HomeMy WebLinkAbout2005-P08368 - addn/remodel/repair ' ' ' PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P08368
Crystal Bay, Minnesota 55323 Per'mit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: ii2ai2oos
SITE ADDRESS: 380 Silver Meadow Dr
Long Lake,MN 55356
PID: 33-118-23-42-0005
DESCRIPTION: UBC Occupancy R3
Construcrion Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Pernut Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: riumoing Eiecmcai�s�ej
NOTICES/REMARKS:
r.L"'1' rl""_"".
FEE SUMMARY: Permit Fee: $ 9�•25 Valuation• $ 3,800.00
Plan Review Fee: $ 63.18
State Surcharge Fee: $ 2.40
TOTAL FEE: $ 162.83
APPLICANT: Owner/Self OWNER: Shawn&Ann Cadwallader
M� 380 Silver Meadow Dr
Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
�z ��.c��
A PLICANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Covies: 1-File(Sir;nitures Re4uired), 1-Aunlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
� , �
Total Fee: $ i Cv Z �'� Date Received: �����' j �G^�'
Entered By: � - Permit#: ; � , ,%•�,-
�
CITY OF OR�N�- BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please p�•int all infoi�rnation)
---------------------------------------------____�___�___--_--------------
THE APPLICANT IS: (circle one) OWN R R CONTRACTOR
�--,,,,
JOB SITE ADDRESS: ��S l�' �, �V��v t''���,������-� �, C��� ���'�-% ZIP• � � >j G
Will this be a P ade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �NO Ifyes, a special event pe»nit is reqirired with Police Department and City Coc�ncil approva/
60 da��s p�-ior to the event. Shuttle birs se�vice wil/be required tulless applicant demonstrates
st ffcient on-siteparlcing is available. Non pernzitted events wil/not be allowed.
NAME OF OWNER: � h��wr1 � f�v�v� �Vv����(�iC�c'�" PHONE• (home)��5���/3� �2�1`��
(work)�5�-_�3 7-t�;�(
MAILING ADDRESS: >�i� S;1�.� ���r��(��.� ��-. � CITY: �;v�1� ZIP: 3 Ss�G
CONTRACTOR: ��� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAI�.ING ADDR.ESS: CITY: ZIp;
STATE LICENSE: # EXPIRATION DATE:
ARCIiITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition Accessory Structure
Move Home Remodel/Alteration t�
PROPOSEDWORK(describein detai�: � ��v�;;� h�������,�� -� ,�,�,�,�k4 . 5�,��=f,��/�, �/�-�-�,�,�„1s
� (��t�tir"iii�lM. �H�a-f C�UtfS A�h'ac�y iH y,n�a(C.�
STORIES: v2 ��s �'"�`�`Y't�SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: � GA�ZAGE STALLS: ATTACHED DETACHED
�in:l�iiir��?�.z c:ti. h�,tiy .,r��ir�/ �� hs•f�r,-���> -
_ ->_,
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � ��-�L� ��
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.
�? j�,-
APPLICANT'S SIGNATURE: f��"/�- �- " � - DATE: � ���i��
31
f f y
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 required to be given individual. An individual asked to supply private or confidential data conceming himself shall be
infonned of: (a)the purpose and intended use of the requested data wi[hin 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 la�own consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identiry 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 law enforcement officer.
'ihe commissioner of revenue mav nlace the notice required under this subdivision in the individual income tax or vrooertv tax refund
inctruetions inctead of on those fortns.
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 confidential. Upon his further request,an individual who is the subject of
stored private or public data on individuals shall be shovm the data without any charge to 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 info�med 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. 'ilie
responsible authoriry shall provide copies ofthe private or public data upon request by the individual subject of the data. The responsible authority may
require the requesting person ro pay the actual costs of making,certifying,and compiling the copics.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days ofthe
date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requesl
within that time,he shall so infonn the individual,and may have an additional five days within which to comply with the request,excluding Sa[urdays,
Sundays and legai holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or piivate data
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days either: (a)con•ect the data found to be inaccurnte or incomplete and attempt to noti}'y 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
disputz shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The detennination oFthe responsible authority 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 pennit or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential infonnation.
You are notified that:
1. The infonnation you furnish will be used to determine your qualification for the pennit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the pernut 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 infoimation 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.
� � _ l l-
�
��t;��,,;,;; �v,l ���t,�-� � �.:. w�.� ; ,,�i�!
First Middle Last
> ���.;� >r '�r"✓ d (��c�a v ��r,
Address
�� ��'?�? S�S �35 � �; �.�-�� ?,�-����f��
���" J n �
City Statc Zip Phone
I understand my�rights as stated above. �
. , � �
j . _
'' .`.�--�-�� � -�;�
,-� ..- �f � � /�{lS
Signature
32
.. . .
CHECK OFF LIST FOR ISSL/AlYCE O.F PER�ti�fITS
FOR OFFICE USE ONL Y
ADDRESS OR LEGAL: 343� 51 Lv C►Z w�G A o 6 w t�R
PID:
DESCRIPTIOtY OF YflORK: tjAsGnn�r T F�n+�s��
--------------------------------------------------------------------------------------------------
ZOtVI�VG REVIE tV B I`: DATE APPROVED: �
BUILDI�VG REVIEW BY: — D.�TEAPPR06'ED: /- rr� -o�
--------------------------------- -
FEES TO BE CHARGED: tL'Iisc. Fees Calculccted By:
PERII�IIT Yes � No
PLAN REVIEGV Yes � �Vo SEYVER COtViVECTION
ST�1TE SURCHARGE Yes _� tVo tiVt1TER COtV�VECTIOtV
It�IVESTIGATIO�V FEE Yes tVo PARK FEE
SAC ,Yes No SITE NSPECTIOtV
Ntunber af SAC U�tits OTHER (specify) "
--------------------------------------------------------------------------------------------------- -
ZO�VING CHECh'LIST ZO�ti�ta D1Sh'iC[.• /UO c�-tt47✓S,P
Fire Departrnerrt: Post Office: Sc/iool Dist�'ict: _..
Lot.�rea: Sq.ft. Acres GVidtlr DepNi
Scuvey Subrriitted: Yes No Date of Scuvey:
Proposed Setbacics:
Fror�t(Lake): Right Side.
Renr•(Sn•eet): Left Side:
Adjacent Str•t�ctures: Y tland:
Building Height: Def. Hgt. cck Kgt.
Got Covernge: �
GrRding: StRff.4pprovccl Date: By: Council rlpproval Da�e:
Septic: Staff.�tpproval Dc�te: 1- � ""� By: o'�-G. S'ai Ta n►�. .i'BR. sY�rL-�
Zoni�:g File: # Resolution: Resolution Dnte:
Shorelancf Disd•ict:
Avg.Setbnck: Blu tbnck: Lot Coverage:
Eiisting Proposecl
Hardcover: 0-7�'
75-250' '
250-500' �—
500-1000'
Hardcover Variance Rec�ccired: Yes o Date of Coiuicil�lpproval:
REt1�lARK�(ir�Itoccse)c
31
G�
��srrl�z�a��o Q�s ou�s oz� s,�Nu��r
:,ig aivp :jvno.�dd}�ssa��N
n,anr nit1�S7X� :SS�J7j��
-�s�Q �S?I3H.L0 d S�14�'Ll�?I
� ��.�sn ox nrl�s;nrNl�.��r
. .�ai�7p
(J�uuad a�v�S�lv�r.p�al,�To— $u�lll�/�utpv.rp 1vtnd �0
(a�t{r.t�d a�v�S)11�A7 ('�.�IN) P.�voB I1vQ9 7�_
.��t(70 (riruosv�.�r) Lro»vp�su��—
IfO1�ll�1.l.lJ 1lAtll'] a�v�da.n� au�wv.t��—
e�op�auuoJ.r�naaS �>>das $ua�oo,�
uo»>atruo�.�arv�g lv��iroi��a��r 1vaoura�j.rano�p.�vH
a.tt,� �urqurnld�— a��S
:s>>7u.�ad a�v.�vdas at��.�»>ba11'.�/.�ofi� :pa.rrnba�suor»adst�l
�, 00 �' g :an�v� �►op�n.qsuo,�pa�vrur�s3
�rso.t
_ .
_ � aD v.rv�
= x .rooj,�p�r�
_ .r .rool�1s j
= s �TraTuasvB
o��Gs.�ad� � a�vroo� bs
�/ �3dd.L ATOLLJ�2IlS.�IJOJ � • v �J8l2
ssr7,��ax,��13r��x�n�zQ7zn g
,. , . .
�G 1�N1'��� ,�j��� �i �I/z'� t"�r��JL� 1/Y-,� �I�'J�/i U
t � -}' _ I
__ - s
��- _ _ !
. . ..
e, :��� � ; �;� �_ ..�.� ., .e����, �:��r ;� __ . . _ . � � . . . �
...� ..;.Y ��`-}� ,r� :.,.r� ' ' .', o;.t .
_ _ . , .. � O �� � °O � $ � � �
R �...,�..e,,.,.., ;;
-- . -. . -. -__ .:.�:�`�-'- .n�•.w �
� j ���� 1 �
�'� t :�,��� �'��.�w�_,�'� ��.���� �
O O x O � :�.�� �a � . :��..��:..��—
;❑ O F ; _���_.�.!�'� f��...>�.�. ,
� � O ���;� � . ..� � �<. .
� O �..�_._.w__ . _ � �
_�
'� R O O O
_.� O / S3
, �. D �—
.. :
a 'f e— .h;
�''''y / { _ . ; �
'�VlT �A�.` S.�._1.. _.L , A�.� � �S.� .._.._._ � �%' . � `�*�, �. .�.� ��...i�F�f-^e- "7 t 1,rJ�.._��t�r1�x.�I
\ .`, .-�'�-�T r�T'p�4�T/�.'��� � "� �
� � \ 2
T ��i �..'.��o "F..l�..� ,..1.�,._r`.�fa � z'�� B- ..�. . �
. RX� . �� '�� . -zr'{ �
\ . �i �,. .,. �..:,.`.�. � .. t .. , w r.... r
r. . .. �.. � :.
• � � �\ I .� . .
,.;-,..,- +�: : '4�. Q T . .. . .
- 3 -n±:,. ;", .:.__. ..� .. ... .:. �{('� �f
.. . .. . . ... . . .. �� �'V 1�ltCi f0 � �. ..� � � � 1 r , r �_.�� ��3 .��. .� �r.., j
'� � .�.����e:,A B� °""r �'�d";�-1 F !';: � . t':� ��—;a-�.� � r� . �) ' ' '"1
:."'AY ; ..:� �.j t'!� ..- � �_ .. . . . '�.. � �V+:.1"'4.,., ._.... ... .., a `
, � �-,�" �.-� _..���
:� _ �����1�+��` � �t��� � �'� _ f.�t _',_,���,'
�� � �� � ��.
v��� �� � O �
�,
,
, s— �—
, ;
� Clv� �'�� f�}��JNO —
, ,
,
� � � � � �
81.,'IL���;`� , I' ;�iv+"�i` .'-' t �.\��E�JV�� - 8— i O
' i'�l.'3PEG�" , _ � ��,,._ � ___
,-.-
� - -F- ---- -----�- � �.�
___.".
E�t�.t � (' �A 7 � . � O Q O `' _ � �€I
i _ . _. _ .p � i'
; . . . ,. --- '`� ���`�G S3 �3
, � _ � . . . �_. ,�_.,7 ,: S� O �
I � � ... � r.�:�ii 1 � ��� � . O
. . . ,. . . � f., � ° .
N, �. . .. .� . . { 'iMC� .iEl'F � \��� ❑ D
� � �
� ,; ► � , � Q °�� ° Q l:1 IJIJLII:AI 0 0�0� , e �
,� . � , _.
,
� . , . .. + r �us r.._
,'.f..�;' �` a�C=: Jtb 8''1�r�3��1 � `
�+;,,.,++� "°�; :'::. � :�:�". ,� �r".'�"��a� '. e' e
• ' '
,,,
, �rY�� "c��i6N* ...��... . :. . ,...,�� .�.:�K�:.: ' ... . ,. .m,..
� �;
1 _ . .�a �.��. #`._ � , �
.».-_,....—. _. _ _ _.. ._._ � _.._.�
� ��5� � �.—__--- ___— _ �4r
m uSfi b e- P�n�-�+-.
DATE TIME
CITY OF ORONO CALLED IN -/i=OS
INSPECTION NOTICE SCHEDULED
PERMIT NO.PO �3 G � COMPLETED ���
ADDRESS 3�d �G��'J �
OWNER Cl�d Gd GZ I/a-G��.�' CONTR. !
TELEPHONE NO. �lS� 'q� ��" �' � 4 �
� DESCRIPTION �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y ION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 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
= 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 �
� °L� l.�.� ���'l
° -� Qr �
�
� � V�
� �..
Q
� '"' �
Z
� -► � �✓
W
�
W �ORK SAT SFfCCYb�PRQCEED � � I� R�ECT COMPLETE
� ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTfON REQUtRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor o ite:
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
� �^ j�P,IE TIME V
�CITY OF ORONO c- n��E�w ��"
INSPECTION TI g`� SCHEDULED � �
PERMIT NO. COMPLETED
ADDRESS�g0 St�ls�,�i� ���� �
OWNER CONTR. ��/f'IB'!^vi,S
TELEPHONE N0. 6 SZ. ��� Z ���
� DESCRIPTION ���� �!n rfl��
� 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
i09 PLUMB�NG RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
� �� �
0
�
� D 9�gY ,8 �a'�
Q
z � �� ��R� ��
W
�
W
�
�
d
W WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. _; pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTIOfV REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContrac ite:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice