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Home My WebLink About2005-P08993 - new structure � PERMIT , CITY OF ORONO Permit ►vumber: � ,� 2750 Kelley Parkway- PO Box 66 P08993 Crysta; Bay, Minnesota 55323 Permit Type: �� New Structure (952) 249-4600 Date Issued: 8/5/2005 SITE ADDRESS: �� 29 Fox St Unit# `� � Long Lake,MN 55356 -�_-� PID: 04-117-23-31-0018 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 101 Permit Class: Building Permit Type: New Structure Permit Sub-type(s): New Home- Single Family DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Septic Fireplace Irrigation Well(state)Electrical(state) NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 5,608.75 valuation: $ 1,000,000.00 Plan Review Fee: $ 3,645.69 State Surcharge Fee: $ 500.00 TOTAL FEE: $ 9,754.44 APPLICANT: Owner/Self OWNER: Dennis Backes � 13771 Berkshire Ln Dayton,MN 55327 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. - ,`�� C� ,�'(G�-- � ��--� ,� . �,�--� LICANT PERMITEE SIGNATURE �SUED BY SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page ] � . ' e `// �./n� , .. ..� � � � �. � !'/ " J ��. Total Fee: $ ` � `. � Date Received: �"��i�3 Entered By: ,_ . _ ;_ Permit#: -� ��.�%�r� � � � . CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all infof•mation) THE APPLICANT IS: (ci�•cle one) OWNER R CONTRACTOR JOB SITE ADDRESS: � �'f y� /c0�c. .S�, ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �,No If yes, a special event permit is�•egirired with Police Depardnent and Citv Coirncil approval 60 days prior to the event. Shutt/e bus service will be requi��ed In�less applicant demonstrates su�cient on-site parking is available. Non pern2itted events will not be nllowed. /� 763 NAME OF OWNER: �.Q�Il�Ij.5 �G G�+ �P.S PHON�: (home) 3�3 /,r'S'� (work�l,2 ,3�0�1 7 75 O MAILING ADDRESS: /,377/ Pr f.shir� Lh CITY: ZIP: s3o� 7 CONTRACTOR: �.S'�/l�..� PHONE: (v/,2. ,36 9 77S'O CONTACT PERSON: �S'cr rn •� MOBILE/PAGER:�[1 36 y 77S`t� MAILING ADDRESS: ,S'G"., .� CITY: -- ZIP: ---� �� STATE LICENSE: # EXPIRATION DATE: �SC�kJlt TYr„� �6 .� ARCHITECT/ENGINEER: �Qa„� p.eSi��, PHQNE: 7&-S �lD.S' MAILINGADDRESS: [��2� f�l(,�/f� jd /J/. �. CITY: 'rp,�;H� /7a,./�ZIP: �"'��.1, NAME: �i�CS Sc litti��f*rs REGISTRATION: # TYPE OF WORK: New � Addition Accessory Structure Move Home Remodel/Alteration PROPOSED WORK(descs�ibe if�detai�: � ; ,;� �_i,� ,��s_.- STORIES: I SQ.FEET OF EACH FLOOR: ,37p0 NO. OF BEDROOMS: �� GARAGE STALLS: ATTACHED 3 DETACHED 3 °fL. ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �, (>UG. ODU I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the �vork 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�vithout a pern�it;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: ATE: '7-- ��.—OS` � �. . � Sec.13.04 RICHTS OF SUBJECTS OF DATA Subd. l. 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. Infonnation requu•ed to be given individual. An individual asked to supply private or confidential data concerning himself shall be infoimed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subciivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any lmown 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 tederal law to receive the data. This requirement shail not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officec. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tar or prooert�ati refund instructions instead of on thosc fonns. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned 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 ro him and,if he desires,shall be infonned of the content and meaning of that data. After an individual has been shown the private data and infonned 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 upoarequest by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and cotnpiling 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 wi[hin that time,he shall so infonn the individual,and may have an additional Gve 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 public or private data concerning himself. To exe�cise this�ight,an individual sha(l notify in writing the responsible autho�ity describing the na[ure of the 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 individuai;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 disap•eement is included with the disclosed data. The detennination of the responsible authority may be appealed pursuant to the provisions of the administ�ative 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 information. You are notified that: 1. The information you fumish will be used to determine your qualification for the pemut or license requested. 2. You may refuse to supply data,but refusal may require that the City deny che pecmit 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 pennit 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 pemiit. /.��s �Gra��-�s 13�c��s First hliddlc Last _13 7� � �3-�r ft�sG,,v��e L v� Address t��'�., 7�on /�Yj� �'S'3,� 7 61.� � 6� 5 7�S`v City Statc Zip Phone I understand my rights as stated above. ,o,c �---- C �%-- Signature � ' � � CHECK OFF LIST FOR ISSUANCE OF PERMITS , FOR OFFICE USE ONLY ADDRESS OR LEGAL: Zq�t p f=o x 3•r— PID: DESCRIPTION OF WORK: �tGw R•cs + ��+�r� � e _�_ ____ -- _-s-- ------------------------------------------------------------ ZO.�i G REV�W BY: DATE APPROVED: � -S-o f BUILDING REVIEW BY: DATE APPROVED: i� - S'-o� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes �/ No PLAN REVIEW � Yes r/ No SEWER CO�TNEC"ITON STATE SURCHARGE Yes � No WATER CONNECTION INVESTIGATION FEE Yes . No _� PARK FEE SAC Yes No _�� " SITEINSPECTION Number of SAC�Units ��a� OTHER (specify) ZOYIt�iG CH�CK LIST Zoning District: Fire Departmenr. Post Office: School District: Lot Area: Sq.ft. Acres �•9� Width 3 Z�t•` Depth I o S d.65 . Survey Submitted: Yes� No Date of Survey: 'i-�q -�S Proposed Setbacks: �s� i4�M,G t Front (Lake): Z� o Right Side: '{S•�2 1 Reaz(Street): 335 Z�� Left Side: 1 bg 'a3 Adjacent Structures: �$�(�qTL,rt,� Wetland: [�0� Building Height: Def. Hgt. Z� � Peal:Hgt. 33� Lot Covera�e: N I A Grading: Staff Approval Date: �-�(;.o S By: �(�� Council Approval Date: � Septic: Staff Approval Date: 7-z7- oS � By: W G• Zoning File: # — Resolution: # �"' Resolution Date: Shoreland District: ^f v Av;. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 2�0-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REv1ARKS (in house): � ' � / I . . �� BUILDING REV�W CHECK LIST �C: _ 2 3 '`f CONSTRUCTION TYPE: �/`} Sq Footage $ Per Sq Ftg Basement x = lst Floor x _ 2nd Floor R = Garage z _ R - TOTAL Estimated Construction Value: $ 1 ,o 0 0,o o c °�- Inspections Required: `Vork Requiring Separate Permits: Site _p�Plumbing Fire Hardcover Removal _�Mechanical Water Connection _�Footing ` OC Septic Sewer Connection _�[ Framing p� Fireplace p�Lawn Inigation _�Insulation (Masonry) Other _�Wall Board _e(IvIpQ,) _�Well (State Permit) —�_F�� Grading/Filling _�Electrical (S[ate Permit) Ocher RENIARKS (Pi i HOUSE): _ -------- -------------------------------------------------------------------------------------------------------------- RE'VIEW BY OTHERS: DAT'E: Access: Existing New Access Approval: Da[e By: -------------------------------------------------- • ----------------- -------------------------------- ----------------- �REI�IARKS (TO BE NOTED ON PERlvII'T')' C O N��TtQN/4� v ss� p2,�w. �3- r� v�IL�.Y� 1=fl 2 (�U�6 c/�! �tA-6�h-�P 8 � ' f^.�('h AA fk .t , r �� ll�h?ck CQ4I�I�CE�EPc�Y I I �1Ma$Otd E�PIgy�0�2 � PaIBllt� � �ch�ck Sof�ue Vecsio�3,9 I I I I �Checked 6yiGat?I I CC�6fY;N?r�epi� SP�YE;�i�?sata ti0�;2 CC�STP.!�TIC�PYPE; Si�1?faaily G�1'E;1-lf-2005 G6TE C�'P�BS;J�1�Y 1120f 5 YItLE;P�IEP,I�•C�t PP.CJECt I9EC�l�TIG9; GE�S B�CFIIs @ES,,, CC��9Y I@EC�lIdPIC�; B�C�1S CQlP9QES(�CC9PP�C1C�. SCI�IEYEP.S IK�E GESIG9(PES,GP�'PI��9G GESIG@) C(�LI9�E;P9SSES P,?qu�?d�6=1061 ro�a�_�� y,1$Bettei Pha�Code �t?d OI �D➢I� �O�t, �dZlf�IDOOI P?ti�et?t P:Valu?E-Valu? Q-Valu¢ �� ----------------------------•--........---.__..._.-----•-•------•------------ CEIII�S 3�N8 Sf�,Q 0,4 uF fi�S;�ood Fta�P,lb"C�,C. �§1� 1§,9 2,0 21u B�',Co�c,lp,r�'hG9,1'bgi1�,0'i�sul 1�J4 10,r r�,r y3 61�I16;wi�as oc Goois,�GOPQ GIdG4 IIPO Q.154 3�2 GI�I�;wi�dows,Eowdatio�,r-5,6 ft2 1r 0,350 pg � 6L1�;Yi�ais,Fo�datioo,>�,6 ft2 259 �,35f� N1 GCC�P.S � Q,016 1 �'nC�1;�;fOfUdC?r �,��bE�E ---------------------•-•---•-•------------------------------------------------- Cq411�CE Sf�i9�t; Phe propos?d 6uildi�q d?sig�des�i6ed here is co�sist?�t wit�t�?6uildir�pla�s,SP?C1f1Cd�l0�Si d�O�IQI CdIC01d�10�S suu�itted nt6 th?p?�it applicatio�, ihe pioposed baildi��as been d?Sl�?d t0�eet tIIP I��IIP�?�tS Of�I?N1M2SO�D ?rgy C P� ./ BIl1..Id�IGP$1�II�I _ ....GdtF ��_��.,) ��a�� '�� DATE TIME � CITY OF ORONO CALLED IN �o'�: V INSPECTION II SCHEDULED ��CI (0�.3� PERMIT NO. U COMPLETED ADDRESS �i � �X S -P � Y�� OWNER CONTR. ��-�'�S TELEPHONE NO.�� 1 — �I �O � � DESCRIPTION � `'�� 01 FOOTING 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 � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q OS 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q � Z W � W � � d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED '-: ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next'nspection 24 hours in advance. �95Z� Z49-46�� OwnerlContr to n it : Inspector. White Copyllnspector's File Canary CopylSite Notice 1 / �� "I' •-�y� � DATE TIME CITY OF ORONO CALLED w G� ��` INSPECTION NOTICE / SCHEDULED "> > �f%Ci PERMIT NO. � J�`'� COMPLETED ADDRESS :�C'l S�C.i /��X --�� • OWNER �� CONTR. D--�.s'�-� -� �f%i, TELEPHONE NO. �-l� � � � �� `� �5�� DESCRIPTION �-�� l�-�� Z%� $ �/' /�Sp � T� �G3�yi'`i 1„ � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING ' Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS -� y 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W � � � O a � O � W � Q � Z W � W � � � d W�ORKSATISFACTORY:PROCEED Ci PROJECTCOMPLEfE W '1O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL RETURN �� CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPE OR ❑ INSPECTION REQUIRED.CALL TO A�ANGE ACCESS. I Ca11 for t i pec�ion 24 hours in advance. (952� 249-4600 OwnerlContr cipr on�site: � Inspector. -- White Copyllnspector's File Canary CopylSite Notice DATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMITNO. �OBg�3 COMPLETED ADDRESS v�Q �C OWNER CONTR. TELEPHONE NO. � DESCRIPTION l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FR,4MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q �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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � � GW �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE WC CORRECT WORK&PROCEED �SUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY --7 V BEFORE COVERING �pERMANENT ��I7-� ( ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR n CITATION ISSUED G INSPECTION REOUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContrac r on ite: Inspector. White Copyll�spector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED�N INSPECTION NOTICE SCHEDULED � � PERMIT NO. onnP�ErEo , ADDRESS Q�E"O �)C �li OWNER CONTR. TELEPHONE NO. � DESCRIPTION l� 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�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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENT : � e . � � � 0 '' - GON� � a �. � b o _ W � Q , � " �� z w � W � � d W WORK SATISFACTORY:PROCEED CI PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ISSUE C RTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTfON REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContra r site: Inspector. � White Copyllnspector's File Canary CopylSite Notice