HomeMy WebLinkAbout2004-P07656 - attached deck � • PERMIT
C ITY O F O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 Po�6s6
Crystal Bay, Minnesota 55323 P21'fY11t Typ@: Addition/RemodeURepair
(952) 249-4600 Date Issued: �i9i2ooa
SITE ADDRESS: 2335 Shadowood Dr
L.ong Lake,MN 55356
P I D: 27-118-23-3 2-0019
DESCRIPTION: UBc occupancy R3
Construction Type VN
Proposed Use: Residenrial
Permit Class: Building Census Code 434
Permit Type: Addirion/RemodeURepair Pernut Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 111.25 Valuation• $ 5,000.00
�lan Review Fee: . $ 72.28
State Surcharg�.Fee: $ 3.00
w .. .
. .., : > TOTAL FEE; _._ . . $ 186.53
APPLICANT; ��ei'%Self -: ` , OWNER: Steve&Kathleen 7ohnston
: . M� . .. �. .. 2335 Shadowood Dr
. ' . ` • .` . Long Lake MN 55356
THE UND�RSIGNED 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 BUILDII�IG CODE REQUIREMEN'I'S.
. �
APPL ANT PE ITEE SIGl�itll'URE ISSUED BY SIGNATURE
Copies: 1-File(Sir;nitures Required), 1-Aunlicant, 1-Monthlv Reports, 1-Assessin¢, 1-Finaz►ce Page 1
. .
,�, l, 'J
Total Fee: $ /v�{ � Date Received: LD'-2��'O��
Entered By: 'INt� �� i i��.�r`; ���'' Permit#: ��? •'�(;�`j�
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT [S: (circle one) ` WNER QR CONTRACTOR
-��J
JOB SITE ADDRESS: Z3 �s �i'`'��c�vi/z>c���7 /-� �IP: �-S �.5��
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
� Yes � No If yes, a special event permit is required with Police Department and City
Council approval 60 days prior to the event. Non permitted events will not
be allowed.
�
NAME OF OWNER: �/�'G�/� - !f'/�S�U PHONE: (home) �S Z Y7�2/J�J
(work) 6/L 3$L-�QU�
MAILING ADDRESS: 23-�s ;���,Z�U� �2 CITY: ��L�,4; ZIP: ��
CONTRACTOR: �'`.�L�//��� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENG[NEER n�j/d�� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Accessory Structure _ _
Addition Move Home
RemodeVAlteration
PROPOSED WORK(describe in detain: �/�-�
STORIES: /�1 SQ. FEET OF EACH FLOOR:�_
NO. OF BEDRO MS: � GARAGE STALLS: ATTACHED�� DETACHED �1 �
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ����U �
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 witho t a ermit;and that the work will be in accordance with
the approved plan.
APPLICANT'S SIGNATURE: DATE: ��Z�`D(
. . •
CHECK OFF LIST FOR TSSUANCE OF PERMITS
FOR OFFICE USE ONLY
A.DDRESS OR LEGAL: Z 33S ,s !�A�ow o�o D�
PID:
DESCRIPTION OF WORK: OccK
ZOYI�IG REVIEW BY: DATE APPROVED: 7• b-o y
BUII.DI�i 1G REVIE'4V BY: DATE APPROVED; � _6_ o��
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERII�IIT Yes � No
PLAN REVIEW Yes �' No SEWE.R CONNECTTON
STATE SURCHARGE Yes �/ No WATERCONNECITON
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZOYING CHE.CK LIST zoaing District: .
Fire Department: Post Office: School District: �
Loc Area: Sq.ft. Acres � Widch Depth
Survey Submitted: Yes ( No Date of Survey: ON
Proposed Setbacks:
Front(Lake): �3�D� t Right Side: 3?,�� t
Rear(Street): I 33� � Left Side: SU�
Adjacent Structures: /�.-�-rr��l.�.e..� �Vetland: —
Building Hei;ht: Def. Hgt. -- Peal:Hgt. —
Lot Coveraoe: /U`-�
Gradino: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: "— By:
Zoning File: # Resolution: # Resolutioa Date: �
Shoreland District: /`�v �
Avg. Setback: Bluff Setback: L.otCoverage:
Existing Proposed
Hardcover: 0-75'
75-250' �
250-500'
500-I000'
Hazdcover Vaziance Required: Yes No Date of Couacil Approval:
REMARKS(in house):
7
. a
BUILDING REVIEW CHECK LIST
�C: 2' 3 � CONSTRUCTTON TYPE: `/N
_ Sq Footage $Per Sq Ftg
Basement . . , x _
lst Floor x . . _
2nd F1oor x = �
Garage z _ �
x =
TOTAL
Estimated Construction Value• $ S, o0 0 °'_
Inspections Required: `vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
_�Footing ' Septic Sewer Connection �
" Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd � (Mfg.) Well(State Permit)
�F�� Grading/Filling Electrical(State Permit)
Other .
REMARKS(1N HOUSE): .
----------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New .
Access Approval: Date gy;
--------------------------------------------------------------
REIVZA�RKS (TO BE NOTED ON PERIVIII�:
8
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.i. Type of data. The rights of individual on whom t6e dats is stored or to be stored shsll be as set forth io this section.
Subd.2. Informatlon required to be glven individual.An individual asked to supply prlvate or coeBdeoHsl data coocerniog 6imselishall be
ioforroed oE (a)the purpose and 9ntended use of t6e requested dats wlthin the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply the reqaested data;(c)any known consequence arisiog from his supplying or refusing to snpply
private or confldendal dats;and(d)the ideotity of other persons or enHHes authorized by state or federal law to receive the data T6is requiremeot shsll
not apply when an iodividual is asked to supply investigaHve data,pursaant to sectlon 13.82,subdivision 5,to a Isw enforcemeot offlcer.
The commissioner of revenue mav olsce the noHce reauired uoder t61s subdivision in the individnal income tax or orooertv tax reNnd
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,so individual s6a11 be informed whether he is the sub)ect of
stored data on indlviduals,and whether it is classifled as publlc,private or confldential. Upon his further request,ao individual who is the subject of
stored private or public dats oe iodividuals shsli be showo the data without any cherge to him and,if he desires,shall be informed of the content and
meaning of that data. After an individual has been shown t6e private data and ioformed of 1ts meaeing,the dsta need not be disclosed to 6im for si�c
moeths thereafter unless a dispute or acHon pursusnt to t6is secdon is pending or additional data on the individual has been collected or created. The
responsible aut6ority shsll provide copies of the private or pablic data upoo request by the individual subject of the data.The responsibie autdority may
require the requestlng person to pay the actuel costs oi maldng,certifying,and compiling the copies.
The respoosible authority shall comply immediately,iipossible,with any request made pursaant to this subdivision,or wlthin 8ve days of the
date of the request,excluding Saturdays,Snndays and legal6olidays,if immedlate compliance is not possible.If he csonot comply wit6 the request within
that hme,6e shsll so iniorm the individoal,and msy have sn additiooal�ive days w9thin which to comply with the requesy eacinding Saturdays,Sandays
and legal6olidays.
Subd.4.Procedure when data is not accurate or complete.An individual may contest the accurscy or completeness of public or private data
concerning himself.To ezercise this right,an individual s6s11 ooHfy 9n wridng the responslble authorlty describing the nature of t6e disagreemeow The
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past reclpients of
inaccurate or incomplete data,including recipients named by the individual;or(b)noHfy the indivldual that he believes the data to be correct. Data in
dispute shsll be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaHon of the responsible authority may be appealed pursuant to the provisions of the administraHve procedure act relaNng to
contested cases.
DATA PRIVACY ADV[SORY
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 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 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 yourself.
6. Your full name is required to process this application or permit.
��/f'� �/1/G-//� C.�Ck�1��fA�
First Middle Last
Address
City State Zip Phoee
I understand my rights a a d above.
S re
DAT TIME �/
CITY OF ORONO CALLED IN �I
INSPECTION N �CE SCHEDULED - .��
PERMIT N0. ��o COMPLETED
ADDRESS__ OZ33S d-
OWNER���� CONTR.
TELEPHONE NO. ��L' c3�Z 7�� `
� �CRIPTION /�/�-v''� � F��r' �' 1
ll� 0( 1�bOTING 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
Z04 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
� 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
� COMM TS:
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GW �ORK SAT�SFACTORY:PROCEED ❑ PROJEGT COMPLETE,
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W .
� ❑CORRFCT WORK,CALL FOR REtNSPECTION TEMPORARY`' .
V BEFORE COVERING . - •pERMANEMT
❑GORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTQTAK�N
INSPEC�OR WILL RETURN
❑STOP ORDER POS7ED.CALL INSPECTOR� - � CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call.for the next inspection 24 hours in advance. �952� 249-46��
OwnerlContract i�
Inspector.
White Copy/lnspector's File Canary CopylSite Notice
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