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HomeMy WebLinkAbout2007-P10896 addition PERMIT CITY OF ORONO 275� Kelley Parkway- PO Box 66 Permit Number: p1o896 Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 4/27/2007 SITE ADDRESS: 1925 Country Club Rd Unit# Long Lake,MN 55356 P��� 27-118-23-43-0002 DESCRIPTION: Proposed Use: Residenrial Census Code 434 Permit Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: Electrical(state) � NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 111.25 valuation: $ 5,000.00 Plan Review Fee: $ 72.31 State Surcharge Fee: $ 2.50 TOTAL FEE: $ 186.06 APPLICANT: Owner/Self OWNER: Glenn&Lois Fredenn MN 1925 Country Club Rd 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 B ILDING COD REQUIREMENTS. � _ .. . /,. �: � � APPLICANT PERMITEE S[GNATURE UED BY SIGNATURE Copies: 1-File(Signatures Required), ]-Applicant, 1-Monthly Reports, l-Assessing,(If Septiq 1-Septic) Page 1 Total Fee: $ � � �h � � Date Received: �j�-�7'07 Entered By: Permit#: �I10�9� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please pf•int all iixformation) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (cif•cle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: � `� �f �� �� n �`� ��� �� ZIP: �S�� �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No !f yes, a special event per•nait is��•egi�ired wit/1 Police Department and City Coarncil appr•ovnl 60 days prior to the event. Shuttle bz�s service wi!!be reqzii�•ed unless applicant dernonslrutes su�cient on-site parking is available. Non-permitted events will not be allowed. NAMEOFOWNER: ��-�1r�( ! �-<-��� '"-*"�( PHONE: (home) ���` zt �3-i���' c.��'� (�.c:�i s'�;��i- ��7� MAILINGADDRESS: � `��`� << <r��'�S �����c� !�' CITY: �<-K ��.��, ZIP: s;T�? �' CONTRACTOR: S� � ` �- PHONE: � CONTACT PERSON: G'�-•��K. f- '-�%> r �t MOBILE/PAGER: MAILING ADDRESS: -�u n�--. CITY: -- - ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: � �u�-�,� ,� .� �- ��� ����� � � PHONE: �����- `�����cY Y� MAILINGADDRESS: i3�'z �r,-�,,, �-�,' �- ,;,� CITY: /-�'<r ZIP:S'�.�� �.� NAME: �f -��: � '������, ` REGISTRATION: # TYPE OF WORK: New Home Addition �_ Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windo�us) Any earth movement may require MCWD review and permits ! PROPOSED WORK(clescribe in detain: STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: A'�TACHED DETACHED , �— .------- <i-- ESTIMATED CONSTRUCTION VALUATION(excluding land): $_ �, � /C% � � - � I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work�vill be in conformance witl:the ordinances and codes of the Cit�� and���ith the State Building Code;that I understand this is not a permit and work is not to start without a pennit;and that tlle work will be in accordance with the approved plan. APPLICANT'S SIGNATURE:� �� ����"`-- DATE: �G' � 7 ��`� �1 Sec.13.0�1 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The ri�hts of individual on whom the data is stored or to be stored shall be as set Yorth in[his section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential dataconcerning himselfshall be informed of. (a)the purpose and intended use oY the requested data wi[hin the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legaily 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 identiry 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 suppiy investi�ative data,pursuant to section 13.82,subdivision�,to a law enforcement officer. The commissioner of revenue mav olace the notice required under d�is subdivision in the individual income tae or orooertv tax refund instructions instead of on those forms. Subd.3. Access[o data by individuaL Upon request to a responsible audiority,an individual shall be infonned whether he is[he subject of stored data on individuals,and whether it is classitied as public,private or contidentiaL Upon his fuRher request,an individual who is the subject of stored private or public data on individuals shall be shown the data without an��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 co this section is pending or additional data on d1e 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 audioriry may require the requesting person to pay the actual costs of making,certifying,and compil ing the copies. The responsible authority shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of fhe date of the request,escluding Saturdays,Sundays and legal 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 additioi�al tive days within which to comply with die request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure�vhen data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To eaercise this right,an individual shall notify in writing the responsible authority 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 notity past recipients of inaccurate or incomplete data,includin�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 iY the individual's statement of disagreement is included with lhe disclosed data. The de[ermination of the responsible autl�ority may be appealed pursuant ro 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 pennit or license from the City of Orono or any of its deparnnents may require you to furnish certain private or confidential infonnation. You are notified that: L The information you furnish will be used to detennine 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 a�encies 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. Li.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. First Nliddlc Last Address Citv Statc Zip Phone I underst nd mv righ as state . `� •'L��1'l��c'--�_ Signaturc . Reset Form �? �CI3EC�K OFF i�IST FOR ISSUANCE O�' PE�'VIITS • FOR OFFICE USE ONLY ADARESS OR LEGAL: ��� 2, �' ��:��htil��cCs� PID: DESCRT.�'1�ON OF WORK: �C�' x(2' =���C����ct �\c:wt �ti<<<.Eil��� �:.�e..�/ ;���..�4 �I� C�;��^�rrz� ZOYING REVIE�V BY: `---------------- DATE APPROVED: � � 0 BtTII�DII�IG REVLEtiV BY: DATE APPROVED; �{ z�i -o-> FEES TO BE CHARGED: Misc. Fees Calculated By: p�g�T Yes ✓` No PLAN REVIEtiV � Yes � No SEtiVER CONNECTION STATE SURCHARGE Yes � I�o `VATERCONNECTIDN INVESTIGATION FEE Yes No -� PARK FEE SAC Yes No —r� SITEINSPECTTON Number of SAC�Uruts OTHER (specify) --------------------- ---------------------------------------�--------------- ZONia�TG CHE.CK LIST Zoning Distric�: L� I/�' �, Fire Deparcment: Post Office: School District: � L,ot Area: Sq.ft. Acres Width Depth Survey Submi[ted; Yes ✓ No Date of Survey: S-�s-�� Proposed Setbacks: �o�t'� � ��+ � Froac(Lake): Y11� &.i�E-&ide: Rear (Stre�t): i1 /a I.ef:Side: I�1� Adjacenc Structures: �]l� �Vetland: --"—"'— Buil�lin� Hei�t: Def. Hgt. -� Peak Hgt. Lot Coverage: Grading: Scaff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: ►" t'` �Y� `�/ � � Zoaing File: n Resolutioa: n Resolution Date: Shorel�,zd Districc: ��%� Avg. Setback: Bluff Secback: I.ot Covera�e: E�scing Proposed Hardcover: 0-75' 75-25Q' 2�0-5Q0' �00-10U0' Ha�dco��er Vzia.cce oo�,�;-,�• yz5 �� Da�e oi Ce�ac,! Approv�!: .,�..��... F.E�L�R�iS (in ho�e): BULLDING REVIEtiV CHECK LIST UBC: �Z • 3 CONSTRUCTION TYPE: Y� Sq Footage $ Per Sq Ftg Basement x = lst Flaor x � _ 2nd F1oor x = GaraQe z _ z — TOTAL Estimated Coostructioo '4'alue: $ .$,�o v �'= Inspections Required: �York Requiring Separate Permits: Sice Plumbing Fire Hardcover Removal Mechanical Water Connection Footing � Septic Sewer Coaaectioa �c Framing Fireplace Lawn Irriga[ion _�Insuiation (Masonry) Other Wall Board (?vifg.) Well (State Permit) _�F�� Grading/Fillin� _�Eleccrical (State Permit) Other REMARK� (IN�iOUSE): " -- -- -------------------------------- REVIE�v SY OTHERS: DAT'E: Access: Ezisting New Access Approval: Date By; ----------------------------------------------------------------------------------------------------------------- REI�LARKS (,'TC� $E N4'i'�'n ni�?PEF� �� : 8 �\ 7`-' ' \\\�� DATE TIME � CITY OF ORONO � CALLED IN ���� �� INSPECTION NOTICE SCHEDULED lQ�(0`{7�I � � PERMITNO. PIO�� COMPL�TED ADDRESS �� V/U�� l��I�.� OWNER C�� ��� CONTR. TELEPHONENO. ��L���� - 737� � DESCRIPTION �YI� �T� � � 01 FOOTING 11 M CHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 RAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 05 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 a � J O � � O � W � Q � Z W � w � � , GW ;�I WORKSATISFACTORY:PROCEED f-� PROJECTCOMPLETE � O�ORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O G CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �; PHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-46�0 OwnerlContractor on te: Inspector. ��� ��` White Copyllnspector's File Canary CopylSite Notice ��!���' ���'�-;� 3 � . .. -�,,,�r��r� r �r . _ . . � � . : _ . . � :_ ��:T.�,-._��._----. -- ;; ,�-�--,- � � = .,:-�.-- .. F , ,�<y _ , z-�.��__�- Y _—_..-�-_:_ _. , ry-.� -; , ; / . _o,. , - - -_ __-.���_ --..-�.d.-....6.�._�� ,. . _ - � . _ _ , ___ l� _ ' � . . ' �, ' . �' . �'XF�` . It :� ! I� �-- ..�.' c_-.Ia �-. ..f f r. .�,� . . ___. - . . . -. . � � ... '- . ' ' ' - ' � � _ f,�. � �.�I�3� '� � s��� � '��t�.`�, i , - _ - -. 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