit#: Z
CTTX OF ORO,N�O W �UI�.,DING FE�MIT Ap�'LICATI4N
All informatton m�ust be submitted i�n full b�fore�lan review wilt be started.
(please print all informallon)
�� .'������s�������.1^____'_..������r��--�w....r��� «�-��...rr���
�'HE A►PPLICANT IS: (circle ane) OWNER �t Cp�TRAC�'p�
�OB S1TE ADD�SS: �
7.!P:
'Will this be a Parade of Homes, Remodeters Showease Home or other Dispiay I�vme? �
❑�'C5 �No If yes, Q specla!event permft is rei�ulred H�lth Pollce Deparbnerr[and C�ty('ozu:cil approvcrl
�4 days priv,•In the cyverrt. Shultle br�.r servlce w111 be reqt�ired unle.cs app/icarrl de,nonsrrates
su�ct�nt nn-sJte pQrking is pvarlcrble. Non.per•mirted everrts N�ill not be a!luwe�i
NAME QF OWN�R: I� I 7
_ PH()IVE: (liome) '� g'"�
MA,ILiNGAD�RESS: 2� 0 r��,^rk) !?rZl 6�
_ a �V6 1lM.�ITY:0�bN0 ZIp:
COIVTRACTOR: ... __PHONE:3zo 2e��ogo
corrT�cT r�r��o : � - - ��N_�. —.
�"'�o' K�► 11�lOBiLEIP GER: G��Z2�go38
MAYLTNG ADDRESS: . , CiTY:
STATE I,ICFNSE; # 2 p� � r0 ZIP::'��.�
1 �.—...,_, EXPI�iA,TIUN DATE: 3 o g
ARCHITECT/�NGTNEF.i�: ���iT���� PHON�: 6 �1339 243�}-
MAILING ADDRESS:����,��� � a��.Y:
NAME: � � ��'� o �
� REGISTRAT�ON: #
T'YPE OF WORK: New Home A.ddition
Accessory Structure �_
Mov� I�iome Remadel/Alteration(ie: Siding, Windows}
Any eazth movem�snt may require �CtND review arid
PROPQSED WOR,I�(describe in�letai�: �ez��-ts: .
STOItIES: I SQ.FEET OF�ACH FL�OR; G�p
NO. OF BEDROOMS:�_ �A��F STALLS: ATTACHED� DET.F�CH�D�
ESTIMATED CpNSTRUCTiQN VAI,UATION(�xcluding land): $
._.:j �20��C'�O --
[hereby apply for a bui Iding permit and(acknowtedge th�t the information nbove is complcte and aecurate;
that tl�e work wiil be in conformartce with the ordinances and codes of the City and with the State Bu;tding
Code;that T understar�d this is nor a permit an work is no to skart withpui a perm�t;and that the wark wilE b�
in accordance with the approved plan, ;
� � i �
APPL�CANT'S SIGNA'�`URF: � � --C
, �, ,
� A'TE: ,,, �
y ���- ��- ��+�
i00f�] t�'3 Ci�LT LOOZ/OZ%�JO
�
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.i. Type of data. 7'he 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 dataconceming himselfshall be
informed oE (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 Iaw enforcement officer.
The commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or prop�rty tax refund
instructions mstead of on those fortns.
Subd.3.Access to data by individual. Upon requestto a responsible suthority,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it is classified as public,private or confidential. Upon his further 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 infocmed 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. 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 costs of making,certifying,and compiling the copies.
1'he responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date ofthe 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.Procedure when data is not accurate or complete.An individual may contest the accuracy or completeness of publ ic or private data
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nawre ofthe disagreement.The
responsible authority 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 if the individual's statement of disagreement 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 PRNACY 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
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 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.
fl-;�'�, �Q �,(.lr� �(i(S"�^ ��
First Middk Last
� l KO �bvr��� 2t�(
Address V J
�i�� f'�') nJ s�3sCv 95 2 �-/73 .i y77
C�tY State Zip P6one
I understand my ri t as stated above.
Signa
� -
� I �
32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �� /����I�"1 �� 1;�p�1 V�/��V�
PID:
DESCRIPTION OF WORK t r c ro n
----------------- 1 y c
--------------------------------=----------------------------------------------------------------------
ZONING REVIEW BY.• � l,G/��� I, ��"'(, DATEAPPROVED:
BUILDINGREVIEWBY.• DATEAPPROiIED: �.3�r d-1
FEES TO BE CHARGED: Misc. Fees Calcz�lated By:
PERMIT Yes �f No
PLAN REVIEW Yes� No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE Yes No ✓ PARK FEE
SAC Yes No� SITEINSPECTION
Nzrmbe��of SAC Units OTHER (spec�)
------------------------------------------------------------------------------------------------------------------------
n
ZONING CHECK LIST 7_oning Distr•ict: n L�' ��7
Fire Depar•bnent: Post Offrce: School Disd�ict:
Lot Area: Sq.ft. .9cr�es Width Depth _
Survey Stirbmittec�: Yes '1 No Date of Sufvey: � � � 7 �Z ��� �
Propose cks: — � � i „ r�,'l,'
Front Gake): Rrght Side: �r���1.�
, "'� � r �� �U�
Rear t � )`� �� Left Side: `j" `
Adjacent St��irctures: YVetland: ! U�
Building Height: Def. Hgt. Peak Hgt.
Lot Covei�age: I V�
Gradrng: StaffAppr•oval Date: Bv: Council Approval Date: _
Septic: Staff�lppr�oval Dale: By:
7_onirrg Fi(e: #�_ Resola�tia�: � Resolzrtia�Date:
S/�or•elund Distr•ict: NlC6VD Per•mit:
�vg. Setback.• 131erffSetbacic: LotCovei•uge: __
Existing Pr�oposed
Hnrdcover: 0-75
75-Z.i 0'
?so-sno�
soo-�000�
�
Hardcover l�aj•iance Requii�ed: }es ���o Date of CouNcil Approval:
REMARKS(in hocrse):
33
BUILDING REVIEW CHECKLIST
UBC: i2 �3 "" u ' I CONSTRUCTION TYPE���
Sq Footage $Per Sq Ftg
Basement x =
Ist Floor x =
2nd Floor• x =
Garage x = �
x =
TOT,�L
d�
Estimated Construction Value: $ �bO+�(�d
Inspections Rer�uired: Work Requiri�rg Sepnrnte Per�nits:
Slte _�Plumbing Fire
Hardcover Remova! r�lechanica! �'( YI'ater Co1���ection
( Footing Septic 'Se1ve�•Connection
j Fran:ing �Fireplace Lmvn Irrigation
_�Insulation �(Masonry) Other
� YVall Boa��d (Alfg.) Well(State Per•mit)
_ �Fina! Grading/Filling _fLC Electrical(State Pe�•ir�it)
Other
REMARKS(INHOUSE):
----------------------------------------------------------------------------------------------------------------------
RE vIEW B Y OTHERS: DATE:
Access: Existing New
Access Approval: Date 13y:
------------------------------------------------------------------------------------------------------------------------
REMARKS(TO BE NOTED ONPERMIT):
3=1
✓
DATE TIME
C OF ORONO CALLED IN =�� "-��--
INSPECTION TICE SCHEDULED
PERMIT NO. � � � COMPLETED
ADDRESS �I �O � (� %� S ��1 W'A �1
OWNER CONTR. �� 1 I�� n � S'�
TELEPHONE NO. �Sf���s I�Q^�
(�3 v�
� n�a.I�ON
�C�FOQT��-� f 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAI 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
v�i COMMENTS:
�
W
0.
� a` �,�r
0
�
0
�
W
�
Q
�
Z
W
�
W
�
�
a
W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for th next inspection 24 hours in advance. (952) 249-4600
OwnedCon on site:
Inspector.
White Copyllnspec or's File Canary CopylSite Notice
\/�� 1 tDAT ,/'�-7 TI �E��v,../�
CITY OF ORONO CALLED IN t 1' '� V( �����l�A�' 1
INSPECTION NOT SCHEDULED �I� l4`Ul Q:� IA'r►2
PERMIT NO. ���� COMPLETED
ADDRESS 2�� ��
OWNER CON . �1�.
TELEPHONE N0. ��Z � '' b��
�
� DESCRIPTION �II�
� ❑ FOOTING ❑ MEC L RI ❑ EXCAV/GRADING/FILLING
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTAL.L. ❑ FOLLOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINA� ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
J (�� �
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
a
� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ext inspection 24 hours in advance. (J52� 249-46��
OwnerlContr n site:
Inspector.
White Copyllnspe tor's File Canary CopylSite Notice