HomeMy WebLinkAbout2007-P10735 - addn/remodel/repair . PERMIT
CITY F ORONO
2750 Kelle Parkway- PO Box 66 Permit Number: p10735
Crystal Ba Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249- 600 Date Issued:
2/5/2007
SITE ADDR SS: 3190 Sussex Rd Unit#
Long Lake,MN 55356
P��: 04-1 7-23-32-0007
DESCRIPTI N: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per r olution#:
Separate permit required: Electrical(state)
NOTICES/R MARKS:
Add an ov rhang at the front stoop of home
FEE SUMMA Y: PermitFee: $ 391.25 valuation: $ 24,750.00
Plan Review Fee: $ 254.31
State Surcharge Fee: $ 12.40
TOTAL FEE: $ 657.96
APPLICANT M.A.Peterson OWNER: John&Mary Kenney
6161 Woodale Avenue , 3190 Sussex Rd
Edina,MN 55424 Long Lake MN 55356
THE UNDE SIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGRE S TO DO ALL WORK(N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOT BUILDING CODE REQUIREMENTS.
�.�-�.._ ��' i'ti d��-
A L CANT PERMITEE S[GNATURE [SSUED BY SIGNATURE!
Copies: 1-Fil (Signatures Reguired), 1-Applicant, 1-Monthly Reports, I-Assessing,(If Septic, 1-Septic) Page 1
C f � j� �0 v7
otal Fee: $ �'J� •� G, Date Received:
nte►-ed By: �- �� � C � Permit#: �-1 I(� � �>-�j
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
__ _--- _ -- ------------- __----
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(please print all informatco�t) -_ _ � _.� .
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HE APPLICANT IS: (cil�cle o�7e) OWNER OR�ONTRACTOR�
OB SITE ADDRESS: 3��� S � ss z x �zo�� -o r-a�,o,M�v zIP: 5 s.;� c�
ill this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ YeS � No If yes, n specia!eve�7t per•mit is regi�ir•ed lvith Police Departrnenl aj�d City Coarncil appr•oval
60 days prior to the event. Sl�irt�le bus servzce 1vr/(be r�equi��ed au�less applicant demonsh�ates
si fficient on-site�arlting is available. No��-permitted events lvill r�ot be allo��ved.
AM�OF OWNER J�I��, �� PHONE: �I10111C� /SZ-4 75 - ¢9� z
(wor(<) --
AILING ADDRESS: 3 �c; S�s�•f� �'�► CITY: ��Y��v ZIP: 5 5 3 s cn
ONTRACTOR: I`��} . P�`f�Y.S"c�1� PHONE: �_SZ.- 925— 9�}-SS �
ONTACT PERSON: !UT A kk Fcfer 5��, MOBILE/PAGER:
AILING ADDRESS: (��;, / G•luJ.�al� Ave - CITY: F��I�� ZIP: 5 S�/-2,4
TATE LICENSE: # �,�.�-7a4- EXPIRATION DATE: 3 - �! - d7
CHITECT/ENGINEER: _R�h kli� e PHONE: ���- 9�5 - 94SS
AILING ADI)RESS: (,j� � �-�o�[ult Prv�� CITY: Ed�y1 ti ZIP: �s �. ,�-
AME: REGISTRATION: #
YPE OF WOI2K: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Sidina, Windows) �
Any earth movement may require MCWD review and permits !
120�'OSEll WORK(describe in detain: Gt�l,� t�v� �✓er��n� G- -1-12e
�Yo� ���n�p a F �oYYbtte �
S ORIES: Z SQ.FEET O�EACH FLOOR:
O. OF BEDROOMS: GAIZAGE S'I'ALI,S: ATTACHED�_ DETACHED_
S�'ili�E1TED COl'�IST'IZUCT'ION VALUA'I'IOIr1(exc➢uding land): � $ ?�� 75 0
I �ereby apply for a buildin�permit and I acknowledge that the information above is complete and accurate;
t} at the work�vill be 'in conformance with the ordinances and codes ofthe City and �vith the State Building
C de;that I understand this is not a permit anci��-ork is not to start�a�ithout a periz�it;and that the��-ork wi ll be
i accordance with the approved plan.
PPLICAIVT`S S�GNA�C�1�2�: � �A'��,: J—,3v- o �
31
1
Scc.13.04 RIGHTS OF SUBJECTS 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 section.
Subd.2. Information required to be given individual.An individual asked to supply private or confidential data concerning himselfshall be
informed of: (a)the purpose and intended use of the requested data within the coilecting state agency,political subdivision,or statewide system;(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 identity otbther persons or entities authorized by state or federal law to receive the data.This requirement shal I
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
_---_ ----,_ _.__.,._._...
The commissioner of revenue makplace tlie notice reauired under this subdivision in the individual income tax or orooertv tax refund
��structions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it is classitied as public,private or confidential. 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 d�at data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies oFthe private or publ ic data upon request by the individual subject of the daw. The responsible authoriry
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible 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 compl iance is not possible. [f he cannot comply with the request
within that time,he shall so inform the indi�idual,and may have an additional five days within which to comply with the request,e�cluding Saturdays,
Sundays and legal holidays.
Subd.4.Procedure when data is not accurate or complete. An individual may concest the accuracy or completeness of public or private data
conceming himsel£ To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The
responsible authority shall within 30 days either: (a)corcect the data found to be inaccurate or incomplete and attempt to noti£y past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be corcect. 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 administrative 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 City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessa.ry 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 reyuest)to review private data on yourself.
6. Your full name is required to process this application or permit.
Czra�ann Nl q#�iPw Ne,v2
First Middlc Last
o/�/ [�looda�c Rvenu� — Fd�y,9 , MN S� 4 2.4
Address
95z- 5zs - 9�s5
City Statc Zip Phonc
I understand y rights as stated above.
Sign�ture
Reset Form 3�
CHECK OFF LIST FOR ISS UANCE OF PERMITS
FOR OFFICE ZISE ONLY
DDRESS OR LEGAL: 3 I9 D SvS 5 2X �O�
ID:
ESCRIPTION OF WORX: X�c1_ __�rn o,lI _------_-cr h a{� Fr w.I- do e.� �f (�a�
------------------------------------------- � ------- --------------------------------�Z----- �+�
ONING REVIEW BY.• � DATEAPPROIjED: Z
UILDINGREVIEWBY: u,Q� DATEAPPROVED: 2• �01
EES TO BE CHARGED: Misc. Fees Calcarlated By:
ERMIT Yes � 1Vo
LAN REVIEW Yes � No SEWER CONNECTION
TATE SURCHARGE Yes � No WATER CONNECTION
NVESTIGATION F�E Yes No ✓ PARK FEE
AC Yes No � SITEINSPECTION
Number of SAC Units � OTHER (spec�)
--------------------------------------------�-------------------------------------------------------------------------
ONING CHECK LIST Zoning Drstrict: —
ire Depnr�tment: Post Office: School District:
ot Area: Sg.ft. Acres Yi�idth Depth
urvey Sa�bmitted: Yes ✓ No Date of Survey: _ 3' 3" �7 �(�le�• Atrni>
o,��, ,n�'� l.t_ �
roposed Setbacks: ,
Front(6ako): ���' Right Side: T1�i
Rear(Str•eet): �'1�4 Left Side: V�l9,
Adjacent Strt�ctz�res: �1Ya Wetland: ►1 ►4'
a�ilding Fleight: Def Hgt. Peak Hgt.
ot Covei�age: �—
rading: Staff Approva/Date: By: Cozrncil Approval Date:
eptic: StaffApproval Dale: By: �(�.)(o
onirrg File: # Resolutio�z: � Resolirtio��Date:
{To�•eland District: �/� N1C6��D Permil:
Avg. Sel6ack: 61z ff Setbac%: Lot Coverage:
Existing Pr•oposed
Hcu�dcover: 0-7�'
?�-?.i 0'
�sn-sno�
.500-l 000'
Flar•dcover I�'ar•iance Regtrirect: 1�s f�'o Date of Coarrrcil Approi-al:
EMARKS(in lrouse):
33
BUILDING REVIEW CHECK LIST
UBC: R• 3 CONSTRUCTION TYPE: V/v
Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
o_,
Estimated Construction Value: $ 2y, 1 5�
Inspections Required: Work Requiring Separale Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
D( Footing Seplic Sewer Connection
pC F►•aming Fireplace Lawn Ir•rigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
�_Final Grading/Filling _�Electrical(State Permit)
Other
REMARKS(INHOIISE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ONPERMIT):
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/ / `
'�/ � DATE TIME �/
� CITY OF O ONO CALLED IN �- �_U 7
INSPECTIO N�I E � SCHEDULED � a-�7 _/�.'cxa�Nj
PERMIT N . � COMPLETED
ADDRESS � �� �C (-�S � \ ��-��
OWNER CONTR. ��•�I.�/'P, _ l'S'�v�
TELEPHO E N0. �Cc,�/�f �.� /-� �% L� � ��� /
� DESCRIPTI N ,��'s�li st C�c frc,� U.'�oJC.l�y-
� 01 G j11 MECHANICAL RI 18 EXCAV/GRADING/FILLWG
02 FRAMING �l 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O TION 24/25 WOOD BURNER/FIREPLACE 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-SIT 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FIN L 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING I 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING iNAL 36 FOUNDATION/REMOVAL
� OWNER/CONT ACTOR TO MEET YOU:_YES_NO
� COMMEN S:
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W WORK SAT SFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT ORK&PROCEED ' ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT ORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC VERING PERMANENT
❑CORRECT NSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSP TOR W4LL RETURN
❑STOP ORD R POSTEd.CALL INSPECTOR �CITATION ISSUED
� INSPECTI N REQUIRED.CALLTO ARRANGE ACCESS.
C 11 for the ne t inspection 24 hours in advance. (952� 249-4600
Owner/C tr ite:
Inspecto
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