HomeMy WebLinkAbout2001-P04582 - addn/remodel/repair CITY OF OR O N O PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: P04582
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 11/9/2001
SITE ADDRESS: 2995 Watertown Rd
Long Lake,MN 55356
PID: 04-117-23-21-0010
DESCRIPTION: UBC Occupancy R3
Proposed Use: tcesidentiai 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: Piumbing iviechanicai Firepiace Eiectricai(siaie)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 293.25 Valuation: $ 18,000.00
Plan Review Fee: $ 190.58
State Surcharge Fee: $ 9.00
TOTAL FEE: $ 492.83
APPLICANT: Tony Eiden OWNER: Tony Eiden Co.
4100 Berkshire Ln 2995 Watertown Rd
Plymouth,MN 55443 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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APPL A F t�TE �I N TU ISSUED BY SIGNATURE
Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Pagel
�1 o, .
Date Received:_! 2 Q1
4-7 Permit#: 4 4 y59 177
OF OR NO - BUILDING PERIVIIT APPLICATION
_...,,.-cation must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER QR CONTRACTOR
JOB SITE ADDRESS: ZIP: `�3,
NAME OF OWNER: PHONE: (home) 55
(work)
NIA LD,'G ADDRESS: 4//O(] j-Askrc- /I CITY: G ZIP:
C' • PH0��3
CONTRACTOR: G)/2
CON�'ACTPERSON: �i ��� kl-z:� MOBILE/PAGER: `y�-y//&-- Jill yS�� -
NIAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: ; ..T —PHONE:
BAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF `YORK: New Addition Accessory Structure
Move Remodel/Alteration ,'K Land Alteration
j
PROPOSED WORK(describe in detail): i�
STORIES: ,\ SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTBIATED CONSTRUCTION VALUATION (excluding land): $ / ,;C a a
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
peri'- ��d that the work will be in accordance with the approved plan.
APPL-.CANT'S SIGNATURE: - L. �, ,i DATE: < >
NOTE! Parade of 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 SLBJECTS 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 dam concerning himself shall
be informed of (a)the purpose and intended use of the requested data within the collecting Imta agency,political subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested dart;(c)any k_owu consequence arising from his supplying or refusing m supply
private or confidential data;and(d)the identity of other persons or entities authorized by stare or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative dam.pursuant to sec_oa 13.82,subdivision S,to a law enforcement officer.
The commissioner of revenue may ol2ce the notice recuired under this subdivision in the individual income tax or orooerty 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 conrdendal. Upon his further request,an individual who is the subject
of stored private or public data 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 dam 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 dam upon request by the individual subject of the dam. The responsible authority
may require he requesting person to pay the acral costs of malting.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
dam concerning himself. To exercise this right,an individual shall notify in writing the respot s:o/e authority describing die nature of the disagreement. ..
The responsible authority shall within 30 days eit`zn (a)correct the dam found to to inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data, including recipients named by the individual;or(b)cotify the individual that he believes the dam to be correct Dan
in dispute shall be disc:osed only if the individual's statement of disagreement is Lncluded wid'i the disclosed dam.
The determination of the responsible authority may be appealed pursue=.,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 depz:ments nay 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 griddle Last
Address
City State Zip Phone
1un ,e stand my rights as stated above. \
Signature U
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: L ,--c-E czT-o"Ai azo
PID:
DESCRIPTION OF WORK:
----
ZONING REVIEW BY: DATE APPROVED: 1,1(4
BUILDING REVIEW BY: DATE APPROVED; I t_)—ol
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes WATERCONNECTION
INVESTIGATION FEE Yes No. PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CHECK LIST Zoning District: O c Q0445e_
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres rDate
Depth
Survey Submitted: Yes No f Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetl d:
Building Height: Def. Hgt. Peak gt.
Lot Coverage:
Grading: Staff Approval Date: B 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: - /Z CONSTRUCTION TYPE: V^-J
Sq Footage $Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 1&OM a'
Inspections Required: Work Requiring Separate Permits:
Site _4 Plumbing Fire
Hardcover Removal oC Mechanical Water Connection
Footing Septic Sewer Connection
Framing _4&Fireplace Lawn Irrigation
�G Insulation (Masonry) Other
Wall Board _Oc (Mfg.) Well(State Permit)
Final Grading/Filling L Electrical(State Permit)
Other
RENfARKS(IN HOUSE):
------- -----------------------------���__---__
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
r _���-------------------------------------------------
REMARK.S (TO BE NOTED ON PERMTD:
8
CITY OF ORONO CALLED IN DATE TIME
INSPECTION NOTICE CHEDULED
PERMIT NO. v OMPLETED
ADDRESS
OWNER CONTR.-_---f'n
TELEPHONE NO. f�=q o - L(q I
DESCRIPTIONlGl -
01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/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
07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 S PTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNEFIXONTRACTOR TO MEET YO _YES—NO
COMMENTS:
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U, WORK SATISFACTORY.PROCEED El PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
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 forthe next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector t / k,LL LL 1
White Copy/Inspector's File Canary Copy/Site Notice
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