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Home My WebLink About2000-P02184 - addn/remodel/repair CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: g}g Poa�B� Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (612) 249-4600 Date Issued: 1/28/00 SITE ADDRESS' 980 Tonkawa Rd LONG LAKE,MN 55356 PI D: 08-117-23-12-0001 DESCRIPTION: Proposed Use: Residential UBC Occupancy: R3 P Permit Class: Building Construction Type: VN Permit Type: Addition/Remodel/Repair Census Code: 434 Permit Sub-type: Single Family DETAILS: Resolution#: N/A Separate permits required fo Electrical(state permit) NOTICES: FEE SUMMARY: Permit Fee: $ 734.75 Valuation: $ 63,000.00 Plan Review Fee: State Surcharge Fee: $ 31.50 SAC Fee: $ 0.00 Misc. Fees: $ 0.00 TOTAL FEE: $ 766.25 APPLICANT- One Call Services Inc OWNER' L D DORR/M A DORR TRUSTEES PO Box 2086 980 TONKAWA RD Maple Grove,MN 55369 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. __e1z1_ V(f� APPLICANT PERMITEE SIGNATU ISSUED BY SIGNATURE Today's Date: 1/28/00 Page 1 CITY OF ORONO 6122494616 01/25/00 17:16 (5 :07/10 NO:909 Total Fee: $ � ,. _ Date Received: Entered BY: eA Permit#; P O2ot Y' CITY OF ORONO - BUILDING PERMIT APPLICATION All Information must be submitted in full before plan review will be started. (please print all infortnarion) THS APPLICANT IS: (circle one) OWNER O ONTRACTO JOB SITE ADDRESS: 980 7DIV44w* „ _ _ ZIP: _ NAME OF OWNER: I ZIArc- PHONE: (home)_ j (work) _ MAILING ADDRESS: CITY: - ZIP: CONTRACTOR: - S£ c- PHONE: 60/2-4Y/7- Qo $ CONTACTPERSON: 44ce7- . c MOBILE/PACER:- Giz-�a i G Z G 3 MAILING ADDRESSCITY: 'lf4�-1F kzZIP: S33 G STATE LICENSE: #—Aa/4,22?(P ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: ____CITY: ZIP: NAME: -_-- REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration - Land Alteration PROPOSED WORK(describe in 4erail): —I-Ke-5 STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ '163. GAO 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. APPLICANTS SIGNATURE. DATE: NOTE! ftrade 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. 5 CITY OF ORONO 6122494616 01/25/00 17:165 :08/10 NO:909 Sec.13.04 RIGHTS OF.SUBJECTS OF DATA Subd. 1, Type of data. The rights of individual on whom the data is stored of to be stored shall be as sat ford[in this section, Sold.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 irvzndod use of the requested data within tho collecting state agency,political subdivision, nr statewide system:(b)whether he troy refuse or is legally required to supply the requested data;(c)any known conwquenea arising from his supplying All refusing to supply private or confidential data;and(d)the idcndty of other persons or entities authohirAl by state or federal law w receive the data. This requirement shall not apply when an individual is asked to supply invostigatfvc data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of myenurg may pjace the faati;s repuired Und a his 50iv'sion inl-iruLyidgal income tax or nrodany tax refund i stet_tinny'nsr.ad of on tit ne icirms, Subd. 3. Access to data by individual. Upon request to a responsible audiority,an individual shall be informed whetlior he is the subject of stored dew on individuals,and whether it is classifted as public,private or confidential. Upon his further request,an individual who is die sabjmt of stored private or public data un individuals sludl be shown the data without any charge to him and, if he desires,shall he informed of the content and meaning of that data. Atter an individual has been slwwn the private data and informed of its meaning,the data need not be disclosed to him for slit months thereafter unless a dispute or action p%4ouant m this sccunn is pending or additional data on the individual has been collected or created. 'rbc responsible authority shall provide copies of the,private or public dam upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making, cernifying,and compiling the copies. no respotusible authority shall comply inimediarely, tf possible,with any request matte porsuaru to tilt sulxilvisiun, or within five days Of the date of the request, exchtding Saturdays, Sundays and legal holidays, if i,nntedlate compliance is swt possible. If lie cannot comply with the request within that time,he shall so Irtforni the individual, and may have an additional five days within which to comply with the request, excluding Saturdays, Suadays dna legal holidays. Subd.4, Procedure when data is not accurate or a mptete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,in individual shall notify in writing the responsible authority describing the stature of the disagreement. The responsible authority shall within 30 days elther: (a)correct the data fourul to be inacu.urate or incomplete azul attempt to notify past reciplents of inaccurato or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be wrTeci. Data in dispute shall be disclosed urily if the individual's statement of disagreement is included with the disclosed data, The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATAPRIVACY 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: I. 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 pertnit 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 fall name is required to process this application or permit. First Middle last Address Ciq state Zip Phone I understand my rights hove. Signature 6 CITY OF ORONO 6122494616 01/25/00 17:165 :09/10 NO:909 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESSOR LEGAL: S e o PID: ----------- --- _ DESCRIPTION OF WORK: --lw-w- l----1w.rrrWYVMrYIwIW-w--r------------ ---- -----r-w------------------------------r-w-----Ww----w-w------- ZONING REVIEW BY: N�+� _ DATE APPROVED: BUILDING REVIEW BY: DATE APPROVED: /•.Z c. . o0 ------ ----Y----- -B -- -------------------- r -- ~ FEES TO BE CHARGED: Misc. Fees Calculated BY: � PERMIT Yes c--� No PLAN REVIEW Yes No SEWER CONNECTION STATE SURCHARGE Yes No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEWSPECIION Number of SAC Units _ OTHER (specify) MViYwV-- ---------------------------------l-------w--------------------------------------------- -------w-vl-.rw-r.. ZONING CHECK LIST Zoning District: N Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width _ Depth Survey Submitted: Yes_�- No pate of Survey: Proposed Setbacks: Front (Lake): Right Side: Rear (Street): Left Side: _ Adjacent Structures: Wetl ..-rr�. ..... w_... Building Height: Def. Hgt. Peak gt. _ Lot Coverage: Grading: Staff Approval Date: _ H Council Approval Date: Septic: Staff Approval Date: ,Zoning File: # Resolution: k- Resolution Date: _ Shoreland District: Avg. Setback: _ Bluff Setback _ Lot Coverage; Existing Proposed Hardcover: 0-75' 75-250' 2s0-500 500-l000, Hardcover Variance Required. Yes No Date of Council Approval: REMARKS(in house): 7 CITY OF ORONO a 6122494616 01/25/00 17:1615 :10/10 NO:909 BUILDING REVIEW CHECK LIST CIBC: t2 CONSTRUCTION TYPE: Sq Footage $Per Sq Ftg Basement _ . x 1st Floor _x 2nd Floor _ x _ Garage _ _r.x X TOTAL Estimated Construction Value: $ (o 3,v uy _ Inspections Required: Work Requiring Separate Permits: Site Plumbing _Fire Hardcover Removal Mechanical 'Water Connection Footing SepticSewer Connection _K Framing Fireplace —Lawn Irrigation V„Insulation (Masonry) Other < Wall Board (Mfg.) Well (State Permit) Final Grading/Filling �_Electrical (State Permit) Other, W------_---........._.....................-............ • ---- REMARKS(IN HOUSE): .,...-----........ ........_.------------------------------------- ------ -----------.--..-w...-_..._.:--------------- REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: pate _ By: _ ......,....,-_��-._._...,.........,..»w...........-----------------------------------------------------------•--------------- REMARKS (TO BE NOTED ON PERMIT): T 8 DATE TIME CITY OF ORONO CALLED IN INSPECTION N ICES SCHEDULED PERMIT NO. 0 �� COMPLETED ADDRESS -! S C5 %XYZ i4aC.U0, -.rf OWNER CONTR. 'b-eVUL TELEPHONE NO. 9 V—9 Oct 3 DESCRIPTION W 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING W 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 Lul 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO C ME TS: cc C C CC LLo W cc Q z W z W j U, �QORKSATISFACTORY:PROCEED PROJECTCOMPLETE rcCORRECT WORK&PROCEED I ISSUE CERTIFICATE OF OCCUPANCY W Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTOTAKEN INSPECTOR WILL RETURN 1-1STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. i Call for the next inspection 24 hours in advance. 249-4600 Owner/Contractor on site: Inspector/, l—:7? White Copy/inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN T— INSPECTION N ICE- I g SCHEDULED PERMIT NO. d t COMPLETED -�" G ADDRESS OWNER CONTR. Q �1 TELEPHONE NO. �9 7 - '30 1 DESCRIPTION YYl�J W 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS ti 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION L 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 Q OWNEWCONTRACTOR TO MEET YOU:_YES_NO Z CO MENTS: c W Cr Q z W z W CC d W P<GW)RK SATISFACTORY.PROCEED Ci PROJECTCOMPLETE cc W �ORRECT WORK&PROCEED C; ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY OU BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. F__ TAKEN INSPECTOR WILL RETURN F CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-4600 Owner/Contract on site: Inspector. - C' � White Copy/Inspector's File Canary Copy/Site Notice