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Home My WebLink About2007-P11616 - addn/remodel/repair PERMIT CIT`. OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: P11616 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 11/28/2007 SITE ADDRESS: 2185 Watertown Rd Unit# Long Lake,MN 55356 PID: 03-117-23-21-0004 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building P Permit Type: Addition/Remodel/Re air Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Fireplace Grading/Filling Electrical(state) NOTICES/REMARKS: 2 story addition,storage in bsmt,family room,2nd fl BR-Move shed 10' FEE SUMMARY: Permit Fee: $ 1,833.75 Valuation: $ 250,000.00 Plan Review Fee: $ 1,191.94 State Surcharge Fee: $ 125.00 TOTAL FEE: $ 3,150.69 APPLICANT: John Holm Construction OWNER: Heinz Otto P.O.Box 2182 2185 Watertown Rd Maple Grove,MN 55311 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. PLICANT PERMIT E SI ATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 Total Fee: / Date Received: Entered By: Permit#: Y- 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: Z �s lnj44AS-OWN 10 ZIP: Will this be grade of�Iomes,Rgmodelers Showcase Home or other Display Home? ❑ Yes No If yg, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non permitted events will not be allowed. OF OWNER: r+ 5 y�L- O Q PHONE: (home) 2- NAME 3- (work) / MAILINGADDRESJ: _�� WPOTAT0WN %CITY: b?4tAO ZIP: 5 S (� CONTRACTOR: Jo*�.I }'� t OG PHONE: 33 9� CONTACT PERS MOBILE/PAGER: t t MAILING ADDRE6S: �2 19CX 7,4Q2_ CITY: A;RLL ZIP: STATE LICENSE: /3 G° �ZR3 3 EXPIRATION DATE: 3 - ARCHITECT/ENGINEER: wpaR6 Ilyun PHONE: 219 -(,qZ- MAILINGADDRESS: 'di% 77D CITY: Ct-*ySSLA'I4E ZIP: 5'4p 2- NAME: NAME: REGISTRATION: # TYPE OF WORK: New�ome Addition � Accessory Structure Move Home Remodel/Alteration(ie: Siding,Windows) Any 4arth movement may require MCWD review and permits! PROPOSED RK(desMbe in detail): 2 5�12� A-(��/�"/[ f ��8 STor2A-GE- AA5M� FUC ND �. FOI¢ao STORIES: .Z J SQ.FEET OF EACH FLOOR: 8 NO. OF BED t0 S: �� GARAGE STALLS: ATTACHED DETACHED_ ESTIMATED CONSTRUCTION VALUATION(excluding land): $ Z5d 1 od o 04 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 th#s is not a permit and work is not t start without a permit;and that the work will be in accordance with the approved pl APPLICANT'S SIGNATURE: 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 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 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 other persons 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 pro e�rty 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 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,if possible,with any request made pursuantato this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not posit le. 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 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 federa*gencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve,some in*nation 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. f First Middle Last 2,l Address City State Zip Phone I unders d rights as stated above. ti Signature (asnoif uJ)SJIYY',W7Y :lvao.rddV pounoD fo alvQ ON sa f .pa anbag aouvtrv7 rano0p rvH ,000l-00S ,OOS-OSZ OSZ-SL 8ur;sSL-0 :.ran00pdVH pasodo.rd ?x;d :affv.ranoD1°7 :pvg79S.fn1g :-lovgjaS lay l?ru rad QM 7LYQ P 1 :l0?.r;sr uv a.rotlS Lp :oivg uo?inlosaAd # :uo.ynlosag g]95-,-L-o # :al?,d$u?uoz :alvQ lvao rddy ffv;S :0r1daS* :alv(7 lvno rddV l?0unoD rCg :oivg lvao rddy ffv1S :8urpv.rrJ OX aSvaano,7107 0 7-8H�vad (, 78H f9a :lg2zaH 2u?pl?ng :PuvPaM 's-oanlonalS luaovfpy J,AWSSa 2Af L4K;y ul :PPS&CO-7 Q S)ivad d •aP?S 1 �rJR1 ' t"o'`f vu %I :s!l0vglaS posoyo rd n� da unS fb alvQ ON saJ .pallnugnS da ung yldaQ rllp?M / sa.r0 6 -1f bS :va.ry l07 l0?r1srQ 1°OtlOS :a0fffO;sod :luaurl vda(l a qd :10u1s?Q 8u?uoz .LSI7 JIO9HO `JNINOZ (wads) YgHLO NW s;?uf2 j6'Sfo aaqurnN NOI.LO9dSHI3,LIS oN sad 3V Y9JNYVd / ON saj 9-7J NOII VDIIEZANI NOL139NNO ULVA ON sal 9DYVHDYA9 9LVIS NOLLOYNNOD(yamyS ON saA Al9IA-7Y N-V7d ON ./' saA LINY-7d :rCg palv1napn0 saa� •oppV =(rlyDy 'HO.78 OIL S33d Lo• t-! :Qy10Ydcrvaiv(r jSA1HIA3YONIQ7IIl8 n •I i•J� :a3AOWCrCrVl va -I7AJIA"ONINOZ AL1 f l� sail C "OM Jo Noiicr jsga :QId :7VD97 90 SSgYaaV A7NO 9Sf1 SOIJYO 2I0,1 S,LI"Jcfd0 IDA[Vf]SSI YOd ISI7d30 JIOSHJ BUILDING REVIEW CHECK LIST UBC: R") CONSTRUCTION TYPE: VN Sq Footage $Per Sq Fig Basement x = 1 st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ Z S6;Od 1 Inspections Required: Work Requiring Separate Permits: Site _g( Plumbing Fire Hardcover Removal pK Mechanical Water Connection _Footing Septic Sewer Connection Framing Oc Fireplace Lawn Irrigation K Insulation (Masonry) Other Wall Board C(Mfg.) Well(State Permit) Final Grading/Filling P4 Electrical(State Permit) Other REMARKS(INHOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTE ONPERM T): Ve, e- ' _ YO h V e l! he checked 2t Alene d -,-10dih91 1473?ec4ck 34 , 60t�;; JDA TIME CITY OF ORONO CALLED IN /^ INSPECTION NSCHEDULED a' PERMIT NO. O COMPLETED --// ADDRESS 02/8>,5- G(� )ed, OWNER CONTR.ILI-Okf'l � TELEPHONE NO. / 2 �P l oZ a3lPl0 D�'�I DESCRIPTION ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAWGRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES NO COMMENTS: cc W a cc Z) 41,O cc O W cc Q Z W z W CC Uj /WORK SATISFACTORY:PROCEED Ll PROJECTCOMPLETE cc W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY Cj BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN El CITATION ISSUED ElSTOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contracon site Inspector. White Copy/Inspector's File Canary Copy/Site Notice �)'6�) 5c� TIME CITY OF ORONO CALLED IN INSPECTION N19T), SCHEDULED PERMIT NO. !!ll COMPLETED ADDRESS S OWNER CONTR. TELEPHONE NO. DESCRIPTION ' P14,5�- 01 FOOTING 11 MECHA C L RI 18 EXCAV/GRA NG/FILLING Q 02 FRAMING 13 MEtt CH IC L FINAL 19 LAKESHOR ETLANDS h 03 INSULATION 24/25 WO URNER/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 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 COMMENTS: W a 0 cc 0 LL W cz Q z W Z W cc WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE 9ElRRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. 4 White CopylInspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTIONQrICE, SCHEDULED PERMIT NO. 1 !!Civ COMPLETED d2 d� ADDRESS 4er T6'w A_.) OWNER ��T� CONTR. TELEPHONE NO. DESCRIPTION S S "� A 4 IIJ S n S? L4 C1 FOOTING ❑ MECHANICAL RI ElEXCAV/GRADING/FILLING Q El FRAMING ❑ MECHANICAL FINAL ElLAKESHORE/WETLANDS Q,,"SULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO cam., COMMENTS: W C cc 0 w cc Q z W Z W cc d cc ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑C ECT WORK&PROCEED ❑ 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 ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: � Inspector. A / Ger L -� White Copyllnspectoes File Canary Copy/Site Notice