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Home My WebLink About2008-00256 - addn/remodel/repair " � CITY OF ORONO PERMIT NO.: 2008-00256 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISsuEn: 10/08/2008 952 249-4600 FAX: 952 249-4616 ADDRESS : 2715 COUNTRYSIDE DR W PIN : 04-117-23-12-0019 LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN : LOT 004 BLOCK 003 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTI VITY : 434-RESIDENTIAL VALUATION : $ 20,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,ELECTRICAL(STATE) KITCHEN REMODEL-ALL INTERIOR WORK. APPLICAI�TT PERMIT FEE SCHEDULE 339.25 STONEWOOD DESIGN BUILD PLAN REVIEW 220.51 7404 WAYZATA BLVD MINNEAPOLIS,MN 55426- STATE SURCHARGE(VALUATION) 10.00 (952)697-5075 TOTAL 569.76 Minnesota State License#: 20534541 OWNER WILSON, MARK& KIRSTIN 2715 COUNTRYSIDE DR W LONG LAKE,MN 55356 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspen for a period of l 80 days at any time after work has commenced. The plic t is responsible for assuring all required inspections are requested� onformance with the State Building Code.This permit may be revoked y time for due cause. I ' oi z' i ° Q �r� /vl ��ll�g Appl't n Permitee Signature Date Is d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � � �.o� �- Total Fee: $ �� '�l. f�O Date Received: ��j�j�� Entered By: �— Permit#: �DO�—�.S�o CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (p[ease print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O -CONTRACTO 2715 Cout side Drive � 55356 JOB SITE ADDRESS: '� ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YCS ❑✓ NO lf yes, a special erent permit is required i+�i�h Po/ice Department and City C,o:tncil app��oral 60 days prior to the event. Shuttle bus service wi//be required rrnless applrcant demonstyates s�sffcient on-site parking is m�ailable. ,�'on-permi�ted events ivill not he allowed. NAME OF OWNER: '�ark Wi�son PHONE: (home) (work) MAILING ADDRESS: ��is Countryside t�rive CITY: orono Zjp. 55356 CONTRACTOR: stonewood Renovation PHONE: (952)697-5075 CONTACT PERSON: �onn�aiy MOBILE/PAGER (6�z��3o-�s3� MAILING ADDRESS: 7404 Wayzata blvd CITY: Minneapolis ZIp; ss4z6 STATE LICENSE: # Bc-zos3asa� EXPIRATION DATE: o3i3 vo9 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(deseribe in detai�: x;tohep R�modei. A�i�nterio�Work STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ "��o o v [hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate; that the work 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 with the approved p(an. .- � , � APPLICANT'S SIGNATURE: � DATE: o9i22ios � i� � 31 s ,. Sec.13Ad RIGHTS OF SUBJEC"I'S OF DATA Subd. 1. 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 orconfidentiai data concerning himselfshall 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 ma��refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity ofother 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.A2,subdivision 5,to a law enforoement officer. The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income ta�or�ertv taY 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 public data on individuals shall be shown the data without any charge to him and,if he desires_shal I 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 immediateh.if possible,with any reyuest 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. Ifhe 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 himself. To exercise this right,an individual shall notity in wTiting the responsible authoriry describing the nature of the disagrecment. 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 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 relatine to contested cases. DATA PRIVACY ADVISORY In accordance�vith M.S. 13.04,Subd.2."Rights of subjects of data".��e��ould like to inform you that your request ibr a permit or license from the City of Orono or any of its departments may require you to furnish certain private or contidential information. You are notified that: l. The information you furnish wi(1 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 eatent necessary to process the permit or license. 4. If your requcsted 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. 5ko►.�.woo� o►J Cyv a First Middle Last �4 0� W�yz�0.. Q Iv�I Add ress I��nu,,po�i S IV�1�J SS yZ� �v�1:1?p �53 � City State 'Lip Phone I understand my rights as stated above. Signature Reset Por�n 32 �: CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: Z7)S Gm�n,»'�-,�,,�,r L'�t2 �AI. PID: DESCRIPTION OF WORK: �c �,-�Q,.o�, (j,�,:y�,p� ZONING REi�IEW BY.• �9� �DATEAPPROijED:Y `�~�s_ BUILDING REVIEi�'BY.• DATEAPPROVED: �T-zb -o� FEES TO BE CHARGED: Misc. Fees Calculated By � M�______________ PERMIT Yes � No PLAI�'REVIEW Yes � No SEWER CONNECTION STATE SURCH.ARGE Yes� No u'ATER CONNECTION INVESTIGATION FEE Yes No_�� PARK FEE SAC Yes No '�/ SITEINSPECTION .�Vzrmber of SAC Units OTHER (spec�) ___w_____________----------________�------- ZONING CHECK LIST Zoning District: N'v c�ati� Fire Department: Post O�ce: School District Lot Area: Sq ft. Acres YG'idth Depth Sw�vey Submitted. Yes /�'o Date of Sm-vey: Piroposed Setbacks: Front(Lake): Right Side: Rear(Streel): Left Side: Adjacen[Structures: N' tland: Building Height� Def Hgt. P k Hgt. Lot Coverage: Grading. Staff,4pproval Da�e: y: Council Approval Date: Septic: Staff�ipp�•oval Date: Zoy7ing File: � Resolution: # Resolution Date: Sho��eland District: MCND Pe�-mit: Avg. Setback: BluffSetback. LotCoverage: Fa isting P!•oposed Har�dcover- 0-�.i' 7S-_'�0' ?.i 0-�00' �00-1000' Hardcover f'ariance Regirired: 3'es No Date of Coz�ncil,9pproval: REIYLARKS(i►7 house): 33 b� �(.LII�X�d Al0 Q3.LO�V�8 O.l) SNNY'W.�?I :�8 aznQ :Znna�ddy�ssa��y n�a� �t(1JSTX� :SS�JJ�/ �3.L 6'Q �S?I3KL O d S�13I�13?I �(�SIlOH�I7)S�IXi�I��X aayl p (;icu.�ad a�n1S)ln�t.��a13�- �utll?.�/8uzpna� jnur.�?� (lrw.rad a1n�S)11?�1 (�$.�LY� P•�no871n�11 .ray�p (rCruosny`�) uot�njnsul uotzn�ual unan7 a�nlda.rr� �utcun.�� uot1�auuo�.ranlas �rJdas �ut1oo,� uoi1�auuo�.raln�( /n�tcmy�al� lnnoura�.rano�p.rnH a.rr� $utqzunld� at?S :s�luirad a�b.rvdas oin.rrnba��.roM :pa.�rnbag suop�adsul Qp p� $ :an�nn uot;�n.rlsuo,�pa�nura�s� 00 7I�.LO.L — x = x a�n.rn� — x aoo�,�puz — x aooj��s j = x luazuasng 8�,�bs aad� a�n�oo,�bs J�� 3dd.l;VOLZ.�l1?I.LS�VOJ • 21 �Jg,'1 .LSI7)L��H��13I�1�J�IQ7I118 �/ � ATE TIME ✓ CITY OF ORON CALLED IN � INSPECTION NO CE SCHEDULED / � �� PERMIT NO. � D COMPLETED ADDRESS Y l/`� w OWNER O R. l�'�QY1��L'DD TELEPHONE NO. �'7��-75 �-I � DESCRIPTION �1��0G�� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC_MAINT. ❑ COMPLAINT J ❑ DEMO-FINAL - ❑ SEPTICINSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING R� ❑ SEPTIC FINAL ❑ HRRD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o � d w `�� --�-�c �f-s 2 Q ��,'r�c� � -� ,� , "f 1.��G�tJ �C� � CC� � �'.�JC'.� � ° �� ►.� W � Q � � Z • � W � � W • � � d W� ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK&PROCEED SSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '�' CITATION ISSUED G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal{for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. �,� � C � White Copyllnspector's File Canary CopylSite Notice