HomeMy WebLinkAbout2002-P05175 - addn/remodel/repair PERMIT
C I TY-�F O RO N O Permit Number:
275t� Kelley Parkway - PO Box 66 Posi�s
Crystal Bay, Minnesota 55323 PEI"1711t Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: si2oi2oo2
SITE ADDRESS: 2975 Somerset Lane
L.ong Lake,MN 55356
P I D: 04-117-23-24-0018
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Buildin Census Code 434
Pernut Class: g
Pernut Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate pernuts required: riumoing iviec;nanicai r,iec;Ricai�statej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 1,049.75 Valuation: $ 110,000.00
Plan Review Fee: $ 682.43
State Surcharge Fee: $ 55.50
TOTAL FEE: $ 1,787.68
APPLICANT: Boumeester Custom Homes, Inc. OWNER: 7oseph&Teresa Lahti
21120 Parkfield Ave. 2975 Somerset Lane
Jordan,MN 55352 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 PERMITEE SIGNATURE ISSUE BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Apolicant, 1-Monthlv Reports, 1-Assessing. 1-Finance Page 1
�tal Fee: $ 7. �'c'S Date Received: � �-��` ��-
, Entered By: :d'�l_.. Permit#: s� ��5/7 S�
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51� � CITY OF ORONO - BUILDING PERNIIT APPLICATIOleT
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� 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 OR CONTRACTOR
JOB SITE ADDRESS: ���� �'�/����,�P�f- 1 e�� ZIP: SS
NAME OF OWNER: ��� �`•Li � PHONE: (home) 9.�3 -�7s�����
(work)
MAILING ADDRESS: �y'7s' S�r:���S-�-� CITY: �`/l�m���a ZIP:
CONTRACTOR: ��'JG,lEN e'P,S�Pl� c�uss�,y-� ��v�•��HONE: ��j� -3l� i' -�s9�
CONTACT PERSON: �r��� MOBILE/PAGER:
MAILING ADDRESS: a i/�� ��t�l��i J i��+�� CITY: .�,�l�o�r�/ ZIP: S"J 35�-
STATE LICENSE: # �-��3 f�'� �s�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAI�iE: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: ��'�:5 h ,��s�„�.�f.
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ //d;-�e�a. �"�
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 work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: i2�/� C, DATE: �""-/� --002
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NOTE! Parade o�Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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._ _ . ,
Sec.13.04 RIGHTS OF SLJBJECTS 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 focth in this secaon.
Subd.2. Information reqirired to be given individuat. An individuai asked w suppiy private or confidenrial data concecning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecdng state agency,polidcal subdivision,or statewide rysum;
(b)whether he may refuse oY is legally required to supply the requesud data;(c)any lmown consequence arising from his supplying or refusing to suppty
private or confidential data;and(d)[he idenriry of other persons or enudes authorized by state or federal law to�eceive the data. This requirement shall.
not apply when an individual is asked to supply invesrigadve data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of re�enue mav place the nodce rewired under this subdivision in the individual income_tax or proaertv taz refund
instrucdons instead of on those forms.
Subd.3. Access to data by iadividual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and wherher ic is classified as public,priva[e or confidenaal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown che data wirhout any charge to him and;if he desires,shall be informed of the content
and meaning of ct►at data. After an individual has been shown rhe private data and informed of its meaning,the data need not be disclosed to him for
six mon[hs thereafrer unless a dispute or acdon pursuanc to this section is pending or addidonal 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 individuai subject of the data. The responsible authoriry
may require the requesting person to pay the actual cosu 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 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 addidonal 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 himsetf. To exercise[his right,an individual shall notify in writing the responsible authority describing[he nature of the disagreement.
The cesponsible authoriry shall within 30 days either: (a)correct the data found to be inaccu�ate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individua!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 de[erminadon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relating co
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 certai.n rights under M.S. 13.04 (available upon request) to review private data on yourself.
(, Your full name is required to process this application or permit.
First Middle Last
Address •
Ciry State Zip Phone
I understand my rights as stated above.
�
Signacure
,� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: Zci�1 S 5 o w.w��e 1t s..e�' 1�4+•rt
PID:
DESCRIPTION OF WORK: g As.aiww.� ��n►.s 1-!
ZO1�tI�TG REVIEW BY: DATE APPROVED: S/7-a�
BUII.DING REV�W BY: DATE APPRUVED; s'-�7-0 3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No � � STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CIi�CK LIST Zoning Discricc: N o G/�i4NG�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:
Reaz(Street): Left Side:
Adjacent Structures: Wetl d:
Building Height: Def. Hgt. Peak gt.
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:
Eusting Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
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BUII.DING REV�W CHECK LIST
�C: _ R�3 CONSTRUCTTON TYPE: \[,W,
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x _
2nd Floor x =
Garage x = �
a =
TOTAL
Fstimated Construction Value: $ 1(DiCbDo
Inspections Required: 1�Vork Requiring Separate Permits:
Site __�Plumbing Fire
Hazdcover Removal _�Mechanical Water Connection
F���g � Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
_�t,Insulation (Masonry) Other
_�e Wall Board (Mfg.) Well(State Permit)
� F�� Grading/Filling _�Electrical(State Permit)
Other
REMARKS(IN HOUSE): .
----------------------__---__
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
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REMARKS (TO BE NOTED ON PERMIT�:
8
V � � � " " DATE TIME
CITY OF ORONO (� ALLED IN
INSPECTION NOTI �-� ��CHEDULED �
PERMIT NO. COMPLETED — !�i vi —
ADDRESS ��'� � �("�0��,��
OWNER CONTR. � `�'1Q/1"�C ,�>
TELEPHONE NO. � � �C� ' �P�%
� DESCRIPTION �
� 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
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 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBfNG 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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��WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTIONRE�UIRED.CALLTOARRANGEACCESS.
Call for the next ins ection 24 hours in advance. (952� 249-4600
OwnerlContract o si .
Inspector. `!
White Copyllnspector's File Canary CopylSite Nodce
/ G� �" c5��/
U DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE _, SCHEDULED �'�- //�
PERMIT NO. 7/ �-� COMPLETED
ADDRESS a�G �"S� ��/1')�/�-� �
OWNER CONTR.��''�S�_/` C�� {�e-i.-�_S
TELEPHONE NO. L-l�� � ��Onf' �-P ��
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y ULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD.' 12 WATER HOOK-UP 17 SITE INSPECTION
Q � 14 SEWER HOOK-UP O6 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
� OWNER/CONTHACTORTOMEETYOU:_YES'' NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑COARECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlCont or on site:
Inspector. �
Whit opyflnspector's File C� ary CopylSite Notice
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