HomeMy WebLinkAbout2003-P06048 - addn/remodel/repair PERMIT
C�`�Y cJF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P06048
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 2�2gi2oo3
SITE ADDRESS: 2990 Somerset La
I.ong Lake,MN 55356
P I D: 04-117-23-21-0011
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Pernut Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Yiumoing iviecnanicai Eiecuicai�staiej
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 643.75 Valuation: $ 50,000.00
Plan Review Fee: $ 418.53
State Surcharge Fee: $ 25.50
TOTAL FEE: $ 1,087J8
APPLICANT: Anthony Thomas Homes OWNER: Frank&Stacey Castiglione
4100 Berkshire Lane 2990 Somerset La
Plymouth,MN 55446 Long Lake,MN 55356
THE UNDERSIGNED EREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO LL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILD G CODE REQUIREMENTS.
��� "���n,���' T�'�ti�� ��
� ----- ���5 , �:—
� —� � ��,� � � �::,_� � -�C c`��'��'1C�� /�
PPLICANT PERM[TEE SIGNAT RE ISSUED BY GNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
4
�Total Fee: $ /�� ��7 � ��/ Date Received: �-� � (..����j�'
Entered By: ��' Permit#: 2 - Zc� -o�
��.y.�,�; �::�1U, -
CITY OF OR�NO - BITII�DIVG PERIVIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
'THE APPLICANT IS: (circle one) OWNER OR ONTRACTO�
JOB STTE ADDRESS: �.` 1`��-z SC�+'l�-�`����C l..�r•..:�- ZIP: `�S�3 5 �^
NAI�IE OF OWNER: ��_«;:4�� i S-T�-`� ��I�t���c��=��-- PHO�IE: (home) ` ,;�2��3 i��- 5 Z�"�
-������ (work) l{.�z � Z> �t � - ���z y-
�
i�iA�Lr'G ADDRESS: L�.�i� S�r+�e�Sc�i CTTY: �,��_�� r.� ZIP: `�S 35�c
CONI'RA.CTOR: �=-,,.;aT"�f-=� �hot��•� 1-�-vr��� PHOi�1E: �"Il���� J �`'1 '�:ZS- 1
� �
CON�'ACT PERSON: i o�1-�l �_.:h-�-� I�iOBILE/PAGER ��Z � �,L, �- �-4�1�1�
NIAILING ADDRESS: �-t«.�c.� �,��r���h'� �� ��=� CITY: �,��-t u�c�.�-T l� ZIP: ����y�l�
STATE LICENSE: # 'c�� �S-y S-c�
ARCHITECT/ENGliYEER: P����
`IAII.I�i'G ADDRESS: CITY: ZIP:
N�y�: REGISTRATION#
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration L� Land Alteration
PROPOSED WORK(describe in detain: �.�_s� l��r 1- ��-�'� �'���"�S� +� t� ���-�1�� T S ,
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOI�IS: GARAGE STALLS: ATT. DET.
ESTII�i IATED CONSTRUCTION VALUATION (excluding lanc�: $ =�-� ��'�=�= � � —
I hereby aoply for a buildin�permit and I acknowled�e that the information above is complete and
accurate; �hat the work will be in conformance with the ordinances and codes of the City and with
� the State Building Code; that I understand 's is not a pe 't and work is not to start without a
pers�'� ��nd that the work will be in acco an with th ap oved plan.
� z,
APPL:�.CANT'S SIGNA DATE: � I`�� IC-��
1�'OTE! P ra ade.Q Homes events require eparate permit approval by Police Depariment and
City Council 60 days prior to the eveni. Non permitted events will not be allowed.
� �
Sec.13.0 t RIGHTS OF SL'BJECTS OF D:�T�
Subd. 1_ Tvpe of da[a. The righcs oi icdividual on whom the dati is s:orcd or ro be swred shalI be as sec foczh ia chis secrion.
Subd.2. Information reqirired to be�rea indiridual. An individual asY:d w suFply privatc or confidendal dara conceraiag himself shali
be informed of: (a)[he purpose and intended use of the rzquesud daa withia eh:coliecang'sar.ageary,polidcal subdivision,or scicewide rystm:
�b)whe:her he cnay rfuse or is le3a[ly czquiced w sl:ppiy che requesud dan;(c)any Icown coa5..';ueace arisin3 from his supp(yi:.g or refusing m suppty
privace or conr.denaal dam;and(d)che idenrin of o�er persoas or enuaes au�horiz:d bY siac_or fcd�rai taw co receive[he da�a_ This requitemenc shall
not apply when an individual is�sked to sspply in�•tsBgadve dae, pursuan[co sec=oa 13.83,subdivision 5,[o a law enfocceWenc officer.
'Itte commissioner of ravenue r�av oli;: the nocce r�uirzd under this subdivision in the individual income ta�c or ocovem az cefur.d
inscrucaons ins;ead of on�hose forms.
Subd.3. ?�ccess to data br-individual. lipon requesc tn a responsibic au�horiry,aa individual shall be inforraed whe�her he i�the subjecc
of scoc�d data on individuals,and wheher it is ctassif:ed as public,pciva�e or con,-:�eaQa1• L:Fon his fur,her cequest,aa individual who is the subjecc
of stord pci�a�e or public daa on individuals shall be shown[he daca wichout any caarge tD h'�and;if he desires, shall 6e inioraed of the conmr.c
az:d meaning oi chat data. Af�er an individual his�een shown che pRvace dara ar.d iniormed oi ics meanin3,�he dara necd no�be disdosed to him for
six mon�s�hereacter unless a d'upute or acriort Fu:suanc w chis secdon is pending or addi¢oaal dara on�he individual has bee¢collec�ed or ereaced.
Tne responsibla auchoricy shall provide copies ot che private or public dac�upon reGu:sc by the itdividual subject of che daei. 'I"ae responsible au�horiry
may r:quir rhe requesring person ro pay the acnia!cosc�of making.cerafying.u:d compiling the copies.
?he responsible au[horiry shall comply in.m:cdiacely,if possible, wich�^.y r.quest�Cc pursuant co this subdivision,or within five dsys ot
the dace of�ho requesc,ezcludin3 Samrdays,Sundays and legal holidays,if immed��::complia.ece is noc possible. If he cannot comp(y with the requesc
wi[hin duc ame,ho shall so inform�he individuai,and may have an addiaoaal five days wichia which to comply wir�che request,ezcluding 3aturdays,
Sundays and 1e3s1 holidays.
Subd.4. Procedure when data is not accurate or complete. An ir.divi�ual may concest[he accuracy or compleceaess of pubiic or pri�•ate '
data cor.ceming himsetf. To exerise chis righc,an individual shall noafy in wriaag 1_Rsporsioie auchoriry describing che nant:e oi the disagreemaac. ..
The responsible auchoriry shall wichin�0 days eici:er: (a)correce[he data found ro Le inac�a��or incomplem and aaempt to nodfy past tecipienes of
inaccura:e or incomplece dan, inciuding recipieea named by [he individual:or(b)�ocify �2:e iLdividual[hac he believes[he dara to be correct Daca
in dispuce sh�li be disc'.osed only if rhe individual's stacemenc of disagreemenc is i^:luded wi_`�che disclosed dam.
"Ihe decerminadon of eha r�sponsible au�horiry may bc appealed purr.:�.-:co che p��isions of[ha administr3rive proce3ure act relaang ro
concesr.d cases.
D�T� PRIVACY :�D`'ISOR�'
In accordance wich 1�1.S. 13.04, Subd.2, "RiQ.hcs of subjeccs oi data", �.�e would like to inform you that your reauesc
for a permit or license from the Ciry of Orono or any of ics depz:men�s nay require you to fumis� certain private or
confiden�ial information.
You are notified thar. .
1, The information you furnish will be used to decermi�.�your qLalitica[ion for che permit or license requested.
?. You may refuse [o suppiv data, but refusal may reeuire that the Cicy deny the permit or license.
;, The informacion may be shared with ocher local, sca��or federal a�encies co the excenc necessary to process
the permit or license.
.�. If your requested permic or licease requires Council action to approve, some information may become
public.
j, You have cena"in riQhts under i�1.S. 13.04 (availabl� upon request) to review private data on yourself.
6, Your full name is required to process this applica�:oa or pe.u:it.
, � _-� _ L' p�� e��._� _�� r�-
Firsc l�tiddle Lasc
`'�\<;.C' �'�� ��= �\ :� L-i L��-.
' Add�ss `�\ `{`-` � }l� _,I �, c:� c.l . � �
`�1..�� "t'1 t�Lf—! �� �1 � - - z `; �
c�ry sn� z;p Phone
I underscaud ri; as sta�ed ao �! ,
� � / v � q
�� ! %
ignacure
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
j FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z 9 9 o SorM �r GAN�= �
PID:
DESCRIPTION OF WORK: ��p�
ZO.�TI�1i G $EVIEW BY: DATE APPROVED: --
BUII..DI�i tG REVIEW BY: DATE APPROVED; Z-Z�s-�3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/' No
PLAN REVIEW Yes �/' No SEWER CONNEC"ITON
STATE SURCHARGE Yes �/ No WATERCONNEC'TION
INVESTIGATION FEE � Yes No�� PARK FEE
SAC Yes No� STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CI�CK LIST Zoning District: _ivo c�-fi4�1r� .
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: We and:
Building Height: Def. Hgt. Pe •Hgt.
Lot Coverage:
Grading: Staff Approval Date: y: Council Approval Date:
Septic: Staff Approval Date: y:
Zoning File: # Resolution: # Resoludon Date:
Shoreland District:
Avg. Setback: Bluff Setbac : Lot Coverage: �
E�ciscing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
� �
BUII,DING REVIEW CI�CK LIST
�C' � � 3 CONSTRUCTION TYPE: V/'V '
! Sq Footage $Per Sq Ftg
Basement . x _
lst Floor x _
2nd Floor x _
Gazage x _
x =
TOTAL
Estimated Construction Value• $ ��.o����
Inspections Required: `Vork Requiring Separate Permits:
Site _�pl�b�g Fire
Hardcover Removal •� Mechanical Water Connecdon
•. —�g Septic Sewer Connection
_�Framing Fireplace Lawn Irri ation
_a�Insulation g
_�Wail Boazd ��0�'� Other
� F�� � ' (Mfg•) Well (State Permit) -
Grading/Filiing _�Electrical(State Permit)
Other
REMAR��.S(Pi 1 HOUSE): �
REVIEW BY OTHERS: DATE: - ___
Access: Existiag New .
Access Approval: Date By. �
REMA►RI�.S (TO BE NOTED ON PER1vII�; -' �'�-�'_`��_�___
8
✓
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED 7-17-03 02;D o
PERMIT NO. COMPLETED
ADDRESS �9�� �S
OWNER CONTR. �7Zy`�-d�� ���J
TELEPHONE N0.
�iz �ga s�9�S �
� 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMpWNT
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 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
�
a
j
0
a
�
0
�
W
�
Q
�
z
W
�
W
�
�
d
W� WORK SATISFACTORY:PROCEED PRWECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ SSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�/ERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL�NSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. (g52) 249-460�
Owner/Con te:
Inspector.
White Copyllnspector'a Ff e Canary CopylSite Notice