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Home My WebLink About2002-P05240 - doors i � PERMIT CrITY�OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P05240 Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: 6i3�2oo2 SITE ADDRESS: 3115 SusseX Rd Long Lake,MN 55356 P I D: 04-117-23-32-0015 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Census Code O/S-Building ,j�.`� �ermit Class: Building �t- �ernut Type: Minor Alterations Permit Sub-type(s): Building efined CiETAILS: pproved per resolution#: $parate pernuts required: I NOTICES/REMARKS: �t_____ �_..___ r�__._n'_' .�..w.:b:. ..».»b:..�..w J.�.G " ' " '"' ' '..... .. FHE SUMMARY: Permit Fee: $ 69.25 Valuation: $ 2,000.00 State Surcharge Fee: $ 1.50 � TOTAL FEE: $ 70.75 A LICANT: A&T Development OWNER: Daniel Delmore&M Raskob 2755 Deer Run Tr E 3115 Sussex Rd Long Lake,MN 55356 Long Lake MN 55356 E UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED ND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF INNESOTA BUILDING CODE REQUIREMENTS. ' , �_, �. ,� ��;��__ �,f��'_ � LICA ERMI E SIGNATUR ISSUEDBYSIGNATURE nies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 i � .. � �� Total Fee: $ ��-' � �� G��, ) Date Received: �- -�� Ente�ed By: �2�. `�-� Perm.it#: US�� CITY OF ORONO - BUII,DING 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 O CONTRACTOR� Q�, � JOB SITE ADDRESS: �l � � ��' S S�� ZIp: �� S ��, --t,'�' � d L �, NAME OF OWNER: ��S\c,�� 1 �r � �� '� PHONE: (home) `�� " �� ' '' (work) � �, ' MAILING ADDRESS: �-�--�_ CITY: ZIP: � a � CONTRACTOR: � l ��..r� �o .^��} PHONE: V �� - �'` � � ti I COi�1'TACT PERSON: w � ltt v � MOBILE/PAGER: �u-'� � ' MAILING ADDRESS: �.-�SS De zr 2�� '1 r f=- CITY: C�(' ��.� ZIP: � STATE LICENSE: # � �5 � H' ARCHITECT/ENGINEER: � � � PHOiVE: `—� 1vIAILING ADDRESS: CITY: ZIP: `� J NAl�IE: REGISTRATION# -- 1 ' TYPE OF WORK: New Additi Accessory Structure � Move Remodel/ teratio Land Alteration �f -+- PROPOSED WORK describe in detain: ��-• � �� 5� ze - �. . � �- t C� ca�,- �y 3� t� �v � ,k.�� ` �-�� (�> "�l � �� ,^,�^' STORIES: SQ. FEET OF EACH FLOOR: � S NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. � ,L ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ � , �r' f' -� -cf I �� J � � � 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 ttus is not a permit and work is not to start without a permit; and that the work will be in acco c w' the approved plan. � , D � l � APPLICAI�'T'S SIGNATURE: DATE: � a-� � '— � � J � NOTE! Parade o�Homes events require separate permit app va�h�Police Department and City Counci160 days prior to the event. Non permitted events will not be allowed. � � . . , Sec.13.04 RIGHTS OF SUBJECTS OF D�T�1 Subd. 1. Type of data. The righ�s of individual on whom che data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial data concerning himself shail be informed of: (a)the purpose and incended use of the requesced data within the collecang'state agency,polidcal subdivision,or sratewide rystem; (b)whether he may refuse oY is legally required co supply the requesced data;(c)any Irnown consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idenriry of other persons or enades authorized by sta[e or fedecal law to receive the data. This requirement shall not apply when an individual is asked to supply investizadve data,pursuan[to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav place the nodce reouired under this subdivision in the individual income tax or oropertv tax refund instructions insczad of on those forms. Subd.3. Access to data by individuai. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whecher it is ctassified as Qublic,private or confidendal. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown[he data without any charge to hun and, if he desires, shall be informed of the content and meaning of chat data. Ahzr an individual has been shown che priva[e data and informed of its meaning,the dara need not be disclosed to him for six mon[hs thereafter unless a dispute or acaon punuant to this secdon is p�nding 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 individual subject of the dara. The responsible authoriry may require the requesring person to pay the actual coscs of makine, certifying, and compiling the copies. The responsible authoriry shail comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the date of the request,excluding Sacurdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compty with the request wirhin[hat time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,exc?uding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. M individual may contest the accuracy or completeness of public or pri��ate data concerning himself. To exercise this righc,an individual shall noafy in wriang the responsible authoriry describing[he nature of the disagreemeat. The responsible auchoriry shall within 30 days eicher: (a)correct the data found to be inaccurate or incomplete and attempt to norify past recipienu of inaccunte or incompiete data, including recipiencs named by [he individual;,or(b)nodfy the individual that he believes the data to be correcc. Data in dispuce shall be disclosed only if the individual's statemenc of disagreement is included with the disclosed data. The de[erminarion of the responsible authoriry may be appealed pursuant to the provisions of the adaunistrative procedure act rela[ing 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 City deny the permit or license. 3, The information may be shared with other local, state or federal a;encies 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. j. You have certain rights under NS.S. 13.04 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or perm.it. First �tiddle Last Address City State Zip Phone I understand y ri t st e ove. Signature t ' CI3ECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY I' ADDRESS OR LEGAL: 3��S 5 v ss�.x [�� , � PID: DESCRIPTION OF WORK: G Ft�►�6� G R�� R s �-z_.,P ' ZO.�i 1G REVIEW BY: N(/� DATE APPROVED: I BUILDI�i tG REV�`V BY: _r,�� DATE APPROVED: � 3�-u z ---_____--___________ ------- ----------------------------------------y-------------- �' FEES TO BE CHARGED: Misc. Fees Calculated B PERNIIT Yes � No PLAi�T REVIEW Yes No v SEWER CONNECTION STATE SURCHARGE Yes �/" No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE ' SAC Yes No SITEINSPECT'ION Number of SAC�Units OTHER (specify) ZO�TING CH�CK LIST Zoning District: ,7iv C l-r��r� 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 Sid . �I Rear (Street): Left Side: i i Adjacent Structures: etland: i ' I Building Height: Def. Hgt. eal:Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: i I Shoreland District: Avg. Setback: Bluff Setba k: L.ot Coverage: Existino Proposed I Hardcover: 0-75' ' 75-250' � � 250-500' � 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: ' REMARKS (in house): ��t N 5 • C�v�`-P N /(�.v. � i SS C= I ; � 7 �� BUILDING REVIEW CHECK LIST �C� � ' � CONSTRUCTTON TYPE: �!'� Sq Footage $ Per Sq Ftg Basement x = lst Floor z = 2nd Floor z = Garage x = R = TOTAL Estimated Construction Value: $_ ZoC�t�i9` Inspections Required: `Vork Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing ' Septic Sewer Connection Framing Fireplace Lawn Inigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) _�Final Grading/Filling Elecuical (State Permit) Other REMARI�S(IN HOUSE): REV�W BY OTHERS: DATE: Access: Existing New Access Approval: Date gy: REMARKS (TO BE NOT`ED ON PERMII�: 8 �� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOT4CE ��y� SCHEDULED � U•' PERMIT NO. t (> COMPLETED �U�' Z ADDRESS �I I c-� � �,�`' r'Q-''`� �-c�' OWNER CONTR.� � T ��''��Cr TELEPHONE N0. �'/� �'— � �� — ��'J 3 � DESCRIPTION `I � ��-�° — �� 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/FIREPLAGE 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 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL / 36 FOUNDATION/REMOVAL � OWNER/CONTRACTORTOMEETYOU:�YES_NO � CO ENTS: a � �J � ot_ S S l.,�r�( . �-- � � 0 � W � Q � 2 W � W � � d W� ORK SATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlConUa t on site: Inspector. � d While Copylinspector's File Canary CopylSite Notice