HomeMy WebLinkAbout2000-P02136 - addn/remodel/repair � ' �� PERMIT �
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po2i36
Crystal Bay, Minnesota 55323 P@t't111t Typ@: Addition/Remodel/Repair
(612) 249-4600 Date Issued: 3isioo
SITE ADDRESS: 2104 Sugarwood Dr
LONG LAKE, MN 55356
P i D: 34-118-23-21-0022
DESCRIPTION: UBC occupancy R3
Construction Type VN
Proposed Use:
Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Single Family
DETAILS:
Approved per resolution#:
Separate permits required: riumoing iviec;nanicai Giecuicai �siaiej
NOTICES/REMARKS:
RACFl�AF1�iT FINiCN/7T1F('1!C/2CFAC(1N PQR('1-T T(1 dCFAC
FEE SUMMARY: Permit Fee: $ 431.65 Valuation: $ 28,500.00
Plan Review Fee: $ 280.56
State Surcharge Fee: $ 14.25
TOTAL FEE: $ 726.46
APPLICANT: Rvc HOMEs OWNER: Rvc HOMEs Irrc
4700 CREEKWOOD TR 2104 SUGARWOOD DR
ORONO, MN 55359 LONG LAKE MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPEC�'IED
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 ISSUED BY SIGNATLJRE
Copies: City,Applicant,Assessor,Finance Page 1
a . .
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Total Fee: $ �7�t�. �(o Date Received: .�- � °'
. Entered By: ,��, Permit#: ��/ 3 ��
CITY OF ORONO - BiTII.DING PERNIIT 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 ONTRA
JOB SITE ADDRESS: 2 �C�L� �c�-zS�w�a� ��ZIP:
NAME OF OWNER• �<<--� v��G�-�� PHONE: (home)C9lZ-���--4'���
� (work) (�iz-� ��-i�l
MAILING ADDRESS: �7oc� clt��er..�e�,p 17C.CITY: �it��r- ZIP: s3'3s�
CONTRACTOR: �I��i �o/H-t.�S PHONE:_ Co�z- 3z�-/�lzZ
CONTACT PERSON: kev« (.L� MOBILE/PAGER:
MAILING ADDRESS: �-t o o c���� � CITY: a(�� ZIP: �--�--�-�
STATE LICENSE: # `7`�e—
ARCHITECT/ENGINEER: j1 � P (��z�.��-,. PHONE: (�S�(-�3 i�-���
MAILING ADDRESS: --� CITY: ZIP:
NAIVIE; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in cietai�: r✓i i � u2- L/-�-�
2 �.e�S a�cn+- t� Z
STORIES: � SQ.FEET OF EACH FLOOR: ��o �
NO. OF BEDROOMS: _� GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ Z$',, S��
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
pernut; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: � DATE: 3-c�r''�
NOTE! Parade of Homes events require separate permit approval by Police Deparlment 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 S[JBJECTS 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 forth in this secdon.
Subd.2. Iaformation reqirired to be given individual. An individual asked ro supply private or confidential data concerning himself
shall be informed of: (a)the purpose and intended use of the requested daCa within the collecting state agency,poliacal subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or
refusiug ro supply private or confidential data;and(d)the identiry of other persons or endties authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply invesdgative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The wmm�ssioner of revernie mav olace the noace reauired under this subdivision in the individual income taz or nronertv taz refund
insuvcdons instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidendal. 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 w him for six months thereafter unless a dispute or action pursuant to this section is pe�ing or additional data on the individual has been
collected or created. The responsible authoriry shall provide copies of the private or pubiic data upon request by the individuai subject of the data.
The responsible authority may require the requesting person to pay the actual cosu of maldng,certifying,and compiling the copies.
The rosponsible 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 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 w�erning himself. To exercise this right,an individual shall notify in wridng the responsible authoriry describing the tiamre of the
disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or i►icomplete and auempt to nodfy
past recipients of inaccucate or ic�omplete data,i�luding 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 authoriry may be appealed pursuant to the provisions of the administradve procedure act reladng
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�ity 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 shazed 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.
�c.'�,�— V c�''� c��-z�
Firs Middle I,ast
Address
City State Zip Phone
I understand my right stated above.
Signatu
6
' � CHECK OFF LIST FOR ISSUANCE OF PERI�IITS � ,
FOR OFFICE USE ONLY • .
ADDRESS OR LEGAL: Z� u�--1 g v f,�A 2 W u c�d.� d2
PID:
DESCRIPTION OF WORK: �3,/��w�„at� F�,��4 t�+ /2 r3.eu�s / 3 s�� �'�
` _____�_________�_ -- 't"�? -- –�c=�,�oti
ZOrZti G REV�E�Y BY: DATE APPROVED: �-��=nu
�. BL�Dl�TG REVIE r�BY: � � DATE APPROYED; �-�`.�o .
. . � :_________ .
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes v� No
pI,AN REVIEW Yes ,� No SEWER COYI�'ECTION _
STATE SURCHARGE Yes ✓ No WATERCONNECTION
INVESTIGATION FEE Yes No P��E
SAC Yes No SITEIN�PECITON
Number of SAC•Units OTHER(specify)
____------- - --- ---------
ZO�Z`�'G CHE.CS LIST Zoning Districr. �-I(�
Fire Department: ��T Post Office: l.onr 6 tM� School D:strict: (h•���v�
Lot Area: Sq.ft. N'n C/�h4w�,� Acres � Width -- Depth –'"
Survey Submitted: Yes � No Date of Survey: ,�,�;/3 9�
Proposed Setbacks: , � �
�
Front(L-akc): �� Right Side: � � - � .
Rear(S�aec): I 3 O Left Side: ')� � �
AdjacentStructures: ATnac.N-L'� Wetland: N/�
Building Hei�t: Def. Hgt. Nd C�rt�G Peak Hat. `—
Lot Coverage: �-1� '
Gradin�: Staff Approval Date: By: Council Appro�-�1 Date:
Sepdc: Staff Agproval Date: By:
Zoning File: # Resolution: #__ Resolution Date:
Shoreland District:
�,�'' Avg. Setback: Bluff Setback: i-O�CO���e� .
Existmo Progoscd
Hardcover: 0-75' .
75-250'
250.500' �
500-1000'
Hardcover Variance R�quired: Yes No Date of Council Approval:
REtii IARKS('in house): �
7
BUII.,DING REVIEti� CHECg LIST -
�C� �� 3 . � CONSTRUCTION TYPE: Y�
Sq Footaoe $Per Sq Ftg
� Bastment . . . x . . _
•. lst Floor � x _ . �
2nd Floor x _ .
Gara�e x _
x =
TOTAL
Estimated Co�truction Value: $_ ��,5-b-o �'=
Inspections Require�: tiYork Requiring Separate Permits:
Site � /� Plumbing Fire
�Hudcover Removal o� Nlechanical Water Connecdon
.. ��FOa�a Septic Sewer Connection �
�Framing . Fireplace Lawn Irri;adon
�_Insulation (M�o�,� Other
�Wall Board (Ivlgg,) Well(State Permit)
F�� Grading/Filling _ o�Electrical(State Permit)
Other
REI�IARKS(IN HOUSE): � �
REV�tiV BY OTHERS: DATE: --- ----
Access: Existing New -
Access Approval: Date gy; �
REI�IARbS (TO BE NOTED ON PERitiIT1�: _'�"~~" -NM
8
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION TICE SCHEDULED �'� ��-
PERMIT NO. b��J COMPLETED 3—Li:� ' �
ADDRESS ��a� ���t�� �r'
OWNER CONTR. i��I C--
TELEPHONE NO. �a-g` ���3
� DESCRIPTION � � f��G� �5211"14.��
ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMI 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
fNSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
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
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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W C7 CORRECT WORK&PROCEED 17 ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ` pHOTOTAKEN
INSPECTOR WILL RETURN
❑ STOPORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
OwnerlContra or on site:
Inspector.���� �C �Ci �5
White Copyllnspector's File Canary CopylSite Notice
D TE TIME
CITY OF ORONO CALLED IN �a 0�
INSPECTION NOTICE SCHEDULED 'v //�� � % �
PERMIT NO. ��c,� COMPLETED � — —'� Z • OL1
ADDRESS �
OWNER CONTR. �-
TELEPHONE NO. —3oZ �• /�f �-/
� D TION C:��
� 0 FOOTIN 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
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
T09 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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� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN � CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
l-1 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContra t r on site:
Inspector. �C�� �
White Copyllnspector's File Canary CopylSite Notice
HY- LAND SURVEYING , P .A.
LAND SURVEYOR5
��'���'��� Proposed Top of Block INVOICE N0. 18325-168 _
F.B. N0. 24I/29
iD ? '� L Proposed Garage Floor 8700 Jefferson Highway SCALE I"= 40�
Osseo, Minnesota 55369
����-�• � Proposed Lowest Floor 493-5761 O Denotes Iron Monument
Type of Building — �uruP�ars �Pl"ttftrtt�P � Denotes Wood Hub Set
` 1 � � For Excavation Only
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� ��� ` x000.0 Denotes Existing Elevation
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N � Denotes Proposed Elevation
���e�, � 4�� Z�o} Sc�, �p ,e,k- t— Denotes Surface Drainage
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LOT 3, BLOCK 4, SUGAR WOODS
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The only ea�emonts ehown are from plats of record of informatlon provided by cllent. �� � ;��
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I hereby certify that this survey was prepared by me or under � /i,�,
my diroct auperviaion, and that I am a duly Regfaterod Lond /.%�� ,1'r f� � , '•y�.�,,,:r�� �
Surveyor under the laws of the Stata of Minneaota. Signed � � '��� --="�= ���—
Surveyed by us this 13TH day of SEPTEMBER , 19 99 Milton E. Hyland, Minn�fj�g. No. 2026�
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NOTE: REINFORCING STEEL TO BE PLACED NO MORE THAN 4' FROM INSIDE (TENSION) FACE OF WALL.
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SEE ATTACu,9r--
FOR
CODE REWjjREpvjENTS
CITY OF MONO
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