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HomeMy WebLinkAbout2005-P08406 - interior remodel PERMIT /CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P08406 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 2/8/2005 SITE ADDRESS: 1035 Tonkawa Rd Long Lake,MN 55356 PID: 08-117-23-24-0004 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Construction Type VN Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Electrical(state) NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 279.25 Valuation: $ 17,000.00 Plan Review Fee: $ 181.48 State Surcharge Fee: $ 9.00 TOTAL FEE: $ 469.73 APPLICANT: Berscheid Bulders OWNER: Barbara Wigley 1509 Division St. 1035 Tonkawa Rd Waite Park,MN 56303 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. a el_ APPLICANT PERMITEE SIGNA ISSUED BY SIGNATURE Conies: 1-File(Signitures Required). 1-Applicant. 1-Monthly Reports. 1-Assessing, 1-Finance Page 1 f Total Fee: $ 4o.:7-3 Date Received: Entered By: Permit#: 'goflt 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 O CONTRACTOR, JOB SITE ADDRESS: 1 o `3 S *TV Not Gu on ZIP: S-S-3 Z'3 Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑Yes ❑No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bur service will be required unless applicant demonstrates sufficient on-site parking is available_ Non permitted events will not be allowed. NAME OF OWNER: �%� `� PHONE: (home) f`�� "— 7/ 7q f fw-ork) _7ir3 - 7-y�-s9vJ MAILING ADDRESS: ' X 3 CITY: ►A,S L9/ ZH': sJ S&,4- j91cjt't4S ORA � CONTRACTOR: V SGV C:C ('�' 1 46 vS PHONE•_3 10 CONTACT PERSON: I.t MOBILE/PAG R: 3 7-c-?eO - I 17- MAILING ADDRESS: )5-01? Qt 's%eti— CITY: W q t� Ye ZIP: .S-b 303 STATE LICENSE: # '3 d 10 EXPIRATION DATE: .--2_)_1. 5' ARCHITECT/ENGINEER: N14 PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accesso Structure Move Home Remodel/Alteration PROPOSEDICK(d sgribe in detail): 6'k P13'✓� O W 11'I E e£ L LA f Z h L:: X t5T.L 11 STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ / 7, © 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: I� DATE: 31 Sec.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 himself shall be informedof. (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 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 of otherpersons or entities authorized by state or federal law to receive the data.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 property 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 whetherhe is the subject of stored data 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 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 that 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 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 compiling the copies. The responsible authority shall comply immediately,ifpossible,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 compliance is not possible.Ifhe 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 ofpublic orprivate data concerning himself.To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreeemeent 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 data,including recipients named by the 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 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. 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. First A)T?--L Middle L Last Address city t f�Gi 1' state "►'►✓� Zip S� Phone 3 T-understand my rights as stated above. �, 4, Svc S Signature 9 �Pl 32 CHECKOFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 1035 -ro"Y.-AWA PID: DESCRIPTION OF YVORK: 1'L��►'� c` Potin w�� v� � � �� ---------------- --------------- --- ----- --------------------------------------------------------------------- ZON[1VG RE VIE PV B Y: DATE APPROVED: 1- 1 -05 BUILDING REVIEW BY: DATE APPROVED: i • 7 - -',%-5 -------------------------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAiV REVIEW Yes r/ No SEWER COMVECTION STATE SURCHARGE Yes ✓ 1Vo WATER COtWECTMV INVESTIGATION FEE Yes tvo PARK FEE SAC .Yes No SITE INSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------------- - ZONING CHECK LIST Zoning District: /yo Ct+onr a— Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes ;Ur No Date of Survey: Proposed Setbacks: Front(Lake): Right Side: Rear(Street): Left Side: Adjacent Structures: Wetla d: Building Height: Def. f-[,-,t. Pe -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 Setba Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes N Date of Council Approval: REMARKS(in house): 31 j B UILDING REVIEW CHECK LIST UBC: R' CONSTRUCTION TYPE: yej Sq Footage S Per Sq Ft.- Basement tgBasement x = !st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Valcne: S 110 0 o Inspections Required: 6{'ork Requir•irrg Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Se"Ver Connection _ ' Framing Fireplace Lawn.Irrigation _r Insulation (Masonry.) Other Wall Board (Mfg.) Well(State Permit) _Pe Final Grading/Filling Al Electrical(State Permit) Other ------------ REATARICS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing Ivew Access Approval: Date By: REMARKS (TO BE NOTED ONPERAIIT): 32 (' ✓ DATE TIME CITY OF ORONO CALLED IN2— 0 INSPECTION NOTI E SCHEDULED aL_L)7 -OS— PERMIT NO. 6) COMPLETED ADDRESS��.�S ��1 ,���C✓Ci //� OWNER ��}}��ii CONTR. TELEPHONE NO.20-9,R0 ZZ2� DESCRIPTION LC',SPrru 6� LurDEMO 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING O� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS N Q`/ 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL 12 WATER HOOK-UP17 SITE INSPECTION 14 SEWER HOOK-UP 06 PROGRESS E 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/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc W Q_ cc J O CC O LL W CC Q Z W z W CC O WCC WORKSATISFACTORY:PROCEED PROJECT COMPLETE UU ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 00 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ElSTOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/C ontractor on ite: Inspector. 's A" White Copyllnspector' File Canary Copy/Site Notice