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Home My WebLink About2000-P02760 addition � � PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 Po2�6o Crystal Bay, Minnesota 55323 P@fllllt Typ@: Addition/Remodel/Repair (612) 249-4600 Date Issued: s�i v2oo SITE ADDRESS: t965 Country Club Rd LONG LAKE, MN 55356 P I D: 27-118-23-42-0020 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Deck DETAILS: Approved per resolution#: Separate pertnits required: rirepiace r,iecu�icai�siaiej NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00 Plan Review Fee: $ 117.78 State Surcharge Fee: $ 5.00 TOTAL FEE: $ 304.03 APPLICANT: MICHAEL/PATRICIA CONNER OWNER: PATRICIA A MONDALE 1965 COUNTRY CLUB ROAD 1965 COUNTRY CLUB RD LONG LAKE,MN 55356 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. � �� `G2�1„� � APP I ANT PERMITEE I NATU ISSUED BY SIGNATURE Copies: City,Applicant,Assessor,Finance Page 1 , i+h Total Fee: $ �.3 Date Received: - (- a Entered By: Permit#: 6 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) OWNE$�R CONTRACTOR JOB SITE ADDRESS: ;9�� o un fi�� /cc 6 �o�.d ZIP: �3 3 S� NAME OF OWNER: /��t 2� l/�Q��c�r� Lo n rt e r PHONE: (home) 9,��- 5�7�-3��a-- (work) 1�� -!��"G- y�y� MAILING ADDRESS: 1 qG�L'or�►TrN C�(�� /Poad CITY: ,�,on .k� ZIP: S"S,3 S CO�;TRACTOR: p w,�� - PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: n. Q • PHONE: I�IAILING ADDRESS: CITY: ZIP: NA�:V�: REGISTRATION# TYPE OF WORK: New Addition �-� Accessory Structure `'� Move Remodel/Alteration Land Alteration PROPOSED`VORK(describe in detai�: r�,� ��c e_ c�p c n dl��' wrtti .3-s�c�s o n__ � a��4n.o�x /�x �� ,0/as �ce� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /0, o o v �,ap�o X• �� 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 of the City and with the State Building 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: 1/.��°��,,,��ti��-�� DATE: ��, , � -- �� !�� _�� NOTE! Parade of Homes events require separate permit approval by Police Department and Ciry Couneil 60 days prior to the event. Non permitted events will not be allowed. 5 Sec.13.04 RIGHTS OF SLTBJECTS 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 ro supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecdng 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 ro supply private or contidential data;and(d)the identiry of other persons or entides authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked ro 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 oroaertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry, an individual shall be informed whether he is the subject of stored data on individuais, 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 thereafrer 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 shali provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the cequesting 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 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 authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to notify past cecipients of inaccurate or incomplete data,induding 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 determinarion of the responsible authoriry 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 priv�te 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 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. � ICh.Cc�� D«nis �onvJ� ►� _ First Middle Last I QG S CJO(.c�t7rc� Lf l� (o �v� � Address /�� D � � s/ � �1.3 S� �.��- e7�7.L ��.Z.Z— Ciry State Zip Phone I understand my rights as stated above. i ' �A � �. Signamre 6 ' CHECK OFF LIST FOR ISSUAI�TCE OF PERII�IITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: I�6� (��,"��1 ,,,Z�L�'� PID: DESCRIPI'ION OF WORK: o rZ c c-t -�- c�� % ZOrZ\�G REV�`Y BY: DATE APPROVED: 8 •� -a o BUII.DING REVIE`� BY: DATE APPROVED: � -� -aa FEES TO BE CHARGED: Misc. Fees Calculated By: PERNIIT Yes _� No ; PLAN REVIEW Yes � No SEWER CONNECTION STATE SURCHARGE Yes ✓ No WATERCONNECTTON INVESTIGATION FEE Yes No � PARK FEE SAC Yes No �' SITEINSPECTION Number of SAC Units OTHER (specify) ZONI:vG CH�CK LIST zoning District: R�.-1 (3 Fire Deparcment: ��v 6 (/�� Post Office: School District: (��Zr�� Lot Area: Sq.ft. N u C 1-rA�,..r.�Acres Width — Depth — Survey Submitted: Yes_� No Date of Survey: - C�cv �� Proposed Setbacks: Front(Lake): (o( . Z� �' Right Side: �'j Z� �' Rear (Street): '�1�(� � Left Side: 1 ZZ� '�. Adjacent Structures: ArTT�4Gbf�s"� Wetland: — . Buildin� Height: Def. H�t. D ��- Peal:Hgt. — Lot Covera�e: O�k Grading: Staff Approval Date: — By: Council Approval Date: Septic: Staff Approval Date: "' By: Zoning File: # Resolution: # Resolution Date: /� Shoreland District: �r 1' Avg. Setback: Bluff Setback: Lot Coverage: 9" Eusting Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: RE1I�IARKS (iIl hOt15e). 7 BUII.,DING REV�W CHECK LIST �C� �'l� CONSTRUCTION TYPE: VN Sq Footage $ Per Sq Ftg Basement x = lst Floor z = 2nd Floor x = Garage x = z = > TOTAL Estimated Construction Value: $ �(�, 0 00 �� Inspections Required: �Vork Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal Nlechanical Water Connection �,� Footing � Septic Sewer Connection - � Framing /l Fireplace Lawn Irriga[ion �Insulatioa (Masoary) Other Wall Board F�� _�(Mfg.) Well (State Perm.it) �� Grading/Filling �Electrical (State Permit) Other REI�tARK.S(IN HOUSE): REV�`V BY OTHERS: DATE: Access: Ezisting New Access Approval: Date By; REI�IARKS (TO BE NOTED ON PER1vII'1�: 8 � . . � . ��o �� pzgt of swwey for ('�ry F. ?�ondale of Lot 2, Block 3, Long Leka Country Club Addition . Hennepin County, M.innesota. � CovNTRY CLVB f Ro,�c 0 a N e�°34'So"r! ►�7' 0 �'�4'1�'33" v : � ' s' l�5. R_ s 3� �l "' �� ..... .. ..... . ioao'. ..... ........ � �� i �� s�.s• i N �� Ex;st,�, �e�. � � oc �lT� P�N GR ItJG ttA ...._.. ..... . 99s• .. .. ... �..... �S" ,` C ��';��i�VcD - (�ot�.�t ��:.ctc ��Y.��e. f?.c' �� U ai`��riv'1Vr'U YY��f�i ►1 1' �� IStOt+�S r �/� � � u D,'s��=`��3i7`vE ,�,y � � _ ' a�d��<; ' �Y ,�.. , : ._. • �'��. "d - -UO � W � --` , ..._` ry .______� N � . � ,\q V 2 : o�k .. . a�0� ... N 87•34'So"�✓ t97.o' ... Certificat,e of Survey: \ I hereby certify that this is a true and correct - represenL�tion of a survey of t,he boundaries of Lot 2, Block 3, Long I,ake (:ountrv Club Addition, and the location of all exiating � buildings thereon. It does nat tnxrport to shov other improvements or encroachments. . ' . Scale: 1" = 50� Cordon R. Coffin Reg. . 064 Dete : 11-2-7b I.and Survey�r and Planner o . 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Cail for the next inspection 24 hours in advance. (952� 249-46�� OwnedContractor on site: Inspector.��/�,/i�G�� White Copyllnspector's File Canary Copy/Site Nodce � . ��1'l�Q C��Y�Q.J� C.)�.) 1 �� .�� DATE IME CITY OF ORONO CALLED IN �'O�3"' C�� I/�2 U��'� INSPECTION N�.�ICE � SCHEDULED /-�`�- �/ 3 :��' �"i1 ' PERMIT NO. C.��7Gi C� COMPLETED !� � ADDRESS �� v[:��i ti y C-�✓d �:_ck' . OWNER�1�C Uil''�� CONTR. /�'��_ ��pn K or. TELEPHONENO. _I!5'� ' y�,�` 71�� DESCRIPTION �r�n�� i✓��5}.�C�f��y� Gr7 �v��,�. �;'�,'� LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 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 FIN 14 SEWER HOOK-UP O6 PROGRESS � 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: � � — ��'v,2�t/ ��nn�S a F ��-�-,�.�D�t� � J 0 a � 0 � W � Q � z W � W � � � ❑WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE W � ❑CORRECT WORK 8�PROCEED �': ISSUE CERTIFICATE OF OCCUPANCY W O�RRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT CI CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN � CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next ins ection 24 hours in advance. 249-4600 OwnerlContract Inspector. White Copyllnspector's File Canary CopylSite Notice DATET-�-\ TIM CITY OF ORONO CALLED IN � w 3"� INSPECTION NO ICE SCHEDULED —� -G� PERMIT NO. �� COMPLETED � � � ADDRESS ��1�-� Co�.r>-}v�%CIC��I=� �-<�aC OWNER C��1'��L� CONTR. �'u'�-� TELEPHONENO. �� '�� DESCRIPTION ��C�I �CI'l l� 01 G 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 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 W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL = 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL J Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z � C M E S: � � C�(e r Ccs' �r�-C' -� � � l/�u � � �C�c � i �S C-r_ � 0 � � � ° � '� � W � Q ti Z W � W � � d C;WORK SATISFACTORY:PROCEED � PROJECT COMPLETE W � [: CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W O �ORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 BEFORE COVERING PERMANENT Cl CORRECTUNSAFECONDITIONWITHIN HOURS. r- PHOTOTAKEN INSPECTOR WILL RETURN i CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR I� INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. 249-46�� OwnerlContr tor on site: Inspector.�(/(W� �� White Copyllnspector's File Canary CopylSite Notice DATE TIME CITYOFORONO CALLEDIN �"�7'd� INSPECTION NOTICE />' SCHEDULED � � ''30 PERMIT NO. PD�7� v COMPLETED ��'� ( • �� ADDRESSL�/� S �cx„nf�y �/��o /� OWNER/I'�c-G � l'onn��/ CONTR. TELEPHONE NO. Y7 5 " 36 ZZ � ION _ �t?n'rG� � l� FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 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 OS 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 � C M T : � ,� � � / � ��? `�" � � O a � O � W � Q � Z W � W � � d W� �VORKSATISFACTORY:PROCEED PROJECTCOMPLETE v W ❑ CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL RETURN [7 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED i_� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-460� OwnerlContrac or on site: Inspecto � ��- � White Copyllnspector's File Canary CopylSite Notice