HomeMy WebLinkAbout2007-P10924 - addn/remodel/repair PERMIT
CI�Y UF ORONO
Permit Number:
2750 Kelley Parkway- PO Box 66 P1o924
Crystal Bay, Minnesota 55323 Permit Type:
(952) 249-4600 Addition/RemodeURepair
Date Issued: 5/8/2007
SITE ADDRESS: 2475 Countryside Dr Unit#
Long Lake,MN 55356
P��� 04-117-23-11-0006
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Addition/Remodel/Re air Permit Sub-type(s): Addn/RemodeURepair
Permit Type: p
DETAILS:
Approved per resolution#:
Separate permits required: Electrical(state)
NOTICES/REMARKS:
Add 12'x 22'-4th Car Garage Next To Existing Garage With Basement
FEE SUMMARY: Pernut Fee: $ 769.75 valuation: $ 68,000.00
Plan Review Fee: $ 500.34
State Surcharge Fee: $ 34.00
TOTAL FEE: $ 1,304.09
APPLICANT: Van Heel Construction,Inc. OWNER: Barbara Hite
2375 Orkla Dr. 2475 Countryside Dr
Golden Valley,MN 55427 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.
v
APPLI PE IT E SIGNATURE IS ED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
ti
� c.j °G
Total Fee: $ � ���� � ��� ' DateReceived• '�����
Entered By: �,,� ,�,� i ' � Permit#: D 92.
��
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all i�zformation)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: Z U i �, ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ 1'CS � NO If yes, a special evenl per����it is��eqiiired tivitla Police Deparlmeni and City Cotirncil appr•oval
60 days prior to the event. Shzrttle bus service wil!be requi�•ed unless applicant dernonsd•ates
strffrcient or�-srte prn•krng is avnilable. �`on-perr��itted events tivill not be allotived.
NAME OF OWNER: ��"1��4-�f�jor�aL �-�.;� PHONE: (home) �S z- �76-�b s�
(work) -
MAILINGADDRESS: �{7S� ��-�r�S�� �r",CITY: Or�'l(S ZIP:
CONTRACTOR: U�`��� �C , PHONE: ���-,�Z`��S�
CONTACT PERSON: M BILE/PAGER: - �-�`�ZO
I MAILING ADDRESS: � , CITY: � ZIP:
STATE LICENSE: # EXPIRATION DATE: f�ar'C�Zbb�
ARCHITECT/ENGINEER: � C�vbFi��-r�'``PHONE: (�SI- �S�- /�v� I
MAILING ADDRESS: a� �ulf CITY: ;(�i,�5 ZIP: SS b��
NAME: {�Q,�J�I� �sr� REGISTRATION: # 7
TYPL OF �JOIZK: New Hame Addition 1� Accessory Str�ictu;e
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may require MCWD review and permits !
PROPOSED WORK(descrihe in detuin: z.� ZZ � Ca�
-e -� � � �
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHEI�
ESTIMATED CONSTRUCTION VALUATION(excluding land): � �� DO d
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the�vork�vill be in conformance witl:the ordinances and codes of the City and�a�ith the State Buildin�
Code;that[ uilderstand this is not a permit and��-ork is not to start without a permit;and that t17e work���ill be
in accordance with the approved plan.
AYPLICANT'S SIGNATURE: � V�c, DATE: � - Z� -?
�l
a
Sec.13.0�1 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on��hom 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[o supply private or confidential da[a concerning himselfshal I be
infonned ot`. (a)the purpose and intended use of the requested data within the collecting state aeency,political subdivision,or sta[ewide system;(b)
whether he may retLse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to suppiy
private or confidential data;and(d)[he identiry 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�,to a la�v enforcement officer.
The commissioner of revenue mayplace the notice rec�uired under this subdivision in the individual income ta�or�roaertv ta�retLnd
insvuctions instead ofon those fonns.
Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be infonned whether he is the subjectof
stored data on individuals,and�vhether it is classitied as public,private or contidential. 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 ofthe content and
meaning of that data. After an individual has been shown the private data and informed of its meanin�,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this secfion is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the priva[e or public data upon request by the individual subject of the data The responsible authority
may require the requesting person ro pay the actual costs of making,certih�ing,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 ofthe request,e�cluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request
within that time,he shall so inform the individual,and may have an additional tive days within which to comply witll the request,excluding Saturdays,
Sundays and legal holidays.
5ubd.4. Procedure when data is not accurate or complete. An individuai may contest the accuracy or completeness oFpublic or private data
concerning himselP. To exercise this right,an individual shall notih in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days either (a)correct the da[a tbund to be inaccurate or incomple[e and attempt to notity past recipients of
inaccurate or incomplete data,includina recipients named by the individual;or(b)notify the individual tha[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 autlionty may be appealed pursuant to the provisions of the administrative procedure act relatine 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 deparnnents may require you to furnish certain p�ivate or I
confidential inforn�ation.
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 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 ri;hts 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.
���e� ��.-�-�`�— �� l-�l
First �'liddle Lxst
7�7� a�k(� �r,
:lddress
� C� �7 6� �S-�/Z -�o s�
City Statc 7.ip Phonc
1 understan m�� rights as state above.
L
Signaturc
Reset Form .i2
� �HECK OFF i,IST FOR ISSU.ANCE O�' �'EK.�K.�IITS
FOR OFFICE USE ONLY
ADDRESS OR LEuAL: ��l'1 S C p���-�-1 S , c�Q ��•
Pli7:
DESCRLP'IZON OF�VORK: z lt,�G� A� ��v
-------------------------------------
ZOYI�iG REV�tiV BY: `-------�/� AATE APPROVED: `� � 1
SU�ZDING REVIE�V BY. DA.TE APPROVED: S-y- 0 7 �
FEES TO BE CHARGED: Misc. Fees Calculated By:
p��T Yes � No
PLAN REVIE`�l � Yes �/ No SE`VER CO�INEC`1TOI�T
STATE SURCHARGE Yes �/ No WATERCONNECTI4N
INVESTIGATION FEE Yes No �/ PARK FEE
SAC Yes No �/ SITEINSPECTION
Number of SAC�Units OTHER (sgecify)
----------------------------------------------------
ZQNT.i�IG CHE.CK LIST zoning District: �IQ'1� .
Fire Department: Post�ffice: School District: �
. i
I,ot Area: Sq.ft. �IZ I ZZ�i Acres Z' �� Width 7i�(, � Depth �,� ��7
Survey Submitted; Yes _ � No Date of Survey: `'� ) �
Proposed acks: �`�� � �
ro (Lake): ���V Ri�t Side: � (,
� .
e (Strez[}: ?/�� laeft Side: 'r ��'� �
i�, .�
Adjacen[ S�ructures: c. ��-�-- �Vetland: t, °
Buil�lin� Hei�ht: Def. Hgt, o •I�- Pealt Hgt.
Lot Coveraoe: N1(�`
//4- g — Council Approval Date: �f � � .
Gradino: Scaff Approval Date: /J Y�
i �
Septic: Scaff Approval Date: � � 5 'a� BY: �
Zoain� File: 7 ��_ Resolution: n Resolution Date:
Shoreland District: I�u N j �
Avg. Se k: �/ � � Bluff Setback: �) i`Ck _ I-ot Coverz;e:
E�istin� Propased
0
��rdcover: 0-75'
' 7�-250'
\� 2�0-560'
__��. f�
�c�-���
ridi�CO'ti2i �+''2.'lcuCe .T�.P.�^.�l!!i'L: :�PS �;p �_ �i3:_ Q�C'J'�!CC11 :��r_OV�: N I ��
F.E�L4RI�S (in house):
BUILDING REVIEtiV CHECK LIST
�C� ��3 CONSTRUCTION TYPE: �/N
Sq Footage $ Per Sq Ftg
Basement x =
lst Flaor z _
2nd Floor z =
Garage X _
z -
TOTAL
Estimated Construction Value; $ Ce`3,OOc� °O
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Coanection
�Footing � Sepcic Sewer Connectioa
—�Fr��° Fireplace Lawn Irrigation
Insuiatioa (Masoary) Other
� Wall Board (Mfg.) Well (State Permit)
—�F�� Grading/Fillin; _�t Electrical (State Permit)
O the r
REMA RKS (IN HOUSE):
-----------------------------------------------------------------------------------------------
REVIE�V BY OTHERS: DA'I�E:
Access: Er.isting New .
Access Approval: Date gy:
- ------------------------------
REI�LARKS ('�'O RE Ncl�n nv p�F�1�P�;:
8
. . , , � _ _
„
, .,; a��_����h
� � - -- �� �
i , • � �,� � w
, � ,- 3 .����r.����-�`��i�' �:� t �-,
� ' ; ��i�E�! ��1�,��a #�.�...,`�'� �i�.'�C1tw��aa �i �
� � � (1/QCl�OON �`�M716r� Q�i�Cf���C��%' � C�
� � � �`l��c� ��'���`��: `— .�`���� �.��J ni ;
� �l e��� �� /1�i�i�
, �
' ( ���� } l
,� i Z � I @(, �Q _. � 1 _
, b � � X ' T��� -_
; � z-?._�s�+ - - --- '�x �' `'`�"� ��,��. ���
; i °- ". z ,
z-f-d , e o-b / o z N
; Z"£86� ' o �'� � .`h t z �
• � TQ6x , p•92 /�/f �E 22 4�E6--------� �
� ��j
N ;�i'�� a5nor� �� '
w/.�'��;� Pasodo�d ' , W
� , � -%i ; ,�`5� '
' °1 Z �0 Q �r'////'/ %�/ ,� i
I€B6�c , EEL.�tti'9 ��r/r � '� � � �
-�- - - ����d - - - - ' � -� _ ° r0 oE'o ;o l.t L'F�4, �
� � �8b� • _�_ _ --- - --a_--� - - - _ ;
--- 6d f 96 � � �B 68 ' .
�i z �-95� �
� 1�o� �
� 2-I-d �'�� ,5�6 � :
� � �
' � . I ,
b ' � O
C} I ' O
� ! -
- ,, �. I
� � � � ►
,
� ,---,--___-_ _.-_
.- -- --- ,
,
___ _, ___
, f .,_..--.._.--- --- . �
. __ . - � :
__ ___,__ __._ , - - , :
� � � � � ,_ � o ; � ��
6BGbx '. , ,
- - --. C�o'09Z �,.Otr ,!S o6� S r x �.,�
.w� _._: _ _ _- , � 6 B6 �
,
: s . �
. _.. � _ ��,� } ��
_ _ __ �
__ __
_...
�_Q6��.._ 'gnb;xj�o af�a�__. . _ _ ����L��^��,tir,
--_ �_____�����1___ _�_:�_,.. .T_ :�-���-��-�lf1C3-�- �_-:1���� �--_ �� � `
--- -��_ . . _ ���6;� ___.:_._ _. _._.____.. .
. ,�+ _ _ _ _
- r -
, - -
� �: _
� k � r' t `� '�! � � t �:t I 3f s ����.i - _
. . � <r 'Y�, i 5..? �i, if ,r.` �, �,. .v
.�._. �r,_.. ......at.F...s.,,. ,. � t � i �' a��,� i. �'h J - ,( ir } tt.. � } � u. a �
. .. _ . . ... .., , . , . _ . ... ,.. ... >.1 �'.. �a::-,'a,M1 .:�1 .� �N.;F� n , � .�t. .._. _,..x t, _.. � ��,. , r. . , .. . .. , _ . .. ._
F � �/ �ATE TIME
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED —� —� l�: G�
PERMIT NO. COMPLETED
ADDRESS ��7 �
OWNER CO R. U�-��e2�_
TELEPHONE NO. 7Gr J� T 3C� 9�Z��
� DESCRIPTION ��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
O
�.
�
O
�
W
�
Q
�
Z
w
�
W
�
�
d
W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. r, pHOTOTAKEN
INSPECTOR WILL RETURN �
_i CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for th next inspection 24 hours in advance. (952� 249-4600
OwnerlCo r on site:
,
Inspector. -
White Copyllnspecto s File Canary CopylSite Notice
�� �j�/` / � T TIME �
y F � � �.�
CIT O ORONO CALLED IN �
INSPECTION N IC SCHEDULED � `
PERMIT NO. 02 COMPLETED
ADDRESS a TS � .�
OWNER CONTR. �Q,�t-��
TELEPHONE NO. 7lO 3 ��O ` 4 Z� ��_
� DESCRIPTION �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
�
o �`V Irrl CA-�✓< , � )�l�-S c'��SY {
'� !�-� ,� � I
�
0
�
W
�
Q
z E,,,� �T t I �e�i.t�Sc�✓�- � C.� �3-4 ��r�re �3�
W �
�
W
�
j
a
W ❑WORKSATISFACTORY:PROCEED Cl PROJECTCOMPLETE
� �CORRECT WORK&PROCEED '_' ISSUE CERTIFICATE OF OCCUPANCY
W
p ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR i:� CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContractor on s'te:
Inspector. � �
White Copyllnspector's File Canary CopylSite Notice