The URL can be used to link to this page

Home My WebLink About2004-P07160 - addn/remodel/repair � ' "' PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P07160 Crystal Bay, Minnesota 55323 P@�CYllt Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 1�23�2004 SITE ADDRESS: 2915 Somerset Lane I.ong Lake,MN 55356 PID: 04-117-23-24-0019 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Construcrion Type VN Buildin Census Code 434 Permit Class: g Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate pernuts required: riumbing iviecnanicai Eiecmcai�siaie j viner-(.ypproved wiin correciions noi�on originai house plans) NOTICES/REMARKS: T_""1____"___"_�"_1_"_ _"_ _"""_""__1 _"'1_"__"u_1__""a/_ "____"1__"___ ��.� v.::�:.u'wu�ji�wii vu ' b .-...•'�iv i� - FEE SUMMARY: Pernut Fee: $ 562.95 Valuation• $ 41,722.00 State Surcharge Fee: $ 21.40 TOTAL FEE: $ 584.35 APPLICANT: Owner/Self OWNER: Brent&Nancy Bordson MN 2915 Somerset Lane 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. 'r-� -c� � �C�� APPLICANT PERMITEE SIGNA RE ISSUED BY SIGNATURE Couies: 1-File(Sir:nitures Required), 1-Auulicant, 1-Monthlv Revorts, 1-Assessin�, 1-Finance Page 1 • '.` .. 4 � Total Fee: $ �g� - ` -� Date Received: I-�r-0`� Entered By: i i� Permit #: ' U 71�,v �-y�-n'�j l �-Z I (~`�� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please prinf all information) � THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �.. `� �-"a ��t .�1e�<s��r L v ZIP: 57 3��% NAME OF OWNER: �� - l�la-x;y�__I ��,,.., PHONE• (home)��52��'��-Q�i��i (work) c�i z �� - la�� C�vq.,.�y) MAILING ADDRESS: ?`��5 S�mE�es�t �N CITY:�.�,., �.•.k� ZIP: ss�5c� CONTRACTOR: ��i�x��;�s�� PHONE: �,7 z -�I 3 �M�,�j CONTACT PERSON:_��,_ti� MOBILE/PAGER: 6i2-�.;�- �vz5 c.Na�,�y) MAILING ADDRESS: '?��5 �so.r,e�zs�.r �.an,� CITY: �--��y �.k� ZIP: �s j r-, c�, STATE LICENSE: # ��-�-v�- ' ARCHITECT/ENGINEER: L�,�z.�r-�.,.� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New �! Addition Accessory Structure ---------- Move Remodel/Alteration Land Alteration PROPOSED WORK (describe in detai�: _ -��s�-, ba�e.�.-,�.`-r- �.x��.��. ,.�� a�t- h.`�t1�✓'c,c;,.,,-, .t- w:nc c�i 1 �✓ n��' �V z.v, o.-i -�-� 1� STORIES: SQ. FEET OF EACH FLOOR: N0. OF BEDROOMS: GARAGE STALLS: ATT. DE r�.s.� u sz �� fi->�,, �1� ESTIMATED CONSTRUCTION VALUATION (exduding land): $ ` 0��+ -�. c��,�n�nt s I hereby apply for a building permit and I acknowledge that the informat �' �� .f� 1 accurate; that the work will be in conformance with the ordinances and cod� ' State Building Code; that I understand this is not a permit and work is not to start without a permit; and that the w�ork will be in accordance with the approved plan. _____-----�---------� APPLICANT'S SIGNATURE:rt-`--�.,,,,�-` 1��.��-�-- DATE: _ � y -c,y NOTE.� Parade of Homes events require separate permit approval by Police Department and City Counci/60 days prior to the event. Non permitted events will nof be a//owed. �. " ,�. � Sec.l 3.04 RIGHTS OF SUBJECTS OF DATA Subd. I. 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 indlvidual. An individual asked to supply private or confidential data concerning himself shall be iniormed 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 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 oi revenue mav place the notice reauired under this subdivision in the individual income tax or oroaertv 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 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 without any charge to him and, if he desires, shall be inFormed of the content and meaning of that data. ANer 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 of the request, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possibie. 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 concerning himself. To exercise this right, an individual shall notify in writing the responsible authority describing the nature of the 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 oi 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 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 (ike 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. ��.rT /1�� h at 1 �ORD��r.� First Middle Last �G 1'rJ ��m �Sc�� l-AnJ� Address 1-��. 1-�k� M�I/ s.�35� �52-ji�3-8'1�19 C�tY State Zip Phone 1 understand my rights as stated above. �,-�9" Signature � . � � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: z 5 �5 S orHErtseT ��,.,c- PID: DESCRIPTION OF WORK: 13}43CMENT' F►��sr� ------------------------------------------------------------------------------------------------------------------------ ZONING REVIEW BY: DATE APPROVED: /- is'-aY � BUILDING REVIEW BY: DATE APPROVED: �- i�Y FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes � No �/ SEWER CONNECTION STATE SURCHARGE Yes ✓ No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITE INSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------------------------------------------------------------------------------ ZONING CHECK LIST Zoning District: N� c�-�4��G� Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front (Lake): Right Side: Rear (Street): Left Side: 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: Bluff Setback: L o t C o v e r a g e : Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): i'�2 f��45�M,ew r �� eN ea.r6��,•9-� s ,r�ac, r,�r�c, (�r_t� � r}-H iv�� l,��.Bc � � r � BUILDING REVIEW CHECK LIST UBC: IZ' 3 CONSTRUCTION T'YPE: �liV Sq Footage $Per Sq Ftg , Basement Z"3oa x 141•i�{ = y/r7ZZ 1 st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ �I��1 ZZ•�� Inspections Required: Work Requiring Separate Permits: Site X Plumbing Fire Hardcover Removal _�Mechanical Water Connection Footing Septic Sewer Connection _�Framing Fireplace Lawn Irrigation �C [nsulation (Masonry) Other �Wall Board (Mfg.) Well (State Permit) Final Grading/Filling oC Electrical (State Permit) Other REMARKS (IN HOUSE): ------------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ------------------------------------------------------------------------------------------------------------------------ REMARKS (TO BE NOTED ON PERMIT): A p�J�W�P�9 w.r�-+ r-a nl�.:u�r S �,� zs� or� D R�V�N h-t !��s-� n�s DATE TIME � ITY OF ORONO CALLED IN �— - INSPECTION NOTIC/'E SCHEDULED --�� %30 PERMIT NO. V COMPLETED ADDRESS D�"1 �� m�SQ/�C.Q.��-- OWNER�G/' S lS� CONTR. GLlJ�'lQ.,✓� TELEPHONE NO. 7So� '7"/�v ��Y� � DESCRIPTION ��,��IP,�� '1��/� (�S� l� 01 TING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS Q SULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE tNSPECTION Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLA�NT � 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: � W C � � O � � O � W � Q � Z W � W � j d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS. Call for the xt inspection 24 hours in advance. (952� 249-46�0 OwnerlCon site: Inspector. White Copylinspector' File Canary CopylSite Notice � I �/ � `� � T TIME � �� ✓ CITY OF ORONO CALLED IN '1` INSPECTION OTIC SCHEDULED l D� �� PERMIT NO. �7 COMPLETED ADDRESS /� Q� � OWNER CONTR. TELEPHONE NO.__ �U�� — �� DESCRIPTION �.,�l�i( � ��` �-%�Q � � ❑ 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 _ �INAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FO�LOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � i / � J O � � O � W � Q � Z W � W � � d W ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR W4LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECT�ON RE�UIRED.CALL TO ARRANGE ACCESS. Cail for the next i s ction 24 hours in advance. (952� 249-460� Owner/Contrac_ o it Inspector. � White Copyllnspector's File Canary CopylSite Notice