HomeMy WebLinkAbout2005-P08705 - accessory structures � • • PERMIT
CITY OF ORONO permit Number:
2750 Kelley Parkway- PO Box 66 Po87o5
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952) 249-4600 Date Issued: 5/23/2005
SITE ADDRESS: 2300 Sixth Ave N
Long Lake,MN 55356
P��� 27-118-23-32-0002
DESCRIPTION: UBC Occupancy U1
Construction Type VN
Proposed Use: Residential
Pemrit Class: Building Census Code O/S-Building
Permit Sub-type(s): Accessory Structure
Permit Type: Accessory Structures
DETAILS:
Approved per resolution#:
Separate pernvts required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 83.25 Valuation: $ 2,500.00
Plan Review Fee: $ 54.11
State Surcharge Fee: $ 1.25
TOTAL FEE: $ 138.61
APPLICANT: Owner/Self OWNER: Mr.&Mrs.O'Rourke
MN 2300 Sixth Avenue N
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.
������Y�:����� �lm ��-
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Si�nitures Required), 1-Applicant, 1-Monthly Reports, 1-AssessinQ, 1-Finance Page 1
, �.
? � � : �.C�
Total Fee: $ ' La/�7 J Date Received: .S l�'�.�
Entered By: �_T.�_,��nc� ` Permit#: i408 70,�"'
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 IS: (circle one)�OWNE R CONTRACTOR
JOBSITEADDRESS: ;�.3oD �h �uP no 1� Ir��-(e zir: �3��
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ YeS �NO /f yes, a special eren�per�nit is��equired with Po/ice Department and Ciry Council approna/
60 days pr•inr to the e��ent. Shi�ttle bus service mill be required unless applicant demonstrales
sufficient on-site parking rs availab/e. Non-permitted events will not be a/lowed.
NAME OF OWNER: .�r�U�-QQbi�1 � �u.rF� PHONE: (home) 9,-r��?-�I'J.5 Q�(,�;
(work) '7(QS-•7�}7-�i5��
MAILING ADDRESS: ,�?,�'j(� [��.1� �� n�� CITY:�p ZIP: /Y)/L�
CONTRACTOR: J��� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition Accessory Structure �_
Move Home Remodel/Alteration
PROPOSED WORK(describe in detai�: � �j de�L S i��l�e r. �Ti��n i'oo-F l.��'f-�t% .�-�r�
WC�.iI�/� l��t�r� �0.�� 1�-Prv�c� I1� x3D
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ,����
l hereby apply for a building permit and[acknowledge that the inforination 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 1 understand this is not a perinit and work is not to start without a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE�G��firZJ �����.��� DATE:
31
Secl3Ad RIGIITS OF SUI3JECTS OF DA'1'A
Subd. I. 7'ype 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 req�iired to be givcn individual. An individual asked to supply private or contidential data concerning himself shall be
informed of: (a)the purpose�nd intended use of the requested data within the collecting state agency,pol itical subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)airy known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identit}�of other persons or entities authorized by state or federal law to receive the data. "fhis 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 officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or vropertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individu�l Upon request to a responsible authority,an individual shall be infonned whether he is the subject of
stored d�ta on individuals,and whether it is classified as publiq private or confidential. Upon his further request,an individual who is the subject of
stored privnte or publ ic data on individuals shal I he shown the data without any charge to him and,if he desires,shal I be infonned 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 authoriry shall provide copies ofthe private or public data upon request by the individual subject of the dat�1. The responsible authority
may require N�e requesting person to pay the actual costs of making,certifying,and compiling the eopies.
The responsible authority shall comply iimnediately,ifpossible,with any requestmade pursu�ntto this subdivision,or within five days of
the date ofthe request,exduding Saturdays,Sundays and legal holidays,if immediate compliancc is not possible. [f he cannotcomply with the request
within that time,he shall so infonn the individual,and tnay have an additional five days within which to comply with the request,excluding Saturdays,
Simdays and legal I�olidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contestthe accurlcy or completeness of public or privnte data
concerning himself. To exercise this right,an individual shall notify in writingthe responsible authority describing the nature ofthe disagreement. 7'he
responsible authority shall within 30 days eitl�er. (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. Dat�in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act rellting to
contested cases.
DATA PRIVACY ADVISORY
li�accordance with M.S. 13.04.Subd.2,"Rights of subjects of data",wc would like to inform you that your request
for a permit or liccnse Ii-om Che City�ot�Orono or any of its departments may require you to furnish certain private or
conlidential information.
You are notified that:
l. The information you turnish will be used to determine your qualification for the permit or license
requested.
2. You may rePuse 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 necessa�y to
process thc permit or license.
4. If your requested permit or license requires Council action to approve, some inform�tion may become
public.
�. You have certain rights under M.S. ]3.04(available upon request)to review private data on yourself.
6. Your full i�a�ne is required to process this application or permil.
KD�i�1 �— �} �Kp(a,rl��
H���sr M�aai� �,as�
o�3oG (��-h �4c��e_ 1?b
Address
ls.� La.�e. M iv �5"3J� 95a-u��-0,05
Cih� StAte %ip Phonc
[ understand my rights as stated above.
��;���;��.�.�n
Signature `�
i2
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2 3 0 0 6'� Igw I'�l c
PID:
DESCRIPTION OF WORK: 3 s���9 S t+�e«-,eL
ZO.�tG REVIE`V BY: DATE APPROVED: 5- ��-dS
BUILDING REV�W BY: DATE APPROVED: �_�� -o�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW � Yes � No SEWFIZ CONNECI'ION
STATE SURCHARGE Yes �/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONI�TG CH�CK LIST Zoning District:
Fire Department: Post Office: School District: �
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes� No Date of Survey: 0 n< <��c.�:
Proposed Setbacks:
Froat(Lake): y v0� + Right Side: Zoo � '�'
Rear(Street): 75 � Left Side: 15�
Adjacent Structures: S U Wetland: N/►9
Building Height: Def. Hgt. � ,�� Peal:Hgt.
Lot Coverage: I� �A
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # — Resolution: !# Resolution Date:
Shoreland District: �IC�
Avg. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
2�0-500'
500-1000' �
Hazdcover Vaziance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
BUII,DING REVIEW CHECK LIST
UBC: U - t CONSTRUCTION_TYPE:---�L1`�--- :---------_—
Sq Footage $Per Sq Ftg
Basement x _ .
lst Floor x _
2nd F1oor x _
Garage x _
a —
TOTAL
Estimated Construction Value: $ 2�58 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/Fllling Electrical (State Permit)
Ocher
RENIA.RKS(IN HOUSE): .
_---�_____---- -------------------------------------
RE'VIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By;
- ---------------------------------------------------------
RENIARKS (TO BE NOTED ON PERMI�:
8
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PERMIT NO. /�G�S'7L'�' COMPLETED
ADDRESS � �� ��'�` '"�`'"�- � •
OWNER -�S`"%�C.'�i� ��`�CONTR.
TELEPHONE NO. �L�:3 " �� � � �`��
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� DESCRIPTION �1��`� S �-�-�'/'
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS: S '"Gr / �"�'� �`�v 2ZrL� -')
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GW p RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� CORRECT WORK&PROCEED !-i ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContract�� ite:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
�� � ✓
�yDqT�/�� TIME
CITY OF ORONO CALLED IN ��
INSPECTION NOTICE SCHEDULED v� �A-�
PERMIT NO,��7n� COMPLETED �
ADDRESS 3D U ce , � ��
;
OWN ER � CONTR.
TELEPHONE NO. �'�o� ��S -� G�l O�
/� �^ r3s�d.�
� DESCRIPTION ?—f`-11�t` - ti'�S S�-CG{ �
� 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 REMUVAL
� 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
i 09 PLUMBING RI 23 SEPTIC FINAL , 35 HARD COVER REMOVAL
J �0 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOH TO MEET YOU:�YES_NO
� COMMENTS:
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W ❑CORRECT WORK 8 PROCEED 1'!: ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREOUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
Owner/Contractor on s� e:
Inspector. (/� r r � ��
White Copyllnspector's File Canary Copy/Site Notice