HomeMy WebLinkAbout2005-P08576 - in-ground pool PERMIT
CITY �F ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Pogs�6
Crystal Bay, Minnesota 55323 Permit Type: a��esso�-y sn-u��ures
(952) 249-4600 Date Issued: 4i2oi2oos
SITE ADDRESS: 2700 Countryside Dr W
L.ong Lake,MN 55356
PID: 04-117-23-12-0012
DESCRIPTION:
Proposed Use: Residential
Census Code 329
Pernut Class: Building
Permit Type: Accessory Structures Permit Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 209.25 Valuation: $ 12,000.00
Plan Review Fee: $ 135.98
State Surcharge Fee: $ 6.50
TOTAL FEE: $ 351.73
APPLICANT: Peterson Pools&Spas Inc. OWNER: Brad&Lily Everett
13110 Excelsior Blvd 2700 Countryside Dr W
Minnetonka,MN 55343 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.
;-
,
__ _ __ �`�-�- LC L��C� t,��./�
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APPLICANT PERM[TEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Sienitures Required). 1-Applicant, 1-Monthlv Revorts, 1-Assessin�, 1-Finance Page 1
✓� �/-s-�s-_
Total Fee• $ �`� �/ � ?=' Date Received:
Entered By: ,��. I�.i >f }�.�y>.i�,;�/ /l Permit#: AvQ.��C�
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS:��� Cr��N i��/S.�tJt ��' c,�� ziP: S��3S`�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ YCS ❑ NO I,fyes, a special event permit is required with Police Department and City Council approval
60 days prior to ihe event. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: ��{Q l� � U�C %% PHONE: (home)�t S� 'y�( ° 7�7 fi (�
(wark)7�3 - �'� • S�((
MAILINGADDRESS: �7�r1' C°c�cJNTi2�/S�f�t P2CITY: QI��1�'i� ZIP: S5 3S1^
CONTRACTOR: (�t T�SZ�I�' I����S f SI��S PHONE: �/��-�/��-�0�O
CONTACT PERSON: �/''1 'c -{ C MOBILE/P�3'rR: ��a-��i- 3s�G
MAILINGADDRESS: � ll� ���t�SzQ� /3LU��' CITY: /t'l i�l� ZIP: 53�3�
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition �_ Accessory Structure
Move Home Remodel/Alteration
PROPOSED WORK(describe in detai�: ������v/v� ���'-f-�►/�-r�k,� �C� L
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 1��� �ZZ�
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 ardinances and codes of the Ciry and with the State Building
Code;that I understand this is not a permit and work is not to art without a permit;and that the wark will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: � d�
�__/
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be srored 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 conceming himself shall be
informed of: (a)the purpose 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)any know�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 ma�place the notice required under this subdivision in the individual income tax or property 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 infonned whe[her 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
srored 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 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 shall comply immediately,ifpossible,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
concerning himsel£ To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the 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,includi�g recipients named by the individual;or(b)�otify 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 ar 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:
1. The information you furnish will be used to determine your qualification far 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.
�Gi� VC� �L G�,i L� �
First Middle Last
�1l � C ��t lS�,�' f3�vD
Address
fZ7�i�r� �l�/ 5`�'3y3 �la ��/ �s�'6
City State Zip Phone
I understand my rights a ate above.
C� � -
Signature J
32
CHECK OFF LIST FOR ISSUA1vCE OF PER1ti.tITS
FOR OFFICE USE ONL Y
ADDRESS OR LEGAL: Z7 o U Go�,.f� Si� �� �'
PID:
DESCRIPTION OF Y(�ORFC: o��
-- - -----------------------------------
-------------------------------------------
ZONItYGREVIE�I�BY: � DATEAPP�ZOVED: �/- � -05 �
BUILDI�YG REVXEW BY: DATEAP,PR06`ED: �- K -6s
-----------------------------------
FEES TO BE C.HARGED: hlisc. Fees Cc�lcccfated By:
PERNIIT Yes ✓ No
PLAN REUIEGV Yes __� tVo SEYYER GOtVNEGTIO�V
STATE SURCH.4RGE Yes __� �Vo LVATER CONNECTIOIV
ItVVESTIG.4TION FEE Yes tVo �/' PARK FEE
SAC .Y�es No // SITE tNSPECTION
tV�u��ber of SAC U�iits OTHER (specify)
--------------------------------------------------------------- --
ZO�VING CHECh'LIST zo+�i,i�Discr�tcc:
Fire Deparhner�t: Post Office: ScJzool DisA•ict: _..
Lot.,�{rea: S t. Acres �Yidth Depth
9•�
S�c�vey Subr�iitted: Yes�_ No Dafe of Scuvey: ON ���
Propased Setbacks:
Froru(Lake): I'-►5� f Right Side: N I f�
Renr(Sn•eet): y� + Left Side: ct� �
AdjacentStruct�u•es: �a G[/efland:
Buildirtg Height: Def. Ngt. — Penk Kgt.
Got Coverage: �
Grnding: Stnff.4pprovcc!Date: --' By: Council rlpproval Date:
Septic: Staff.�{pp�•oval Date: — BY�
Zoniizg File: # ^ Resolutio�t: # Resol��tion Dnte:
Shoreland Dist�•ict: N�
flvg. Setbnck: Blceff Setbac�:: Lat Coverage:
Esisting Proposect
Har•dco�er: 0-75'
75-250'
250-500' �
500-1000'
Hardcover Vnr•iarice Reqeiireci: Yes No Date of Cot�itcif�pproval: _
.RE�I�lARKS(irr.liouse): '
,, 31 : '
� ; :
t 47, ry'' �%
B UILDING RE vIE F�v CHECh'LIST
UBC: — COi��STRUCTIO�V TYPE: —
Sq FooraJe S Pe,•Sq Ft,�
Base�ne,u � _
!st Flaor x =
3nd Floor c =
Garc�e � _
s =
TOTAL
aL2
Esti�rtated Coltstricctiou Vali�e; ,S � Z�000
Inspectio��s Required: 6E'a•k Requi�•i��g Separate Pern�its:
Site Pl�ur�bing Fire
Hai�dcover Removnl A�fechani.cal GYater Coartection
�Footirig Septic Setiver Cau4ection
Frnnii��; Firep(ace Lntiwi.lrrigntiat
h�scclation (i�lasonr}�) Other•
GY"czlf Boar•d (Nlfg.) 4Vell('State Perinit)
0� Fiiiad Gradi�tg/Filli���; Elecd-ical(Stn�e Per�nit)
Otlie�• '
REIYIARICS(IN HO US,E):
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RE lfi"E Yv B Y OTHERS: DATE:
,4ccess; Existing iV"e�v
:lccess�{pprovcil: Date By:
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RE�'�.t.�Rh:S (TO BE�VOTED ONPEXtNIIT):
3?
LIGHT STEP
APPUCATION APPLICATION E-'�— B �A�
8' 8' 8' 8'
16'x32' RECTANGLE p
4 4 5 12-8' PANELS TYPE II �
8 8 L
8-BRACES
e'
35�-9" g• 6� I -CORNER ASSEMBLY SET —
I -16 x32 COPING STRAIGHT SET 6"R
g� 8' I -90' COPIN� CORNER SET
4' 4' S I -STEEL HARDWARE KIT E F G H J �K J
SteelSteolnsa��aoion� I -VINYL LINER
B 8 8 8 To install 6'steel ai S I Z E A B C D E F G . H J K L
ep,use 4'filler on eAher aide.
Ta install 8'steel etep,use 3'filler on either side. 16" x 32' 16' 32' 8' 3"4" 8� 14' S'6"'.4'6'�4'6" 7' 4'B"
2' 8' 8' 8' 8' Remove both 8'panels for ehher step. �6' z -4' 16' 34' 8' 3'4" 10' 14 S"6"I 4'6"',4'6' 7' 4'8"
16' x 34' RECTANGLE �g'x 36' IB' 35' 8' �3'4" 12" I4' S'6''4'6' 4'6" 9' 4'8"
4' 4 5� 12-8' PANELS TYPE IL 20'x 40' 20' 40' 8'6"' 3'4" 13�-fi 15=6 7' 4' 6' 8' S'2"
8' 8'
2- 2' PANELS
8. 37'_7" 8� 6. 10-BRACES
I -CORNER ASSEMBLY SET ��
8 8 5� I -0°3COP NGNCORNERGSETSET 6"R -�-��— �
4' 4' —�
I -STEEL HARDWARE KIT
2' 8' 8' 8" 8' I -VINYL LINER � '
4' 8' 8" 8' 8'
\ I �z'o I
18' x 36' RECTANGLE `°"`"' ��. � TURNBucxLE ;�%
5' S' 6� ! �
8� 8� 12-8' PANELS TYPE II
2- 4' PANELS `�""'� pArvEL ���
40'-3" 8, 6,2-2' PANELS ,..��.<<o�c� .�sE.av
8 12-BRACES //�
8" B I -CORNER ASSEMBLY SET �TA�� �
5 5, 6• I -18 x 36 COPING STRAIGHT SET 6"F1
I -90" COPING CORNER SET
2 2 I -STEEL HARDWARE KIT • : . �'
4� 8� .___.8� 9� Steal Stqp Installation[ 2`VERMICUUTE �
--`-._ _.-_._ _. _-. �. -..
��'� I –VINYL UNER Toinstall6'steelst oa snrro '
� ' _ To install 8'steel ste�p,uae 4'filler on edher side. ' � � � � ���ll
8' 8' 8' 8 8' � �_ ��sh�I ��
-�. Remove both 8'panels and 7 panel for either Step. � �,i CONCRETE
F(JO7EA
I 20' z�' RECTANGLE ��6 DEPTM MN.
6 8 8 6 6 �`�
14 -8' PANELS TYP E IIL � ���pp,1u5TABLE TUwW�lBUCKLE BaaCE
2-4' PANELS
g� 44'-9" g� g• 12-BRACES
8, � 8' i -CORNER ASSEMBLY SET
I -20 x 40 COPING STRAIGHT SET 6" R STERLING Fort wayne Poo�s, �f1C.
6� I -90° COPING CORNER SET �/�/�L�
6• / 6' � � 510 Sumpter Drive
4' 4' �, I -STEEL HARDWARE KIT
I -VINYL. LINER � Fort Wayne; IN 46804
8' 8' 8' 8' e' ` �" "'
��ngM STR-001 I oaB. February 1991
General Nctes: Scale: i '
Toinstall6'steelstep,use6'filleronertherside. 1,Alver�cal6mensimsareianliner N�A Rectangles, 6�� radius comer
To install B'steel step,use 5'filler on either side. extusiais on all poais.
Remove both 8'panels and 4'panel for either step.
, Ezcava6on Notec:
1.Shc lo have mmmum beadrg capadry of THIS BROCHURE IS FOR ILLUSTRAi IVE PURPOSES ONLY
2000 P.S.F. The manufacurer makesorily Ihose represenlaUaxwhid�xe smted in i5writlen warranry.
2.Locate tap ot pod a1 least 6'abare �Y������taaons,uaa�ments,a conuacts made by t�e deaiericontracta b he
surtaxdng land elevafim. custaner regardng any materials produced Gy Ihe manufacNrer xe attibuude to he
' J. Exwva6on stiall be 2'larger Nan poal aY ����ror contracta my.The dealer a coneacta«ho sells a installs your pool is an
xouM. Fllvddsunderbaseolpanelsand independentcmtractaandrrotanagentaempoyeeofthemarn�fxwrer.Theconstruc0on
ymP�W�� methodsdlusvatedxasuggesumsandapqymtybmrmalg�oundo�ntliems.Theremay
4. BadpM with ran-ezpansrve material. be addi9onal perauums and�or methods of construcnon. The respmabq.y is he
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�� DA�.C� TIME �
CITY OF ORONO CALLED IN � �
INSPECTION T SCHEDULED � �=l
PERMIT NO. COMPLETED `� N
ADDRESS a 7DD � �
OWNER CO TR. �
TELEPHONE NO. � �
� 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
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Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAI 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
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//W �r wORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
q�Ll CORRECT WORK&PROCEED
� ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. u PHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forihe next inspection 24 hours in advance. �95Z� Z49-4600
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