HomeMy WebLinkAbout2006-P09749 - addn/remodel/repair !
' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Po9749
Crystal Bay, Minnesota 55323 Permit Type:
Addition/Remodel/Repair
(952) 249-4600 Date Issued:
4/19/2006
SITE ADDRESS: 1080 Brown Rd N Unit#
Long Lake,MN 55356
P��� 27-118-23-42-0013
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Addition/Remodel/Re air Permit Sub-type(s): Addn/Remodel/Repair
Permit Type: P
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Electrical(state)
NOTICES/REMARKS:
Basement remodel, add bathroom, and egress window
FEE SUMMARY: Pernut Fee: $ 125.25 valuation: $ 6,000.00
Plan Review Fee: $ 81.41
State Surcharge Fee: $ 3.00
TOTAL FEE: $ 209.66
APPLICANT: Owner/Self OWNER: Eric Bull&Carrie Miller
NIN 1080 Brown Rd N
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.
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APPLICANT PERMITEE SIGNATCIRE ' ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
Total Fee: $ -�C�f 4 '�i% Date Received: ����D�
Entered By: ,�- '� Permit#: ,Qo 9 7�q
CITY OF ORONO — BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print a[1 information)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
J�B SI•I•E E�D�SS: ]080 N.Brown Road ZIP: 55356
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ YCS Q✓ No lf yes,a special event permit is required with Po/rce Department and City Council approval
60 days prior to the event. Shuttle bus service wil!be required unless applicant demonstrates
suffrcient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: Er'c�.B°�� PHONE: (home) (9s2)4�6-o3so
�WOCk� (952)249-0817
MAILING ADDRESS: �080 N.Brown Road CITY: Orono ZIp: 55356
CONTRACTOR: Homeowner PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: N/A 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 may require MCWD review and permits!
PROPOSED WORK(describe in detain: Basement remodel,add bathroom,and egress window
STORIES: 1 SQ.FEET OF EACH FLOOR: �soo
NO. OF BEDROOMS: 3 GARAGE STALLS: ATTACHED ✓ DETACHED
.�
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ (,i, 60�
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 o the City and with the State Building
Code;that I understand this is not a permit and work is not to start wit ut a permit;and that the work will be
in accordance with the approved plan.
� � �� /
APPLICANT S SIGNATURE: � � DATE: I l
31
C�-iEC� OFF i�IST FOR ISSUANCE O�' �'ERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �U S O (V (.3(Zo w� 1��
PID:
DESCR�TION OF WQRK: �ns cv►-.a.-� (2-�-rw�d-e.�-
------ --- -------_�_________--------
ZOV�IG REVLE�V BY: DAT'E APPROVED: .v/�
SUII�DING REVIEtiV BY: DATE A.PPROVED: ti-/sB-a;6
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes r/ No
PLAN REVIEW Yes ,/ No SE`�ER CO�TNECTION
STATE SURCHARGE Yes � No WATERCOi�NECTION
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No � SITEINSPECTION
Number of SAC�Units OTHER (specify)
----------------------------------_—_---------------------------------------------
ZOt�T��IG CHE.CK LIST zoning Discrict: /Uv G��-e.
Fire Department: Post Office: School District:
L,ot flrea: Sq.ft. Acres Widch DepCh
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetl d:
Builuin� Heighc: Def. Hgt. Peal:Hgt.
Lot Covera�e:
Grading: Scaff Approval Date: B : Council Approval Date:
Septic: Staff Approval Date: BY�
Zonin' File: # Resolutioa: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Ezistin� Proposed
a
Hardcover; 0-75'
75-250`
Z�0-500'
SOQ-lOQO'
Hardcover Variance Required: Yes No Dace oi Council Aporoval:
RE`LARKS (in house):
�
SUII�DING REY.�`y CHECK LIST
�C� � � CONSTRUCTTON TYPE: V/J
Sq Footage $ Per Sq Ftg
Basement x =
lst FIQor x =
2nd F1oor x =
Garage z =
z _
TOTAL
Estimated Construction value: $ 69�t�
Inspections Required: tiYork Requiring Separate Permits:
Site �_Plumbing Fire
Hazdcover Removal Mechanical Water Coanection
Footing � Septic Sewer Connectioa
_�Framing Fireplace Lawn Inigation
_�Insulation (Masonry) Other
�,Wall Boazd (Mfg.) Well (State Permit)
_�F�� Grading/Filling _p�Electrical (Scate Permit)
Ocher
REI��RKS (INHOUSE): �
_--_------------------------------------------------------------------------------------------------------------
REVLEW BY OTHERS: DAT`E:
Access: Ezisting New
Access Approval: Date By;
REI�IARKS (TO SE NOTED ON PERi12['1�:
8
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 set forth in this section.
Subd.2. Information required to be given individual. An individual asked to supp�y private or confidential data conceming himself shall 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 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 identity of other persons or enti[ies 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 revenue mav place the notice required under this subdivision in the individual income tax or oro�ertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shal I be informed whether he is the subject of
stored data on individuals,and whether it is classified 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 data 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 private or public data upon request by the individual subject ofthe data. The responsible authority
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of[he request,excluding Saturdays,Sundays and legal holidays,if immedia[e compliance is no[possible. [f he 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 wmplete.An individua]may contest the accuracy or completeness ofpublic or private data
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreemenL 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 wrrect. Data in
dispute shall be disclosed only if the individuaPs statement of disagreement is included with the disclosed data.
The determination of[he responsible authority may be appealed pursuant to the provisions of the administrative 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:
l. 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 inf'ormation may be shared with other local, state or f'ederal 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 namc is required to process this application or permit.
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