HomeMy WebLinkAbout2008-P11913 - addn/remodel/repair PERMIT
CIT�� C�� ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P11913
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued:
3/14/2008
SITE ADDRESS: 1940 Sixth Ave N Unit#
Long Lake,MN 55356
PID: 27-118-23-42-0003
DESCRIPTION: UBC Occupancy R3
Construcrion Type VN
Proposed Use: Residenrial Census Code 434
Pernut Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Fireplace Electrical(state)
NOTICES/REMARKS:
Basement Finish
FEE SUMMARY: Permit Fee: $ 466.75 Valuation: $ 30,000.00
Plan Review Fee: $ 30339
State Surcharge Fee: $ 15.00
TOTAL FEE: $ 785.14
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.
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APPLICANT PERMITE SIGNATURE SSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
. , ��'�;D�
3'�2
Total Fee: $ �$s. /7 Date Received: 3'�Z -�$
Entered By: Permit#: �//9/3
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
� (please prirtt all information)
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THE APPLICANT IS: (circle one) OWNER OR ONTRACTO�R�
JOB SITE ADDRESS: l% y�' �G�ti� �y Cl�octh: � ZIP:
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. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER �; i i� 1' i e►2 �bh 1 PHONE: (home)_1,5�-`�7.�`'�/`f3
�> (work)
MAILING ADDRESS: �DC�I �-l�C'�f"�,�y.�i {�o�,�CITY: �o� ',L'f' ZIP:
CONTRACTOR: jZ�Pr•�; ��c'� �,���Sc:--C�y15�. �_.�L PHONE: �v i�-�1'�%p�%7 7
CONTACT PERSON: � r��i�,-� _ �,��:ti MOBILE/PAGER: lG�.� - �`�7-n� I 1
MAILING ADDRESS: �D�(j j��rli,ti-cf ,�'� CITY: i°�'��.�%�- ZIP: yy1.�
STATE LICENSE: # ����Y'o�.� y✓`� `/� EXPIRATION DATE: �3 ��3l ' �'�j
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Add' ' n Accessory Structure
Move Home �/Alteration (ie: Siding, Windows)
Any earth movement may .require MCWD review and permits!
PROPOSED WORK(describe in detain: .� rJ�✓�ti ,�y���yir,.✓ t
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
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ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �3('i�D4
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 wark is not to start without a permit;and that the wark will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: � .� DATE: � —�d ��v g
31
Sec.13.04 RIGHTS 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. Information required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be
informed of (a)the purpose and intended use ofthe 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 to supply
private or confidential data;and(d)the identity of other persons or entities authorized 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�,to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or properry tax refund
instructions mstead of on those forms.
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 shal l 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 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 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 authority
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an additional five 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 individual may contest the accuracy or completeness of public or private data
conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature ofthe disagreement. The
responsible authority 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 thc individual that he believes the data to be corzect. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disdosed data.
The determination of the 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 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 yourse(f.
6. Your full name is required to process this application or permit.
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I understand m�y i s as tated above.
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Signature
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BUILDING REVIEW CHEC%LIST
UBC: IZ�'3 CONSTRUCTION TYPE: V�
Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 3 V,00� '�
Inspections Required: Work Requiring Separate Permits:
Site �_Plumbing Fire
Hardcover Removal �Mechanical Water Connection
Footing Septic Sewer Connection
�c Framing �C Fireplace Lawn Irrigation
' (Masonry) Other
oC N�� D'�{Mfg.) Well(State Permit)
ocFinal Grading/Filling _�Electrical(State Permit)
Other
REMARSS(INHOITSE):
REVIEW BY OTHERS: DATE:
Access: Fxisting New
Access Approval: Date By:
REMARg.S(TO BE NOTED ON PERMIT):
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�_� �;�- ,/
ATE TIME
CITY OF ORONO CALLED IN o�
INSPECTION N TICE SCHEDULEO Q' D��L[
PERMIT NO. � COMPLETED
ADDRESS 6� ���7�� ��/�P
OWNER CONTR.
TELEPHONE NO. - � -7D.3" 7 �
� DESCRIPTION � .
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O SULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W� ❑ ORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� RRECT WORK,CALL FOR REINSPECTION TEMPORARY
RE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46�0
OwnerlContractor on site:
Inspector. / 9�/��
• White Copyllnspector's File Canary CopylSite Notfce