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Home My WebLink About2000-P02049 (Addition/Remodel) ` PERMIT � CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: �2ee� PG�o'�9 Crystal Bay, Minnesota 55323 (612) 249-4600 Date Issued: i�io�oo SITE ADDRESS: 22ss ab�gaonway LONG I,AKE,MN 55356 P��: 03-117-23-23-0007 DESCRIPTION: Proposed Use: Residential UBC Occu an R3 P �Y� Pernut Class: Building Construction Type: V� Pernut Type: Addition/RemodeURepair Census Code: 434 Pernut Sub-type: Single Family DETAILS: Resolution#: 0.00 Separate permits required; ��u�br�-, y, �/�el�r,�c�� Sf�fie� Separate inspections require NOTICES: F E E S U M MA RY: permit Fee: $ 542.75 Valuation:� 40,000.00 Plan Review Fee: $ 352.83 State Surcharge Fee: $�;8�85-600 ��' • , • TOTAL FEE: $ 915.58 AP PLICANT: Boyer Building corporation OWNER: S T&K W POLEY 18283 Minnetonka Blvd 2285 ABINGDON WAY Wayzata,MN 55391 LONG LAKE MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIF'IED AND AGREES TO DO ALL VJORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STA`I'E OF NIINNESOTA BUII,DING CODE REQUIREMENTS. . �� ' APPLICANT P TI'EE SIGNATURE /� Today's Date: 1/10/00 , Page 1 \ � � � Total Fee: $ �`v p�� Date Received: 9 � Entered By: �,� Permit#: 3� �� CITY OF ORONO - BiTII�DING 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: oi��5 �b�N�do� �� zrn: �.�3�� ' NAME OF OWNER: ��+K�T E PO��'( PHONE: (home)�0�1-/yl3 (work) r�oy-o.sc�� MAILING ADDRESS: o� �f5 s9-bi�uc�� C.t�u�y CITY: prvr.�e� ZIP:S53.S� CONTRACTOR: � I�ill�.in�� C�,^+��r�.�irir� PHONE:_ �%17.5-��7 CONTACT PERSON: �'�� J,e�� MOBILE/PAGER: MAILING ADDRESS: /g�aF�3 rn t�A- �Lv�( CITY:/��/� ZIP: �3`t/ STATE LICENSE: # ��'� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CI1'Y: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration '� Land Alteration PROPOSED WORK(describe in detai�: Remod�l ki I�e�n,� C�v�e,t+ (�v�l �o , o STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. 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 start without a permit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: �� '�� DATE: !��C�� NOTE! Parade o Homes events require separate permit approval by Police Deparlment and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 Sec.13.04 ItIGHTS 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 reqirired to be gtven individual. An individuai asked to supply private or confidential daCa concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the wllecting state agency,poli6cal subdivision,or statewide system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequence azising from his supplying or refusing to supply private or confidential data;az�d(d)the identiry of odier persons or entiries 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 rever►ue mavplace the nodce reauired under this subdivision in the individual income tax or oror�ertv tax refitnd instrucdons instead of on those forms. Subd.3. Access to data by individual. Upon request to a respoasible aut�oriry,an individual shall be informed whether he is the subject of stored data on u�dividuals,and whether it is class�ed 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 dara 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 privare or pubGc data upon request by the individual subject of the data. The respoasible authority may require the requesting person to pay the actual cost�of maldng,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 SaNrdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply widi 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. S�bd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data co�erning himself. To ezercise this right,an individual shall norify in writing the responsible authority describing the nawre of the disagreement. The responsible authoriry si�all within 30 days either. (a)correcc the daa 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 determinatian of the respoasible authority may be appealed punuant to the provisions of the administrative procedure act relating to contested cases. AATA 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�ity 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 fumish will be used to determine your qualificarion 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. �2/n� ,� ��/��`r�� First Middle Last � l'.�!� �vGGrs� Address C��- d�k1 �3�1 �177s=i��t`7 Ciry ' State Zip Phone I understand my rights as stated above. � � Signature 6 � � . • r ' CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 22�5 ►�f3�� ^� u� �4 k PID: DESCRIPTION OF WORK: (1-�-�w�� ZONING REVIEW BY: N I�- N DATE APPROVED: BUII.DING REVIEW BY: DATE APPROVED: �z- t ) -S �' FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ,/ No PLAN REVIEW Yes � No SEWER COrfNECTTON STATE SURCHARGE Yes // No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTTON Number of SAC Units OTHER (specify) ZONING CHECB LIST Zoning District: �jv Ghl'��tFa•Q 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�ide: Rear(Street): Left Side: Adjacent Structures: Wetl d: Building Height: Def. Hgt. Peak gt. 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: REMARI�S(in house): 7 � . ti . BUII.DING REVIEW CHECK LIST � UBC: IZ"� CONSTRUCTION TYPE: �l/�1 Sq Footage $Per Sq Ftg Basement , x = lst Floor x = 2nd Floor x = Gazage x = x = TOTAL •� Estimated Construction Value: $ �(d�Oo C� Inspections Required: Work Requiring Separate Permits: Site �Plumbing Fire Hardcover Removal Mechanical Water Connection ' Footing Septic Sewer Connection _�Framing Fireplace Lawn Irrigation �C Insulation (Masonry) Other _�Wall Boazd (Mfg.) Well (State Permit) �Final Grading/Filling vLElectrical(State Permit) Other REMARTZ�(IN HOUSE): � REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMI�: 8 DATE TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED ' PERMIT NO. ` COMPLEfED '� �'� �� ADDRESS � �`�� OWNER CONTR. ��L�� TELEPHONE N0. �� -�� DESCRIPTION ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING h� 02 FRAMING 13 MECHANICAL FINAL 19 IAKESHORE/WEfLANDS Q SULATIO 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 O6 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 J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a J O � � O � W � Q � 2 W � W � � � d W ❑WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. �- pHOTOTAKEN INSPECTOR WILL REfURN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-46�� OwnerlContractor on site: p�'';11� `� Inspector. G'�t- �`��.--�•°�-�.� White Copylinspector's Fite Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION N TICE SCHEDULED r_ � PERMIT NO. �� COMPLETED �� 0•�� ADDRESS L�-F3'S �0��.�� -�f OWNER CONTR. �vS�e�' TELEPHONE W0. � DESCRIPTION �PGvloct�� tV 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS H ULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z . 12 WATER HOOK-UP 17 SITE INSPEC770N Q 05 FINAL 14 SEWER HOOK-UP O6 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 J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMM S: � � W a O ` � �. � O � W � Q � W � W � � d � �IIORKSATISFACTORY:PRQCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTI FICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RERtRN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR �INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 OwneHCantractor on site: Inspector.L/�,�_��G,�ce.� White CopyMspector's Flle Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED �� PERMIT NO. �o a a y 9 COMPLETED �� ?--� 3.�a c� ADDRE�S �-�S �6� �� OWNER CONTR. TELEPHONE N0. � DESCRIPTION��G'°?d� � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y ON 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL 04 WALL BD 12 WATER HOOK-UP 17 SITE INSPECTION OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL 2 OWNER►CONTRACTOR TO MEET YOU:_YES_NO y COMM S: W ` a j O >. � O � W � Q � Z W � W � � ORKSATISFAGTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK 8 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.CALLINSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next ins�ction 24 hours in advance.473-73rJ7 Owner/Contract r on site: Inspector. �� 1 White Copylinspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN �-��- v� l�f�s INSPECTION N T� IC� � SCHEDULED _O� /a,�o b PERMIT NO. O o COMPLETED � � "� /�'CXJ ADDRESS v�oZ �S OWNER ONTR. � TELEPHONE NO. ��`5 � � � 7 � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOREMIETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � . 12 WATER HOOK-UP 17 SITE INSPECTION 05 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 J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAI Q OWNERICONTRACTOR TO MEEf YOU:_YES_NO Z y COMMENTS: � W a 0 � C4"`" � � O � W � Q � 2 W � W � � d /�/wORK SATISFACTORY:PROCEED �ROJECT COMPLETE W �C O CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �pHOTOTAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-46�0 Owner/Contractor on site: Inspector./��G%�.�e-�i�� White CopyMspector's Flle Canary CopylSfte Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTIC SCHEDULED c� � q`� PERMIT NO. Pd�� COMPLETED -2�'�O � `Qp ADDRESS aa`�� '1 OWNER CONTR. �� TELEPHONE NO. Z`E-7.S_�a'a�7 � DESCRIPTION ty 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 ZQ4 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 J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO ��., COMMENTS: � W a o ? r� �°�1%�(' _� 9'�'C. ''/ f �;, � � , � ' LJ�- �i�►'1 ) � ) o , � W � Q � Z W � W � � O W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEiE � )�ORRECT WORK$PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W. � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL REfURN � CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. - -- '"`_ __-�. Call for the next inspection 24 hours in advanc�. 249-46�� `- _ _v_��b._._---�-� Owner/Contractor on site: Inspector.�at-��uJr r White Copyllnspector's File Canary CopylSite Notice