HomeMy WebLinkAbout2003-P05641 - entrance monuments PERMIT
CITY OF ORONO Permit Number:
2755 Kelley Parkway - PO Box 66 P05941
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952) 249-4600 Date Issued: 2/18/2003
SITE ADDRESS: 3015 Watertown Rd
Long Lake,MN 55356
PID: 04-117-23-22-0030
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Accessory Structures Permit Sub-type(s): Entrance Monuments
DETAILS:
Approved per resolution#:
Separate permits required: Eieciricai(state)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 63.15 Valuation: $ 1,800.00
Plan Review Fee: $ 41.02
State Surcharge Fee: $ 1.40
TOTAL FEE: $ 105.57
APPLICANT: Tony Eiden Co. OWNER: Tony Eiden Co.
4100 Berkshire Lane N 4100 Berkshire Lane N
Plymouth,MN 55446 Plymouth,MN 55446
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.
/I� t
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Sienitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
Total Fee: $ 105, 5-7 Date Received: /1�1 /0 3
Entered By: /2Permit#:
CITY OF ORONO - BUILDING PERNUT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
-------------------------------------------------------- --------------------------------------------------
THE APPLICANT IS: (circle one)( CONTRACTOR
JOB SITE ADDRESS: '3 d ,`— Gt'/,y e r 40 W/I IP:
NAME OF OWNER: /7-onPHONE: (home)
(work)76'1 - 5-y-q-O 2 s-j
MAILING ADDRESS: ZX CITY: v 1 ZIP:
CONTRACTOR: To bly Fl`WY1-7 PHONE:
CONTACT PERSON: t-a xg-1W L),yt,1W M_ OBILE/PAGER:I/2-rVO t*
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): FP 1 raj11'r- 4/ i-11
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
00
ESTIMATED CONSTRUCTION VALUATION (excluding land): $
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 ccordance with the approved plan.
APPLICANT'S SIGNAT DATE: /— —d 3
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 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 dam,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue may place the notice reauired 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 dam 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 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
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 dam, 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 PRIMACY 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 Middle Last
Address
City State Zip Phone
I understand my hts as stated above.
Signature
BUILDING REVIEW CHECK LIST
UBC' _ CONSTRUCTION TYPE:
Basement
Sq Footage $Per Sq Ftg
-
1st Floor xx
2nd Floor a
Garage x
x _
TOTAL
Estimated Construction Value: $
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical
_,Footing - Water Connection
Septic Sewer Connection
Framing
Insulation Fireplace Lawn Irrigation
Wall Board (Mason') Other
Final
(Mfg.) Well(State Permit)
Grading/Filling >(- Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERINEM:
8
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESSOR LEGAL: 3 o t S t✓1�I�Tc �w NAVO
PID:
DESCRIPTION OF WORK: Cnf-rnq�vct �1�toivv n�•o, ,
ZONING REVIEW BY: DATE APPROVED:
BUILDING REVIEW BY: DATE APPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes v No SEWER CONNECTION
STATE SURCHARGE Yes t/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SI TEINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes_X No Date of Survey: b• 7-5- v Z
Proposed Setbacks:
Front(Lake): S Right Side: 5�
Rear(Street): Left Side:
Adjacent Structures: N /✓- Wetland: _
Building Height: Def. Hgt. 0. 1<- Peak Hgt. —
Lot Coverage: —
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: 1%5 0
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
CITY OF ON
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ORONO BUILDiNG prrnAl_
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KEEP THIS PLAN SET ON SITE ATAL'L TIMES
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30 / ,S
Fie, I v 4 -r-
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1-147-64-1
30l
F-T-
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DATE TIME
CITY OF ORONO CALLED IN Z4
INSPECTION NOTICE SCHEDULED 1-1-a-03 /D.30,41m
PERMIT NO.Or),4 21'// COMPLETED
ADDRESS JL -7 W
OWNER CONTR. t -�
TELEPHONE NO.
DESCRIP ON
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
LL Q ING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti 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
07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBI 36 FOUNDATION/REMOVAL
Q OWN CONTRACTOR MEET YOU:-&Z-YES—NO
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WU WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Call for the ne inspection 24 hours in advance. (952) 249-4600
Owner/Contract te:
Inspector.
White Copynnspectoes F e Canary Copy/Site Notice
Established in 1982 63132
LOT SURVEYS COMPANY, INC . INVOICE N 93310
LAND SURVEYORS SCALE: 1 " = 100,
REGISTERED UNDER THE LAWS OF STATE OF ?MINNESOTA o Denotes Iron Monument
7601 73rd Avenue North 7R5 -560-3093 ❑ Denotes Wood Hub Set
Fax No. 580-3522 for excavation only
Minneapolis, Minnesota 56428 x000.0 Denotes Existing Elevation
(6-0010)Denotes Proposed Elevation
--�--- Denotes Surface Drainage
NOTE: Proposed grades are subject
TONY EIDEN COMPANY to results of soil tests.
Proposed building information
1 Y
must be checked with approved
U ' _. ` �ll;:f •:.� .,moi; -,
building plan and development or
`' grading plan before excavation
W4 �.4 and construction.
Proposed Top of Block
Proposed Garage Floor
Proposed Lowest Flobr
( oe 7V 1-1"le Q'4 p Type of Building
C7 OFORONi !0
ITE
� ,�,�� � � a �,�✓' s ,°„ �� (r�� _�;i t�NTr�{ ce rwoNfu,�..d„�s
0 APP 1�l t�l.�L.� `J��i��'..1 f�t*.FJt SISI,
�. i D k— n�'
�7 DAT �- ►3-0
lrvT 3
R �
�t i Property located in Section
4, Township 117, Range 23,
Hennepin County, Minnesota
II I
I
Sketch of Lots 2 & 3, Block 31 LD
OLD CRYSTAL ROAD SEOOND ADDITION
i
The only easements shown are from plate of record or information
provided by client. ,
We hereby certify that this is a true and correct representation of
a survey of the boundaries of the above described land and the
location of all buildings and visible encroachments, if any, from or on
said kmd.
Surveyed by us this 25th day of June 20, 2
Rev Drawn By Signed 4` _
File Name Charles F n erson, Minn. Reg. No.21753 or
Gregory R. Prosch, Minn Reg No. 24992