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Home My WebLink About2004-P07748 - plumbing CIT� OF ORONO PERMIT 27,�,0 Kelley Parkway - PO Box 66 Permit Number: Po��4g Crystal Bay, Minnesota 55323 Pel'1111t Typ2: Addition/Remodel/Repair (952) 249-4600 Date Issued: ��26�2004 SITE ADDRESS: 140 Brown Rd S Long Lake,MN 55356 PID: 03-117-23-12-0011 DESCRIPTION: Proposed Use: Residential Pernut Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Pernut Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate pernuts required: riumoing Eiecmcai�staiej NOTICES/REMARKS: .,_,_ � ,---�- ----- n�---�-=-- r�-- =--, � ,- - --=-- ._�...... ..............W, .......,...d, .�.,�...,.,......�.....:b FEE SUMMARY: PermitFee: $ 391.25 Valuation: $ 25,000.00 State Surcharge Fee: $ 13.00 TOTAL FEE: $ 404.25 APPLICANT: D&7 Home Solutions OWNER: Mr. &Mrs. Coleman 7680 Kurt Street 140 Brown Road S Loretto,MN 55357 Long Lake MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � - c/ I"/�(�"� APPLI A PE ITEE SIGNATURE 1SSUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Anplicant 1-Monthlv Reports, 1-Assessine, 1-Finance 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 informatio�z) ---------------------------------------------------------------------------------- ------ �-------------------------------- THE APPLICANT IS: (circle oiie) OWNER O ONTRACTO JOB SITE ADDRESS: �� '�'r1 �'� ZIP: �5�.�� Will this be a Par e of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, a special event peYmit is required with Police Department and City Council approval 60 days prior to the event. Non perrnitted events will not be allowed. NAME OF OWNER: ��v� �,G��E��-� PHONE: (home) 9SZ L/7.�--7�l� � � (work) MAILING ADDRESS: %y�' S,�/Z�/1 /c'C!� CITY: v�, L�,(�� ZIP: SS 3s� CONTRACTOR: ��r.l ��n� ,So�vl�ich� LL.e PHONE: 7l�3- y77-��17 CONTACTPERSON: nU� ,�� MOBILE/PAGER: (o/Z -.SSS�Oy(�S' MAILING ADDRESS: �(o sbU �Uiz f St. CITY: L�2Cl�a ZIP: SS.�ST STATE LICENSE: # ��-Z�3�`'07�2b ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Accessory Structure Addition Move Remodel/Alteration� Land Alteration PROPOSED WORK(describe in detai�: (e� -�bi.�c Z ��f�i I��S ��U/71�/h /- . 4�' �/ � . 'GL STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. , ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ZS{oo�.� I hereby apply for a building pernut 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 pernut and work is not to start without a permit; and that the work will be in accordance with the approved plan. � i APPLICANT'S SIGNATURE: � � DATE: ��Z�-m� r Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.1. Type of data. The rights of individual on rvhom 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 confidential data concerning himself shall be informed of: (a)the purpose and intended use ot 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 identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to suppfy 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 propertv tax refund instructions instead ot 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 confidential. Upon his further request,an individual who is the subject of stored private or public data on individuais 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 additio�al data on the individual has been collected or created. The responsible authority shall provide copies of the privute 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,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.If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional£ve days rvithin 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 this right,an individual shall notify in writing the responsible authority describing the nature of the 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 o[ 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 stntement of disagrecment is included with the disclosed data. The determination of the responsible authority may be appea►ed 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 infor�n 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 un tand my rights as ted e. '� ��. �'�� 7 � Signature CHECK OFF LIST FOR ISSUAl�tCE OF PERI�IITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: / `t v �3lL�.,��,. /La�ro S PID: DESCRIPTION OF WORK: ��,�,.,,,� (�. 5 C�� ZOVI�IG REVIEW BY: � DATE APPROVED: BUII.,DIPIG REVIE`V BY: DATE APPROVED: �-Zs-�Y FEES TO BE CHARGED: � / Misc. Fees Calculated By: PERI�IIT Yes (/ No PLA��t REVIEW Yes �a +-� SEWER CONNECITON STATE SURCHARGE Yes No WATERCOiVNECTION INVESTIGATION FEE Yes No PA.RK FEE SAC Yes No SITEINSPECTTON Number of SAC�Units OTHER (specify) ZONIi�1G CHE.CK LIST Zoaing District: /1!d C C�`,r�yv� Fire Department: Post OfFice: School District: Lot Area: Sq.ft. Acres Widch Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Fron[ (Lake): Right Side: Rear (Stree[): Left Side: Adjaceat Structures: `V and: Building Height: Def. Hgt. ea�:Hgt. Loc Coverage: Gradino: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolutio : f� Resolutioa Dace: Shoreland District: Avg. Setback: Bl ff Setback: L.oc Coverage: Eu ��o Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: RE1�Z4RKS (in house): 7 BUILDING REV�W CHECK LIST �C� �\ � CONSTRUCTION TYPE: �� _ Sq Footage $ Per Sq Ftg Basemen[ x _ lst Floor z _ 2nd Floor z = Garage x = x = TOTAL Estimated Construction VaIue: $ Z��C�o v "-= Inspections Required: `Vork Requiring Separate Permits: Site _DS_Plumbing Fire Hardcover Removai Mechanical Water Connection Footing ` Septic Sewer Connection � _�Framing Fireplace Lawn Irrigation Insulation (i�tasonry) Other �Va11 Board (Mfg.) Well (State Permit) _Q�Final GradinglFilling �D '\Electrical (State Permit) O[her RENIA_RKS (Li1�HOUSE): . ---------- -------------------------------------------------------- REVIEW BY OTHERS: DAT'E: Access: Ezisting New Access Approval: Date gy: ----------------------------------------------------------------------------------------------------------- RENLARKS (TO BE NOTED ON PER1tiIIT�: 8 G � �'� DATE2 TIME " CITY OF ORONO CALLED IN � J 0� INSPECTION OTICE SCHEDULED L! O �0�_ PERMIT NO. � � COMPLETED ADDRESS �7� S � I�d LJ /� OWNER CONTR. �`� I �� TELEPHONE NO. �D /oZ S�S `�l� "" C� �� S � DESCRIPTION �h a-� �— � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING Rt 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � Q a � � O � � O � W � Q � Z W � W � � � / d / W WORKSATISFACTORY:PROCEED PROJECTCOMPLETE V � CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the n xt inspection 24 hours in advance. (952� 249-46�� Owner/Con site: Inspector. White Copyllnspector's ile Canary CopylSite Notice ✓ C�""1 DATf� TIME CITY OF ORONO CALLED IN �J INSPECTION TIS�E ,/� ,� SCHEDULED � D:d C� PERMIT NO. � / 7 7' COMPLETED ADDRESS ��D /��UrI /� S- OWNER CONTR. D��I '�I�� TELEPHONE NO. �l� ��-/ ��o� � DESCRIPTION ��rn�� j��"" �� 01 FOOTING / 11 MECHAN AL RI 18 EXCAV/GRADING/FILLING �FRAMING QK� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS INSULATIONOK ✓ 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 4 WER HOOK-UP 06 PROGRESS � 07 DEMO-SITE D7� 7 S PTIC MAINT. 21 COMPLAINT � 15 EPTIC INSTALL. 22 FOLLOW-UP �LUMBING RI C\K 3 SEPTIC FINAL 35 HARD COVER REMOVAL J 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � J O � � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED C I PROJECT COMPLETE � O CORRECT WORK&PROCEED !J ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. L; pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next in pection 24 hours in advance. �95Z� Z49-46�� OwnerlContrac�sit : '�spector. � "��te Copyllnspector's File Canary CopylSite Notice