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Home My WebLink About2004 - P07153 - addn/remodel/repair PERMIT C'ITIOF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P07153 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 1/6/2004 SITE ADDRESS: 2775 White Oak Cr Long Lake,MN 55356 PID: 04-117-23-42-0015 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential BuildingCensus Code 434 Permit Class: Permit Type: Addition/Remodel/RepairPermit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 251.25 Valuation: $ 15,000.00 Plan Review Fee: $ 163.28 State Surcharge Fee: $ 8.00 TOTAL FEE: $ 422.53 APPLICANT: Owner/Self OWNER: Stacy Sullivan MN 2775 White Oak Cr 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. (1A, ( APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Si&nitures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1 ' . Total Fee: $ Date Received: Entered By: Permit#: 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) �WNE OR CONTRACTOR JOB SITE ADDRESS: S L,U l w ' O C- lel r(-4 ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [7 o 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. J NAME OF OWNER: � t�L. V �.�v PHONE: (home)( - /o 0 (work) MAILING ADDRESS: `7 t `i,-t_-k V P1 CITY: i) (,p 1 S ZIP: j3_; D 3 CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Accessory Structure Addition Move emodel/ lteration V" Land Alteration PROPOSED WORK(describe in detail): C. 'ti t.�- � b A-E_ L 4-tAL STORIES: a SQ. FEET OF EACH FLOOR: l r�D O !3 D 0 NO. OF BEDROOMS: 'Y GARAGE STALLS: ATT. _ DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 106-0 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: ,X ,9/0-1-�-'...k4 C t L DATE: - - i/ 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 pe mit. 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: 2.77 S 64,04_, &1c c tGc e' PID: DESCRIPTION OF WORK: .6Rs6--ii c t-'r- ,iv i s H ZONING REVIEW BY: N/,4 DATE APPROVED: BUILDING REVIEW BY: � .,� DATE APPROVED: I_ ' -0'r FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes tr. No PLAN REVIEW Yes 1/ No SEWER CONNECTION STATE SURCHARGE Yes No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC-Units OTHER (specify) ZONING CHECK LIST Zoning District: No Fire Department: Post Office: School District: • Lot Area: Sq.ft. Acres W th 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 Hgt. 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): 7 1 ! + BUILDING REVIEW CHECK LIST UBC: 4. 3 CONSTRUCTION TYPE: V/•1 Sq Footage $Per Sq Ftg Basement x _ 1st Floor x _ 2nd Floor x Garage x = x TOTAL Estimated Construction Value: $ /S' UV o Inspections Required: Work Requiring Separate Permits: Site ( Plumbing Fire Hardcover Removal .e- Mechanical Water Connection Footing Septic le Framing p Sewer Connection Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) y— Final Grading/Filling om Electrical(State Permit) Other REMARKS(IN HOUSE): • REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMIT): • 8 Iii, NIP • ,. ... i 1 . . giviiqj ._ti • . e..-:1,...., ....tf, (.) SQ. SPECIAL NOTE CITY OF ORONO • ',...) ' BUR..;:;',is!Cs ":"P7 T PLAN FiEN!EW SEE ATTACHED SHEET . . FOR '<Ill.()‘Ge. OC.-1-1=Z-ra ft, 44e ••• •'...:!:•. ...., •-.: '7 :.:; 77::. "...7.•:' ,"'_;":,::.) (X1ShV\ CODE REQU!REMENTS .-.: . .-, :-.. - .:,- :-.:-:-..:-.„7,. r---- . - . i7, ---- • . ,- '::1:, :.,: r •;! :,•,...: i.1;;7 i;!.., '1;;;'. ./....:-...:::,r;.:63. 1--UT CI a eC Rcr.: • ''', ...: :, :•-::: . ,Z.-t,-•.::':•7:.;:,'•••...!...if;•:,'471eVi. . KE.Ci=IiiiS PLAN SET ON SITE AT ALL.TIMES ' -----(-------- --------P . L ........_...,) 14%..) . / 1 1. 1- - -- ----------......--- ------__ - / 1 - --,t- ( 1 . 1 1 . . f ‘.'....C1 _ \\/..."---4 1 r--- 1 I GO \17-0q-- ...- - i i ..- V .. 518 Type X Sheetrocit --- /- Underside Of Stairs And Walls • ) . 1 PROVIDE TREATED PLA l'ES /WHEN 71 LAYED ON CONCRETE . . '.. -13 EL D..;;...ii '."...•i 't.., '.1"--n..-...)1.1":-.;....:j. .1 C-r-,;'n-v‘_„,,, .... , f ! • 1.7:'.7:" i'-.!• ;f..--]. i'..:',i....:.,..-!!,i!L-1-VI:f!..-;!i.-}-1 _ •-.--"' 'i'• •.''1. Ci_E7.1-,,li ! . 3.7 Et.`..,...s!. F . Mn.J. OPENING 44" MAX. SiLL HEIGHT ....__ I 1 I i ' 1 .1111111. 111.1111.1 i '•••-1-...- 4. S4 / DATE T Y IME CITY OF ORONO CALLED IN 9 INSPECTION NOTICE SCHEDULED 5--7 /:0 0 PERMIT NO. /'O 7 l 5--) . COMPLETED��- ADDRESS a?77S L'L Y. -.-1-- e-c_.- OWNER //rcQ�.�P G =- c�G,,.CONTR. TELEPHONE NO. (3'/ 2- 2 2- pW 2 i DESCRIPTION 14'-�-C — F- �--e-C� � 'e LU 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS ,SJ 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 `I 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP tzy 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 CC '[ at &Am c.‘ . stiitLc 0 Q C�,txo PP Pb 707.5 z f p Pa-15-7 W z W cc 2 WORK SATISFACTORY:PROCEED CIPROJECT COMPLETE CC W ❑CORRECT WORK&PROCEED CIISSUE CERTIFICATE OF OCCUPANCY O CI CORRECT WORK,CALL FOR REINSPECTION TEMPORARY OU 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 for the next i spection 24 hours in advance. (952) 249-4600 Owner/Contrt t Inspector. White Copylinspector's File Canary CopylSite Notice CDATE TIME CITY OF ORONO CALL IN Pb-7.08 5„11--- (./ 1-7 INSPECTION N IC SCHEDULED /—x-03 /0:04 PERMIT NO. /0 /t 7_2`✓ COMPLETED ADDRESS ‘2775-4A/142:P% T- OWNER / l t(TR.` TELEPHONE NO. 1/2 212_ 8Te 2g DESCRIPTION tL 01 FOOTING 11 MECHANICAL RT 18 EXCAV/GRADING/FILLING 4. 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL • 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 i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q OWNER/CONTRACTOR TO MEET YOU: YES_NO COM ENTS: cc Lu - V1/4-k. k OY Q. cc thri" 0 cc 4. W Q z s a be r• -1,. mss W z W cc c:,, Li, ❑ RK SATISFACTORY:PROCEED ❑PROJECT COMPLETE CC W,� ORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.1 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN CISTOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance. (952) 249-4600 Owner!Contracto : Inspector. White Copyllnspector's File Canary Copy/Site Notice T� TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED l-23-051- !D:oD PERMIT NO. P07/ S3 COMPLETED ADDRESS 07 7 75 L Z �c— OWNER/C ONTR. TELEPHONE NO. b/2- 2- Z ?5(Z r DESCRIPTION ///SizZaAaL1/ 1/1-er7 LU 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL 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 `4 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP LU09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc W cc O cc 0 LL W cc W W cc O WCC WORK SATISFACTORY:PROCEED CIPROJECT COMPLETE ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT LI CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN CI CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractpr 'te: Inspector. White Copyllnspector's ile Canary Copy/Site Notice 3_DTIME CITY OF ORONO CALLED IN INSPECTION ICE SCHEDULED 3- -D+- .3:op PERMIT NO. 7/53 COMPLETED /- ADDRESS a77S (fit Q��1 4 tC/t� OWNER 1(ie-� �-U �� tO 66 TR. /., TELEPHONE NO. k/-7 O `l p DESCRIPTION44• ! 2—r w d e4 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS " 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL • 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 Lij 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU: YES_NO o COMENTS: cc I 41145e VILkSA& 4 4s cc O cc • ?- /AP- Acces Z)r- 61 ✓t 1MCe O z cc O WCC ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0' CORRECT WORK,CALL FOR REINSPECTION TEMPORARY • FORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED 0 STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the ne inspection 24 hours in advance. (952) 249-4600 Owner!Contracto it : Inspector. �: White Copyllnspector's Fil Canary Copy/Site Notice