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Home My WebLink About2004-P08051 (add/remodel/repair) � PERMIT ��TY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Pososi Crystal Bay, Minnesota 55323 Pel"t111t Typ2: Addition/RemodeURepair (952) 249-4600 Date Issued: io�2o�2ooa SITE ADDRESS: 3225 Bayside Rd I.ong Lake,MN 55356 PID: os-ii�-23-4i-ooi� DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: ^------.�i--- "-�---=---'-`' e n'--"- ^'---' FEE SUMMARY: Permit Fee: $ 441.75 Valuation: $ 30,000.00 Plan Review Fee: $ 287.13 State Surcharge Fee: $ 15.50 TOTAL FEE: $ 744.38 APPLICANT: Doug Boschee Homes Inc. OWNER: Mr. &Mrs. Sheldon 9160 Brockton Lane N 3225 Bayside Rd Maple Grove,MN 55311 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. � APP A PERM EE SIGNATU S UED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 . �;I t_�t � �:�� Total Fee: $ �� Date Received: � �� Entered By: ,ii j�'Yt� ��'t--' Permit#: �j��'OS� � . ' i_ ; . .. .�r j , I ��; CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please p��i�zt all infor•t�iatio�t) THE APPLICANT IS: (cia•cle orte) OWNER O CONTRACTOR JOB SITE ADDRESS: 3�� 1�y �,`-�.r �2� ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If>>es, a special event per»ait is r�eyirired witlr Police Depm�tnient and Cih�Counci/approval 60 d�iys prior to the event. Shuttle bats service will be required u�iless applica�at den:onsh�ates su�eient on-site pa�-king is availcable. Non perrnitted events will not be allowecl. NAME OF OWNER: �d�1 r�h.��o�� PHONE: (home) (work) MAILING ADDRESS: �� CITY: Z1P: CONTRACTOR i vc, ',� -,rt 1� J'c, PHONE: ��3- ��•v- �,�y� CONTACT PERSON: • MOBILE/PAGER: ti1 � 3� y2-'d 2��y� MAILINGADDRESS: �I(QD f3/zOCYC-fdN Lq! <[/, CITY: ✓l �r �, ZIP: s.�i/ STATE LICENSE: # -�.�p p �,�-� S� EXPIRATION DATE: ,� - �/- f�5 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Hoine Remodel/Alteration � PROPOSED WORK(desc�-ibe in detai�: [�a,� J��'� C1.�1's J'C?�cl/'� t/•�-r �a Y J�(''G1Dz. ��C[9� /ll STORIES: �- SQ.FEET OF EACH FLOOR: %(p f� NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED o G ESTIMATED CONSTRUCTION VALUATION(excludingland): $ 3a. oa c "i I hereby apply for a buildinb permit and I acknowledge that the information above is complete and accurate; that the work will be in confornlance 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. r APPLICANT'S SIGNATU DATE: jQ •� �' 7-c�0 �/ 31 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 se[forth in this section. Subd.2. [nfonna[ion required to be given individual. An individual asked to supply private or confidential data conceming himself shall be infonned 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 identiry of other persons or entities authorized by sta[e or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investi�ative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofticer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or pronei7v tax refund instructions instead of on those fonns. Subd.3. Access to data by individual. Upon reques[to a responsible authority,an individual shall be infonned whether he is Ihe subject of s[ored data on individuals,and whe[her it is classitied as public,priva[e or contidential. 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,shail be infonned of the content and meaning of that data. After an individual has been shown the private data and infonned of its meaning the data need not be disclosed to him for six mondis therealRer unless a dispute or action pursuant to this section is pending or additional data on die individual has been collected or created. Tlie responsible authority shall provide copies of the priva[e or public data upon request by the individuai subject of the data. The responsible authoiity may require the requesting person to pay Ihe 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 ofthe date ot�[he request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the requcst within that time,he shall so infonn the individual,and may have an addi[ional tive days within which to comply with the request,excluding Satw�days, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individu�l may contest the accuracy or completeness of public or piivate daki conceming himself. To exercise this right,an individual shall notify in writing the responsible autho�ity describing the nature ofthe disae��eement. The responsible autho�ity shail within 30 days either: (a)con-ecl the data found to be inaccura[e or incomplete and attempt to notify past recipienU ot inaccurate or incomplete data,induding recipients named by the individual;or(b)notity the individual that he believes the data to be con�ect. Da[a in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The detennination of[he responsible authority may be lppealed pursunnt to the provisions of the adminisUative 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 inforniation. You are notified that: 1. The infonnation you furnish will be used to detennine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the City deny the perniit 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 requu-es 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 requ� to process this application or permit. 1 G� ' �S� C r 1C'K,�� First Middle Last c1!l�'U l�Roc`c�vy C.0 �f/ Address �,.�� a �� i�C:.�.� .�S3�i �W3- ��i-��y� City Statc Zip Phone I un rstand my rights as s ted ove. � Signature 32 , � CHECK OFF LIST FOR ISSUA1vCE OF PE.R1ti�tITS FOR OF'FICE USE ONL Y ADDRESS OR LEGAL: 3Z-Z S �A � � '�'� PID: DESCRIPTI0IV OF Y[�ORK: S o c.42� �� N� `� S L�5°"` a""` _ -_ -- - -------------------------------- ------------ ZONItVG REI�IEY[�BY: DATEAPPROVED: i� � s �� y B UILDING.RE VIE�3�B Y: DA TE APPRO 6'ED: , o -�9 - �y ------------------------------- FEES TO BE CHARGED: 1�'Iisc. Fees Calctciccted By: PERNfIT Yes ✓ �'�o PLANREVIEGV Yes �� Vo SEYVER CO�V�VEGTIO�V STATE SURCH.4RGE Yes � 1Vo tiT%ATER GOtWECTIO�V INVESTIGATION FEE Yes No PARK FE'E S:�C Yes !Vo SITE NSPECTIO�V Nat�izber• of SAC U�iits OTHER (specify) -------------------------------------------------------------------------------------------- T.O�VIIVG CHEC.F�LIST Zor�i�ig District: N v CG�fr� Fire Deparhnerrt: Post Off ce: Sclaoo!District: ___. Got,�t�•en: Sq.Jt. Acr•es GYidtic Deptli Scuvey S«bruitted: Yes No DRte of Stuvey: Proposed Setbadcs: Frortt(Lal;e): Right Side: Rear•(St�•eet): Left Side: Adjace�lt Strc�ctures: G�etlaizd: B«ilcfiiTg Height: Def. Ngt. Peak Hgt. Got Coverage: Grading: StaffApproval Date: By: Council Appraval Date: Septic: Stnff,�ipproval Date: BY'� Zo�tirlg File: # Resoli�tia�: # Resoltttiola Date: Shor'eland Dish•ict: Avg. Setback: Blc Setbacic: Lot Cover•age: Eti ing Proposed Hardcover: 0-7�' 75-Z.i 0' 250-500' 500-1000' Nardcover Variaftce Reqiiired: Yes o Dnte of Council Approval: RE1I�IARKS(i�i liouse): 31 � B UILDI�VG REVIEIY CHECK LIST UBC: `< ' � CONSTRLiCTIO�V'TYPE:�,(/�) Sq Footaue .�Per Sq Fr� Base�i�enr .r = Ist Floor x = ?nd Floor x = Garage s = .� _ TOT.�iL Estimated Construclio�t Vnlue: S�� Qpv � Lispectior:s Required: lG'ork Reqcririag Separate Perutits: Site Plu�,�bi,tg Fir•e Hardcover Re�noval Mechaiiicnl Y�arer Connecfion Fooh:rtg Sep[ic Setiver Coiv�ection �Franzi�ig Fu'eplace Lawn Irrigatiai �huulatiai (rL(asonrz�) Otlier � GY"alf Board (Mfg.) 6Yell(S�ate Permit) _�Finaf Grading/Fi(Linj E(ech-ica!(State Perniit) Other -------------------------------------------------------------------------------------------------------------------------------------------- RE1titARIiS(IN HO USE): ------------------------------------------------------------------------------------------------------------------------ REY7EW BY OTHERS: DATE: .4ccess: E.ristin,; rVetiv .�{ccess�lpproval: Date B�•: ------------------------------------------------------------------------------------------------------------------------ RE�l�I�1RIiS (TO BE NOTED ONPER.N,tIT): 32 � U �/ DATE �/ TIME CITY OF ORONO CALLED IN ��/ INSPECTION NOTICE SCHEDULED �2 /�°�C�� . '�% ��1 PERMIT NO. ;`��:��"��"? � coMP�ETE� �, � �� '� ADDRESS -�. v� � � `J/��- ;`-�-t OWNER CONTR. � v` �` <<�� .� ��r�' TELEPHONE N0. T rl�.�� ,� / �' l�� . � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLINC Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � �LATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Q Z . 12 WATER HOOK-UP 17 SITE�NSPECTION Q 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 = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � J O a � O � W � Q ti Z W � W � � d ��WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED n_ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN 7 CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �95Z� Z49-460� OwnerlContractor ite: Inspector White Copyllnspector's File Canary CopylSite Notice � ' AT TIME V CITY OF ORONO CALLED IN � � �'dr INSPECTION NOT�E SCHEDULED �� a`� PERMIT NO. ��b51 COMPLETED ADDRESS `�ZZ �� --�1 S>�Ip- ,(�� OWNER CONTR. TELEPHONE NO. �n r � �o� ' (�-I� - I O L}- � DESCRIPTION �l'��-m'/�q' ' �y,�-� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h 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 J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC INAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU: YES_NO � COMMEN� � � �s � �P,�r' ` �P.u�_� C� j � O �. � O � W � Q � Z W � W � � d W� ❑ RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W � RRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REiNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN � CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContract� ite: Inspector. White Copyllnspector's ile Canary CopylSite Notice / " � ��/�' ' DATEf TIME v CITY OF ORONO CALLED IN �Q< INSPECTION NO IC � SCHEDULED -1�1�Jl��"� rERMIT NO. � COMPIETED ADDRESS 3�a s r 3 c� �;S Ir,l o ' ��,� OWNER CONTR.T t?L;_�, TELEPHONE N0. �`'�� "' �� O 3 (� � DESCRIPTION ��'�� — ��l �,�� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 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 COMPIAINT � 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 Z OWNERICONTRACTOR TO MEET YOU _YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED � PROJECT COMPLETE � ❑ CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,� pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '�CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe n xt inspection 24 hours in advance. (952� 249-46�� OwnerlContr o ite: Inspector. White Copyllnspector's File Canary CopylSite Notice