HomeMy WebLinkAbout2003-P06441 - pool CITY OF ORONO PERMIT
2750 Kelley F`-arkway- PO Box 66 Permit Number: Po64ai
Crystal �r.iy, Minnesota 55323 Permit Type: a��essory srru�cures
(952) 249-4600 Date Issued: 6i26i2oo3
SITE ADDRESS: 960 Brown Rd N
I.ong I.ake,MN 55356
PID: 27-118-23-43-0025
DESCRIPTION:
Proposed Use: Residential
Pernut Class: Building Census Code 329
Permit Type: Accessory Structures Pernut Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00
Plan Review Fee: $ 117.78
State Surcharge Fee: $ 5.50
TOTAL FEE: $ 304.53
APPLICANT: Master Pool&Spa OWNER: Garry&Shannon Banks
6415 Wayzata Blvd. 960 Brown Rd N
St. Louis Park,MN 55426 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SfATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
_ > , '` � � ✓ �� lL.�_ �� `` , �
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_ APPLICANTPERMITEESIGNATURE ISSUEDBYSIGNATURE
Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
' Total Fee: $ ��JU y ' � -' Date Received: � —/ 7 Q_�
Enterec��By: �c� Pernut#: /q p(o S��// _
I.—v,�,� `_�' �: j Z `�
' CITY OF ORONO - B�DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all infortnation)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ��C� !�G_ �?�u/� �C C.�. ZIP:
NAl�iE OF OWNER: �,;�-,e r �s f f h?�/�',� (,3���S PHONE: (home)
. (work)
MAILI�i tG ADDRESS: q��LO.�r'�u/t� CITY: •�`ii?c:��� ZIP:
�S�—.��f'3— G Z �� �
CO\�TRACTOR: 17'1��t��`Yz �C L� ��f��- _ PHONE:.� 1�"� 3�'��" � �% � �
CO��TACT PERSON: j�c�-�� N10BILE/PAGER:
NL4ILING ADDRESS: E�`��� Li/v�,'Y Z�'� ��.�CITY:�-cr'-tf� q�P�ZIP: ��Z�'
ST?,T'E LICENSE: #
ARCHITECT/ENGINEER: PHOi�TE:
MAII..I�i 1G ADDRESS: CITY: ZIP:
N���; REGISTRATION#
TYPE OF WORK: New� Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detain: ,Q�'il"i � --- �1� ��i�C�t,� r��
STORIES: SQ. FEET OF EACH FLOOR: �� � `�.�-�
NO. OF BEDROOVIS: � GARAGE STALLS: ATT. DET.
ESTLI-IATED CONSTRUCTION VALUATION (exclud.ing land): $ (� G�, L�
I hereby apply for a buildin; permit and I acknowled�e 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 BuildinJ Code; that I understand this is not a permit and work is not to start without a
permit; and that the work wiR be in accordance with the approved plan.
APPLICAlVT'S SIGNATURE: ��- �A�� � ' �
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
5
Sec.13.04 RIGHTS OF SUBJECTS OF D.�TA r
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 secaon. •
Subd.2. Information required to be given indiridual. An individual asked ro supply private or confidendal data conceming himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide
system;(b)whether he may refuse or is legally required to suppfy the requested data;(c)any Imown consequence arising from his supplying or
refusing co supply privat�or confidenaal dara;and(d)the idendry of other persons or enuaes aurhorized by srate or federal law to receive the data.
This requirement shall not appiy when an individual is asked to supply investigative data, pursuant to seccion 13.82, subdivision 5, to a law
enforcement officer.
'Ihe commissioner of revenue mav lace the notice re uired under this subdivision in the individual income taz or ro ertv tax refund
instrucrions 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 public,private or co�denaal. Upon his further request,an individual who
is the subject of stored private or public dara 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. Aher an individual has been shown the private data and informed of iu meaning,che data need not tx
discfosed to him for six months thereafter unless a dispute or acdon pursuant to this secdon is pending or addidonal data on the individual has been
collected or created. The responsible authoriry 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,certifyin„and compiling the copies.
'Il�e responsible authority shal]comply immediately,if possible,with any request made pursuant to this subdivision,or within five days
of the da�e of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possibie. If he cannot comply wi[h
the request wi[hin that cime, he shall 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 conceming himself. To exercise tfus right,an individual shall notify in writing the responsible authoriry describing the nature of the
disagreemenc. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy
past recipients of inaccurate or incomplete dara,including recipienu named by the individual;or(b)nocify 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 dara.
The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminis�auve procedure act reladn�
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 �ity of Orono or any of its departments may require you to furnish cer[ain
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 licease 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
C�ry State Zip Phone
I understand my rights as stated above.
Signature
6
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
., FOR OFFICE USE ONLY
ADI�RESS OR LEGAL: �(�O /V a �3 R o w N R.•o,a,�
PID:
DESCRIP"I'ION OF WORK: (�o 01
ZOi�TING REVIEW BY: 4. �_ DATE APPROVED: G�Z y�63
BUII,DING REVIEW BY: DATE APPROVED: Z •Z y-v3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
pLAN REVIEW Yes c/ No SEWER CONNECTTON
STATE SURCHARGE Yes �� No WATERCONNECITON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZOrT�1i G CHECK LIST zoning Disuicc:
Fire Depar[ment: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes�_ No Date of Survey: biv l=�1�.:
Proposed Setbacks:
Front (Lake): 2 Z S � Right Side: f b 3� �
Rear (Street): i do' fi Left Side: � 5Z' �'
Adjacent Structures: ZS' t Wetland: N/✓a
Building Height: Def. Hat. /J I p Peak Hgt. —
Lo[ Covera�e: —
Gradin�: Staff Approval Date: —' By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: � — Resolution: !# Resolution Date:
Shoreland District: rv�,
Avg. Setback: Bluff Setback: Lo[Coverage:
Existing Proposed
Hardcover: 0-75'
75-2�0'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RENIARKS (in house):
7
. ,
. .
BUILDING REVIEW CHECK LIST � .
UBC: � N f/� CONSTRUCTION TYPE: —
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor R =
2nd Floor R =
Garage x =
R -
TOTAL
Fstimated Construction Value: $ 1 0,c�o o °O
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_�Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�Final Grading/Filling Electrical (State Permit)
Other
REi�IARKS(IN HOUSE): �------�-
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REVIEW BY OTHERS: DATE:
Access: Existing NeW
Access Approval: Date By;
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RENIARKS (TO BE NOTED ON PERMI�:
8
/
�� DATE TIME
CITY OF ORONO `CALLED IN C�I?�'��3
INSPECTION NOTI E SCHEDULED ��°3 1V•'..��
PERMIT N0. `�'�''`��� COMPLETED
ADDRESS �lo(� /�r��n � N '
OWNER CONTR. �/�5,-E-�1� f c�v I
TELEPHONE NO. � I> I� ��p � ` � -� ��
� DESCRIPTION ���� 1 I I��S �- �" ��� �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOHTOMEETYOU: YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL AETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (95Z� 249-46QQ
OwnerlContract� i e:
Inspector.
White Copyllnspector's FII Canary CopylSite Notice
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