HomeMy WebLinkAbout2007-P10867 - pool outdoors in ground PERMIT
CIT OF ORONO
2750 elley Parkway- PO Box 66 Permit Number: p10867
Cryst I Bay, Minnesota 55323 Permit Type: Accessory Structures
(952) 49-4600 Date Issued:
5/2/2007
SITE A DRESS: 3160 Sussex Rd Unit#
Long Lake,MN 55356
PID: 04-117-23-32-0008
DESC IPTION:
Proposed Use: Residential
Census Code 329
Permit C ass: Building
Permit T e: Accessory Structures Permit Sub-type(s): Pool-Outdoors-In Ground
DETAI S:
Approv per resolution#:
Separate permits required:
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NOTI ES/REMARKS:
FEE S MMARY: Pernut Fee: $ 542.75 valuation: $ 40,000.00
Plan Review Fee: $ 352.79
State Surcharge Fee: $ 20.00
TOTAL FEE: $ 915.54
APPL CANT: Dolphin Pool&Spa OWNER: Richard&Patricia Chenitz
3405 Highway169 North 3160 Sussex Rd
Plymouth,MN 55441 Long Lake,MN 55356
TH UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
A AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MI NESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERM E S NATURE ISSUED BY SIGNATURE
Co ies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
Total Fee: $ �'l�5.S� Date Received: �` ��7
Entered By: _ q,S Permit#: /�/D�j(o7
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(p[ease pf•int all informatio�z)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle aze) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 3��� S�ssc� /�� ZIp: SS�S�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �No /f yes, a special event per•n�it is r•eqi�ired wit/z Police Depai•tment and Ciry Council appr•ovc�l �
60 days prior to the everlt. Shuttle bus service tivil!be reqarired z�nless applicanl deaionstrates
suffrcient on-srte parkrng is crvailable. Non�errniued events wi/1 not 6e allotived.
NAME OF OWNER: ����'� C/Jri��7—Z PHONE: (home)95-2- 97 5�"Sj�S
3/(0 ,SJ/SS/`� no/�/� O/I9i✓� �work)
MAILING ADDRESS: CITY: ZIP: S�S�
CONTRACTOR: ������'� '��'�s PHONE: ��3 .S'�-Z-9��
CONTACT PERSON: �^1 MOBILE/PAGER: 7G3�.30� - 00.2
MAILINGADDRESS: 3��5 w �G`I /J� CITY: /ll�'�^•�t�l ZIP: SSS��I
STATE LICENSE: # o?o.Z �S�S.z EXPIRATION DATE: 3�j/ -08
ARCHITECT/ENGINEER: PHONE: .
MAILING ADDRESS: / CITY: ZIP:
NAME: REGISTRATION: #
TYPL OF V`✓ORK: New Home Addition Accessory Structure
Move Home RemodeVAlteration (ie: Siding, Windows)
Any earth movement may require MCWD review and permits !
PROPOSED WORK(descrihe ir:detnin: -��✓C���O ..Zo ' x S�7�, S�"�MM rt�A.�
�0 � .S9 F�
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS:. GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): � `7��,��� • Qo
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the�vork�vill be in conformance«�itL the ordinances and codes of the City and���ith 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: � ' --2 �7
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATr�
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[his section.
Subd.2. Information required to be given individual. An individual asked to supply private orcontidential data concerning himselfshall be
infonned of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide systetn;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identicy of other persons or entities authorized by state or federal law to receive the data. TIZis requirement shal I
noc apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision�,to a la�v enforcement officer.
The commissioner of revenue maJ�olace the notice required imder this subdivision in the individual income tax or propertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon req�estto a responsible authority,an individual shall be informed whether he is the subject of
stored data on individuals,and�vhether it is classitied as public,private or confidential. Upon his fuRher 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 ofthe content and
meanin�of[hat data. After an individual has been sho���n the private data and informed of its meaning,the data need not be disclosed to him for six
months thereatter unless a dispute or action pursuant to this seccion is pending or additional data on d1e individual has been collected 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,certifying,and compil ing the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or wi[hin tive days of
the date ofthe 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 additioiial tive days within which to comply with the request,excluding Saturdays,
Sundays and legal I�olidays.
Subd.4. Procedure wfien data is not accura[e or complete. An individual may contest the accuracy or completeness of public or private data
conceming Ilimself. To exercise this right,an individual sllail notity in writing the responsible authoriry describing the nature of the disaereement. The
responsible authority shall�vithin 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notity past recipients of
inaccurate or incomplete data,including recipients named by die 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 wilh the disclosed data.
The detennination ot the responsible authonty may be appealed pursuant to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. l 3.04,Subd.2,"Rights of subjects of data",we would like to inforni 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 pern�it or license.
4. If your requested permit or license requires Council action to approve,some information may becoine
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.
�On/ .✓J/JL�/J �1U.�.r��✓✓1I_�.'te
First i�liddle Last
� �oS /✓�� /G 9 .y�
.address
�l_���77� .^-,� SS�S�i 7�3 -5�`-1�9��
Cih� State Zip Phonc
I understand my rights as ated above.
Siena urc
Reset Form �?
1/ ..,
, C�iEC� OFF i.,IS'Z' FOR TSSUANCE OF �E�'VIITS _�:. .., _., �',.�) - �"�;!P-��i;�'
FOR OFFICE USE ONLY '
AD RESS OR LEGAL: �j C�'��r��� ; _. . �
P
]DE CRIPrIrlON OF WORK: /IGw ��
---------------------
-----------------------------
-- --- ------------- � AA'TE APPROVED: " U�
ZO G REVLE`V BY: ,o,� .
$ DIt�IG REVTEtiV BY: DATE APPROVED: 3
----_--------- ------ ---------------------------=--------------------�---------
� S TO BE CHAk�GED: Misc. Fees Calculated By:
p T Yes No
P AN REVIE`V Yes No SEtiVER CONNECTION
S ATE SURCHARGE Yes �/ No �VAT'ERCONNECTION
I STIGATION FEE Yes No ✓� PARK FEE
S C Yes No --� STI'EINSPECTION
umber of SAC�Units OTHER (sgecify)
------------------------------------------------------
Z NIi�1'G CHE.CK. LIST Zoni.ng Districr. �� '� �.
F e Departmenc: Post.Office: School District: �
t Area: Sq.ft. Acres Widch Depth
rvey Submitted: Yes No Date of Survey:
roposed 5etbacks': ��' '
Front F�e): ri/� R�sCSide: d
Rear (�eat}: ' V "Left Side: ��
/
Adjacent Structures; � � bVetland:
auilclin� Hei�hr. Def. Hgt. Pealt Hgt.
Lot Coverage: �'1/�
Gradino: Staff Approval Date: By: Council Approval Date: '
Septic: Staff Approval Da[e: �- J�-fl� �Y���
Zoain� File: n Resolution: n Resolution Date:
Shoreland District: /��/
Av�. Setback: Bluff Setback: L.ot Coverage:
E�istino Propased
Ha.rdcover: 0-75'
7�-250'
2�0-56a'
�00-1000'
ndi�co'�2i �y'3"ic�:c� .n.�.^iL'ii��: v�s �!0 Dd�� o` Cc'�.LIl='� ���rOva�:
F.EtiL�R�.S (in hou5e): Ov �. � � r�'
� � � , r � r„�
Cv,�-5 .e,�- a� s r �•�-J�h S a o 7
. ,
BUILDING REVIEW CHECK LIST
�C- '—" � CONSTRUCTION TYPE: '"
Sq Footage $ Per Sq Ftg
� Basemen[ • . .. x = .
Ist Floor � x � _ . . . . ,
2nd Floor x = � � .
Garage z _ .
z =
TOTAL
Estimated Coastruction'4�alue; $ �{b,Ol�p °a
Inspections Required: `York Requiring Separate Permits:
5ite Piumbing Fire
• Hardcover Removal r/I�Iechanical Water Connection
. �_FOOC�g � Septic Sewer Coaaection ��
Fr�° • Firepiace Lawn Irrigation
Insuiation (Masonry) Other
Wall Boazd (Mpg,) Wetl (State Perm.it)
—�F�� Grading/Filling �Eleccrical (State Permit)
Other
REMARKS (lN HOUSE): �
- ---------------------------------------------------------------
REVIE�V BY OTI�iERS: DATE:
Access: Ezisting New •
Access Approval: Date gy; �
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RE1�zARKS (TQ BE N4TED 4N PERiI�II'I'):
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-������ ��, ���� MEMBER
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— DOLP�ll1V POOL � SPA � o
� 3405 Highway 169 North, Piymouth, MN 55441 S AT P OL
=' office (763) 542-9000, fax (763) 542-9001 INSTITUTE
Minnesota Contractors License#BC-20266452
CUSTOMER �`����� � ��� ������ DATE � �� � ��
ADDRESS �-�a uS.S�` r��/�i�
CITY ���^'° STATE �• ZIP
PHONE#HOME -2`9�`�-" _3�'��E s-?-S` ��.���i'S�--�7�- 7`M9 /2/'-�1
SALESMAN �~�� SUBMITfED BY �o� ,
�_�� _
��' 11� POOL DATA
POOL SIZE �`�� '� �� POOL SHAPE ��U�'��� 4��
STEP TYPE � /� �r� LOCATION __
CAPACITY �G ��� GALS. TURNOVER RATE HRS
PERIMETER %��� LIN. FT. RATE OF FLOW �, GPM
SURFACE AREA X�'!'O SQ. FT. MANIFOLD�SIZE .� li��LC /%''
CONSTRUCTION EQUIPMEN
PANELS _L�_.�-,,�,n� 51"�/i'(
LINER
COPING ,��� ,�.,;-�,,�� - �/1,>� -�, 1'NC�� � .�_ C � DI�N P�.AN
BOTTOM MATERIAL ��'� ��ns� �� 'F a
DECK BRACES '�^'�� ' ���� '"` �
ADDITIONAL EXCAVATION '
FILTERATION EQUIPMENT �Y � �.j.
PUMP ! /��r'.'��i��/-�rr� S�,,c��fr, l%�„-.}'-J
FILTER - -�5� ,��1't""'`o S�M�
HEATER 3��� �o� /,!7-(/ ��/ii°/��
SKIMMERS %w�'
INLETS Ti.t'✓�� �
MAIN DRAIN ;>-✓� -�'�rl /���r�C
SAN ITATI O�I �'���J c�^i: v G„i�2C� /L�r-��-�' �O 1�iv�i �:�,-�»n (S/��T
DECK EQUIPMENT
DIVING BOARD �Ol/� _S.�. 5,��-t',� S/�r�r�
SLIDE -------—
LADDER L� �,r✓�lc_ r.✓ �;�,�Q /-li�iC �
HANDRAIL ��"t
ANCHOR CUPS& ESCUT
UNDERWATER LIGHT �� �'r' `�����C ���` r) ��l�'t':'�
OTHER
MAINTENANCE EQUIPMENT
AUTO CLEANER m����-'''�` �-`, a-?�'<J T"
SOLAR COVER ------- -
SOLAR REEL __-------- .
WINTER COVER /)/`.c'�`o� S.�ti�`" �`'�`�
AUTOMATIC COVER �o�-�;'/t ���X �i�;-r. �r,,��.�_ LID TYPE �<<'s,� .�-���'r�� - /.J��•-�i,�l�r-� C,^�'�j
CHEMICAL KIT -<�-- � wf S��T�
MAINTENANCE KIT inc.lud .s�wat .r t.st kit-th .rrnom .t .r-vac, ,m h .ad-va .> >m hote-t .I .s .npic�I .
OTHER
ELECTRICAL �'�L' ��`�� ''�S GAS LINE �� �`�'`�'-'
FENCING �� �s RETAINING WALL WORK - - - --
DECK WORK ,�'O� S� r-'� _�>'�'"��,r�;, ����f`T% �Xr•�� , ,/�. � S��`�-
ACCEPTED BY �Ss�*/� �' DAT� a' ` �5` -��
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CITY OF ORONO CALLED IN O� /��
INSPECTION NOTI�I�p/_�7 SCHEDULED �
PERMIT N0. f"� oC� � COMPLETED
ADDRESS �` ll/ � � ��
OWNER CONTR. �
TELEPHONE NO. c� "l" —
� DESCRIPTION , �- �d�
lL 01 FOOTING 11 MECHANICAL RI 18 E CAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
H
Q 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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING Rt 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W{LL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Ca11 for the n xt inspection 24 hours in advance. (952� 249-4600
OwnerlContract ite:
Inspector.
White Copyllnspector's F le Canary Copy/Site Notice
� �Q,� ATE TIME �
CITY OF ORONO �'�/ - ' `CALLED IN g �/D'7
INSPECTION N TICE SCHEDULED Z l r7_�11
PERMIT NO. ����_ COMPLETED
ADDRESS ��� Q � ��-� �
OWNER CONTR. ��1.Q/�iY1 /�
TELEPHONE NO. � �3— �O '�C� C�`�_
� DESCRIPTION p�� t�/ l�c� �
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 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 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTAIL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU�ES�NO
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� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the xt inspection 24 hours in advance. (J52� 249-4600
OwnerlContr�tey site:
inspector.
White Copyllnspector' File Canary CopylSite Notice