HomeMy WebLinkAbout2002-P05056 - pool in ground - � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Posos6
Crystal Bay, Minnesota 55323 Permit Type: A��essory sr�u�r�reS
(952) 249-4600 Date Issued: s�i�2oo2
SITE ADDRESS: 480 Sussex La
I.ong I.ake,MN 55356
P I D: 04-117-23-31-0013
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Pernut Class: Building Census Code 329
Pernut Type: Accessory Structures Pernut Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate pernuts required: Eieciricai�staiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 321.25 valuation: $ 19,200.00
Plan Review Fee: $ 208.78
State Surcharge Fee: $ 9.60
TOTAL FEE: $ 539.63
APPLICANT: Peterson Pools&Spas Inc. OWNER: Mike Kerrison
13110 Excelsiar Blvd 480 Sussex La
Minnetonka,MN 55343 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 REQ �REMENTS.
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APP ICANT PERM E SIGNATU E ISSUED BY S[GNATURE
Copies: 1-File(Si�nitures Required), 1-Apnlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
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Total Fee: $ ��,; Date Received: C ����
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Entered By: �^ ,,� •� �,1��, Pernut#: - J ��;�
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CITY OF ORONO - BUI�,DII�G PERMIT APPLICATIOleT
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER OR O �
JOB SITE ADDRESS: ���C� �U�S� X �fir�� ZIP:
NAME OF OWNER: ll� �i;��sc=i� PHONE: (home) 7(: � � y> 3 �C�L �
(work)
MAILING ADDRESS: s -�� Z CITY: �_„��,,..,� ZIP:
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CONTRACTOR: �'�-��z 5e,�. Y"���s �- S< „ PHONE: `l'��Z -<< 3 :-3G i c
CONTACT PERSON: .1��r=�= /1�pF �� MOBILE/PAGER: � r � - z � c -3 5->s-
MAILING ADDRESS: i�3✓i c: f�� z�s«:;- �`.��CITY: �2/��.�� ZIP: �--��1
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
NIAII.I\i'G ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition � Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: ,;:;�;,-�,�� ��;,%_c .��.�� ���.�.��, ���, E
STORIES: � SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /9 � ��;
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: � -��` ' DATE: / 7 � Z-
NOTE! Parade of 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.
Sec.13.04 RIGHTS OF SCTBJECTS 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 ia this secaon.
Subd.2. Informadon reqirired to be given individual. An individual asked w supply private or confidential data conceming himself shall
be informed of: (a)the purpose and intended use of the recryested data wirhin the collecting state agency,politica!subdivision,or statewide sysum;
(b)whether he may refuse oY is legally required to suppty rhe cequested data;(c)any known consequence arising from his supplying or refusing to supply
privace or confidendal data:and(d)the idenriry of ocher persons or entides authorized by state or federal law to receive the data. This requiremeat shall
not apply when an individual is asked to supply investigadve data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the noace required under this subdivision in the individual income rax or oroperty taz refund
instructions instead of on[hose forms.
Subd.3. Aecess to data by individual. Upon requesc to a responsibie authority,an individual shall be informed whether he is the subject
of stored data on individuals,and wherher it is classified as public,private or confidendal. Upon his further roquest,an individual who is the subject
of storod private or public data on individuals shall be shown[he data without any charge to him and;if he desires,shall be informed of the content
and meaniag of that dara. After an individual has been shown the private data and informed of its meaning,the dara need not be disclosed to him for
six months thereafter uniess a dispute or acdon pursuanc to this secrion is pending or addiaonal 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 iadividual subject of the dara. The responsible authoriry
may require the requesring person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possibie,with aay request made pursuant to this subdivision,or within five days of
the date of the requesc,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 addiaonal 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 pubiic or private
dara concerning himseif. To exercise this right,an individual shall noafy in writing the rosponsible authoriry describing the nature of the disagreement.
The responsible su[horiry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, including cecipients named by the individual;or @)nodfy the individual tha[he believes the data to be correct: Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with tt►e disclosed data.
The decerminadon of the responsible authority may be appealed pursuant to the provisions of the administradve 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 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 Ciry 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.
First Middle Last
Address .
Ciry State Zip Phone.
I understand my rights as stated above.
Signaturo
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �0 �S�ssccX c,r4,v�
PID:
DESCRIPTION OF WORK: oo /
ZOtiTvi G REV�W BY: DATE APPROVED: �!-ZK-o z
BUILDING REVIEW BY: — DATE APPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAi�t REVIEW Yes _� No SEWER CONNECTION
STATE SURCHARGE Yes v No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC�Units OTHER (specify)
ZOIVI�`G CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes�_ No Date of Survey: lo•L� • O�
Proposed Setbacks:
Front(Laicc�: (6�� � Right Side: SO� t
Rear (St�aet): 250' t Left Side: L6v � =
Adjacent Structures: 3c�' Wetiand: ��� '+'
Building Height: Def. Hgt. — Peal:Hgt. �
Lot Coverage: �
Grading: Staff Approval Date: " By: Council Approval Date:
Septic: Staff Approval Date: '� By:
Zoning File: # � Resolution: # Resolution Date:
Shoreland District: �U
Avg. Setback: Bluff Setback: LotCoverage:
Eusting Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
_ . . • .
Bi.TII.DING REVIEW CHECK LIST
�C� � CONSTRUCTION TYPE: '—'
' Sq Footage $Per Sq Ftg
Basement . . x =
lst Floor x =
2nd Floor x =
Garage x = �
x =
TOTAL
Estimated Construction Value: $ J 9_u,a�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
_. _�.F���g � Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
_,�F�� Grading/Filling �_Electrical(State Permit)
Other
REMARI�.S(IN HOUSE): .
REV�W BY OTHERS• DATE: ----------------� ---
Access: Ezisting New
Access Approval: Date By;
REMARI�.S (TO BE NOTED ON PERNIIT�: N ~N
8 .
V DATE TIME
CITY OF ORONO CALIED IN
INSPECTION TIC�F SCHEDULED S —
PERMIT NO. � OS COMPLETED �l � `'vy .� ^ O
ADDRESS
OWNER ���l,Q��i1 � CONTR. -�?�Q,C.a.B,•� �`�'o-p.�
TELEPHONE NO. l� � �. v2-O� �rP�pF�'
� 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 OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
w ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR W4LL RETURN ❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REOUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContr c r on site:
Inspector.��"! �
White Copyllnspector's File Canary Copy/Site Notice
Este�bli$hed in 1982 57148 �
L��' ��1 ��l(� �� �A �', IN�. �B��oE No, 8�3-12 .
LAND SURV]�YORS SCALE: 1 " = 60� �
REGIST�RLD UNDER TFiE LAWS OI� STATE OI' MINNESOTA o Denotee ►ron Monument
7t301 73rd Avenue North 812-6�0-3093 O penotea Wood F1ub Set
Fax No. 680-3622 for excavat(on only
2�lnneepolle, Nlnneeote 66428 x000.0 ponotoe Exlstln9 Elovat(on
����I'��,�I'�',� �p�,'����,�'��� 000.o Denotee Propoeed Elevat(on
-�--_— Denotee Surtace Oralnage
T"�e'r-.n.►� T1�NY EIDEN COMPANY
�f, ���"`� 1�"'�a NOTE: Proposed gradea are nubject
�'�5c� 0 9�.2
to reeulta of soll teata.
lrr,crl ' � p ' Propoeed bullding (nformatlon
i u� �; Property located in Section must be checked with approved
�.� ��; - ' 4, Township 117, Range 23, building plan and dovolopment or
� N �' , �9•a groding plrn befora axcavatlon
,;: 7� � Hennepin County, Minneso�a
` `� � and conatructlan.
N�� �"4� ( 'P�g�¢ q�3_Z Propoeed Top of Block:
hl �
o� �� /�g..� ��2•1 Propoeed Gara9e Floor
r/`- �� q �.S
�' �' 9�2 S �$r�,C'� �Propoaed Loweat Floor
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,� �.6 �/U 6+ _ �� Type of Bullding
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BY
L,ot 2, 131ock 3, Fox B� . DATE �t�z.`���Z, .
, �s_ ,
��x � �Q�` , p Z.onc� -
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3 �t,��,vC_ Qc7X�'.� COr,nec�C�c� 'D� �.01� � IQ�
I !I
� � �� p�;h.P�f `i�PS C�a C
7he only easemente ahown arn froni plols of record or Informalion
� �Cl�p1��t, ��o�
provided by cllent. �
d �'n�•�r_S -S
We hereby <;ertify that this is a true und correct represenlat(on of
a survey oi the boundor(es of tho obove dascribed land ond tlie `�.__,
localion of ail builclings and viell>I� encroactunents, if nny, (rom or on Slgne
soid lond.
29th Choriee F, Anderaon, Mlnn. Reg. No.21753 or
Surveyod by us 11�is day of J�e 2Q0'D Gregory R. Praech, Allnn Reg No. 24992