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Home My WebLink About2007-P11274 - re-side PERMIT CITY OF ORONO 2750 Kelley P�rkway- PO Box 66 Permit Number: P11274 Crystaf'Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 7/31/2007 SITE ADDRESS: 2650 Countryside Dr W Unit# Long Lake, MN 55356 PID: 04-117-23-12-0014 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side DETAILS: Approved perresolution#: Separate permits required: NOTICES/REMARKS: Stucco front and garage side elevation FEE SUMMARY: Permit Fee: $ 542.75 valuation: $ 40,000.00 State Surcharge Fee: $ 20.00 TOTAL FEE: $ 562.75 APPLICANT: Krech Exteriors OWNER: Robert Jorgenson 5858 Blackshire Path 2650 Country Side W Inver Grove Heights,MN 55076 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. � W � APPI.ICANT PERMITE � E SIGNATURE ISSUED EY S[GNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 PERMIT CITY OF ORONO 275� Kelley P�arkway- PO Box 66 Permit Number: p11274 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 7/31/2007 SITE ADDRESS: 2650 Countryside Dr W unit# Long Lake,MN 55356 PID: 04-117-23-12-0014 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Stucco front and garage side elevation FEE SUMMARY: Permit Fee: $ 542.75 Valuation: $ 40,000.00 State Surcharge Fee: $ 20.00 TOTAL FEE: $ 562.75 APPLICANT: Krech Exteriors OWNER: Robert Jorgenson 5858 Blackshire Path 2650 Counri-y Side W Inver Grove Heights,MN 55076 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. ' / � __ C APPLICANT PERMITEE SIGNATURE SUED RY SIGNATURE Copies: 1-File(SignaruresRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, l-Septic) Page 1 Total Fee: $ Date Received: Entered By: Permit#: 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 OR ONTRACTOR JOB SITE ADDRESS: �S� C�vn.�r.tis��. P�►��c cves� ZIP: S S 3 S(p Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ 1'eS ❑ NO !f yes, a special event permit is requi�•ed with Police Department and Ciry Council approval 60 days prior to the event. Shuttle bus se�•vice will be required unless applicant demonstrates sufficient on-site parking is available. �'on-permitted events will not be allowed. NAME OF OWNER: �er� �'o��sah PHONE: (home) `fS2- 47S- ►3�08 Sf}M E (Work) MAILING ADDRESS: CITY: br-o ho ZIp; ss3S� CONTRACTOR: 14��h F�,k-�cr�d� PHONE: �S�- 4�$ -�3�8 CONTACT PERSON: 8�1 � J.c 1t-FxM�o MOBILE/PAGER; (�I z- ¢!¢-�3s m1 MAILING ADDRESS: S�s8 Qlq�ksk•� n�-�'ti CITY: =t-�+.,� (��a 1++-ZIP: sso 2� STATE LICENSE: # 2 034� r3s- EXPIRATION DATE: 3 r 3� /o g 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 detain: _ S�cco t=ro.,-} � 6a,.t,�.� s:d�¢ Eleu�.-}+'., STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED 3 DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��i ��• � I hereby apply for a building permit and I acknowledge that the information above is complete and aecurate; that the wark 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 withthe approved plan. APPLICANT'S SIGNATURE: G�2s�—��%� DATE: 7�3/�0 7 31 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. l. Type of data. The righu of individual on whom the data is stored or to be stored shall be as set forth m this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be informed of: (a)the p�rpose 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)an��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 shall 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 may place the notice reauired�nder this subdivision in the individual income tax or pro�ertv tax refund instructions instead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authorit},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 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. Afrer 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 of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying and compiling the copies. The responsible authority shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe 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 authority describine the namre 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 ro be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is induded with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure ac[relating[o 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 Address City Statc Zip Phone I understand my rights as stated above. L://i�2'iW" (/ Signature � Reset Form 32 �� I I a�c�� 8 !� �Q'� D��fi TIME O� � l CITY OF ORONO CALLED IN INSPECTION ICE SCHEDULED � �'� � PERMIT NO. � �� OMPLETED ADDRESS ��SD GD GcJ OWNER CONTR.��"PC�i �� TELEPHONE NO. �� a � �7" �� DESCRIPTION �l�n q - � $lo�P4 �'(kCGO loZ Sd�$ �' � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � Q 02 FR,4MING 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 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 � COMMENTS: � W a j D 0 � � 0 � w � Q � z W � W � � d W WORKSATISFACTORY:PROCEED , PROJECTCOMPLEfE W lC CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. �; pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the ne t inspection 24 hours in advance. (J52� 249-4600 OwnerlC o ite• Inspector. White Copyllnspector's File Canary CopylSite Notice