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HomeMy WebLinkAbout2004-P08091 - addn/remodel/repair CITY OF ORONO PERMIT 2750 Kelley Parkway- PO Box 66 Permit Number: P08091 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 11/16/2004 SITE ADDRESS: 3520 Watertown Rd Long Lake,MN 55356 PID: 32-118-23-43-0013 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential 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: Plumbing Mechanicai Sepuc Eiecmcai(state) NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 1,413.75 Valuation: $ 175,000.00 Plan Review Fee: $ 937.23 State Surcharge Fee: $ 90.50 TOTAL FEE: $ 2,441.48 APPLICANT: Owner/Self OWNER: Thomas&Jennifer Schulenberg MN 3520 Watertown Rd 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. APPLICANT PERMITEE SIGNATURE I UED BY SIGNATURE Copies: 1-File(Siknitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessine, 1-Finance Page 1 Total Fee: $ Date Received: O� Entered By: ffY'1L Permit#: d$O� 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) OWNS R CONTRACTOR JOB SITE ADDRESS: �SV� L.J(,� '�el'�(9�,✓v� _ZIP: Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? [:] Yes RNo 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 sit ffcient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: Z2 &tcLtqtecALe,41-aPHONE: (home) `Y73-Op 6P / (work) SOY-zigs- MAILING ADDRESS: �Z� (f1C CA"-1A CITY: Goy ZIP: CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration _ ,,' PROPOSED WORK(describe in detail): lil Da4e- Ay�- L4 1j e,,j �c d d ..mac r9 f= d ✓� � 4/i,�2r /� i D✓' `D r.0.ns `8 .tet STORIES: SQ.FEET OF EACH FLOOR: 13;00 NO. OF BEDROOMS: 3 GARAGE STALLS: ATTACHED �s DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 179;DQ 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.I� APPLICANT'S SIGNATURE: 'DATE: l�(,?"cjy 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. I. 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. dk--t 4s �f� ���L-1 lei 1z i---4 _ First Middle Last Address 0eVA�-Co /tiAV- =Sll 4'73-ao6p City State Zip Phone I understand my rights as stated above. Signature 32 Y � CHECKOFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: -kS ZO W A TE 2-�-�►�N �A D PID: DESCRIPTION OF WORK: Alo f Fo�ivoi4rio�! qn,�p /ltr-7�aDec.. ------------------------------------ ----- ------------------------------------------------------------------------ - ZONING RE VIE TV BY: DATEAPPROVED: 11- 5-o y B UILDING RE VIE W B Y: DA TE APPR 0 VED: -------------------------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes t/ No PLAN REVIEW Yes 4--" tvo SEWER CONNECTION STATE SURCHARGE Yes tvo WATER COtWECTIOtV INVESTIGATION FEE Yes tVo ✓ PARK FEE SAC Yes tVo .i SITE INSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------7-------------—------------------------------------------------------- ZOiVING CHECK LIST Zoning District: /V0 G11 6!* Fire Department: Post Office: School District: _... Lot,Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Surveys Proposed Setbacks: Front(Lake): Right Side: Rear(Street): Left Side: Adjacent Structures: We and: Building Height: Def. Hot. Pe 'Hgt. Lot Coverage: Grading: Staff Approval Date: y: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Set ck: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required Yes Date of Council Approval: REMARKS(iia house): 1 [ Y BUILDING REVIEW CHECKLIST UBC: (Z•3 CONSTRUCTION TYPE: V/J Sq Footage S Per Sq Ftg Basement x = 1st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: S 1"751000 Inspections Required: Work Requiring Separate Permits: Site __.Qe_Plumbing Fire Hardcover Removal _ ( Mechanical Water Connection 'Footing —.¢f Septic Sewer Connection X_Framing Fireplace Lawn Irrigation 4 Insulation (itfasonry) Other Wall Board (Mfg.) Well(State Permit) Final Grading/Filling _pc Electrical(State Permit) Other REAlARKS(INHOUSE): REVIEW BY OTHERS: DATE: Access: Existing New :access Approval: Date BY: REMARKS (TO BE NOTED ON PERMIT): 32 `/_ T,(�, TIME CITY OF ORONO CALLED IN / INSPECTION TICE SCHEDULED -/ off;t1fl PERMIT NO. COMPLETED �J ADDRESS 3520 /�— � OWNER CONTR. TELEPHONE NO. 61 2 7 DESCRIPTIONOL W 01 FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS O 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 ZUT 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc Q. O `-0 �m cc O a O LL W QC Q 2 W W cc O W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE LU W El WORK&PROCEED ElISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ElSTOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contrac r n site: Inspector. White CopylInspector's File Canary Copy/Site Notice DATE TIME (�'CITY OF ORONO CALLED IN -/ -os- INSPECTION oSINSPECTION NOTICESCHEDULED CSS 30 pPM PERMIT NO. SCS b O COMPLETED n ADDRESS 552 0 LOCA-::V e-C b LIJ (2 OWNER 70 M 26)26L�7, CONTR. TELEPHONE NO. S Z Z00 S / DESCRIPTION 6CA-sQ(y1m Uj 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING LL QCr I RAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS 03 TION 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 J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc COle cc J cc e6v O O W Q Z W Z W CC J O W X.FK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED 7- ISSUE CERTIFICATE OF OCCUPANCY 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V 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. (952) 249-4600 Owner/Contractor, A si e Inspector. White CopylInspector's File Canary Copy/Site Notice DATE TIME V CITY OF ORONO CALLED IN INSPECTIONTICE SCHEDULED PERMIT NO. &JOR0 9 Z COMPLETED ADDRESS c3:2�7;10 (LI OWNER A.a `CONTR. TELEPHONE NO. `,52, O 1 DESCRIPTION �� / 1t�1 CG✓� �Y lS�rGt�J L"� 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 Z 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: LU cc 0 a cc 0 U_ w cc Q z w W 0 Wj LlWORK SATISFACTORY:PROCEED ElPROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN 171 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/Contract o Inspecto White Copylinspector's File Canary Copy/Site Notice DATE TIQ5� � CITY OF ORONO CALLED IN INSPECTION,�`�OTI E SCHEDULED 3'. 30644 PERMIT NOJ" O 0 COMPLETED ADDRESS �J L�� l�77iGtin � OWNERS Lk-16,4 CON R. &.6� TELEPHONE NO.x,52 q7(p _73 t DESCRIPTION W 01 FOOTING 11 MECHA ICAL RI 18 EXCAV/GRADING/FILLING W 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WA L BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 5 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: cc W Q_ cc J O CC O W W CC Q Z W z W CC OW WORK SATISFACTORY:PROCEED `StPROJECT COMPLETE Uj W 11CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V 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. (952) 249-4600 Owner/Co ite: Inspector. - atAb White Copylinspector's Ile Canary Copy/Site Notice p</ DATE 9—t-- TIME CITY OF ORONO CALLED IN INSPECTION N TIC SCHEDULED a &-o PERMIT NO. kq / COMPLETED ADDRESS 35030 ley OWNER ONTR. q TELEPHONE N0. DESCRIPTION `ram in 01 FOOTING 11 MECHANIC L 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Q 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 OWNER/CONTRACTOR TO MEET YOUX YES_NO COMMENTS: Som cow cc W a cc J O CC O UL W CC Q Z W z W ac d WWORKSATISFACTORY:PROCEED ElPROJECTCOMPLETE W cc ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR 11 CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance. (952) 249-4600 Owner/Contrao0if e: Inspector. White CopylInspector's Fil Canary Copy/Site Notice 6� A TIME CITY OF ORONO ALLED IN INSPECTION NOTIs SCHEDULED S-V_O PERMIT NO. CJ D COMPLETED ' �.,// ADDRESS �J�oZ� �.L' or�-�L_- OWNER -S ONTR. TELEPHONE NO. DESCRIPTION 4 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 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 OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc W C cc J O O W Qc Q Z W z W CC d WWO RK SATISFACTORY:PROCEED 1-1PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY Q ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.C LL TO ARRANGE ACCESS. Call for the ex inspection 24 hours in advance. (952) 249-4600 Owner/Co act o sit Inspector. White Copy/inspector's File Canary Copy/Site Notice TIME-lo CITY p 8D/jZ� TIME CITY OF ORONO CALLED I6N ��(( INSPECTION NOMC 3- PERMIT NO. MPLETED ADDRESS c36 2-0 lxh_VaU OWNERCONTR. TELEPHONE NO. /gg S2" 177- 8(18' DESCRIPTION _ IQ 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING Q 02 FRAMING 13 ECHANICAL FINAL 19 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPE 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 0-9--PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 LUMBING FINAL© 36 FOUNDATION/REMOVAL NERICONTRACTOR TO MEET YOU:_YES_NO in COMMENTS cc J O CC QUIti UL �_ S W Q � � &q o --0 t` z W W cc O Wcc ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY D/CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C1 EFORECOVERING 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 n xt inspection 24 hours in advance. (952) 249-4600 Owner/Con site: Inspector. White Copylinspector's File Canary CopylSits Notice