HomeMy WebLinkAbout2007 - P10795 - addn/remodel/repair • PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P10795
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 • Date Issued:
3/5/2007
SITE ADDRESS: 945 Willow View Dr Unit#
Long Lake,MN 55356
PID: 28-118-23-44-0009
DESCRIPTION:
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit T e: Addition/Remodel/Repair Sub-type(s): Addn/Remodel/Repair
YID
DETAILS:
Approved per resolution#:
Separate permits required: Fireplace Electrical(state)
NOTICES/REMARKS:
Partial Lower Level Finish
FEE SUMMARY: Permit Fee: $ 532.65 Valuation: $ 39,000.00
Plan Review Fee: $ 346.22
State Surcharge Fee: $ 19.50
TOTAL FEE: $ 898.37
APPLICANT: Tom Potter Construction Inc. OWNER: Timothy&Brenda Wicks
6531 Devonshire Dr. 945 Willow View Dr
Chanhassen,MN 55317 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.
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APPLICANT PERMITEE SIGNATURE .UED BY SIGNATURE 4
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
Total Fee: $ (Fq Er 3 7 Date Received: & c '-' 7
Entered By: Permit#: A/o79..5�
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 OI CONTRACTOR
JOB SITE ADDRESS: 7--/3 jjtl, L(,otJ 1)16 C) LAAi IA (6- ZIP: 5-53
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
Yes 3 No 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. 'Von-permitted events will not be allowed.
NAME OF OWNER: '7/V' IA) c_/ 5 PHONE: (home) 15Z- L/73-01'-7o
AA/6
(work)
MAILING ADDRESS:9/S L) tL,W V��L) CITY:AA/6 Mge ZIP: 6:535-6,
CONTRACTOR: 7Z/V l PDTT6/? C44JS7, JA.' PHONE: /6 2- 4/7. -ago
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CONTACT PERSON: "Th/vi ATfic--2 MOBILE/PAGER: 6/L- 28Z- 7y3k
MAILING ADDRESS: 473-3/ ikuo,)5i z6 ,(,l✓'CITY: elkte/fA556)ZIP: 553/7
STATE LICENSE: # .2013o/ £// EXPIRATION DATE: 3 — 3 /— c) '7
ARCHITECT/ENGINEER: Iq- PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) )<
Any earth movement may require MCWD review and permits !
PROPOSED WORK(describe in detail): Fit),3 tl 5/LTS ►2T 1CIi/1 /4-464
a0 cA/46 /2E-A Izaccz. of �x1'S-ri".✓c. /4-o
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 39 o oo. 0 c)
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: Pat -2:7 — .07
�— W DATE: p2
31
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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 himselfshall 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.
1 IA)
1 OfI 5 t LL2A-An
First Middle Last
6631 ()EUO.J-5 h
Address
MA) 65-3 1 7
•
City State Zip Phone
I unders d my rights as stated above.
Signature
Reset Form 32
CHECK 01:0F LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: \L �w
PID:
DESCRIPTION OF WORK: ART.\,A-4- eL- �►n, is+�
—
ZONENG REVIEW BY: ---- N ------ DA'L'E APPROVED: _
BUILDING REVIEW BY: ,, . DATE APPROVED: 2,-2.g-01
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes V. No
PLAN REVIEW Yes ,. No SEWER CONNECTION
STATE SURCHARGE Yes ,/ No WATERCONNECTION
INVESTIGATION FEE Yes No ,/ PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC.Units OTHER (specify)
ZONING CHECK LIST Zoning District: NO CHANGE_
Fire Department:
Post Office: School District: •
•
Lot Area: Sq.ft.
Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: •
Front(Lake): Right •-
Rear(Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. • gt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: " Resolution Date:
Shoreland District: Lot Coverage :e
Avg. Setback: Bluff Se back: — ----
Ex_isting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardccve. ba_ acce Required: Yes -- —
F.E L\ S (Li hou e): — —
•
BUILDING REVIEW CHECK LIST
UBC: 2 .3 CONS I RUCTION TYPE: u/•
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x •
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 361,6 Oc) 11
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal ' Mechanical Water Connection
Footing Septic Sewer Connection
„( Framing o< Fireplace Lawn Irrigation •
o. Insulation (Masonry) Other
Wall Board DL (Mfg.) Well (State Permit)
Final Grading/Filling >4 Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT):
CITY OF ORONO P/O7q3CALLEDIN
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AT� TIME 'fj/
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INSPECTION N SCHEDULED - c2-
PERMIT NO. COMPLETED l
ADDRESS 9 5 &!/lw Vim/ 4
OWNER CONTR. Tlfh1 Pe _./e
TELEPHONE NO. 7 /67„—c2Fcg -' 7L/3(
DESCRIPTION /,zSaJai
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
c 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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09 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:
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W ❑ ORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
OO ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
C CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN
❑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:/
Inspector. ttJ (1" 145
White Copy/Inspector's File Canary Copy/Site Notice
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< A TIMEri CITY OF ORONO DIN
INSPECTION NO,s�,�.-s SCHEDULED lb�7 ? -o
PERMIT NO. ti0 a/ ' COMPLETED 9
ADDRESS (NJ W i1l� Vl ri"-' n //
OWNER QCONTR.—r:-L 1 tom/
TELEPHONE NO. i/a aLJICiI 7 V36p
DESCRIPTION Y"r a'l'l I n
LV 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Lk, 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
' 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 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
• OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
WCWCC
ORRECT WORK&PROCEED CI ISSUE CERTIFICATE OF OCCUPANCY
C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP 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/Contractor on site:
Inspector. Li(,.--//e,
White Copy/Inspector's File Canary Copy/Site Notice