HomeMy WebLinkAbout2000-P03092 - pole building � '. � PERMIT
CIT�Y OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po3o92
Crystal Bay, Minnesota 55323 Permit Type: accessory smz��ures
(612) 249-4600 Date Issued: ioi2v2o
SITE ADDRESS: 2940 Sixth Ave N
LONG LAKE, MN 55356
P I D: 28-118-23-31-0001
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: �'�� n"�
Census Code 328 v�
Permit Class: Building � �`°
Permit Sub-type(s): Accessory Structure ��%L � �� •��•'��' '
Permit Type: Accessory Structures
;
DETAILS:
Approved per resolution#:
Separate permits required: Eiectricai(staie j
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 293.25 Valuation: $ 18,000.00
State Surcharge Fee: $ 9.00
TOTAL FEE: $ 492.83
APPLICANT: NATHAN ZIERHUT OWNER: STONEGATE FARM INC
2940 CO. ROAD 6 2940 SIXTH AVE N
LONG I.AKE,MN 55356 LONG LAKE MN 55356
THE UNDERSIGNID HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WTI'H ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUII.,DING CODE REQUIREMENTS.
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APPL A ' [T ATU ISSUED BY SIGNATURE -
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Copies:City,Applicant,Assessor,Finance Page 1
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� �Total Fee: $ L/9�, CJ�� Date Received: :f'�/�/t���
Entered By: C�_ Permit#: ,!"r;; ��^�j��
����,c��c� /'� _�.3�:- ��'� ><,
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) OWNER� R CONTRACTOR
JOB SITE ADDRESS: ���,/(1� �J����t ✓ � 4,��� �% ZIP: ��5����,.
NAME OF OWNER: SJ�'d,r�e �c�fE? �d r,� PHONE: (home) �/��-- 7��?C�
(work) 1�l� - ���::�2
MAILING ADDRESS: ��r�5 /r l c �" CITY:��'e�t ,�i�4�,�,`r Z�:-�
CONTRACTOR: ��«�- �,,, Z�:��,� •f- PHONE: �f y�G���%
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: ;;�y�� �', ��� � CITY: ���; ; r �_ ZIP: J��j �'
STATE LICENSE: #
ARCHITECT/ENGINEER: .��u�c'_s�t�Qi��r �c ftr�in�HONE: ��l- ��C��i
MAILING ADDRESS: �,�S„r,;� �i�y z�r�t ��,�,�'.. CIT : .�%.�/'r,� �/, • ZIP:
=�
NAME: ��,1��;�(�,� REGISTRATION# .����-,��y f
TYPE OF WORK: New � Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: (�,r5�'��c:� yo�X y�"D,7/� bu��d�',�4. �'���7c�rf
��c.:� /l?Cf'a� S,�lr' S lrt.�� /",1c'�. ,Sr� G ffz:r'�.��,C��nn
STORIES: _� SQ. FEET OF EACH FLOOR: l �(1/�
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� Ly0%%
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 Ciry 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: "^���� /Yu,�f��j�-- DATE: � G� G n r%
1/�"�-
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
9
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Sec.13.04 RIGHTS OF SLJBJECTS OF DATA
Subd. 1. Type of data. The rights of individuai 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 indiridual. An individual asked to supply private or confidential data conceming himse(f shall
be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polirical 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 shall
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 nouce required under this subdivision in the individual income tax or propertv 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 informed whether he is the subject of
stored dara on individuals,and whether it is classified as pubGc,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 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
thereafrer unless a dispute or acdon pursuant to this section is pending or additional data on the individual has been collected or created. The responsible
authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the
requesting person to pay the actual costs of making, certifying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of the
date of the request,excluding Satuidays,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 of the 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 inciuded with the disclosed data.
The detemiination 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 yourself.
6. Your full name is required to process this application or permit.
� � ���
�(�t�Cl�'t ��L�/h�f S � �. --
First n�l,n /'�,�, ,����Middle Last
v� 7 V �1
Addr'ss /� _' �1�/� �
��ilt�;� �111C -L' ��i� �.�'�J��C' !'7 �li'���,�
Ciry � State Zip Phone
I understand my rights as stated above.
�
. ���'i(,� 1�' p� /�
Signature
10
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z.�j'yf> C� u.rl 6
PID:
DESCRIPTION OF WORK: �.�
-----------------------------------------�'}----- -------------------------------------------------�--�--:------------
ZONING REVIEW BY: C�' o DATE APPROVED• v u� -c�c�
BUILDING REVIEW BY: �rc GG��� DATE APPROVED: �c� • �- ��
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FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �c No SEWER CONNECTION
STATE SURCHARGE Yes _� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: —��
Fire Department: �v1��/� Post Office: �y9 �/'�e School District: ��
Lot Area: Sq.ft.�K�9e Acres �b Width I 3��+ Depth �YS
Survey Submitted: Yes � No Date of Survey: �5�
Proposed Setbacks: i
Front (Lake): C�'2-13 Right Side: I �z�
Rear (Street): �,� b� ��" Left Side: � l�O O � t
Adjacent Structures: Wetland: �//�
Building Height: Def. Hgt. / �� Peak Hgt. Z-O
Lot Coverage: �
Grading: Staff Approval Date: � By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: L,ot Coverage:
A/'�� I Existing Proposed
/� Hardcover: 0-75'
75-250'
� 250-500'
� 500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
27
3
BUILDING REVIEW CHECK LIST
UBC: �."� CONSTRUCTION TYPE: U�(/J
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor �4O x �.00 = (
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ /� ,f��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
� Footing Septic Sewer Connection
?� Framing Fireplace Lawn Irrigation
�C Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�Final Grading/Filling ?C Electrical (State Permit)
Other
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REMARKS (IN HOUSE):
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REVIEW BY OTHERS: DATE: �
Access: Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMIT):
28
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� 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
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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DATE TIME
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Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
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W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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OwnerlContractor on site:
Inspector. ��-j.��� .���,�_�
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED '�f�
PERMIT NO. U COMPLETED � '�� '�'
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� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADINGIFILLING
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 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
� 10 PLUMBING FINAL � � 36 FOUNDATION/REMOVAL
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INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46�0
OwnedContractor on site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice