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Home My WebLink About2007-P00085 - addn/remodel/repair • PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p11185 Crystal Bay, Minnesota 55323 Pel'r11it Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 7/18/2007 SITE ADDRESS: 210 Big Island Unit# Excelsior, MN 55331 P�� 23-117-23-23-0034 DESCRIPTION: UBC Occupancy R3 Construcrion Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Electrical(state) NOTICES/REMARKS: Remove/Replace existing 26x12 deck,R/R 2 windows, 1 door and add 4 windows FEE SUMMARY: Permit Fee: $ 542.75 Valuation: $ 40,000.00 Plan Review Fee: $ 352.79 State Surcharge Fee: $ 20.00 TOTAL FEE: $ 915.54 APPLICANT: Structures Unlimited, Inc. OWNER: Mike Isaaman 5425 Clayton Drive 616 Lincoln Avenue Maple Plain,MN 55359 St. Paul,MN 55102 T E UN ER ED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED ND A REE O DO ALL WORK IN STRICT COMPLIANCE_WITH ALL CITY OF ORONO ORDINANCES AND STATE OF INN SOT UILDING CODE REQUIREMETyT��:---""�� _----- _ ' , rlr � e/ APPLICANT PERMIT SIGNA RE ISSUED BY SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 l (y / � Total Fee: $ � -I � � � Date Received: � 7•Z,•�7 Entered By: �<. E� Permit#: A-(�(��j CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OI2�CONTRACTOR,i f � : JOB sITE��uEss: � �' !' � � �--,S�G�� - �� zrr: Will this be a arade of Homes,Remodelers Showcase Home or other Display Home? ❑ yes ��10 If yes, a special event permit is required with Police Department and City Council approval � � 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: -J�.\�' , PHONE: (home) (work) MAILING ADDRESS: Z�f��'� '�-��s�r�•�.a.;� �„r_�f -, � CITY: C��•Z'�' ZIP: � �CONTRACTOR: � - . ,..��,,��,�i, ��`�� : � �,, PHONE: (•� 1 � '�'.. / ��l�l; � CONTACT PERSON: -�;, ��:�- 1�,�;,� , �,�, MOBILE/PAGER: MAILING ADDRESS: � :• ��, � �� ._.t�� CITY: � i�_ r�lr � �� ZIP: �- 1��; STATE LICENSE: # ;�� /-" �; - , EXPIRATION DATE: � � < �` ARCHITECT/ENGINEER: ��r PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Stru re Move Home R�emodel/Alteration (ie: Siding, indows), Any earth movement may require MCWD review -and permits ! PROP�SED WORnK(deseribe in detai�: �-� � ��-��)�c- � ��t z��c/� y�G�' 1 110 Ue -�- �S p n�� Z w i✓�C�-+,,i 5 / I/2. G� � /4I�'L W,�✓i C�W S ,� STORIES: _� SQ.FEET OF EACH FLOOR �� NO. OF BEDROOMS: Z GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ `f(��OCo I hereby apply for a building permit and I acknowledge t t�he information above is complete and accurate; that the work will be in conformance with the ordinan es nd codes of the City and with the State Building Code;that I understand this is not a per t a d work i n to s t without a permit;and that the work will be in accordance with the approved plan.; �'�_ _ i APPLICANT'S SIGNATURE: DATE: ��`��'I�Z 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The righu 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 supply private or confidential dataconceming himselfshall be informed of. (a)the purpose and intended use of 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 shal I 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 alace the notice required under this subdivision in the individual income tax or prooertv tax refund instructions 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 confidential. Upon his further request,an individua]who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,ifhe desires,shall be informed ofthe 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 ofthe 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 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 wiYh the request within that[ime,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 complete. An individual may contest the accuracy or completeness of public or private data conceming himself. To exercise this 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 correck Data in dispute shall be disclosed only if the individual's statement of disagreement is induded with the disclosed data. The determination ofthe 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: 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 Councii action to approve, some information may become pub(ic. 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. ' ' i�� ' S First Middl Last C ��.' ' ('�� Address -'�1 1� �',� M.� �, � � z��/ .� Cit State Zip Phone I und rstand.m�rlghts s sta d above. __.__�--,` , ------__ � Signature � `'--`- , Reset Form ' 32 �CHECg Ok'�k' LIST FOR YSSUANCE OF ��TS �OR OFFICE USE ONL1'� � ADDRESS ORLE�AL: � � r� PID: : c��t- ►Zz��o-e<- O� OF WORK: - �`' 1�`^"� '�`' pE5 CRIP'I'I .------ -�'- ------- ------------------- ----------------- ________------- -- -- — -- - ---- -= ^ YIi�TG �ZEVIE�V BY: ^ ,{�'�t D�,.TE APPROVED. I I J C� ZO D.A.TE APPROVED; -� - 1 e - o'-7 $UII�DING REVIE�V BY: . � . . �`EES TO BE CHA-RGEA:` �/ Misc. Fezs Calculated By: P��T Yes ✓ No PLAN REVIEtiY � Yes f No SE�VER CO�INECTION tiVATER CONNECTION STATE SURCHARGE YeS � NO FEE INVESTIGATION FEE �'e5 N0 --�- SITEINSPECTION SAC Yes No OTHER (specify) Number of SAC�Uruts __________ ______________________ --, -r------------------- ------------ ----'---�------"_ � �p1,�'l��IG �CH�CK. L�S�' Zoai.ng Districc: _ • Pos[Office: School District: � � Fire Dep3rtment: , L,ot Area: Sq.ft. �'� f � �� i Acces ;J ' `�� 'I Width � D U � Depch Survey Submittect: Yes �o x Date of Survey: �roposed Setbacks: �o t Side: ' � Froat(Lake): � � Rear (Street): Left Side: �dj3.r.P.^.f Srnir��1r�.:: tiVPrl�d; Buil�lin� Hei�i[: DeF. Hgt. _� Peak.H�t. Lot Covera�e: Gradin,, Staff App- B Council Approval Date: ' o• Loval Date: Y� 5 e�+�c ,�e.�.�.., Szp�ic: Staff Approva! D2te: �L7�'e� ��''� �y: �� Resolutioa: „ Resolution Date: 7oa�n� File: ��__ — Shorzl2r�d DiStfic�: �,Ca�,e��,� AvQ. Setbac;�:: BIuF�Setback: � �_. � Propose� E�stino H�ecavec: G-i�' 7�-2�0' ----- 2�V'��J ,�� J-;�'�'v n� �� V J: _ O: �v��._=�. n�_ � –" — }-I a r�;•�'�'':'C' Y��.�..'.� _ ..:;l:'.:�.�i, i Z� • r�1L'�:-�ti (Ln hp'��): �. . SUILDING REV]E�V C�LECK LIST USC: 12 ' � ' CONSTRUCTION TYPE: �j/L/ Sq Footage $ Per Sq Ftg Baseazeat . .. X _ . lst Floor � x � _ 2nd F7oor x _ � . Garage x _ z = TOTAL Estimated Construction VaIue: $ �-(0,c�c�c� °—" Inspections Required: tiYork Requiring Separate Permits: 5 ite Plumbing Fire Hardcover Removal Mechan.ical Water Coaaectio❑ x Footing ` Septic Sewer Coanection � � _�_Framing Fireplace Lawn Irrigation �iii3ii0u (LV125ppLy) OCt1eC `Val1 Board (Mfg.) Well (State Permit) � F�� Gradia�/FIllin� � Elec[rical (Scate PeRnicl Other REI�IA.�tKS (IN HOUSE): ' ---�- ---- ------------------------------------------------------------------------------------------------------------ REVIE�V $X OTHERS: DA'T�: Access: EziSting New Access Approval: Datz gy; - ----------------- RE`�LAP�KS (TO EE NOTED QN�FR��T'I�}; � �"r� � /�`1 � k ��i � � °� s �� _c1- �,�'. --� $b -� x T � � � y� � �l � � g,�;, ��, -� � � .:,��. � � `�� m� �` '`� �v I ' �r' b �� .` � ♦ > � > �) , � '�},_�1-�-- � .�, v t3j t- -.� z �J�� 3 `� � •.q� � � � � �� .. '-� ;�� . � j r:� Q z I �- . , .. �s � � � �I -_� ,� � � 4 '-; � „ � '� ,� — _. ' �, � : t..� . �..� ...._ -a (` Wg � ;:; ;� __. , =� � � a S O `I 0° � -. ��;� � � � -4- Q� . ,_ , �- ly` . � ut � s_ ' :, � �� - - : �..,.�,,.;,_...__.._...__........F ,_ �.-. � � C7 Q �' > `'=`_ � � y t.� �'-3 L� � Q �—�' � O Q !'� � � � �, \,.� � U � � � li; W L .,; j-:i(� � .. _ �O' � � �, iL" �� . :, ..- z 7� ` � '_ _ '. F-� c �:: d d, (`n , �� a: ,-� � � �,�, ..,� � M � rs, ,.�� _ ,_ ` - � � s� � '� � °- � ,� � - -_ � � _ ` � ��, �1 ��s�aential General Contra r l� `� STRUCTURES c o� `� ` � � � � � V `.�n � � � � NLIMITED, INC. V� � � � � � ROSS A. LANGHANS � , �9 � � � � 763-479-1890 ' � � � � N�� ,;z, � � a/ x ��ullders License#2��33 � _� � 5�?� C'layton Dri�e, Maple Plain, MN 55359 J � � i � � � ! V'�