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Home My WebLink About2007-P11528 - addn/remodel/repair PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P11528 Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodevRepair (952) 249-4600 Date Issued: 10/16/2007 SITE ADDRESS: 2630 Countryside Dr W Unit# Long Lake,MN 55356 P�� 04-117-23-12-0015 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addirion/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Mechanical Fireplace Electrical(state) NOTICES/REMARKS: Relocate 2 Gas Fireplaces. New Wet Bar In Basement,Add 2 Windows. FEE SUMMARY: Permit Fee: $ 1,133J5 Valuation: $ 124,475.00 Plan Review Fee: $ 736.94 State Surcharge Fee: $ 65.00 TOTAL FEE: $ 1,935.69 APPLICANT: Sawhorse Inc. OWNER: Todd&Katherine Urness 4740 42nd Ave N. 2630 Countryside Drive W. Robbinsdale,MN 55422 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. � � ,� IiV� Vv1 APP�1,1 ANT ITEE SI NATURE ISSUED BY SIGNATURE i Copies 1-File(SignaturesRequired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 �;� �� 52� � �j Total Fee: $ �% v Date Received: � �,ntered By; !'` Petmit�#: , CITY (�F ORO1oI4 - BUILDING PERA�[T APPLICATYOI�T All information must�e submitted in fuil before plan review will be started. (please print all informatzon) �-------��-----�-------- ----- T�iE ,t�PL,ICANT IS: (circle ane) OWNER OR CONTRACTOR • �,_ � � JOB SI7'E ADDRESS: .Z-C�3� C�",v,-�� , G � __ ��: �s �� NANI� OF OWNER: �p ��u�l��`'� ��N�`�� PHON�: (home) ' (vc�ork) MAILING AI)DRFSS: ��-�-- CYTY: _ -- ZIP: CONTRACTO�t_ , ar.� 25�:-, �` - � � 1�,�� .sPHONE: 7(0� 'S-�'3c53s"- Z CON'TACTPERSON: '� �,qti MOB�I.E/P G�ER� �v( Z- z-2 i - �� MAII.ING ADDRI:SS: ��lyo y2rJ-� �- �� l�,�a _CTTY: �aa;.�-��F��` ZIP: �;5 y z z STAT� LICENS�: �l 2:3��Z- _ ARCHITECT/EN�GINEER: P�QNE: _ MAIL�NG ADDR�ESS: CITY: ZTP: NAME: REGISTR.ATIQN#1 _ ;�� , ��C � �� TYPE OF WOR�: New Addition Accesso[y Strucriue . � �� N1ove Remodel/Alteracion � Land Alteration ��-- -..��`�\� � � PROPOSEA WOYZK(descri6e in derai�; ��:Y--��.-�= 2- ��s 1-,z� �� "`', � Z ;ti��<.,�, �Q iJ�� c.,��r �.'�;F �N �a�=m�T l��n �� STORIES: SQ.F�ET OF EAC�i FLOOR: • �� NO. QF B�D�tOOMS: GARAGE STALLS: ATT. DET. i � ,<<i� EST�TED CC)NSTRUCTION VALYJATION (excluding land): $ �2-1 i�-E'�5 I h�reby apply for a builfling permit and I acknowledge that the infozmation above is compleie and accura�e; tha�the work wi11 be in conformance with�he ordinan�es and codes of the Ciry and with the Srate B�tilding Code; that I understand this is not a permit and work is not to start vcrithout a penzlit; and that the work will be ' accordanc�with the approved plan. A.PF.'LICAI�T'S SYGNAT �:� _DATE: /0 3 6_ � —_ 1VOTE r P�r d�Q�F�'ome.,� events require separate permit approvul by Police Depa.rtment and Ciry Cou�tcil 60 days priar to the event. Non perntitted events will not be allowed. * Sec.13.04 RIGHTS OF SUB.IECTS OF DATA Subd. I. 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 to supply private or confidential data concerning himselfshall be informed of. (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to suppiy the requested data;(c)any known consequence arising from his supplying or refusing to suppiy 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 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 place the notice reouired under this subdivision in the individual income tax or pro�erty 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 individual who is the subject of stored private or p�blic 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. Afier an individua]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 of the 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 le2al 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 wri[ing 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 reeipients 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 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: 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. First Middle Last .:, . _J, �� :: . ,:,:v Address ��— � �� ,i'��'y i�7�� /�" -> �;/f'.,<'�� C �-�rl o��..�--�- City State Zip Phone I understand m,y ri�hts as sta ed above. .-� � _------ Signature;� Reset Fonn 32 Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION Ali information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS ❑ NO If yes, a special event permit is required lvith Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site pa��king is available. Non-permitted events will not be allowed NAME OF OWNER: PHONE: (home) (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement may require MCWD review and permits! PROPOSED WORK(describe in detai�: STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 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 Ci�� 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: DATE: 31 � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: Z.b 3 J Cov,•,�-rt-z�r s�D c (J� PID: DESCRIPTION OF WORK: rJ�L ZONING REVIEW BY.• t� ~ DATEAPPROI�ED:� �� BUILDING REVIEW BY: DATEAPPROVED: �o - s-07 -------_--_----------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes � No PLAN REVIEW Yes� No SEWER CONNECTION STATE SURCHARGE Yes � No WATER CONNECTION INVESTIGATION FEE I'es No_� PARK FEE SAC Yes No � SITEINSPECTION Number of SAC Units OTHER (specify) ---------------------------- ZONING CHECK LIST Zoning District: �U �� Fire Department: Post Office: chool District: Lot Area: Sg.ft. Acres Width Depth Su�vey Submitted: Yes No Date of Survey: Proposed Setbacks: Firont(Lake): Right Side: Rear(Street): Left Stde: Adjacent Structures: Wetland: Building Height: Def Hgt. Peak Hgt. Lot Coverage: Grading: StaffApproval Date: By: Council Approval Date: Septic: StaffApproval Date: By: Zoning File: # Resolution: # Resolution Date: Shoreland DisU�ict: CWD Pei-mit: Avg. Setback: BluffSetback.• LotCoverage: Existing Proposed Hardcover: 0-75' 75-?50' 250-.i 00' .i 00-1000' Har�dcovei� Variance Required: Yes No D te of Council Approval: REMARKS(i��house): 33 B UILDING REVIEW CHECK LIST UBC: 1Z '� CONSTRUC7ION TYPE: �/� Sg Footage $Per Sq Ftg Basement x = 1 st Floor x = 2nd Floor x = Garage x = x = TOTAL ou Estimated Construction Value: $ 1 Zy,�{�S — Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal �Mechanical Water Connection Footing Septic Sewer Connection _�Framing �Fireplace Lawn Irrigation �Insulation (Masonry) Other �_ Wall Board o� (Mfg.) YGell(State Permit) ___�Final Grading/Filling �'Electrical(State Permit) Other REMARKS(INHOUSE): REVIEW BY OTHERS: DATE: Access: Fxisting N'ew Access Approval: Date By: REMARKS(TO BE NOTED ONPERMIT): 34 �� °� �- ✓ I DA � ,pf` TIME ` CITY OF ORONO CALLED IN b ��I/�v� INSPECTION NOT(I�CEj SCHEDULED C 11� � PERMIT NO. 1`-�( �� COMPLETED ADDRESS � �OJU ` C�lh-n't�.`�1C� �� C�� OWNER CONTR. C��P��_ TELEPHONE N0. � �c�+ ' �c� I ' �� DESCRIPTION � � �' � � ❑ FOOTING ❑ MECHANICAL RI EXCAV/GRADING/FILLING � ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS Q ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � � DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTI FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOA TO MEET YOU: YES_NO � COMMENTS: � W � � � O a � O � W � Q � Z W � W � � d ��WORKSATISFACTORY:PROCEED CI PROJECTCOMPLETE W ❑'CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR W4lL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on si e: Inspector. l!'� ��j� � White Copyllnspector's File Canary Copy/Site Notice `I� � �J �L-�� TIME • / V CITY OF ORONO CALLED IN /o�- /D O7 INSPECTION �ICE` �, SCHEDULED � � ��' � PERMIT NO. �`J� COMPLETED \ � ADDRESS �. OWNER CONTR��/�� TELEPHONE NO. *�`►' � — � - o l� - `t�"-3S � DESCRIPTION � Ct,� � ❑ FOOTING � MECHANICAL R ❑ EXCAV/GRADING/FILLING Q �-FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W C � � O a � O � W � Q � Z W � w � � a � , ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ':�CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal1 for the nex inspection 24 hours in advance. (952� 249-4600 OwnerlContr n i e: Inspector. � White Copyllnspector's File Canary CopylSite Notice