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Home My WebLink About2004 - P07757 - addn/remodel/repair PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P07757 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 8/6/2004 SITE ADDRESS: 1030 Willow View Dr Long Lake,MN 55356 PID: 28-118-23-41-0012 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Permit Class: Building Census Code 434 Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: n_____:- n---.---._t FEE SUMMARY: Permit Fee: $ 293.25 Valuation: $ 18,000.00 Plan Review Fee: $ 190.58 State Surcharge Fee: $ 9.50 TOTAL FEE: $ 493.33 APPLICANT: KJS Construction Inc. OWNER: William&Carmne Ladermann 2582 Morningside Rd. 1030 Willow View Dr Medina,MN 55356 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. cy< 0 j , ,,, \..._ lietc LI >11C SI AP ICANT PERMI SIGNATURE ISSU D BY SIGNATURE Copies: 1-File(Signitures Reciuired), 1-Applicant, 1-Monthly Reports. 1-Assessing, 1-Finance Page 1 L, S.4•0‘1/4 • Total Fee: $ 'f/4B.3,3 Date Received:1- 0 If Entered By: ( Permit#: 4a 77 '7 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 O CONTRACTOR JOB SITE ADDRESS: IOi Ili I I ciit View c*• ZIP: Will this be L arade of Homes,Remodelers Showcase Home or other Display Home? 0 Yes 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. Non permitted events will not be allowed. NAME OF OWNER: ?)l 1 Lc a e mit 1 1 PHONE: (home) I4 O f `f (woiic) (0 ( 7141 MAILING ADDRESS: 1 OW W k( IDI Y�j(4'V CITY: ZIP: ll`` .E . CONTRACTOR: 4Jk S fi�(C�h UY) Irle-• PHONE: 703-4-1/Pl u1Q-?SSA CONTACT PERSON: .I4. S Sfivi m1 , MOBILE/PAGER: LO Id-8.77-o7IS- MAILING ADDRESS:a 5 ?. it,'ap41 I hop ir'Lt la CITY: M,e d i 0 ZIP: '35-3%o /0S-ASTATE LICENSE: # 2'04 S"i 1-5 g 0 EXPIRATION DATE: PM 1/0S- ARCH n E C T/ENGINEER: RCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration X PROPOSE WORKdescribe in detail): 16 l' A , , - IN Ord t AI ;/. FP6Vtal t LOL7.u , Fifa'. ' . STORIES: 'J SQ.FEET OF EACH FLOOR: NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 1 (a,D 0 0 43- 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 permi .n% work is not to start without a permit;and that the work will be in accordance with the approved plan. h APPLICANT'S SIGNAT " ;1 / "-- DATE: 9-) 1-41/ 31 • CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: I b 3 O v,cw PID: DESCRIPTION OF WORK: ID RSew.a, ZONING REVIEW BY: DATE APPROVED: BUILDLNG REVIEW BY: �'`Q ( ,_ DATE APPROVED: S- y o Y FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ,/ No PLAN REVIEW Yes ,/ 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: A./(.3 C i-Fr ,c- Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres idth Depth Survey Submitted: Yes f., No D•to of Survey: Proposed Setbacks: Front(Lake): Right Side: Rear(Street): Left Side: Adjacent Structures: 'etland: Building Height: Def. Hgt. Peak Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: 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 N. Date of Council Approval: I REMARKS (in house): NA NS 0 tJ t` LAI;" 1= rt rt^ IL r 1v.,,44 2 N 5 i C Tz O N -(S/TC ,% r /N c t1) 7 • BUILDING REVIEW CHECK LIST UBC: CONSTRUCTION TYPE: \.//`-) Sq Footage $Per Sq Ftg Basement x 1st Floor x = 2nd Floor x Garage x x = TOTAL Estimated Construction Value: $ I t,U00 Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection )C Framing Fireplace Lawn Irrigation ,( Insulation (Masonry) Other �! Wall Board (Mfg.) Well (State Permit) .1_ Final 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 PERMIT): 8 Sec13.04 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 Berms. 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 maybe 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. LLA IJ � First Middle Last � 1�61?{�t ti rL . A dress ti4LI c so Le(a-g77-o7, City State Zip Phone I understai rights as stated above. 41 if Signatn A 32 [ 4TE TIME CITY OF ORONO CALLED IN `, L INSPECTION NOTICE .�7C SCHEDULED �IO C7 Moo/W'4, PERMIT NO. PO 77S7 J7 COMPLETED ADDRESS /G 30 .-3, gok.) (}/.e.4,),) 47/2- OWNER CONTR. /J S C - m TELEPHONE NO. & (' ?77 07/S DESCRIPTION W 01�a3�Tll N 11 MECHANICAL RFI 19 EXCAVLAKES GRADING/FILLING Q -821RAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS SULATION 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 4.1 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: cc W cc O cc O W cc W W d WCC WORK SATISFACTORY:PROCEED CIPROJECT COMPLETE ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CZ ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN El CITATION ISSUED ElSTOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the n t inspection 24 hours in advance. (952) 249-4600 Owner/Contraph ite: Inspector. White Copy/Inspector's File Canary Copy/Site Notice