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Home My WebLink About2000-A002006 - addn/remodel/repair � PERMIT CITY OF�ORONO 2750 KeIIQy Parkway - PO Box 66 Permit Number: aoo2oo6 Crystal Bay, Minnesota 55323 PefClllt Typ@: Addition/Remodel/Repair (612) 249-4600 Date Issued: 2/��00 S I TE AD D RE SS: 232o snaaowooa Dr LONG LAKE,MN 55356 P��: 27_118-23-32-0014 D ES CR I PTI O N: uBC occupancy R3 Construction'I�pe VN Proposed Use: Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Single Famil_y DETAILS: Approved per resolution#: Separate permits requirec�: riumoing Eiecu-icai�siaiej N�1T1!'`CC/�C11AAD1lC• ., � ,.,��.,,, .��,�-.� .�.�. BASEMENT FINISH FE� ci innnnn ov� . �. „� „� L vv�v��v�n� � � . YCI11lLLPCG: � iv�.�--� 9,QOQ.Q�) Valuation: � Plan Review Fee: $ 108.68 State Surcharge Fee: $ 4.50 TOTAL FEE: $ 280.43 AP PLICANT: SKYLINE ASSOCIATES OWNER: R J�D J��EIN 6833 PILLSBURY AVE S 2320 SHADOWOOD DR RICHFIELD MN 55423 LONG LAKE MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO D ALL IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MIN�ES TA ING CODE R�QUIREMENTS. .-------_ , /' �j� dv` ._._._' -� -� ��_.,�-- �2/ `_� � �� ICANT PERMITE�SIGNATURE ISSUED BY SIGNATCJ Copies: City, Applicant, Assessor, Finance Page 1 INSPECTION RECORD CITY �OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number. aoo2oo6 Crystal Bay, Minnesota 55323 (612) 249-4600 Date Issued: 2��00 SITE ADDRESS: 2320 Shadowood Dr LONG LAKE, MN 55356 APPLICANT: SKYLINE ASSOCIATES 6833 PILLSBURY AVE S RICHFIELD MN 55423 Proposed Use: n�---=-c--�- y�,-(-�;��gle Family i a,�uut.�uv-t �. o Pennit Class: Building Permit Type: Addition/RemodeURepair Separate inspections required: Building: Framing Insulation Wallboard Fina1 General: Plumbing: ALL INSPECTIONS MUST BE CALLED 24 HOURS IN ADVANCE. THbS CARD MUST BE POSTED IN A / CONSPICUOUS PLACE ON TI�PREMISES ON WHICH THE WORK IS TO BE DONE. PROOF OF WORKER5' COMPENSATION INSURANCE COVERAGE Minnesota Statute Section 176.182 requires every state and local licensing agency to withhold the issuance or renewal of a license or permit to operate a business in Minnesota until the applicant presents acceptable evidence of compliance with the workers' compensation insurance coverage requirement of Section 176.181, Subd. 2. The information required is: The name of the insurance company, the policy number, and dates of coverage or the permit to self-insure. This information will be collected by the licensing agency and put in their company file. It will be furnished, upon request, to the Department of Labor and Industry to check for compliance with Minnesota Statute Sec. 176.181, Subd. 2. This information is required by law, and licenses and permits to operate a business may not be issued or renewed if it is not provided and/or is falsely reported. Furthermore, if this information is not provided and/or falsely reported, it may result in a $1,000 penalty assessed against the applicant by the Commissioner of the Department of Labor and Industry payable to the Special Compensation Fund. Provide the information specified above in the spaces provided, or certify the precise reason your business is excluded from compliance with the insurance coverage requirement for workers' compensation. Insurance Company Name: (NOT the insurance agent) Policy Number or Self-Insurance Permit Number: Dates of Coverage: OR I am not required to have workers' compensation liability coverage because: ( � I have no employees covered by the law. ( ) Other (Specify) I HAVE READ AND UNDERSTAND MY RIGHTS AND OBLIGATIONS WITH REGARDS TO BUSINESS LICENSF,,S, PERNIITS AND WORKERS' COMPENSATION COVERAGE, AN� �CERT�Y TH��' THE,IN�ORMATION PROVIDED IS TRUE AND CORRECT. � ,= , ,- �%��/��--�� ' d� (Signatur� ' � (Date) , �� ;'� ,, -� �;� / ��'�- _, �'�z- ��-�'��7� _ .�;�,�'� , �� (Company) (Business Phone Number) r Total Fee: $��'C� • Date Received: �" � 7� Entered By: �'�. Permit#: ,a ��,�p0 � CITY OF ORONO - BITII.DING PERIVIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all inforntation) -------------------------___---------------------- - __- �_- ---------------- THE APPLICANT IS: (circle one) OWNER C�QNTRACT!� JOB SITE ADDRESS: �3�u S��JOU1C�D ��ZIP: �'3.5� � NAME OF OWNER: D�J B�F.I� PHONE: (home) �/2-�3`�'{8 (work) MAILING ADDRESS: o23�a SI�i4�vr�D CITY: o (.A� ZIP: 5"�'3S� CONTRACTOR: lV�� So�� PHONE: f�lL�ff2�-Q3 7� CONTACT PERSON: MOBILE/PAGER: ��Z --7v1 "d`�� MAII.ING ADDRESS: ��33 ��u�cy z�c-�v CITY:��l�c.� ZIP:�z� STATE LICENSE: # �b�7 5D 8� ARCHITECT/ENGINEER: /�!)� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move RemodeUAlteration�p _ Land Alteration PROPOSED WORK(describe in detain: ..�til�5�C STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ � pt9Z1 , 0 0 I hereby apply for a building permit and I acknowledge that the inforination above is complete and accurate; that the work will be in conforinance 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 w' the ap oved plan. APPLICANT'S SIGNA . DATE: � r I��d NOTE! �arade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. Sec.13.04 RIGFTTS OF SLJBJECTS OF D�Ta Subd. 1. Type of data. The rights of individual on whom the dara is stored or rn be stored shall be as set focih in this section. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenaal data concerning himself shall be informed of: (a)the purposa and inrended use of[he requesred data wichin the collecting�tate agency,polidcal subdivision,or srauwide rystem; (b)wherher he may retuse oY is legally required to supply the cequcsud data:(c)any known coauquence arising from his supplying or refusing to supply privace or confidenaal dara;and(d)che idenriry of ocher persoas or enrides au[horized by stats or federal law to receive the dara. This requirement shall not apply when an individual is asked to supply in�'esdgarive dard,pursuant to secdon 13.82,subdivision 5, to a law enforcemenc o�cec. The commissioner of re�enue mav pla- che nodce rewired under this subdivision in che individual income tax or propem raz refund insttuctions inscezd of on fiose forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be infoaned whether he is the subjecc of stored data on individuals,and wheeher ic is classified as public,private or confidenaal. lipon ivs further request,aa individual who is the subjecc of stored private or public dara on individuals shall be shown rhe data wiehout any charge to him and;if he desires, shal!be informed of the contenc and meaning of rhac dara. Afrer an individual hu been shown[he privace dara and informed of its meaning,the data need not be disclosed to him for six mon[hs[herea8er unless a dispute or action pursuanc to [his secdon is pending or addidonal dara on the individual has been collected or creaced. The responsible authoriry shall provide copies of die private or public data upon request by the individual subject of the dara. The responsible au[horiry may require che requesting person to pay the accual cosu of making.cerdfying,and compiling the copies. The responsible authoriry shall comply immediately,if possible,wirh any request made pursuant to this subdivision,or wichin five days of the dace of the request,exciuding Sacurdays,Sundays and legal holidays,if immediate compliance is not possibie. ff he cannot comply with the requesc within rhac titne,he shall so inform[he individual,and may have an addidonai five days wirhin which to compiy wi[h 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 exercise this right,an individual shal!nodfy in wridng the responsible authoriry describing the nature of the disagreemenc. The responsible au[horiry shall within 30 days eicf:er: (a)correct the data found to be inaccurace or incomplece and attempt to nodfy past recipienu of inaccurate or incomplete data,including recipienc�named by the individual;ar(b)notify the individual thac he believes rhe data to be correct. Data in dispute shall be disclosed only if che individual's stacement of disagreement is included wirh rhe disclosed data. The decerminadon of the responsible au�horiry may be appealed punuant to the provisions of the adminisaadve procedure act reladng 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 ics 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 Ciry deny the permit or license. 3, The information may be shared with other local, state or federal a�encies 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. j, You have certain ri�hts under M.S. 13.04 (available upon request) to review private data on yourself. (, Your full name is required to process this applica[ion or permit. �� 1�� F`�� 1 t Last G833 f�uuis�3 . �o. aaa�s5�,t.e�+t�r�� N^'� �Z 3 ��Z"�4—9�7 7 Ciry /� State Zip Phone I understand my ri� s as stated ab e. Signa re CAECK OFF LIST FOR ISSUANCE OF PERti�IITS FOR OFFICE USE ONLY • . ADDRESS OR LEGAL: 23?-0 ��.}q�c�wc�o 0 1�� PID: DESCRIPTION OF WORK: f�p��,�� s�-r -- ZO�'G REVIEW BY: ~ DATE APPROYED: 2 -2- na �. BL'ILDL,iG REVIE�V BY: � � DATE APPROYED; � - 2- �� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes �/ No pLAN REVIEW Yes �' No SEWER CONi�'F.CITON _ STATE SURCHARGE Yes �' No �VATF.RCOiv�'vECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEI�i TSPECTION Number of SAC�Units OTHER(specify) Nr ___ ___ ZO`Z`�'G CH�CK LIST Zoning District: � . Fire Department: Post Office: School DSLLict: • � Lat Area: Sq.ft. Acres ' Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: � Front(Lake): Right Side: � � � . Rear(Street): Left Side: Adjacent Structures: We land: Building Hei�t: Def. Hgt. Pe 'Hgt• Lot Covera;e: ' Grading: Staff Aoproval Date: Council Approv�l Date: Nv Qeet.w.•M.�, Sepdc: Staff Agproval Date: �� Zoning File: # Resolution: # Resoludon Date: Shoreland District: Av�. Setback: Bluff Setbac : L'°�C°�=�e= . . Ezistmg Progosed Hardcover: 0-75' . 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes N Date of CouncL Approval: RE��IARKS ('in house): � 7 BUII�DING REVIEW C�CB LIST . �C� �Z� 3 . � COYSTRUCTTON TYPE: U/U Sq Footage $Per Sq Ftg � Basement . . . x . _ ' -, lst Floor . � x . _ . �. � . . 2nd Floor x _ . Gara;e x _ x = TOTAL Estimated Coastruction Value: $ �, O oo � Inspections Required: ZVork Requiring Separate Permits: Site � _�plumbing Fire Hudcover Removal blechanical Water Connecdon �Footing ' Septic Sewer Connection � � D Framing , Fireplace � Lawn Irrigadon �Insulation (Masonry� Other Wall Boazd (�{g,) Well(State Perm.it) �F�� Grading/Filling otElectrical(State Permit) Other REI�IARKS(1N HOUSE): , . REVIEtiV BY OTHERS: DATE: -- _� Access: Existing New . Access Approval: Date gy; � REI�IARSS (TO BE NOTED O�T PER1vITI�: __�"�w- ----- 8 DATE TIME CITY OF ORONO CALLED IN � INSPECTION N I SCHEDULED - �� PERMIT NO. � ��COMPLETED —�— �� ADDRESS �� L� ��1�C�i�.: L,Zi� �� OWNER CONTR. c->�L-i��►�ls? . /`�`�`�_C TELEPHONENO. C'�lt �O�� --� � DESCRIPTION ��l�C�-�'� � �u"`'�G��1.."� � l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � AMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS NSULATION 24/25 WOOD BURNER/FIREPLACE 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 COMPLAWT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBING RI 23 SEPTIC FINA� 35 HARD COVER REMOVAL = 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL J � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O >. � O � W � Q � Z W � W � � GW ;�NORK SATISFACTORY:PROCEED PROJECT COMPLETE � ��CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED C 1 INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-4600 OwnerlContractor n site-' Inspector. White Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION dNOTICE SCHEDULED �/� Z% �� PERMIT NO.TJ ��,,��t�� COMPLETED L^I%�� 3 � �� ADDRESS '�.��C., .`�c' ��l.ti�=-�%� P �• OWNER CONTR. `��I VLk TELEPHONE NO. ��`��- ��7� � DESCRIPTION LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 4 WALL � 12 WATER HOOK-UP 17 SITE INSPECTION OS FINAL 14 SEWER HOOK-UP O6 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 � COMMENTS: � w � � � O � � O � W � Q � Z W � W � � � ORK SATISFACTORY:PROCEED � PROJECT COMPLETE W � CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT Cl CORRECT UNSAFE CONDITION WITHIN HOURS. -� pHOTO TAKEN INSPECTOR WILL FiETURN i' CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR Cl INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-460� OwnerlContractor on site: Inspector. �/�'�� .�-�� White Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN 3/�z 7/D d INSPECTION N TIC SCHEDULED 3�-��'�o° � � PERMIT N0. ' �� COMPLETED y'� ZS�"t� �r '�� ADDRESS�oZ C� ��-p��'�� OWNER CONTR. TELEPHONE NO. �i�-< - ��/ - �-�'�� DESCRIPTION �/!'�l�i,T�e�� -��a��r��..� 1��-� � 01 FOOTING 11 MECHANICAL RI 18 E��1 /GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WA BD. 12 WATER HOOK-UP 17 SITE INSPECTION = 5 FIN 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAfNT � 07 DEMO-FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACT R MEET YOU:_ ES_NO � C N�MENTS:�� -��- � L�i, �� '� �'� � w � a j 'C � �"y i�- j^, O • � R-r t/ I'_ �, � I'OOhr� �',, � � / G's Cr�1''r�� Q W i Q�� Z W � W � � d W ❑WORK SATISFACTORY:PROCEED ^ PROJECT COMPLETE � ❑ CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY W ��ORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. r pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. Z49-46�� Owner/Contractor on site: Inspector.7 Y I_r�zl�'Q�� White Copyllnspector's File Canary CopylSite Notice I;,cy ELM.- � res"' J pa ;r {5� e F • I } e ' � i VV N �w � 1 0 lb