HomeMy WebLinkAbout1997-009385 - addition �- _ —
PERMIT
� CITY OF ORONO PERMIT TYPE:
27,�50 Kelley Parkway- P.O. Box 66 >;W i Y�W
Crystal Bay, Minnesota 55323 Permit Number: _
� (612)473-7357 Date Issued:
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: . : , u .. _,:_.., _ OWNER:
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APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
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Total Fee: $ /����. ,� � Date Received: �7 J `�' �
, Entered By: �. �> Permit#: �> � P'S
. CITY OF ORONO - BUII..DING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
- �----,..
--------------------------------------------------------------------r�=`==------=�----- -- - ---------------=-
THE APPLICANT IS: (circle one) OWNER CONTRACTOR�
JOB SITE ADDRESS: �(� �l C��T}�-- i3�'-i"1 t� (L�� ZIP: '�
NAME OF OWNER: ��g� N � PHONE: (home)�j=GYo�'2
(work)
MAII.INGADDRESS: CIL� N��t{ j��N . +�f). CITY: ��1.-A��. ZIP:
'�
CONTRACTOR: aL��, ���. PHONE: �'��-�j0�
CONTACT PERSON: � �.{ �� MOBILE/PAGER: �� -3 c�3 Z
MAII.ING ADDRESS: 2� ' �,ti . CITY: �:(r�, ZIP:��3 '�31��
STATE LICENSE: # (oZ�3 3
C=u�( �+r�c:� r��.�,-.J,;.��> ,
(^�1�� i�1��.� PHONE:
MAII.ING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
,��.�- ,:x�L :���i�� -f 1°:...�.ctii
TYPE OF WORK: New t�� '.' Accessory Structure �
Move Remodel/Alte ation Land Alteration
PROPOSED WORK(describe in detain: (xZti< d����lc�►� �v �
„
��x IS H-�, ���� � ��L �-�� �WJ.���
STORIES: ` SQ. FEET OF EACH FLOOR: �-
NO. OF BEDROOMS: - GARAGE STALLS: ATT. - DET. f
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �zi'.�'T
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 perm.it and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATL�-_-=:_:--� -� DATE:`>�'i- � �G[�1
NOTE! Parade qf Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
■ 1 ,
Sec.13.04 RIGEiTS OF SLJBJECTS OF D�TA
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 reqtrired to be given individual. An individual asked to supply private or confidendal data concerning himself shall
be informed of: (a)the purpose and iatended use of the requested data within the collecdng�tarE agency,poliacal subdivision,or statewide system;
(b)whether he may refuse ot is(egally required to supply the requested data;(c)any known consequence arising from lus supplying or refusing to suppty
priva[e or confidenaal dara;and(d)the idenary of other penoas or enddes authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve data,pursuant to secdon 13.82,subdivision 5, to a law enforcemenc officer.
The commissioner of revenue mav place the nodce required under this subdivision in the individual income rax or propem raz refund
instiucdons instead of on those forms.
Subd.3. Access to data by iadividual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored data on individuals,and whether it is classified as public,private or confidenaal. Upon his further request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wichou[any charge to him and,�if he des'ues, 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 disc(osed to him for
siz months thereafcer unless a dispute or acdon pursuant to this secaon is pending or addidonal dara on the individual 6as been collected or created.
The responsible authoriry shall provide copies of the private or public dara upon request by the individual subject of ihe dara. The responsible authoriry
may require the requesring person to pay the actual costs of making, certifying,and compiling the copies.
The responsibie authority shall comply immediate(y, if possible, with any request made pursuant to this subdivision,or wichin five days of
the date of the request,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shail so inform the individual,and may have an addidonal 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[his right,an individual shall nodfy in wriring che responsible authoriry describing the nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomple[e and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipients named by the individual; or(b)nodfy the individual that he believes the dara to be correct Data
in dispute 5ha11 be disclosed only if the individual's statement of disagreement is included with the disc(osed data.
The deteraunarion of the responsible authoriry may be appealed pursuanc to the provisions of the administiadve procedure act mlating 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 fumish 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 a�encies to the extent necessary to process
the pemut or license.
4. If your requested perm.it 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 da[a on yourself.
6. Your full name is required to process this application or permit.
��
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Fint Middle 1-ast
����-`-> �/�f�S 1 1 �.��-- -
Address
� �9.1�.i��i���i�c�'i L-Z N _ `�..�!'�`-r 5 ..51��� '�7�-�L-�-�-
City State Zip Phone
I understand my rights as stated above.
�"- ,, ------
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Signamre
' CHECK OFF LIST FOR ISSUANCE OF PERIVIITS
FOR OFFICE USE ONLY
. ADDRESS OR LEGAL: `I l�l� N o2T�t (3Rowr► ILoA-r�
PID:
� DESCRIPTIONOFWORK: _ (��uc /�-D4i,o�
ZO'vING REVIEW BY: DATE APPROVED: �- 1-5 7
BUII..DING REV�W BY: DATE APPROVED: �- S-�!�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes i/' No
PLAN REVIEW Yes c� No SEWF.R CONNECTTON
STATE SUR`HARG�E Yes r/ No WATER CONNECITON
INVESTIGAT'ION-�EE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONIlVG CHECK LIST Zoning District: R�C-I�--------------------------------------- --------
Fire Departmenr. n� r.�' Post OfFce: la.� CAw� School District: p/l.�nr0
Lot Area: Sq.fr. Il�v C1�.�9,,v��Acres — Width — Depth --
—T
Survey Submitted: Yes_� No Date of Survey:
Proposed Setbacks:
Front (Lake): . �i U' Right Side: �U� �
Rear (Street): Z Zp '. Left Side: 170� S
Adjacent Structures: (}i-T�9c�bk.c� Wetland: N (A
Building Height: Def. Hgt. (u ��4 Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoaino File: # Resolution: # Resolution Date: �
�(•� Shoreland DisL-ict: .
Avg. Setback: Bluff Setback: I.ot Coverage:
- Existing Proposed
Hardcover: 0-75'
75-250' . �
250-Sa0' .
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REiI�ARKS (in house):
• 26
BUII.DING REY�W CHECK LIST �
�C� - � ' 3 CONSTRUCTTON TYPE: �h�
� Sq Footage $ Per Sq Ftg
Basement x _
lst Floor x = . .
2nd Floor x _
Gazage x _
z =
TOTAL
Estimated Construction Value: $_(9,(��p °°
Inspections Required: � Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
x Footing Septic Sewer Connection
D� Fram.ing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
°� F�� Gradin�/Filling Electrical (State Permit)
Other
REt12A.]E2KS (IN HOUSE): _�_� _ ---_ _____�---------
�_____�_ �___�_---
-------- �_______-------
REV�W BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gy.
REMARKS(TO BE NOTED ON PERA�II'I'):� ��� �
27 _ _ � ��: �i;.
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SCHERER LIC,#20062933
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� �'�:�� ��� C�rtificate of Survey
' ���� ��"� fcr Inark k�. P.�bbia;�
����'�� �� �'�Y of Lo� <4 Block 1 The Faz-c� ,:�t Lon Lake
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0 [}ISAF7P �VE �TH REVIS10hIS
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��56"E e Qa�l"� 9 -9-q ',
��(103��8 ������Q A/67°4T57"W 7759� 1,
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� I hereby ce:tify that �
� �O / � this is 8 tz�.;e and carrect � �
� �; / representatien of n sur�e5 of oo. � �
o ° / the boi:ndaries of Lot 24, �loc'r_ 1, \ N, ��� j ;
� � � The Farm at Long I.ake, the locr�tion �N £ I '
.�9' � of alI existing buildir.gs, if ar.y, ,y'� i !
5���j trereor, and the proposed location of a \ N 69 ,
�/ orcposed building. It does r.ot purport L�____��� i '
- / � s h t�w e t r e. i a�p r c v e m e r.t s o r e n c r o a c h m e r.t s. �
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Sc�le: l u = 5C' � : , '--. �.�.-y
�; _ Gordon R. Coffin . Ido, 6064
DQte : 1G-10-8� ' "_ :; Mark S. �ronberg r'�eg. No.12755
o . Iron marker _> � .,. �: L,and Surveyors and Planners
,. ' i�;,+`�
,�a Long I,ake, �'�nnesota
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May 16, 2007
r .4 �
INFORMATION ONLY—RE: 900 BROWN ROAD NORTH
This is simply a note to try and re-cap the chain of events regarding the sewer connection
on the property listed: 900 Brown Road N.
Scott Obrainger had been working with the contractors, home owners and Title Company
to determine the amount owed for the sewer connection.
This property also needed a Sewer Agreement signed before issuing any permits. This
was an agreement between us and Long Lake. (Scott said this is not completely ready,
but it's ok, to issue the sewer connection permit)
The title company was told by Scott .O. that an amount owed was $25,690.00, which was
a breakdown of: $24,015.00 SEWER CONNECTION & $1,675.00 SAC. This had to be
paid before we could issue the sewer connection permit.
This would be for Levy#14194/ 97-1
On May 11, 2007 we received a check from Home Title, Inc. in the amount of
$25,690.00. However, when we pulled the street file (which Lin had) and checked in
Govern we realized that SAC Charges had been paid#5450— 10/O1/1984. Therefore, the
check that the title company sent was an overpayment.
I spoke with Ron Olson our Finance Director, and he suggested I call the Title Company.
He would prefer they send a new check, but if we had to we could refund the amount that
they overpaid. However, we could only make the check payable to the Title Company,
not a homeowner.
After speaking with the Title Company, the decision has been made to send them a
refund.
This letter is to request a refund for the SAC amount that was overpaid to be made to:
Home Title Company, Inc.
2605 Campus Drive
Plymouth, MN 55441
Send to the attention of: Tammy McCloud
Send a refund in the amount of: $1,675.00 ($25,690.00 - $24,015.00 = $1,675.00)
/�
Respectfully, '��
1
Rachel Dod e I "'�' �� �
g
City Admin strators Approval Signature
Copies: �inance Department �Street File [j�'Scott.O. �n.V.
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED --
PERMIT NO. � -� COMPLETED
ADDRESS � � W '`1 � '
OWN ER � CONTR.
TELEPHONE NO.
; �
� DESCRIPTION `E �� � 4� L t d �
4� 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 WA�L BD. 12 WATER HOOK-UP 17 SITE INSPECTION
FIN 14 SEWER HOOK-UP 06 PROGRESS
� DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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DATE TIME
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DATE TIME
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DATE T�ME
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