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Home My WebLink About2000-P03263 - addn/remodel/repair PERMIT �IT�' OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po3263 Crystal Bay, Minnesota 55323 P2fllllt Typ@: Addition/Remodel/Repair (612) 249-4600 Date Issued: l 1i29i2o SITE ADDRESS: 1003 Cox Farm Rd LONG LAKE, MN 55356 PID: 27-118-23-33-0014 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Census Code 434 Permit Class: Building Permit Sub-type(s): Addn/Remodel/Repair Permit Type: Addition/Remode]/Repair DETAILS: Approved perresolution#: Separate permits required: riumoing iviecnanicai r.iectricai �siaiej NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 542.75 Valuation: $ 40,000.00 Plan Review Fee: $ 352.83 State Surcharge Fee: $ 20.00 TOTAL FEE: $ 915.58 APPLICANT: A& T DEVELOPMENT OWNER: S SWENSON&C A BAIER 2755 DEER RUN TR E 1003 COX FARM RD LONG LAKE, MN 55356 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. :� /��-� <'/"`�� /'�'' APPLI ANT PERMITGE SI NATURE [SSUED BY SIGNATURE Copies: City, Applicant,Assessor, Finance Page 1 ` Tot'al Fee: $ �/� �8 Date Received: !� /� c ; Entered By: �� Pernut#: ;��:� �� . ; CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) � _------ ------------------------------------------------------------------------ ------------ - - --------------------- THE APPLICAIVT IS: (circle one) OWNER O CONTRACTO JOB SIT'E ADDRESS: 1 O c7 � �� 2-r rti �c��Ip: � � �3 � �` N�IE OF OWNER: �Q.-�� - � �''' �'"��'� PHONE: (home) . (work) MAILING ADDRESS: 0.,�..�.\ CITY: ZIP: `t o�'�-`� ��'- CO\"TRACTOR: � �� e��-\�o��,� PHONE:_ � '�'�s`�' CO��'ACT PERSON: ` o s MOBILE/PAGER: �]�- "�- o� � 3 ��a) l�LAILI�i 1G ADDRESS: �2-I SS � R,,�'��. �-. CITY: 7 rv�� ZIP= S � ST�,TE LICENSE: # � �5(� � n p�c��S ARCHIT'ECT/ENGI'�Ii EER: ��— PH0�1E: �Z 4II.ING ADDRESS: CITY: ZIP: 1V.e�1LE: REGISTRATION# TYPE OF WORK: New Addition ✓Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK (describe in detain: STORIES: � SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: � GAR.A.GE STALLS: ATT. DET. ESTLI-IATED CONSTRUCTION VALUATION (excluding land): $ �U � I hereby apply for a buildin� pernut 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 Buildin� Code; that I understand this is not a permit and work is not to start without a permit; and that the work wifl be in acco wit the approved plan. � ! /�/� APPLICA1�T S SIGNATURE: DATE: ��- NOTE! Parade o Homes events require separate permit approval by Police Department and City Counci160 days prior to the event. Non permitted events will not be allowed. 5 s • � Sec.13.04 RIGFITS OF SUBJECTS OF DATA Subd. 1. Type of data. The righcs of individual on whom the data is stored or to be stored shall be as set forth in this secdon. Subd.2. Information required to be given individual. An individual asked ro supply private or confidencial data concerning himself shall be informed of: (a)the purpose and incended use of the requested data within the collecang state agency,polidcal subdivision,or statewide rystem;(b)whether he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refiuing to supply privace or confidenaal dam;and(d)the idenaty of other persons or endaes authorized by state or federal law to receive the dara. This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income raz or orooerrv tax refund insrrucdons instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsibie authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is c(assified as public,private or confidendal. Upon his furrher request,an individual who is the subjecc of stored private or public data on individuals shall be shown the data without any char;e to him and, if he desires,shall be informed of the content and meanin�of that data. Aher an individual has been shown the privace data and informed of its meaning, the data need noc be disclosed to him for six months thereafter unless a dispute or acdon pursuant to this secaon is pending or addioonal data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible auchoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. 'Ihe responsible authoriry shall comply irnmediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saarrdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request wi[hin that time, he shall so inform the individual,and may have an addidonal 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 compie[eness of pubtic or privace dara cor,ceming himself. To exercise this right,an individua]shall noafy in writing the responsible authority describing the nature of the disasreement. The responsible aurhoriry shall within 30 days either: (a)correcc the data found to be inaccurate or incomplece and attempt to nodfy past recipients of inaccurate or incomplete dara,inctuding recipients named by the individual;or(b)noafy the individual that he believes the data co be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disciosed data. The determinadon of the respoasible authoriry may be appealed pursuant to the provisions of the administraave procedure act relating to concested cases. DATA PRIVACY ADVISORY In accordance with N1.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 [he 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 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 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. �. 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. Firsc Middlt Last �ddress �«Y State Zip Phone I understand my ' as ed bove. Signatu 6 � ' ` CHECK OFF LIST FOR ISSUANCE OF PERIVIITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: I vc�3 C�x �=A�'� �� PID: DESCRIPTION OF WORK: q D�p i r�o�► ZO�iING REVIE`V BY: DATE APPROVED: /�- �g -� BUII.DING REVIEW BY: DATE APPROVED: 1� � � -� FEES TO BE CHARGED: Misc. Fees Calculated By: PEKMIT Yes ✓ No pLAI�1 REVIEW Yes ✓- No SEWER CONNECTION STATE SURCHARGE Yes ✓ No WATERCONNECTTON INVESTIGATION FEE Yes No �G PARK FEE SAC Yes No � STTEINSPECTION Number of SAC Units OTHER (specify) ZO��ING CHECK LIST zoning Disuicc: N� �� Fire Departmen[: Post Office: School District: Lot Area: Sq.f[. Acres Width Depth Survey Submitted: Yes_ c� No Date of Survey: �'Z`'�'�'`� Proposed Setbacks: � � Front (Lake): I ls -� Right Side: (�O �= Rear (Street): Z 5� � t Left Side: L 6 0 � t Adjacent Structures: A�%��r—� Wetland: N��- Buildin� Hei�ht: Def. Hgt. D•�C Peal:Hgt. Lot Covera�e: N�� Grading: Staff Approval Date: '— By: — Council Approval Date: Septic: Staff Approval Da[e: �' By: Zoning File: # — Resolution: # Resolution Date: Shoreland District: �v Av�. Setback: Bluff Se[back: L.ot Coverage: Ezisiing Proposed Hardcover: 0-75' 75-2�0' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: gE�iARKS (in house): 7 ..�, BUILDIl�'G REVIEW CHECK LIST �gC; �2 � 3 CONSTRUCTION TYPE: V/v Sq Foo[age $ Per Sq Ftg Basement R = lst Floor R = 2nd Floor x = Garage x = R - TOTAL Estimated Construction Value: $ ��p p o0 Inspections Required: Work Requiring Separate Permits: Site �C Plumbing Fire Hardcover Removal �Mechanical Water Connection Oc Footing Septic Sewer Connection �Framing Fireplace Lawn Irrigation � Insulation (Masonry) Other �� Wall Board (Mfg.) Well (S[ate Permit) �F�� Grading/Filling _�Electrical (State Permit) Other --------- REMARKS (IN HOUSE): ---------------------------------------------------------------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: ExistinQ New Access Approval: Date gy; ----------------------------------------------------------------------------------------------------------------------- RENIARKS (TO BE NOTED ON PERMIT�: 8 CITY OF ORONO CALLED IN L�T`�C��C� T�G /�� INSPECTION N �C� � SCHEDULED � � —3c-' � .�� - '- �j ' t�-<� 0 � C.K'� PERMIT NO. 1�C.% � COMPLETED ADDRESS � ��-' 3 � �� `�� OWNER CONTR. � � ��p TELEPHONE N0. �� `� �� DESCRIPTION �� / �� LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL v Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z � COMMENTS: � w a � ,� � � 0 � � 0 � w � Q � z W � W � j � �ORKSATISFACTORY:PROCEED I PROJECTCOMPLETE W � G ORRECT WORK 8 PROCEED f ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. pH0T0 TAKEN INSPECTOR WILL RETURN r' CITATION ISSUED ❑ STOP ORDER POSTED.CALL INSPECTOR C; INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. 249-46�0 OwnerlContrac r site: Inspector. � �� White Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN �'�p-�� INSPECTION NOTICE SCHEDULED %-��`aa -�— PERMIT NO. ��b 3 COMPLETED />-�� 1 �C� ADDRESS �DC�3 CC�X I'a'.�'^" �`-r'�� OWNER CONTR. �d-� TELEPHONE N0. �� - �I S/S � DESCRIPTION ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 �AKESHORE/WETLANDS h 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z� .04_WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL = 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL J Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � j d W�jWORKSATISFACTORY:PROCEED - PROJECTCOMPLETE � ❑ CORRECT WORK&PROCEED ! ISSUE CERTIFICATE OF OCCUPANCY w O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT I�CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL RETURN C STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED Ci INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-4600 OwnerlContr ctor on site: Inspector. � �� White Copyllnspector's File Canary CopylSite Notice / DATE TIME CITY OF ORONO CALLED IN (�� r� ' C� INSPECTION NOTICE SCHEDULED `� PERMIT NO.Pu 3�(�i3 COMPLETED �- `� 'd �� = ADDRESS � ��3 l �� E�rm �' OWNER CONTR. � �� '��P TELEPHONE NO. r7(� 3 v `= 3� — � ��-� .--�-�t� l..t I ct_'t-r t� t' J' � � DESCRIPTION �L`�""�Z8-1 l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS O03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL 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 Q = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: �( 5 �5�� w a j � � 0 a � 0 � w � Q � z w � W � � GW �WORKSATISFACTORY:PROCEED PROJECTCOMPLETE W � Cl CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY O i i CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT f 1 CORRECTUNSAFECONDITION WITHIN HOURS. pHOTOTAKEN INSPECTOR WILL RETURN C; STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED [ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-46�� OwnerlContract r on site: Inspector. -� �C S White Copyllnspector's File Canary CopylSite Notice DATE IME CITY OF ORONO CALLED IN /- �—Cry � ` �� INSPECTION TI E , SCHEDULED - U / • � C� PERMIT NO. � �� COMPL ED � �C � A�� RESS G C .� - ;� �Ci1Z.ti%,-� � c� OWNER 1 CONTR. �`� � �� f— TELEPHONE' 0. �� S J--' �� DESCRIPTION � 01 FOOT 11 fv1ECHANICAL RI 18 EXCAV/GRADING/FILLING FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS 03 ULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � C,p ENTS: W � a �t� :t-� '..�� .C <, o D %,.-� a ., � � � � �__ � �� _ W ,. � Q � � ,_._ z W � W � j d W ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLETE � C 7 ORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY W Q RRECT WORK,CALL FOR REINSPECTION TEMPORARY � ' BEFORE COVERING PERMANENT C] CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED Ci INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-46�� OwnerlContrac on site: Inspector.�'G�G'�L��C�/�r� White Copyllnspector's File Canary CopylSite Notice ✓ DATE TIME CITY OF ORONO _� CALLED IN 2—/�— �f f�'yT � INSPECTION NOTICE �,��(i� SCHEDULED �'� 'oo il,.i PERMIT NO. �C ' connP�ETE� L�� ADDRESS � p��-� �('�X ��i M ��• OWNER CONTR. �� TELEPHONE NO. �'�� 7 �'=�� DESCRIPTION � s'�C�C ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS I � � 0 O-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP Q = 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 � � O � � O � W � Q � Z W � W � � W� �ORKSATISFACTORY:PROCEED K�ROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ( ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT �7CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN INSPECTOR WILL RETURN Cl STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CAlLTO ARRANGE ACCESS. 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' QA�E_ -- I/� 2� �v . * � ,� �, �. . � �� .�� I.egal Description . �. Lot 2 , I31ock 2 , SIIJIDOWOOU P'11RM. � . . `1'his survey shoa�s th� location of � proposed house in relation �t6 the above described property . It does not purport i:o show any other . improvements or encroach►nents . � o : Iron m�r)cer � '• , ,.__�a�-_ _ ; .existing elevation • �-�_ : proposed elevation �. � ' P.�`ffi e'tFv,�r�o,�r , �� .�,�rF�r,�r = /vop,8 ' � z� Ti/ir F.�inu . �o/8.,f -• . • . . �I G.�.f.t6t' Ftod.t = /ai6, 6 • ' '�'' . • , - a, , . � i I I��•rthy crrli(�� Ih�il Ihi�;�urvr�� w��s ��rr��rr�l 1�� mc��r un�lrr m�-�firrrl su��rr• unrt: 6" 24" 94 /' 1 � 1 � yisic�n, an�i tinl I am a�I�ily rrt;ist��rr�l Ci�-il l�i�};in��rr an�l I.an�l��n��c��c�r un�lrr r••• ,-r"9f ��v �•zc-v+ �� thr I��ws n( Ih�� `�l,ilr u( ��liiini�<��I,i. I�� _ (-O� �.t nl I J , : 'n ' •l. � ,,�%�r:��,:_ .._��%��_,��. � - ----- �)�- -207 J'-.— ------- --- �1>II Nc). �� /- Ivl��ih S. (�raiil�cr}; hlinii��ul,i I.ic�•nsr Nuinl,cr I?15�� • �.�+ • I ' � ^L rWnlolia:uer'L^xu�acx.natTr�rranrr.�manunca� �