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Home My WebLink AboutP08458 - addn/remodel/repair PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: P08458 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 2/28/2005 SITE ADDRESS: 575 Oxford Rd Long Lake,MN 55356 PID: 05-117-23-41-0029 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential 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: Plumbing Mechanical Electrical(state)Other-(Remodel existing 3 levels&add over main level) NOTICES/REMARKS: ......................... '-'-.closer to ,vacant lot to south FEE SUMMARY: Permit Fee: $ 5,062.50 Valuation: $ 885,000.00 Plan Review Fee: $ 3,305.96 State Surcharge Fee: $ 445.50 TOTAL FEE: $ 8,813.96 APPLICANT: Boyer Building Corporation OWNER: Mark&Kristen Anderson 3435 County Road 101 575 Oxford Rd Minnetonka,MN 55345 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. dA /_ 16// O Y -, (410/ APPLICANT PERMIT ,'SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Siznitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1 Total Fee: $ ck- Date Received: 02-isu-05-- Entered By: 7 Permit#: A bg YS' y1,-y33 2'12 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 OR CONTRACTOR JOB SITE ADDRESS: )7 5 sex F),-V /2 /2 ZIP: ..H`)' ! i Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? n Yes p' No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Non permitted events will not be allowed. NAME OF OWNER: /7)Q i /?o YV2 PHONE: (home)%V-Vn --oc.z2 (work) MAILING ADDRESS: 3 )`) .s ' h S3 G y I? / CITY: `'i7/.1c ZIP: r�,3 /1 iv<z <,� 5 CONTRACTOR: �Git�� /��' ' /14 C.c / `�J �� PHONE: l�'�/7 ��' 2 CONTACT PERSON: J 6'/x/2 ,7 C / - MOBILE/PAGER: 6/2 t 3 - MAILING ADDRESS: >Y- Cl /c) /0/ CITY: 127or;X;- ZIP: STATE LICENSE: # ARCHITECT/ENGINEER:, PHONE: MAILING ADDRESS: CITY: ZIP: NAME: \ REGISTRATION# TYPE OF WORK: New Accessory Structure Addition Move Remodel/AlterationA' Land Alteration PROPOSED WORK(describe in detail): )11 C.)4/7 1Z--4,c lic /424, %f STORIES:- SQ. FEET OF EACH FLOOR: .Z-?1-6 NO. OF BEDROOMS: S_ GARAGE STALLS: ATT. y/ DET. 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 st without a permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: -f V -� ; ' ?�sZ i DATE: 00,5.7 `) 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 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,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 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. 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 ADDRESS OR LEGAL: S-1•5 O x i=o rz,0 12-t,A-6 PID: DESCRIPTION OF WORK: ZA►S sTaA7 leloo' D dN 1- 61c:c1c fto = ^'4 ZONING REVIEW BY: j DATE APPROVED: Z•23-o ( BUILDING RE VIEW BY: U� DATE APPROVED: z. z3•oj FEES TO BE CHARGED: Misc. Fees Calculated By: PERIVIIT Yes .-/- No PLAN REVIEW Yes ,-. -' No SEWER CONNECTION STATE SURCHARGE Yes No WATER CONNECTION INVESTIGATION FEE Yes No //' PARK FEE SAC Yes No SITE INSPECTION 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 pe No Date of Suvey: y•2-& -9f 6nr gaff 1=1�C- Proposed Setbacks: pts KOPITposy 40d rne..•1 Fre+at(Lake): 4 40 ‘-1 s'1 Right Side: X3.0 ?0 R.efa•(Street): l6ct i Y5 Left Side: 90 HO' Adjacent Structures: 0.1C Wetland: Building Height: Def. Hgt. c_____&1__Cire Peak Hgt. Lot Coverage: ' /4 1 4 Grading: Staff Approval Date: /4/14 By: Council Approval Date: Septic: Staff Approval Date: f J/4 By: Zoning File: # NO Resolution: # Resolution Date: Shar-eland District: y 'e5 +-Avg. Setback: 0 .K 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): >f \+n-' -i-o Iso 1 vwscA &A5-I-, hs? (A/GC Asa V AG f CrP i-c, ,S e-I -T.-1-c 31 . BUILDING REVIEW CHECK LIST UBC: 1?-3 CONSTRUCTION TYPE:W()j Sq Footage .S Per Sq Ftg Basement x = 1st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: S CIgS, 000 •—• Inspections Required: Work Requiring Separate Permits: Site OS Plwnbing • Fire Hardcover Removal . . tv[echanical Water Connection Septic Sewer Connection X Framing Fireplace Lawn-Irrigation rC Insulation (IL[asonn) Other << Wall Board (Mfg.) Well(State Permit) Final Grading/Filling .0 Electrical(State Permit) Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMIT): 32