HomeMy WebLinkAbout2007-P10794 - addn/remodel/repair :A
` PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p1o794
Crystal Bay, Minnesota 55323 Pe�mlt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued:
7/9/2007
SITE ADDRESS: 1940 Sixth Ave N Unit#
Long Lake,MN 55356
P��� 27-118-23-42-0003
DESCRIPTION: UBC occupancy R3
Conshuction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Pernvt Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate pemuts required: Plumbing Mechanical Septic Fireplace Electrical(state)
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 2,113.75 valuation: $ 300,000.00
Plan Review Fee: $ 1,373.94
State Surcharge Fee: $ 150.00
TOTAL FEE: $ 3,637.69
APPLICANT: Brian Stephenson Construction Inc. OWNER: Jim&Judy Pierpont
2025 Pawnee Rd. 1801 West Farm Road
Medina,MN 55340 Long Lake,MN 55356
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.
I
. �
APPLICANT PERMITEE SIGNA RE SSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
_ �; .
Total Fee: $ �r � ''� � - � 1 Date Received: `�� �[� � ��
Entered By: ��� , Permit#: � - 2�-(� 7
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before �lan review will be started.
(please p��int all inforniation)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle oste) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 6 �S�L' S txf�� ,��U�f��+h �o.v�/�K�' ZIP: �*���v5 G
Will this be a Parade of Homes, Remoclelers Showcase Home or other Display Home?
❑ YCS �NO ITyes, a specic�l eveht permit is requir�ed tivith Police Depcu�tmef�t n�7d Ciry Counci!app��oval
60 da�,s prror to the ei��ent. Shut�Ie Gzrs service 1-vil!be reqirired a�mless applicar�t demonsU•ates
sa��cient of�-side parking is available. Non-per��riiltecf eve��ts tivill r7ot be allotived.
NAM�OFG1W1�1E1�: �i�n � Svc1��p i�'�e��,rt�r PHONE: (home)`P�v?-Gi'�5��`ll�l..3
(work)
MAILING ADDR�SS: /��71 �L�'-��F�r1� k'd� CITY: ���L�rX ZIP:
Ct)r�TRA�TO�: ,�jR\.ft-�S-����hc-v�.sc�a C��;�s�-, �L"�:.'t... PI-�Ol\TE: 7�:� .�17�' "�.?z`'.�1.
� CONTACT PERSON: (�R�it-� 5-fC�.���St•,� MOBILE/PAGER: G"�!vZ` y�`1-c.3�1 T 7
MAILING ADDRESS:,,`��� i�yu:v,�� k',�_CITY: jY'l�cl�.%�',fi- ZIP: . ".S �_3-t v
STATE LICENSE: #�a,�,�,�, yj"9 �XPIRATION DATE: 3~3% -v 7
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
T'YPE OF WORK: New Home Elddition � Accessory Structure
Move Home RemodeVAlteratio►1 (ie: Sidiiig, Windows)
Any earth movement may re uire MCWD review and permits !
PIZ�POSED W�RK(descril�e in detuil�: _,q�,D vC n� �1C�tiZ, (�-.�n.�;�: ��rrL,�t��C�'++�
STORIES: � SQ.FEET OF EACH FLOOR: I Z,jL'�
NO. OF BEDR001VIS: r� GARAGF. STALLS: ATTACHEI�� DETACHED_
c�£a
ES'TIIVIA'�d'ED CONSrI'12UC�'IOI�t VAL;UAZ'IOl!'(e�clucling lancl): � _:j��`�,��t� �
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 E3uildin�
Code;thaC I understand this is not a permit and worlc is not to start�vithout a permit;ancl that the��vork will be
in accordance with the approved plan.
,
APPLICANT'S SIGNATURE: � � � I�AT�: �+�`" ��
31
. c,
.
Sec.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. Information required to be given individual.An individual asked to supply private or confidential dataconcerning himseifshall be
informed of: (a)the purpose and intended use of die requested data within the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legal ly required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities suthorized by state or federal law to receive the data.This requirement shal I
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofticer.
The cotnmissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual.Upon request to a responsible authority,an individual shall be inforn�ed whether he is the subject of
stored data on individuals,and whether it is classified as public,private or confidential. Upon his fuRher request,an individual who is the subject of
stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed 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 thereatter unless a dispute or action pursuant to this section is pending or additional daca on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible autltoriry
may require the requesting person to pay the actual costs of making,certitiying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request
within that time,he shall so inform the individual,and may have an additional tive 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 individua(may contest the accuracy or completeness of publ ic or private data
concerning himsel£ To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature ofthe disagreement.The
responsible authoriry 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 individual;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 disagreement is included with the disclosed data.
The detertnination of the responsible authoriry 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 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.
c�R �/;'%li � �JIJL"S� ���C'V45C).C�
First Middle Last
o��� �1'twN�� ��
Address
�If t..d 1�r1 m�r �.�31/D 713=�-6�"d�
City Statc Zip Phone
I understa my rights tate abov
Signsture
' Reset Form 3'
s . . .
CHECK OFF LIST FOR ISS UANCE OF PERMITS
FOR OFFICE US ONLY j���>�—
,
ADDRESS OR LEGAL: �i`�`� ��L�/` ' /X 11 Gv1�`
PID:
DESCRIPTION OF WORK �1(,�U r+ �ltk�t( �l a,r.4 y',�., Z��d S/��L� c`.x.✓ �»-i 4��r,a/ h cus�= rsai*�'�
----------C�-�-��`"�----��"-��J`�LG.lr�_.���..L'�c.-�c�]------�-�------------------------------------------- �'dc���c�
-------- 1 1
ZONING REVIEW BY: �/- DATEAPPROVED: Q
BUILDING REVIEW BY: wQ,�.,�r:.,.A..- DATEAPPROVED: (�,•��{ �u-"7
-------------------------------------�- ��-------------------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculatecl By.�
PERMIT Yes�_ No
PLAN REVIEW Yes L No SEWER CONNECTION
STATE SURCHARGE Yes �-� No WATER CONNECTION
INVESTIGATION FEE Yes No �--'" PARK FL'E
SAC Yes No �,,.- SITEINSPECTION
Na�mber of SAC Units OTHER (spec�)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST 7oning Drstrict: �� ' ��
Fire Deparh�ze��t: Post Office: Schoo!Dish•ict:
. ,� �
Lot Ar•ea: Sq.ft. .9c��es �i��2- GVidth Depth ��7`�"
Stuvey St�bnlitted: 1'es �� No Date of St�rvey: �P�� V /
Proposed Setbacks: h t�� �+
Front.�Lcrlce}� ��_ �kt Side: -T
F �
Rear CCt,...N�}: �Z.(�E f be}'E Side: ��
Adjacent Str•arctures: ri f=k Y�'etland: Vl�
Bzrr(cfingHeight: Def. Hgt. ZZ� +' PeakHgt. G.�'}�t GY�d¢.,�-a ��"S��t�`''� '�
���� –
�'�.b�' ��c=��r
Got Coverage: ���f��-� �. �y,
�: S /0
Grading: StaJf Approva!Uate: .By; Council Approval Date:
( � �= �� a �� .. . . _ .
Septic: StnffApprovalDate: }:
7v�zing File: # Resolittiorr: # Resolutior�Date:
Shorelafid District: / AICIf�D Permit:
Avg. Setback: 13h ff Setbncic: Lot Coverage.•
6xisting P��oposed
Ha��dcoi�er: 0-7.i'
?�-2.i 0'
zso-sno�
soo-i000�
Har•dcovei• [�"ariance Required: }as fVo Dare of Coc�ncil�1pp�•oval:
REMARKS(in hocrse): - --�.:—�:-� , _.
/ -4,�1/lSA�J
C�w�U L Z J
>;
. . . i
B UILDING RE vIEW CHECK LIST
UBC: � �- CONSTRUCTION TYPE:
Sq Footage $Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage ,r =
x =
TOT,�L
Estimated Construction Value: $
Inspections Required: 63�ork Requiriirg Separate Permits:
Site �'"Plumbing Fire
Hardcover Re»toval �Sylechanica! Yt�ater•Connection
�Footiag t/Septic Seiver Connectia�
•,c Fr•an:ing ✓�Fireplace Lmvn Irrigation
_�Insarlatiorz _ ([Llasoniy) Other
�GVa/1 Board t/ (Nlfg.) Well(State Per•rnit)
Fina/ Grading/Filling _f�Electyical(State Per•niit)
Other
REMARKS(INHOUSE):
----------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access App��ovnl: Date B}�
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REMARKS (TD BE NOTED ON PERMIT): —�?r�l�.�.,a� % - --� -� ' - � -_/
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34
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CITY OF ORONO CALLED IN �
INSPECTION N IC SCHEDULED __�� __�
PERMIT NO. COMPLETE
ADDRESS �9�D � . /Cl .
OWNER CONTR. �
TELEPHONE NO. �l o� l7O a o2��
� DESCRIPTION / l
� 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
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector. (G�c
White Copyllnspector's File Canary CopylSite Notice
' J l
OD� TIME
CITY OF ORONO CALLED IN l �//����
INSPECTION NQ�1��7n, / SCHEDULED � '� 7 �,t�
PERMIT NO. ` 7 `"f' COMPLETED
ADDRESS f 9.����� �'47J`P�
OWNER CONTR. G����'`.7'
TELEPHONE NO. lO�a ��lO lS�oZ�/
� DESCRIPTION ��O�n G�
t� 01 FOOTING 11 MECHANIC I 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 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 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT
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:
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0 ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �; pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
Owner/Contractor on sit ••
Inspector. � �
White Copyllnspector's File Canary CopylSite Notice
�
D TIME
CITY OF ORONO CALLED IN _�
INSPECTIONN TIC�E7/� SCHEDULED /D� -b7 /t�
PERMIT NO. �l� `7� COMPLETED
ADDRESS �7U� dS��'S��- � � `
OWNER CONTR.�S C�
TELEPHONE NO. ��o� o�� � T��
� DESCRIPTION �al�'l /
� ❑ FOOTING ❑ MECHANICAL I ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULAT�ON ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMM�NTS:
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V FORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR �� CITATION ISSUED
D INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
�� �CWI� DA TIME �
CITY OF ORONO CALLED IN � ��
INSPECTION N SCHEDULED �=�-�� Q�
PERMIT NO. � COMPLETED
ADDRESS �
OWNER CONTR. `(s2�-��
TELEPHONE NO.�1�� � / � �7
� DESCRIPTION �
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHOREM/ETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. � FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL p FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORE CO�/ERING PERMANENT
❑CORRECTUNSAFECANDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on si e- -
' Inspector.� �_, _
White Copyllnspecto�'s File Canary CopylSite Notice
1���1�- �
CITY OF ORONO CALLED IN
—F�--�� T�
INSPECTION NO CE SCHEDULED �v � : O j'1�l
PERMIT NO. D C MPLETE
ADDRESS � C� Nn
OWNER CONTR. G i -
TELEPHONE NO. � �
� DESCRIPTION � �
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATiON/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
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INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContractor on site:
Inspector._�� �
White Copyllnspector's File Canary Copy/Site Notice
� ��- �� ����, /
D � TIME
CITY OF ORONO CALLED IN I ��
INSPECTION NOTICE SCHEDULED � �
PERMIT NO. �� �� COA�LETED /� �3f-G7 3'>'b '
ADDRESS ,- l � J\ �� `�- 1�•
OWNER CONTR. � �o��
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TELEPHO O. � �� ���
� DESCRIPTION �Irn��-' `f' 1 1 `r UC�
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING �
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
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� COMMENTS:
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V BEFORECOVERING PERMANENT
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INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor on site
Inspector. ''� l �
White Copyllnspector's File Canary CopylSite Notice