HomeMy WebLinkAbout2000-P02363 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P02363
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(612) 249-4600 Date Issued: 515100
SITE ADDRESS: 2570 Thoroughbred La
LONG LAKE,MN 55356
PID: 04-117-23-11-0016
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Deck
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 125.25 Valuation: $ 5,800.00
Plan Review Fee: $ 81.38
State Surcharge Fee: $ 2.90
TOTAL FEE: $ 209.53
APPLICANT: STEVE FILIPS OWNER: S N&B J FILIPS
2570 THOROUGHBRED LANE 2570 THOROUGHBRED LA
ORONO,MN 55356 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 REQUIREMENTS.
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ISSUED BY SIGNATURE
Copies:City,Applicant,Assessor,Finance Pagel
Total Fee: $ a0 9.S3
Date Received: y _ 00
Entered By: d1, Permit#: f}D a 3 Q-
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER�R CONTRACTOR
JOB SITE ADDRESS: 0 i N o 2 a kC N p rz�ro zip: 5 3 S
NAME OF OWNER: 3r�60 -q- 0 f-rL-S.PS PHONE: (home)_Li 4 -q o y Ca
(work)
MAILING ADDRESS: TW Qa0u(;N',5WCrrY: 62on)o ZIP: S53sG
gra - 3a. s �
CONTRACTOR: PA-F A C R EN0 6 A C A PHONE: -
CONTACT PERSON: MOBILE/PAGER: ,-Li S. s B e x
MAILING ADDRESS:/o o C*-^i3f A CITY: (3 eY")sy L ZIP: s 3 0
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE;
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition AccessoryStructure
D- _
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): AO Q J�p To
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ :5000 0' 0'0
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: L-f - 1.0-0 0
NOTE! parade Qf 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 SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or m 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 himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting State agency,political subdivision,or statewide system;
(b)whether he may refuse of 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 of other persons or entities authorized by state or federal law to receive the dam. This requirement shall
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 may place the notice required under this subdivision in the individual income tax or oroyeiN tax refund
instructions 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 dam on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject
of stored private or public dam on individuals shall be shown the dam without any charge to him and;if he desires,shall be informed of the content
and meaning of that dam. After an individual has been shown the private data and informed of its meaning,the dam need not be disclosed to him for
six months thereafter unless a dispute or action pursuant to this section is pending or additional dam on the 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 dam. The responsible authority
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 trade 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 additional 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 concerning himself. 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)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete dam,including recipients teamed by the individual;or(b)notify the individual that he believes the dam to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed dam.
The determination of the responsible authority 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 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.
i3 G7-i-T
First Middle Last
Address
State Zip Phone
City
I understand my rights as stated above.
Signature `
i
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS ORLEGAL: ZSZ J 'i'K pRc9.i6tt (.�S�LC.O
PID:
DESCRIPTION OF WORK:
ZONING REVIEW BY: DATE APPROVED:
BUILDING REVIEW BY: DATE APPROVED: s•Z-o
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓' No
PLAN REVIEW Yes _� No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CHECK LIST Zoning District: aR•It;
Fire Department: —uN&UIG6 Post Office: Qo School District: b 20 N,
L
Lot Area: Sq.ft. OolJ,> Cid Acres Width Depth
Survey Submitted: Yes_ c, No Date of Survey: 95-11 -415"
Proposed Setbacks:
Front(Lake): 12.0 Right Side: 35
Rear(Street): I IS +' Left Side: t t t; � �-
Adjacent Structures: A 77vge-ty,cpO Wetland:
Building Height: Def. Hgt. /✓(4 Peak Hgt.
Lot Coverage: —
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
• Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
BUILDING REVIEW CHECK LIST
UBC: n '3 CONSTRUCTION TYPE: V✓`�
Sq Footage $Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x
TOTAL
Estimated Construction Value: $_ X 9 0 d ns'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
K Footing Septic Sewer Connection -
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit),,
_ pf—Final Grading/Filling Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERNM):
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CITE' OF ORONO �2
BUILDING P FR PLAN REVIEW
INSPECTOR Ili I �D
DAT S• L-�t^0 PERMIT IVO. -
/�APPROVED AS SUIRAITTED
D APPROVED WITH CORRECTIONS AS NOTED
G NOT APPROVED---CORRECT&RESUBMIT
Thssa comments are for your information.All work shall be dons
in fir, compliance with aN applicabie building and zoning cod9,
including itz.ns not speciflcatiy rated in this rf!-J".
'KEEP THIS PLAN SET ON SITE AT All TIMES
DATE TIME
CITY OF ORONO �a CALLED IN
INSPECTION NOTIC SCHEDULED
PERMIT NO. COMPLETED
10,
ADDRESS ����
OWNER CONTR.
TELEPHONE NO. �
DESCRIPTION v}ECIC
~ FOO 11 MECHANICAL RI 18 EXCAWGRADING/FILLING
W
2 FR 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
O 03 INSULATION 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-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 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/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED i' PROJECT COMPLETE
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6tORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
OO ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTOTAKEN
INSPECTOR WILL RETURN
ElSTOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advanCee.. 249-46'
Owner/Contractor on site:
Inspector./A C _ -G49�
White Copy/Inspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT CEIW3�j SCHEDULED �� 3 —
PERMIT NO. / COMPLETED
ADDRESS
OWNER CONTR.
TELEPHONE NO.
DPTION �/�'c IC
TTTI 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 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-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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W
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W� ORK SATISFACTORY*PROCEED ROJECTCOMPLETE
W ❑ CORRECT WORK&PROCEED /F ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
E:1STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-4600
Owner/Contractor on site:
Inspector._/,��+✓ �D �/l�
White CopylInspector's File Canary Copy/Site Notice
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Established in 1962
LOQ' SURVEYS COMPANY, INC. F 8. No"699-5481702-66
LAND SURVEYORS SCALE I" _
REGISTERED UNDER THE LAWS OF STATE, OF MINNESOTA Denotes Iron Monument
o Denotes Wood Hub Set
7601 73rd Ave. No. 560-3093 For Excavation Only
Minneapolis, Minnesota 55428 x000.0 Denotes Existing Elevation
urbeporg �ertififAte � Denotes Proposed Elevation
_ +41--m Denotes Surface Drainage
I
EIDEN CONSTRUCTION Proposed grades are subject to results /O?J ,2 Proposed Top of Block
of soils tests.
14 , Proposed Garage Floor
023,2 Proposed Lowest Floor
Type of Building -
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Lot 4, Block 1, OLD CRYSTAL BAY ROAD 2ND ADDITION
Proposed building information must be checked with ripproved building plan
before excavation and construction.
The only easements shown are from plats of record or information provided
by client
We hereby certify that this is a true and correct representation of a survey
of the boundaries of the above described land and the location of all buildings �.
and visible encroachments, if any, from or on said land. _
Signed—
Surveyed by us this 11thday of AUgUSt 19 95 R mond A. Prasch Minn. rleg. No. 6743