HomeMy WebLinkAbout2003-P06379 - addn/remodel/repair CITY OF ORONO PERMIT
Permit Number:
2750 Kelley Parkway - PO Box 66 P06379
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 6/10/2003
SITE ADDRESS: 2165 Watertown Rd
Long Lake,MN 55356
PID: 03-117-23-21-0023
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): Porch-Residential
DETAILS:
Approved per resolution#:
Separate permits required: iviechanicai Firepiace mecmcai(stale)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 251.25 Valuation: $ 15,000.00
Plan Review Fee: $ 163.28
State Surcharge Fee: $ 8.00
TOTAL FEE: $ 422.53
APPLICANT: Anthony Thomas Homes OWNER: R&M Kantor
4100 Berkshire Lane 2165 Watertown Rd
Plymouth,MN 55446 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 BUILD G CODE REQUIREMENTS.
�,
APPLICANT P RMITEE SIGNQ.TURE ISSUED BY SIGNATURE
Conies: 1-File(Siznitures Required), 1-Awlicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
Total Fee: $ Z2 • 5 3 Date Received: k -3 -03
Entered By: iZ/] s' U/g Permit#: fi O(�z ��9
CITY OF ORONO - BUILDING PERTNUT 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 CONTRACT
JOB SITE ADDRESS: �U �1(iY�rN� IU91jIb ZIP: 'L✓`r
NAME OF OWNER: Q�l�i � , 'I
PHONE: (home)
(work)
NIALLING ADDRESS: I(1� lr �n �� CITY: AN ZIP:
CONTRACTOR: W10m PHONE: ���- Dom-✓�
CONTACT PERSON: NIOBILE/P GER: — I
MAILING ADDRESS: 4400 tr tr CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF `YORK: New
Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): (mG&&O" oy �Pn wo
s ,F
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTL IATED CONSTRUCTION VALUATION (excluding land): $ 16 DOD '6a
I hereby apply for a building, permit and I acknowledge that the information above is complete and
accurate; chat 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
perm
-it- ?-nd that the work will be in accordance with the approved plan. L
APPLICANT'S SIGNATURE: DATE: l� ' '3g, —0-4
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.I3.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the dam is mored 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 dam concerning himself shall
be informed of: (a)the purpose and intended use of the requested data within the collecting 3mr_agency,political subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(e)any known coas-quence arising from his supplying or refusing to supply
private or confdendal dam;and(d)the identity of other persons or entities authorized by star_or federal law to receive the dam. This requirement shall
not apply when an individual is asked ro supply investigative dam.pursuant to se-.--;Oa 13.82,subdivision S,to a law enforcement officer.
The commissioner of revenue may ola- the notice required under Ns subdivision in the individual_income tax or orooetty 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 conrdendal. 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 aced not be disclosed to him for
sit 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 dam upon request by the individual subject of the dam. Tae 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 a_y request made pursuant to this subdivision,or within five days of
the date of die request,excluding Saturdays.Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within chat 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 disagreemear. ..
The responsible authority shall within 30 days eit.`.er. (a)correct the dam found to be inaccumtn or incomplete and attempt to notify past recipients of
inaccurate or incomplete dam, including mcipieats named by the individual;or(b)notify the individual that he believes the dam to be correct. Dam
in dispute shall be disc:osed only if the individual's statement of disagreement is included wic'i the disclosed dam.
The determination of the responsible authority may be appealed pursu+_.t 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.
?. 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.
S. You have certain rights under NI.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 Middle Last
Address
City State Zip Phone
I understand my rights as stated above.
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESSOR LEGAL: zt`5 w AST-awo., (Lo
PID:
DESCRIPTION OF WORK: (L s crrj,o,J on-CJ, )754 1z
ZONING REVIEW BY: J-4 ~ � DATE APPROVED: 6-6 -o3
BUILDING REVIEW BY: DATE APPROVED: 6- `- 03
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ,/ No
PLAN REVIEW Yes t/ No SEWER CONNECTION
STATE SURCHARGE Yes—� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CHECK LIST Zoning District: ti o C y,�sYu
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetlan
Building Height: Def. Hgt. Peak H t.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # esolution 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
r
BUELDING REVIEW CHECK LIST
R
UBC: 3 CONSTRUCTION TYPE: Vl%-�
_ Sq Footage $Per Sq Ftg
Basement x _
1st Floor x
2nd Floor x _
Garage x _
x =
TOTAL
Estimated Construction Value:
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
_X Framing _�Fireplace Lawn Irrigation
_ K Insulation (Masonry) Other
Wall Board (Mfg,) Well(State Permit)
—pc- FinalGrading/Filling k_Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PEP.M17):
8
ORONO Copy
4100 BERKSHIRE LANE
PLYMOUTH, MN 55446
Phone: 763-559-0251 Fax: 763-559-6423 }
PROPOSAL
Bob and Monique Kantor Date: May 30, 2003
2165 Watertown Rd.
Orono, MN 55356
Home Phone: 952-476-0875
Bob's Cell: 612-968-0474
This is a proposal and shall be considered the specifications for this project, items
included:
1. To build Four Season Porch—Approximately 12' x 16', 192 Sq. Ft.
• 2" x 6" exterior wall
• 25/32 Built-Rite sheathing
• Scherer Bros. windows 2- 4-2660, I.ow E, 3' swing door
• Insulated walls R-19 and ceiling R-38
• 1" x 6" Pine tongue and groove boards on ceiling and walls
• Seal and varnish pine interior boards
• Electric outlets and switches to code
• Electric heat, under ceramic with thermostat
• Exterior weatherproof outlet
• Ceiling fan and light fixture allowance of$200.00
• Ceramic tile floor- up to $4.00 per sq. ft. allowance '
• Clean-up CITY OF ORONO
• Permits B U II-U'iNIG - A T PLAf,q s i-VIE V
• Final cleaning/windows INSPECTOR
• No �'Er`-A,,1"i NO.
rain gutters included �-
• No landscaping included C =cI TED
Ell
lo _ . .. 1: v;or<3i.=.Ji J9 dons
coft
KELP i NiS Pi.r1N SE7 ON *ITE AT ALL TIMES
2. Remove existing fireplace and chimney and install new gas Superior
see through fireplace
A. Four season porch side
• Raised stone hearth
• Cultured stone face Door to ceiling
• Birch box mantel
B. Family room side
• New ceramic surround
• New ceramic raised hearth
• Install existing mantel
C. Run new flue from basement fireplace through existing chimney
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DATE TIME
CITY OF ORONO CALLED IN y`
INSPECTION N TIC � SCHEDULED
PERMIT NO. G X371COMPLETED
ADDRESS 216S (,vAr-crtTaw/
Otl Nf--R —MAf! CONTR.
TELEPHONE NO.
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 16 EXCAWGRADING/FILLING
h
6RAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q (f ISULATION 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
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
CCUj
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CC
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W
W
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WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
cu EICORRECT WORK&PROCEED EIISSUE CERTIFICATE OF OCCUPANCY
O ❑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 11 CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next'nspection 24 hours in advance. (952) 249-4600
Owner/ContraeVn it
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
V/
TIME
CITY OF ORONO CALLED IN
INSPECTION NOE� 3�� SCHEDULED
PERMIT NO. COMPLETED
ADDRESS Z l S f 't )n f ,2 ff ''C,-� l/1
OWNER CONTR. - lUA UXQ / ,
TELEPHONE NO. O 7 pm
DESCRIPTION
14 01 FOOTING 11 MECHANICAL RI 18 EXCA GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
H 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
W
0.
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O
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O
0.
W
cc
Q
2
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W
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WCC WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next in ection 24 hours in advance. (952) 249-4600
Owner/ContractoroT".3
e-
Inspector -
White Copy/Inspector's File Canary Copy/Site Notice
V
D TE TIME
CITY OF ORONO CALLED IN C
INSPECTION NOTI F SCHEDULED
PERMIT NO. ✓ COMPLETED
ADDRESS �
OWNERnONTR. S
TELEPHONE N0. `�
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 18 EXCAWbRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
CC
cw<�
cc
cc
cc C/l 2tt�
0
LL
W
cc
Q
2
W
W
CC
LLJ�ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CC
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
El CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor si
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
I �ATrr TINIER
CITY OF ORONO CALLED IN `(5
INSPECTION NOT SCHEDULED -50
PERMIT NO. 0 3 COMPLETED
ADDRESS �- CDS I of _-f e�LAX
OWNERD06 +r CONTR.
TELEPHONE NO.
Co 12_ --G C10—
DESCRIPTION
T 1 rte[ _ ick
4j 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Coo 03 INSULATION 24/25 WOOD BURNERIFIREPLACE 34 TREE REMOVAL
Z 04 BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
W
a
Cr
tuQco
Q
Po1
W
W
C
t WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C1 BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex inspection 24 hours In advance. (952) 249-4600
Owner/Con o s te•
Inspector.
White CopyMspectoes File Canary Copy/Site Notice