The URL can be used to link to this page

Home My WebLink About2001-P04700 - addn/remodel/repair . _ _ , � - � PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P04700 Crystal Bay, Minnesota 55323 P2fC711t Typ2: Addition/Remodel/Repair (952) 249-4600 Date Issued: 12i6i2oo� SITE ADDRESS: 2760 Countryside Dr W L,ong Lake,MN 55356 P I D: 04-117-23-12-0011 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residentiaf Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: ►'iumbing iviecnanicai Eiec�ricai�sratej NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 181.25 Valuation: $ 10,000.00 State Surcharge Fee: $ 5.00 TOTAL FEE: $ 186.25 APPLICANT: Souldance Ent. LLC OWNER: .►on&Molly Stern 6115 Sunset Dr. 2760 Countryside Dr W Mound, MN 55364 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 BUILD G O E REQUIREMENTS. � ` . �� nPLICANT PGRM]TEF.SIG U E [SS :DBYS[GNATDRE iSiQnitures Reauired). 1-Aoolicant, 1-Monthlv Reports. 1-Assessine, l-Finance Page 1 _ � , , .. i4, �;` (JT'G'fr.� ; �.(]. Rox 6b ; ' ' Cr_�ystai �a�y t�l 553'c3 l95t)249-4b��U � iP/Ot,/Ol 15:17:�5 � rustarner; PtJ4ii10 � ��ERMITS - Itl{ILDING � 1 � t?.00 4.v(1 ' � base Fee � 1 � IBI.2'.`1 181.c5 �'lan �eview k P u.(� �.OO Mail in Fees ;. H G.GU 4.�G , � 5tate Sureharge SAC Charge� 5,t►G 5.� 1 Q.UO �J.(t0 � Ir�aestigation Fee , I C+ G.O(1 0.UO , TAXT€ITAL 186.�5 � TOTFN SALE f1.0�? f<heek keceiv�d 186.�5 18b.� ' � a-+�r� a.�n c��r�,� 03 r��s# i6eaa � � � Total Fee: $ /��Q.o�S� Date Received: �a.-(D-01 Entered By: Permit#: �o Y 70 D CITY OF ORONO - BUILDING PERNIIT APPLICATIOl`1 All 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: ��O CO��CRYSID� �� (\, ZIp; NAME OF OWNER J� �j��1v PHONE: ome S - �"�`� S c� )� t `{ 2 g ► 3 (work) MAILINGADDRESS: casL� �t . �1� , crrY:��,�z�� z�:��c� � lA 2 CONTRACTOR:�� L�A IvC F. E@�a �,L C PHO�IE: � - l�j 2. CONTACT PERSON: �-�� .t (�j Q �S�iOBILE/PAGER: �� (�'l� MAILING ADDRESS:C��(1� �J►�'j�T �, CITY: (`�l��l tJ C� ZIP:=�(�,� STATE LICENSE: # 'Z��R S� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration� Land Alteration PROPOSED WORK(describe in detai�: STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. o� ESTI�i IAT'ED 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 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 accordan i the approved plan. APPLICANT'S SIGNATURE: DATE: bE�,.. �f- I� ,�d0 I NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. � '� Sec.13.04 RIGH'I'S OF SUB.TECTS OF D?�T�1 Subd. 1. Type of data. 'Ihe rights of individual on whom[he data is stored or[o be scored shall be as set for[h in this secrion. Subd.'_'. Information reqirired to be�vea individual. An individual asked to supply private or confidendal dara conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecang"state agency, polidcal subdivision,or sratewide system; (b)whether he may refuse oi is legally required to supply[he requested data;(c)any lmown coasequence arising from his supplying or refusing to supply privace or confidenrial data;and(d)the idenriry of other persoas or enddes authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesd¢adve dara,pursuant to secdon 13.82, subdivision 5, to a law enforcement o�cer. The commissioner of revenue mav place [he nodce reauired under this subdivision in the individual income tax or propem rax refund instructions instead of on chose forms. Subd.3. Access to data bp individuai. Upon reques[to a responsibfe authoriry,an individual shall be informed whether he is the subject of stored data on individuals, and whe[her it is classified az public, privace or confidendal. Upon his further request,an individual who is[he subjecc of stored private or pubtic data on individuals shall be shown the dara wichout any charge to him and,�if he desires, shall be informed of the content and meaning of ehat data. Aftzr an individual has been shown the private data and informed of i[s meaning, the data need not be disclosed to him for six months thereafter unless a dispute or action pursuanc co ehis secrion is oending or addidonal data on the individual has been coilected or crea�d. The responsible authoriry shall provide copies of the privace or public data upon reques[by the individua!subject of the data. The responsible authority may require the requesdng person to pay the actual cosrs of makin¢,cerufying,and compiling the copies. The responsible authoriry shall comply immedia[ety, if possible, with aay request made pursuant to this subdivision,or within five days of the date of the requesc,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot compiy with the request within tha[time,he shall so inform the individual,and may have an addidonal five days within which to comply wi[h the cequest,excluding Sarurdays, 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 pri�•ate data concerning himself. To exercise this right,an individual shall nodfy in wriring the responsible authoriry describing rhe nature of the disagreement. The responsible auchorirv shall within 30 days eicher: (a)correct the data found to be inaccurate or incomplece and attempt to nodfy past recipienn of inaccurate or incomplece data, including recipien�s named by ehe individual; oc(b)nodfy the individual tha[he believes �he data to be correct. Data in dispute shall be disciosed only if the individual's statemenc of disagteement is included with the disc(osed data. The de[erminadon of the responsible authoriry may be appealed pursuant co the provisions of[he administr2dve procedure act reladng to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Ri�ts of subjects of data", we would like to inform you that your request for a pernut or license from the City of Orono or any of its depar[ments may require you to fumish certain private or confidential information. You are notified that: 1. 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 [he City deny the permit or license. 3. The information may be shared with o�her local, state or federal a�encies 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. j. You have certain rights under N1.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 �tiddle Last Address �ity State Zip Phone I understand my ri�hts as stated above. Signature . , T � � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: Z� �O � Go•� •�•T-rr�,,S-� ryP PID: DESCRIPTION OF WORK: ZO.vI�Ti G REVIE�V BY: OV � DATE APPROVED: BUILDING REVIE`V BY: DATE APPROVED: , 2.- �- c� � FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes �/ No PLAN REVIEW Yes No �� SEWER CONNECTION STATE SURCHARGE Yes �/ No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) Zl7NIt�1G CH�CK LIST Zoning District: /Ud Ga-s-,�v��-2 Fire Department: Post Office: School District: L.ot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Fron[(Lake): Right Side: Rear (Street): Left Side: Adjacent Structures: Wetla�d: ; Building Height: Def. Hgt. Peak�gt. Lot Covera�e: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: ', Zoning File: # Resolution: # I� Resolution Date: Shoreland District: Avg. Setback: Bluff Setback: ' L.ot Coverage: EziSling Proposed Hardcover: 0-75' 75-250' �� 2�0-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 � . s , . . BUILDING REV�W CHECK LIST �C� _ � ' 3 CONSTRUCTION TYPE: �N Sq Footage $ Per Sq Ftg Basement x _ lst Floor x _ 2nd Floor x _ Garage R = R = TOTAL Estimated Construction Value: $ �V,p t�p�� Inspections Required: `Vork Requiring Separate Permits: Site �Plumbing Fire Hardcover Removal _S Mechanical Water Connection Footing ' Septic Sewer Connection _�Framing Fireplace Lawn Irrigation ��Insulation (Masonry) Other _d Wall Board (Mfg.) Well (State Permit) �F�� Grading/Filling p�Elecuical (State Permit) Ocher RENIARKS (IN HOUSE): --------------------------------------------------------------------------------------------------------------------- REVIE`V BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ------------------------------------------------------------- REI�IARKS (TO BE NOTED ON PERitiiTI�: 8 DATE TIME CITY OF ORONO ` CALLED IN INSPECTION NqTI �(�D SCHEDULED PERMIT NO. COMPLETED �'' v -�� ADDRESS r � �� OWNER CONTR. �� TELEPHONE NO. � ` � ' " ( �' � DESCRIPTION ��-�-�` �C�C�� O7 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 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 � OWNER/CONTRACTOR TO MEET YO�YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � j � �] yORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE W � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContr cto on site: Inspector. 1%'/�Q��G2,�GiI� White Copyllnspector's File Canary CopylSite Notfce � � , / k( .� DATE TIME CITY OF ORONO �� `J_CALLED IN INSPECTION NOTIC SCHEDULED PERMIT NO.______�� COMPLETED C- �" Z' % _ � ADDRESS C�F� OWNER CONTR. �--�C�/- � TELEPHONE NO. �l.�—l3C>�� -'I ��_ � DESCRIPTION �� -� a-m-L l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADIN /F LING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATIGN 24/25 WOOD BURNEFUFIREPLACE 34 TREE REMOVAL Z 04 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 FOILOW-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: � W � � � O � � O � W � Q � Z W � W � � � �.MIORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W C❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � O CARRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-46�0 OwnerlCont a r on site: Inspecto �'� � S White Copyllnspector's File Canary CopylSite Notice