HomeMy WebLinkAbout2005-P08813 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P08813
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
6/16/2005
SITE ADDRESS: 2995 Watertown Rd Unit#
Long Lake,MN 55356
PID: 04-117-23-21-0010
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Electrical(state)
NOTICES/REMARKS:
Remodel existing screen porch with addition&remodel existing deck
FEE SUMMARY: Permit Fee: $ 492.25 Valuation: $ 35,000.00
Plan Review Fee: $ 319.96
State Surcharge Fee: $ 17.50
TOTAL FEE: $ 829.71
APPLICANT: Streeter&Associates OWNER: Micheal&Berit Francis
18312 Minnetonka Blvd 2995 Watertown Rd
Wayzata,MN 55391 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.
APPLICA T PE SIGNATURE UED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, I-Monthly Reports, 1-Assessing,(If Septic, l-Septic) Page 1
Total Fee: $ • Date Received:
Entered By: RD Permit#:
Lam`► U- I10IT
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) t OWNER O CONTRACTOR
JOB SITE ADDRESS: p_ -t cS-- W 4A-d 4cu✓n K4zl. zip: 5,S-3
C5 (-0 ✓_o AAM '
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes WNo If yes,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.
NAME OF OWNER: M t (� 'F�' C t PHONE: (home)
(work)
MAILING ADDRESS: d?1C=4j,�'-r}t'..1n CITY:O/V na ZIP: S^�
CONTRACTOR: -iqf 'Aej PHONE: QT1-y4l
CONTACT PERSON: 5 CD'ft MOBILE/PAGER: 6 86(^c18 i G
MAILINGADDRESS: 10631_ m•.^-6-64A NOCI CITY: oQ ZI : sS-3q
STATE LICENSE: # 1 3 a EXPIRATION DATE: 3 3 t
ARCHITECT/ENGINEER: 56A-2 GS Q�K47De4 PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition Accessory Structure
Move Home Remodel/Alteration r
PROPOSED WORK(describe in detail): RQ�a 2L �. i Q�. 'L^e d
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 3Z 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: DATE: d
31
� 1
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 mayplace 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 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,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.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 ofpublic 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 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.
Firs
w/; VIA n Middle Last
Address �-1�\
City State Zip Phone
I u2,41,
and my ri hts
I u as st ed above.
Si a re
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ZS g t W.4 TLIZT O c a ri lZpAO
PID: of
DESCRIPTION OF WORK f20440 D C C- Gur t 1,40ACA,
ZONING REVIEW BY: DATEAPPROVED: (y-Cr-OP
BUILDING REVIEW BY: DATEAPPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes !/ No SEWER CONNECTION
STATE SURCHARGE Yes r/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (spec)
ZONING CHECKLIST Zoning District: /vo C,116 oc�
Fire Department: Post Office: SchoolDistrict:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No ate of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetland
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:# 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):
33
BUILDINGREVIEWCHECKLIST
UBC: 1 . 3 CONSTRUCTION TYPE: \/N
Sq Footage $Per Sq Fig
Basement x =
Ist Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 35'.ao b
o_
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
_e Framing Fireplace Lawn Irrigation
8 Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
_,Final Grading/Filling K Electrical(State Permit)
Other
REMARKS(INHOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
34
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�T TIME
CITY OF ORONO CALLED IN �`� OS
INSPECTION NOT I SCHEDULED
PERMIT NO. - COMPLETED
ADDRESS n_6-/ r&JZ, 21Y2
OWNER CONTR. j�eGtev
TELEPHONE NO.
12ESCRIPTION Foo
� 01 OOTING 11 MECHANICAL RI 18 EXCAWGRADIN ILLING
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
LU 09 PLUMBING RI 23 SEPTI FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU: YES NO
COMMENTS:
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WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
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❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
d0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORECOVERING 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 for the next inspection 24 hours in advance. (J52) 249-4600
Owner/Contractor on site:
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Inspector. A�l
White Copy/Inspector's File Canary Copy/Site Notice
DATE TIME V
CITY OF ORONO CALLED IN
INSPECTION NOCE SCHEDULED
PERMIT NO. 1 3 COMPLETED sno
ADDRESS 5211 J c-J A -1-J?U L.S N r{e
OWNER CONTR. S 4 ,1Qe -,-cf'
TELEPHONE NO.
DESCRIPTION
W 01 FOOTING \ 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
U4. �AMING C 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
03 INSULATION 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
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
v
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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W ORKSATISFACTORY.PROCEED 11PROJECTCOMPLETE
( ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORECOVERING 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 for the next inspection 24 hours in advance. 249-4600
Owner/Contractor on site:
Inspector. , I fr179_
White CopylInspector's File Canary CopylSite Notice
A" DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. P0R9'/.3 COMPLETED
ADDRESS . 91 S_ IL)L i C97 211
OWNER CONTR.
TELEPHONE NO.
DESCRIPTION
01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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
OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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W C WORK SATISFACTORY:PROCEED PROJECT COMPLETE
cc C CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
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0 C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
Cj BEFORECOVERING PERMANENT
C CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTOTAKEN
INSPECTOR WILL RETURN
C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site: I _
Inspector. S
White Copy/Inspector's File Canary Copy/Site Notice