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Home My WebLink About2005-P09312 (add./remod/repair) PERMIT �IT`'�( OF ORONO 2750 Keliey Parkway- PO Box 66 Permit Number: P09312 Crystal Bay, Minnesota 55323 P21'llllt Typ@: Addition/RemodeURepair (952) 249-4600 Date Issued: I1/17/2005 SITE ADDRESS: 3245 Carman Rd Unit# Excelsior,MN 55331 PID: 20-117-23-14-0010 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit T e: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair YP DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: Remodel Exisiting Interior Space&New Ex Entry,Winsow&Doors FEE SUMMARY: Permit Fee: $ 1,105.75 Valuation: $ 120,000.00 Plan Review Fee: $ 718.74 State Surcharge Fee: $ 60.00 TOTAL FEE: $ 1,884.49 APPLICANT: Lake Country Builders OWNER: Jon&Kirsten Nielsen Peter W.Jacobson 3245 Carman Rd 339 Second Street Excelsior,MN 55331 Excelsior,MN 55331 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. � � �C�- � �-�t � � ��Y�^ C �_ � G'�-�J / � APPLI ANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signa[ures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � i�_�S- D� � 1 ' ` `I �/�-� Total Fee: $ �88y- �9 Date Received: ` f�` Entered By: Permit#: /(� � � 7 C CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please pr•int all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �� LI S CQ,'��C� �j�,,�� ZIP: _ S �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit is reqa�irect tivith Police Depai�tr��ent and Ciry Council c�pproval 60 days pr�ior to the eve�7t. Shtrttle btrs ser•vice wrll be rega�ired 2cnless applicant demonsb�ates su�cient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER:��O�13 `l t�(S fi2 r� /V I e I S�Y� PHONE: (home) /t"� (wo►•k) MAILINGADDRESS: ��LI 5 �-c(✓I'yt,fivt �G� CITY: �✓Gt�/{ ZIP: SS� 3.3 I CONTRACTOR: ' / PHONE: 9 sa. Gi�y 7�� CONTACT PERSON: Ja��In � MOBILE/PAGER:Sq,,.v6, �1 2 • $lDU.d6�Il MAILING ADDRESS: �3 � a"t �r{e CITY: C XLQ�,�►a r ZIP: sS'33 ► STA'TE LICENSE: # �,G EXPIRATION DATE: ARCHITECT/ENGINEER: ��(,r✓� �{Y1o�11� PHONE: c/7G�• -]1 Z ( � I oZ, � MAILING ADDRESS: �-�- CITY: ZIP: � NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration � PROPOSED WORK(�lescribe in detain: /�d��;(/( �� ') C.� G�c1z-� . !� fi, j � ' �.��5 � `ra/'�s�c-� � s�o��Es: I s�.�E��r oF��cx��,00�: NO. OF BEDROOMS: GARAGE STALLS: ATTAC�-IEl) I3ET'ACHED EST'I10'IAT�I)CONS�'RUCTION VAL,UAT'ION(excluding lanci): � ��d _ Q � U I hereby apply for a building permit and I acknowled�e that the information above is complete and accurate; that the work wil I be in conformance with the ordinances and codes of the City and with the State Bui lding Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: ATE: ld . �� .�j � 31 � Sec.13.04 RIGHTS OF StiBJECTS OF DATr� Subd. 1. Type of data. The riehts of individual on whom the data is stored or to be stored shall be as set forth in this section. --- - -Subd_2._[nfocmation-cequired-to be given individuaL An indiv.iduaLaskecLtasupply_private or confidential.dataconce�ninghimselfshall be __._..___�__ informed ot`. (a)the purpose and intended use of d�e requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is le�ally required to supply the requested data;(c)any kno��i 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�i�hen an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may_place the notice required under this subdivision in the individual income tax or property taz refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible aud�ority,an individual shall be informed whetherhe is the subjectof stored data on individuals,and�vhether it is dassitied as public,private or contidential. Upon his further request,an individual who is the subject of stored private or publ ic data on individuals shal I be shown the data without any charge to him and,if he desires,shall be infonned of the content and meaning ofthat data. After an individual has been sho�vn the private data and informed of its meaning,the data need not be disdosed 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 authoriry shaU provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require[he requesting person to pay the actual costs of making,certifyine.and compilin�the copies. The responsible authority shall comply immediately,ifpossible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and leeal holidays,if immediate compl iance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days�vithin 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 diis 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 determination of the responsible authority may be appeated pursuant ro the provisions ofthe administrative procedure act rela[ing to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inforn�you that your request for a permit or license frotn 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 infonnation you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supp(y 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. 1'our full name is required to process this application or permit. ��r�� J, � I�G ,�S�� First Middle Last ?� � �� 5�-�-�� Address .��rc �lsiv/ f�1/� SS3�� S�. �7y. 7/�l Citv State "Lin !'hone � � � I unders nd my r'ghts as stated �bove. r aturc �? � CHECK OFF LIST FOR ISSUAi�tCE OF PERMITS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: 32 y5 CA�'�vy�iv /l�„�p PiD: DESCRIPTION OF WORK: /�x-n�wbe�. ZOv'Pi TG RE'VIE�V BY: DATE APPROVED: l�-iv' �S BUILDI`'G REVIE`V BY: DATE APPROVED: �r-iy-o S FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes � No PLAN REVIEW Yes No SE`VER CONNECTION STATE SURCHARGE Yes � No WATERCONNECTION INVESTIGATION FEE Yes No ✓ PARK FEE SAC Yes No ,/ SITEINSPECTION Number of SAC Units OTHER (specify) ---------------------------------------------------------------------------------------------------------------------- ZONI�tG CH�CK LIST Zoning Districc: � G/ Fire Departmen[: _ post Office: School District: Lot Area: Sc.ft. Acres Width Depch Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Fron[ (Lake): Right Side: Rear (Street): Left Side: _ Adjacent Structures: Wetl . Building Height: Def. Hgt. �Pe Hgt. Lot Covera;e: Grading: Staff Approval Date: By: Council Approval Date: Septic: S[aff Approval Date: By: Zoning File: # Resolution: # Resolution �ate: Shoreland District: Avg. Setback: Bluff Setback. Lot Coverage: __ EeistinJ Proposed Hardcover: 0-75 7�-250' �l 2�0-500' � �0a-1000' ' Hardcover Variance Required: �'es P�'o Dace of Councii �pproval: ��iY�2�S (�n h�ouse): 7 � BUILDING REVIEW CHECK LIST �C� �" � CONSTRUCTTON TYPE: �//U Sq Footage $ Per Sq Ftg Basement z = lst Floor z = 2nd Floor x _ Garage R = R = TOTAL Estimated Construction Value: `' $ � -L�f�ov �— Inspections Required: `Vork Requiring Separate Permits: Site �'' Plumbing Fire Hardcover Removal _�{ Mechanical Water Coanection _�f Footing ` Septic Sewer Connection oc Framing Fireplace Lawn Irrigation _�Insulation (�tasonry) Other Wall Board (Mfg.) Well (State Permit) —�F�� Grading/Filling �Electrical (State Permit) Other RENIARKS(IN HOUSE): — ^`—_ ------ ----------------------------------------------------------------------------------------------------- REVIE�V BY OTHERS: DAT'E: Access: Existing ?��,�,� Access Approval: Date gy; - -----------------------------------------------��-------------------------------------------------------------- REVIARKS (TO BE NOTEI) ON PERNII�: 8 � 1" DATE TIME � CITY OF ORONO CALLED IN �'��' �� INSPECTIONNOT�G� SCHEDULED .�jrJ_UC: �'.C�c>-�M PERMIT NO. 'r •� '� COMPLETED ADDRESS �� C�l'e 11 % �'� /�� OWNER CONTR. ��_ �C�iJ�t f��.i,��C�� TELEPHONE NO. /S^-� � 3 �' G' �S�' � DESCRIPTION � � � �-CJ�� . l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLiNG � 02 F AAdit�IG.-,._...._ 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS Q 03 INSULATI � 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 N/ALL 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 J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O � � O � W � Q � Z W � W � � d W WORKSATISFACTORY:PROCEED f� PROJECTCOMPLETE � ❑ CORRECT WORK&PROCEED ❑ 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 REQUIflED.CALLTO ARRANGE ACCESS. Call for the next spection 24 hours in advance. (J52� 249-46�� OwnerlCon n �it : Inspector. White Copyllnspector's File Canary CopylSite Notice �\� DATE TIME / CITY OF ORONO CALLED W � 0'-LS^ INSPECTION NOTICE SCHEDULED /Z �/-oS �`� PERMIT N0. �'��/r}' COMPLETED ADDRESS �c�' �(5 C��r-,"►'`r'`-."^ ��, OWNER CONTR. �Kc- C.ov°n t�v F�l�rs� TELEPHONE N0. �� -/7� 7��I � DESCRIPTION t� FOOTIN � 11 MECHANICAL RI 18 EXCAV/GRADING/FILUNG � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 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 RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � o � � �� i G V �V O � � � ` O `� � W � Q � 2 W � W � � G ;,.; W �'�1 WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-460� OwnerlContractor-on s�te: ` ;t' Inspector. `� ; �►-,�� .,.,,,,,,.,_ White Copyllnspector's File Canary Copy/Site Notice �� z � � DATE TIME CITY OF ORONO CALLED IN �� 'G INSPECTION NOT C SCHEDULED +v A� C' -�I PERMIT NO. �O j `� COMPLETED ADDRESS � � `-1 �� 'ts_i v, e c;, I��/ OWNER CONTR. �� -�_-� � r/��'s TELEPHONE N0. �7 ��( 7 �� 7�� DESCRIPTION /�G12�)�� • l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING �� RA_�M-I-NG 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS: Q03-i14S�TI�ON 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL / Z 04 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 = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMEN S: � � � � OC � � 0 � � 0 � W � Q � Z W � W � � d W Cl WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑ CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. J PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance. (J52� 249-4600 OwnerlContra 't : Inspector. � White Copyllnspector's File Canary CopylSite Notice