HomeMy WebLinkAbout2007-P11303 - deck � � ' PERMIT
CITY OF ORONO
2750 Kc�liey PaPkway- PO Box 66 Permit Number: p11303
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952)249-4600 Date Issued:
8/27/2007
SITE ADDRESS: 430 Stubbs Bay Rd N Unit#
Long Lake,MN 55356
PID: 32-118-23-13-0005
DESCRIPTION: UBC Occupancy R3
Construcrion Type VN
Proposed Use: Residenrial
Census Code 434
Permit Class: Building
Permit T e: Accessory Structures Permit Sub-type(s): Deck-Attached
YP
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Deck-akeady built,we did footing
FEE SUMMARY: Permit Fee: $ 111.25 valuation: $ 4,200.00
Plan Review Fee: $ 72.31
State Surcharge Fee: $ 2.10
TOTAL FEE: $ 185.66
APPLICANT: Owner/Self OWNER: C�xstom Structures LTD
MN P.O.Box 633
Wayzata,MN 55391
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.
✓ l� �
APPLICANT PERMITEE SIGNATURE � SSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
�f s,
7 � � . ^
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Total Fee: � �S��� Date Received: ", �
Entered By: Permit#• /� I
CITY OF ORONO - BUILDING PERMIT APPLICATION
Al!information must be submitted in full before plan review will be started.
(please pri�it all i►zfornuttion)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
' � `�%���G'�.`� /�f��� ZIP• �aJ'��=%l_�
JOB SITE ADDRESS: '-��(_ ' >�`
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ YCS ❑1�10 If yes,a special event permit is required with Police Deparhnent and City Cotatcil approva! —
60 davs prior to the event. Shuttle bus service will be required unless applicant demonstrates
su�cient on-site parking is available. Non-permitted events will not be allowed.
NAME OF OWNER• PHONE: (home)
(worl:)
MAILING ADDRESS• CITY: ZIP:
CONTRACTOR ��U�i�IrYl ��i�UC���"`'� L��� PHONE: �`�Z--��1��- `jC7�10
CONTACT PERSON: � Al�l� l�-iL�Z`'c. MOBILE/PAGER �(12-Z-`��-(t��44
MAILING ADDRESS:(rr,r�Tl.U�I� K`�C�7R � Z+�- CITY: ��1���� ��� ZIP: _`�`�Z-�`i i
STATE LICENSE: # Zc=-`=�C='�7r�}`'; EXPIItATION DATE: `= I �'�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGIST'RATION: #
TYPE OF WORK: New Home Addition Accessorv Structure
Move Home Remodel/Alteration{i.e.: Siding,Windows)
D�.C��. ��4 �� ��� �"..
PROPOSED WORK(describe in detain: ��
STORIES: SQ.FEET OF EACH FLOOR:
NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_
ESTIMATED CONSTRUCTION VALUATION(excluding land): S �C%��1..//�
�
I l�ereby apply for a building permit and 1 acknowledge that the infonnation 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 undcrstand 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. � 0
_____._�-�'e , ��; ;� �
APPLICANT'S SIGNATURE: /��'`----�� � DATE: � �
31
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Sec.13.04 RIGHTS OF SUBJECTS ON DATA
Subd.1. Type of data. The nghts of individual on whom the data is stored or to be stored shall be as set forlh in this section.
Subd.2.Information required to be given individual. An individual asked W supply private or coniiden[ial data concerning himself shall be
infornied of: (a)the pucpose and intended use of lhe requested data within the collecting state agency,political suUdivision,or statewide svstem;(b)
whether he may refuse or is legally requued to supply the requesled dafa;(c)any known consequence arising from his supplVing 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 enfonement officer.
T'he commissioner of revenue mav vlace the notice required under[his subdivision in the individual ineome tax or procertv tax refund
instructions instead of on those forms.
Subd.�. Access to data by individuaL Upon request to a responsible authority,an individual shall he informed whether he is the subject of
stored data on individuals,and whether it is classified as public,private or conf idenliaL Upon his futther request,an individual who is the subject of
stored private or public data on individuals shall be shown the data without any charge[o him and.if he desues,shall be informed of the content and
meaning of that data. After an individual has been shown the private da[a and informed of its meaning,the data need not be disclosed to him for six
months thereafler unless a dispute or aclion pursuant to this section is pending or additional data on the individual has been coIIected 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,cer[ifying,and compiling the copies.
The responsible authority shall camply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,exduding Saturdays,Sundays and]egal holidays,if immediate compliance is not possible.If he cannot compi��with the request
within that time,he shall so infortn[he individual,and may have an addiGonal five days within which to comply wilh the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4.Procedure when data is not aa:urate ot eomplete. An individual may contest the aa;uracy or completeness of public or private data
concerning himsel£ To exercise this right,an individual shall notify in writing the responsible authority descnbing the nature of the disagreement.The
respon�ible authority shall within 30 days either: (a)co�rect the data found to be inaccurate or incomplete and at[empt to notify past recipients of
inaccurate or incomplete data,incluciing recipiertts named by the individual;or(b)notify the individual that he believes the data to be conect. Data in
dispute shall be disclosed only if the individual's statement of disagreeinent is mcluded wiUx the disclosed data.
The detennination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relatine 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 lhat your request
for a permit or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential information.
You are notiYied that:
1. The information you fumish 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 mav be shared with other local, state or federal agencies to the ea�tent necessary to
process the permit or license.
4. If youur requested permit or license requires Council action to approve,some information may become
public.
�. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Your full name is requireci to process this application or permit.
First Middle Last
Address
City State Zip Phone
I understand my rj�hts as state above. ���nn {�
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Si gn atu re
Reset Form 32
, � CHECK OFF LIST FOR ISSUANCE OFPERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �l'�n sTv!�/�,��/�q�
PID:
DESCRIPTIONOF WORK: �G�c.
ZONING REVIEW BY.• e DATEAPPROVED: �—�(��G
BUILDING REVIEW BY.• DATEAPPROVED: �-�� - 07
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 �/ SITEINSPECTION
Number of SAC Units OTHER (spec�)
ZONING CHECK LIST Zoning District: '
Fire Department: Post�ce: School District:
LotArea: Sq.ft. Acres�' 2'3� Width Depth
Survey Submitted: Yes � No Date of Survey: U � {It ��y� t 8
Proposed Setbacks: u� �
Front(Lake): /�� n.�ag�it Side: /?�C}
r �„{}1
Rear(�): d L�'t Side: �
p�� r /�� /
Adjacent Structures: �(� Wetland: V�
Building Height: Def. Hgt. h/C} Peak Hgt.
Lot Coverage: /']�
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Sta,fJ'Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District: n,� MCWD Permit:
Avg. Setback: B1uffSetback: LotCaverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover f�ariance Required: Yes No Date of Council Approval:
REMARKS(in house):
33
B UILDING REVIEW CHECK LIST
UBC: �'3 CONSTRUCTION TYPE: V N
Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
z =
TOTAL
Estimated Construction Value: $ `l�Z�d
�
Inspections Required: Work Requiring Separate Per»rits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
JC Final ` Grading/Filling Electrical(State Permit)
Other
REMARKS(INHOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
34
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: City of Orono
Planning&Zoning Plan Review
Site Plan Review Date:� �`f � 7
lt�'�PPROWEQ �C12c�.(L) •
� that this survey, plan or report was prepared by �APPROVED WITH REVISlONS(see notes)
�y direct supervisian and that I arn a duly Registered ❑DENIED
under #he I s of the State of Minnesota.
� Stafl: �/"�
�� �
August 3Q, 20Q5 �
MN License No. 239FB pote
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