HomeMy WebLinkAbout2007-P10686 - remodel master bath PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p10686
Crystal Bay, M;.nnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
. 1/12/2007
SITE ADDRESS: 2700 Countryside Dr W Unit#
Long Lake,MN 55356
P��� 04-117-23-12-0012
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Pern,it Type: Addition/Remodel/Repair
Permit Sub-type(s): Addn/Remodel/Repair �'`��
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
Remodel Master Bath
FEE SUMMARY: Pernlit Fee: $ 421.55 valuation: $ 28,000.00
Plan Review Fee: $ 274.01
State Surcharge Fee: $ 14.00
TOTAL FEE: $ 709.56
APPLICANT: Silver Bullet,Inc. OWNER: Brad&Lily Everett
2611 First Avenue S. 2700 Counh-yside Dr W
Minneapolis, MN 55408 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.
S� .!�d <✓� `=�cc t� � 7-��r `
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PPLICANT PE MI �G SIGNATURE [SSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
C�-� 1-�=�7
Total Fee: $ ���. � Date I2eceived: I"���CJ�
-- _ _
� Entered By: Permit#: ;'^� �(_-<.�' {� ��
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan i•eview will be started.
(please p��int all iriformatio�z)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDR�SS: o� 7�O � b�e n '1"r 4' S� � �LJ f � �: ZIP:
Will this be a Parade of Homes, Remodele►-s Showcase Home or other Display Home?
❑ Yes ❑ No If yes, a special event perrrrit is reqriired tivith Police Dep�u•tment nrvd City Coi�ncil approi�al
60 da�-s pria^to tlae erenl. Shuttle Gus servlce will he reqarired zrraless applicant dernonsb�a/2s
sz�ffrcient on-srte par•ki��g is available. IVorrper�irrit[ed everits ti�vill not be allotived
1�1AM�OF OW1�1ER: �� � i) f �,�r«� �-�1�' �e-N PHONE: (home)
� , (wock)
MAILING ADDRESS: �?Oc� ' �, �r� ,c e CITY: y��n0 ZIP:
�. . -- I �v, �� :
COl`1'I'PACT�R: � ._, � le �' u ��f`�" C�� n��'1:E: (,, i � _ � �.� �� _ h )��
CONTACT PERSON: ��y��c�r�� �o���Sc�r 1 �-�MOBILE/PAGER: C p 1� - �1�� �)- �?�� !
MAILING ADDItESS: �� (� ) ► 1�� �v r°� � � CITY: ���� �;�l� ZIP: ���l��v
STATE LICENSE: # .3 ��n �'( �XPIRATION DATE: � �� o `
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
�'YPE OF WORK: New Home Addition Accessory Structure
Move Home RemodeVAltecatio►1 (ie: Sidiilg, Windo�vs) _�_
Any earth movement may require MCWD review and permits !
PROP��EL)V`d�RK(desc�•i1�e isr det�ri�:
�� -, CI e ��.S�I E' r � � '�"�r�-
STORIES: SQ.FEET OF EACH FLOOR:
NO. O�' BEDROOIVTS: GARAGE S'I'ALLS: A'I"TACHED DF;TACI�E�:�
�S'TI1VIf1TE�D CONS'T�ZLJ�'�I�l�VAL�J�1'TION(e�clidding land): � � �. �c�Ci - c�c�
I hereby apply for a buildin,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 Citv and with the State BuildinQ
Code;that I understand tl�is is not a permit and��ork is not to start�vithout a permit; and that the��ork��ill be
in accordance ���ith the approved plan.
AYPLICANT'S SIGNA�'URE��-,��c�u,i�:_, �, .c�,� I�,�_�,�, DA�'E: � /� o " _
�-J
31
Scc.13.Od R[GHTS OF SUBJGCTS OF DATA ^
Subd. l. Type of data. The ri�hts of individual on whom the data is s[ored or to be stored shall be as set foRh in this section.
Subd.2. [nfonnation required to be given individual. An individual asked to supply private or confidential data concerning himselfshall be
intbrmed of: (a)the purpose and intended use of fhe reques[ed data within the collecting state agency,political suUdivision,or statewide system;(b)
���hedier he may refuse or is legally required to supply the requested data;(c)any known consequence arising Yrom his supplying or refusing to supply
private or confiden[ial data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall
noc apply when an individual is asked co supply imestigative data,pursuant to section 13.82,subdivision�,to a law enforcement ofFicer.
The commissioner of revenue mayplace the notice required under this subdivision in the individual income tax or propertv tax refund
instructions instead of on those fonns.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infornied whether he is the subject of
stored data on individuais,and whether it is classifled as public,private or contidential. Upon his tLrther request,an individual�vho is the subject of
stored private or public data on individuals shall be sho�an N�e data without any char�e 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 meaning,the data necd not be disclosed to him for six
months thereatter uniess 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 d�e private or public data upon request by d�e individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of making,certif}ing,and compil ing the copies.
T11e respoitsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of
the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compl iance is not possible. Ifhe cannot comply with[he request
�vithin that time,he shall so inPorm the individual,and maJ�have an additional tive days within which to comply with the request,e�cluding Saturdays,
Sundays and le�al holidays.
Subd.4. Procedure when data is not accura�e or complete. An individual may contest the accuracy or comple[eness of publ ic or private data
concerning himself. To esercise this right,an individual shall notify in writing HZe responsible authority describing the nature ofthe disagreement.The
responsible authority shall within 30 days either. (a)correct the data found to be iiiaccurate or incomplete and attempt to notif'y past recipients of
inaccurate or incompiete data,including recipients namcd by the individual;or(b)notity the individual that he believes the data to be correct. Data in
dispute shall be disclosed only ifthe individual's stafement of disaereement is included with the disciosed data.
The detennination oCthe 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 infonn 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:
1. The information you furnish will be used to detemiine 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 pernlit 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 revie���private data on yourself.
6. Your full name is required to process this application or permit.
First �liddlc Last
Address
Cih' Statc 7_ip Phonc
I understand my rights �s stated above.
_ _�
C.
f-_ L .l � ��1�..�F'�
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�, .�turc
Reset Forn� 3�
�HECK p�`F' i.�IST FOR ISSUA.NCE OF PER.�.'VIITS
FOR OFFTCE USE ONLY'
.A_DARESS ORLEirAL: 2�UC� C.o.�NT�S� �� ►O2_ �.Jes;
Pll�:
DESCRLPT'TON OF WOR.K: SrL2 .�3��-+ �2.�.wwQ'=��—
ZO�IG REVIE�V BY: r---��______� pATE APPROVED:
gU)ZDING R.EV]EtiV BY: D,A.TE APPROVED: �- �/ - o-7 �
F`EES TO BE CHA_RGED: Misc. Fezs Catculated By:
pEg1�T.IT Yes ,/ No
PLAI�T REVZE`V Yes ✓ No SE�VE.R CONNECTION
URCHARGE Yes No �VATERCONNECTION
STATE S _��
INVESTIGATION FEE Yes No _/� PARK FEE
SAC Yes Na _�� SITEINSPECTTON
OTHER (s ecify)
Number of SAC�Units P
ZQNI�tG CHE.CK LIST Zoning Distric�: �JO G►-F�N C��. .
Fire Degartment: Post Office; School District: � '
�.�or p,rea: Sq.ft.
Acres idth Dep[h
Survey Submitted: Yes No ate oE Survey;
. ;
Proposed Setbacks; ' �
Front(Lake): Ri�t Side�`� ,
i
Rear(�cree�j: L�f[5i�le:
Adjaceet Structures: j �VeCland:
Builuin�Height: Dei. Hgt, Peak.Hg�.
L,ot Coverz�e: �
� $v� vGliIICii n p:0'•'g-1 T7�[': �
Gradin�. ScaFE Approv�l D�te; � � �'-
Septic: S�a`i AppCQ'lal DaCe: E;�:
Zoaing Fuz� R Reso?ution: n Resolu:ion Da:e:
Shcrel�,.d Distr`:c;:
Av�. SetbacK: Blu`f Seiback: I.otCoverage:
v E�.iStso Proposea
Hz�dcover: 0-75'
7�-2�Q'
2�0-SQO'
���-.'vCy��
_-�•_ �;�...'.2:C' D,'^"!r � :z� �.�..'_._ . �'0'��ril ��zn,SOVZ:
..__�C',.,. ..y_ ._ •
F.E.�L�.R.T�S (in housel:
M
EUILI�ING RE'VIEtiV C�ECK LIST �
��� �7' 3 � CONSTRUCTION TYPE: �L N
Sq Footage $ Per Sq Ftg
Basement • . X _
Isc Fioor x � _
2nd Floor x _ .
Garage x _
x —
TOTAL
Estimated Constructioa `�alue; $ Z�,UCk� `��
Inspections Requirec�: �York Requiring Segarate Pecmits:
Site �( Plumbing Fi.re
Hardcover Remova! �c Mechaaical � Water Coanection
Footing ' Sep[ic Sewec Connection
� � Framing Fireplace Lawn Iniga[ion
Insula[ioa (Masonry) O[her
�Vall Board (Mfg.} Well (Scate Permit)
°� F�� Grading/Fillin� o� Eleccrical (State Permit)
O che r
REMA.RK� (IN HOUSE): ' -- '-
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REVIE�V S'Y OTHERS: DA�'E:
Access: Er�isting �,�eW
Access Approval: Date gy:
---------------------------------
REyIARb'S (,'�'0 F3F NQ'r'rn nu pEF�i1�';:
8
"/�,�,^
^ D�TE TIME �
CITY OF ORONO CALLED IN �'`
INSPECTION TI E SCHEDULED 0�•S D �
PERMIT N0. � � COMPLETED
ADDRESS a7 DO �
OWNER C NTR. S�L-�. ��3L���`""
TELEPHONE NO. ��a /O 7 7 7S �
� DESCRIPTION �/`�'J'h� �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WA�L BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED f-i PROJECT COMPLETE
W C CORRECT WORK&PROCEED C, ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN ,� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Ca11 for the nex i pection 24 hours in advance. (952� 249-4600
Owner/Contra r i -
Inspector.
White Copyllnspector's File Canary CopylSite Notice