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Home My WebLink About2007-P11590 (building) PERMIT '� CI-TY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P11590 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 10/18/2007 SITE ADDRESS: 3855 Bayside Rd Unit# Long Lake,MN 55356 P�� 05-117-23-23-0007 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Roof DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 9�•25 va�uation: $ 3,300.00 State Surcharge Fee: $ 1.65 TOTAL FEE: $ 98.90 APPLICANT: Incline Enterprises Inc OWNER: John Thiesse 26175 Birch Bluff Rd 3855 Bayside Rd Shorewood,MN 55331 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 MINNE TA BUILDING CODE REQUIREMENTS. ' � _ � PLICANT PERMITEE SIGNATURE S ED BY SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) 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 infoYmation) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: � `3� � � ?U�c.� )c �f� �J ZIP: Will this be Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ 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 su�cient on-site parking is available. Non-permitted events will not be allowed. _/' NAME OF OWNER ,) ��'"� t � ��JS r PHONE: (home) (work) MAILING ADDRESS: 3° �� r�� y ��, � CITY: (� �� ZIP: � . . CONTRACTOR: .�1 v�� ,��.t,�-;��s�-�" PHONE: �s L `�� y d�� CONTACT PERSON: �„ �„ MOBILE/PAGER: �,,j� �� o�� MAILING ADDRESS: �� ,�,;�s /�i�F� k',l CITY: 5��r�w�Y-� ZIP: ,'�s� STATE LICENSE: # 7Jt C,�,�;r EXPIRATION DATE: �- 5 c - �;', ARCHITECT/ENGINEER: 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 ay require MCWD review and permits ! PROPOSED WORK(describe in detai�: ��z.cr— � 6�-�- +- ,r'c��-��- 7� S � � STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � � v v I hereby apply for a building pennit 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 a work is not to start without a permit;and that tlle work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: / \ DATE: 1 � --( c�- U ? 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. l. Typc 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 contidential data conceming himself shal I be informed of. (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legal ly required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply privale or confidential data;and(d)the identity of other persons or entities authorized by state orfederal 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 mav 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 publ ic,private or confidential. Upon his fuRher 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,ifhe desires,shall be informed ofthe 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 ofthe data. The responsible authoriry 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. Ifhe 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 conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe 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 detennination of the responsible authoriry may be appealed pursuant to the provisions ofthe adminisVative 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. First Middle Last Address City State Zip Phone I understa y ghts as tated above. \ Signature Reset Form 32 � ,� 1 11\ � � � I ATE TIME � CiTY OF ORONO CALLED IN `O � INSPECTION NO{T-�ICE SCHEDULED ^L�� PERMIT N0. l" �I. �� COMPLETED ADDRESS 3 g �� '�� I�-� . OWNER CONTR. �-�G� �n� TELEPHONE NO. ��J I – � �� — �C��(1 � DESCRIPTION a-�" � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � • a I J � rtQ - 0 a � ° _�� )�C�J�� 'I�CP� � Q � z W � W � � � WORKSATISFACTORY:PROCEED Cl PROJECTCOMPLETE W ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor on site: r Inspector. � • � ! ��.f,o White Copyllnspector's File Canary CopylSite Notice �(J� �� D TE TIME V "1 CITY OF ORONO CALLED IN Q � � INSPECTION NO CE SCHEDULED -� �' � PERMIT NO. COMPLETED ADDRESS ��-J� w J�� OWNER CONTR.��/�_C�'� 1'�r_0_�__ � TELEPHONE NO. � DESCRIPTION l" )�� T / ^ � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL � ❑ FOUNOATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES�NO � COMMENTS: � W � � � 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,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �j pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 24J-46�� OwnerlContractor �te: Inspector. White Copylinspector's File Canary CopylSite Notice