HomeMy WebLinkAbout2006-P09514 -addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P09514
Crystal Bay; Minnesota 55323 Permlt Type: Addition/RemodeURepair
(952)249-4600 Date Issued: 1/9/2006
SITE ADDRESS: 1920 Sixth Ave N Unit#
Long Lake,MN 55356
PID: 27_118-23-42-0002
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Electrical(state)
NOTICES/REMARKS:
Basement Framing, Sheetrock&Paint
FEE SUMMARY: Pernut Fee: $ 139.25 valuation: $ 7,000.00
Plan Review Fee: $ 90.51
State Surcharge Fee: $ 3.50
TOTAL FEE: $ 233.26
APPLICANT: Owner/Self OWNER: Brian&Beth Canington
MN 1880 Sixth Ave N
Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL fMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ►SSUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page l
� Total Fee: $ Z.�-� • L-�- Date Received: ��- � Z��°`='
Entered By: �I� , �1�Zg-< < �4 Permit#: �`r-=� �4
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNE R CONTRACTOR
JOB SITE ADDRESS: � ���Z7 �� 1q V�. !�} > ZIP: S S.�S�
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes �NO Ijyes,a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
su�cient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: l3 f�� (hV� Cc,'�f f ► �o� �q r� PHONE: (home) ��15�-�/ -D��S
(work) S�- �,58-��Q 3
MAILING ADDRESS: I ���� �� �V� N- CITY: �� �r�u ZIP: .SS`'S
CONTRACTOR: N�� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CIT'Y: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: � �j� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home RemodeUAlteration(ie: Siding,Windows)
PROPOSED WORK(describe in detai�: l5 G �
STORIES: SQ.FEET OF EACH FLOOR:
NO.OF BEDROOMS: GARAGE STALLS: ATTACAED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 7� (,���(i
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.
APPLICANT'S SIGNATURE: /�;i,.� � � DATE: ��� �-1/U$
�
31
, Sa.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.1. 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.Infomiation required to be given individual.An individual asked to supply private or confidential data conceming himself sMall be
informed of: (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 W supply
private or confidendal data;end(d)the identity of other persons or entid�authorized by smte or federal Iaw to receive the deta This requirement shall
not apply when an individual is asked to supply investigative data,pucsuant to sation 13.82,subdivision 5,to a Iaw enforcement officer.
The commissioner of revenue mav,Dlace the notice reauire�ueder tl�s sub�vision in the in�vidual inwme tax or p� Y re ��d
instructions instead of on those fortns.
Subd.3.Access to data by individual.Upon request to a responsible authoriry,an individual shall be infom�ed 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 wit6out any charge to him and,if he desires,shell be infom�ed of the content and
meaning of that data. After an individual 6as been shown the private data and informed 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 coll�or creatod.The
responsible authority shall provide wpies 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.
The respoasible suthority shall comply iwnediately,ifpossible,with any request made pursuant W thia subdivision,or within five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate ccimpliance is not possible.Ifhe cannot comply with the request
within that dme,he shall so infortn the individual,and may have an additional five days within which to comply with the request,excluding Sadudays,
Sundays and legal holidays.
Subd.4.Procedure when data is not accucate or complete.An individual may contest the accuracy or completeness ofpublic or�xivatc data
conceming himself.To exercise this right,an individual shell notify in writing the responsible suthority describing tbe nature ofthe disa�t The
responsible suthority shall within 30 days either: (a)cortect the data found W be inaccmate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individuel that he believes the data W be comct.Data in
dispute shall be disclosed only if the individual's statement of disagreement ia included with t6e disclosed data.
The detemiination of the responsible suthority may be appealed pursuant w t6e provisions of the adminishative 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 yow request
for a permit or license from the City of Orono or any of its departments may require you to fiunish certain private or
confidential information.
You are norified 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 pernut 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 youtself.
6. Yow full name is required to process this application or permit.
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Firat M1ddle Last
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Addresa
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City State 7�p P6one
I understand my rights as stated above.
/ �
Signature
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, � SUII�DING REVIEtiV CHECK LIST
UBC: 2 • 3 CONSTRUCTION TYPE: �!/�
Sq Footage $ Per Sq Ftg
Basement x _
lst Floor x _
2nd Floor x _
Garage x _
x =
TOTAL
Estimated Construction Value: $ -7,c�c� �
Inspections Required: tiVork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing ` Septic Sewer Connection
_�Framing Fireplace Lawn Irrigation
1L Insulation
Wall Board ��0�� Other
—� . (r'Ifg•) Well (State Permit)
—�F�� Grading/Filling cC Electrical (State Permit)
Other
REMARKS (IN HOUSE): �
----------------------------------------------------------------------
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By;
-----------------------------------------------------------------
RE�'IARKS (TO BE NOTED ON PERt1�II1�: S � � � , v
C��l.t�o�!h (',4,r� n!e r (� /�-f�D � C,.�r iT9 0� '�
_s� '� �c_-�vl�9-iG6�s�.-� �
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C�CK flFF LiST FOR iSSUANCE OF PEitMITS
FOR OFFICE USE ONLY
A.DDRFSS OR LEGAL: (�j�p 5 i x T,� A►"-e No.
PID: •
DESCRIPTION OF WORK: ( snwe�. �v e� ��rv�s �t
ZO�1TtG REV��V BY: DATE APPROVED:
BUII..DING REVIEW BY: DATE APPROVED;
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW � Yes �/ No SEVVER CONNECTION
STATE SURCHARGE Yes ✓ No WATER CONNECITON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZOI�tING CH�CK LIST Zoniag District: /(1rJ GN?4/u6 E�
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes o Date of Survey:
Proposed Setbacks:
Front(Lake): Right Sid
Rear(Sueet): Left de:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: luff Setback: L.ot Coverage:
usting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes N Date of Council Approval:
REVIARKS (in house):
7
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� ��%��'�' DATE TIME
CITY OF ORONO CALLED IN � �
INSPECTION NOT CE SCHEDULED �
PERMIT NO. C,i � COMPLETED
ADDRESS � ��O �'C�tl�Z� �C:�-� /v
OWNER �y i�.(�1C��Y) CONTR. '
TELEPHONE N0. �S o�` 7"a `� "`v��
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� DESCRIPTION � �
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING �
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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�ES_NO
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W ORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑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 ARRANGE ACCESS.
Call for th in pection 24 hours in advance. (952� 249-4600
OwnerlCo act n te:
Inspector. �
Whit opyllnspector's File Canary CopylSite Notice