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Home My WebLink About2005-P08711 - addn/remodel/repair PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P08711 Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 5/12/2005 SITE ADDRESS: 1050 Cox Farm Rd Long Lake,MN 55356 P�� 27-118-23-32-0017 DESCRIPTION: Proposed Use: Residential Permit Class: Building Census Code 434 Permit Sub-type(s): Addn/Remodel/Repair Permit Type: Addition/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: �, - T - -� n -- --�--. -_�- -- - ...-�.:;:::::., ..�;;::.�:��::.��b.;:.:b� FEE SUMMARY: Permit Fee: $ 23.50 valuation: $ 400.00 Plan Review Fee: $ 15.28 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 39.28 APPLICANT: Owner/Self OWNER: Eric&Diann Zoner � 1050 Cox Farm Rd 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. ��. ,� \ � � c � �` �'`� /��l � � c � J APP CANT PERMITE SIGNATURG 1 SUED BY SIGNATURE Copies: 1-File(SiQnitures Requrred), 1-Applicant, 1-Monthlv Reports, l-AssessinQ, 1-Finance Page 1 Total Fee: $ ' �� % � Date Received: .S=�l—�-� Entered By: ;, Permit#: �AD87// CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all infortnation) ----------------------------------------------------------------------------------------------------------------------- -- _. THE APPLICANT IS: (circle one) OWNER R CONTRACTOR JOB SITE ADDRESS: IL��J�C} �-��( l��,e/l 1 �/ ZIP: �,S �5(� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ yeS � �i O If yes, a special event permit is required with Police Department and Ciry Council approval 60 days prior to the event. Shzrttle ba�s service will be reqzrired unless applicant deinonstrates sa ffrcient on-szte parking is available. Non pennitted events will not be aZlowed. NAME OF OWNER ��<< ��«i,�r� ��y+C: � PHONE: (home)y52 y�3 ��%2 (work)�ySZ �y� (�,3�9 MAILINGADDRESS: /(`S� Ct�x �r�.r•,-� l�l CITY: ��'o��a ZIP: �53$6 CONTRACTOR: r�,'a PHONE: CONTACT PERSON: C r�� Z�.:.�� BI AGER: y,'� 5�r s ��y r MAILING ADDRESS: CIT�': ZIP: STATE LICENSE: # EXPIRATIOiv DATE: ARCHITECT/ENGINE�R: ti.�-� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration ` PROPOSEDWORK(describeindetai�: � /ylnv� �c�,�„�c�,�u k-'c^rt�,r� clase-f ��f� c ct,��;c_c,-e_ . � 1'T L,. STORIES: � SQ.FEET OF EACH FLOOR: ��3� ,5'T/ NO. OF BEDROOMS: _� GARAGE STALLS: ATTACHED�_ DETACHED C. ESTIMATED CONSTRUCTION VALUATION(excluding land): $ '�'GE' I hereby apply for a building 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 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 plan. APPLICANT'SSIGNATURE: �,G p �'� DATE: S - (�-C',�j , 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 stored 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 known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorizcd by state or federal law to receive the data.This requirement shall not apply when an individual is asked ro 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 authoriry,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 pnvatc or public data on individuals shall be sho�vn the data�vithout 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 untess a dispu[e or action pursuant to this section is pending or addi[ional data on the individual has been collected or crcated. 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,if possiblc,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 reques[ 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 da[a is not accurate or complete. An individual may contest the accuracy or completeness ofpublic or pnvate data concerning himself.To exercise this right,an individual shall notify in w�iting the responsible authoiity describing the nature of the disagreement.The responsible authority shall within 30 days either: (a)con-ect 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 induded 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 infoml 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 detennine your qualification for the pernzit 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 i�1.S. 13.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. 'G r f� �}e.il e✓� �e n�� First Middle Last r. � � � C- �j C �_�K �'C�1"r� k L ct c� Address �� -,��,�-� ��Z��.1 �S.�S� z� S�3 City State Zip Phone I understand my rights as stated above. <. � L�� Signature 32 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: _ 1 p 5� c�x �A r�.w. (�.o r� PID: DESCRIPTION OF WORK: C,�,y�� p� � a N � n/ b r+�tl�c� ZO.�I�1i G REVIE`V BY: � DATE APPROVED: BUII..DING REVIE`V BY: DATE APPROVED: FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes ✓ No SEWER CONIVEC"ITON STATE SURCHARGE Yes �/ No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPEC'I'ION Number of SAC Units OTHER (specify) --------------------------------------------------------------------------------------------------------------------- Z0�1Pi 1G CH�CK LIST Zoning District: �v o C l-F-�q,��c�e O Fire Department: Post O�ce: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front (Lake): Ri� Side: Rear (Street): Left ide: Ad;acent Structures: Wetland: Buildin� Heioht: Def. Hgt. Peak Hgt. Lot Covera�e: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: !# Resolution Date: Shoreland District: Avg. Setback: Blu f Setback: I,ot Coveraje: Ezi ting Proposed Hardcover: 0-75' 75-250' 2�0-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REI�IARKS (in house): 7 BUILDING REVIEW CHECK LIST �C� _ �Z` 3 CONSTRUCTIONTYPE: �.1� Sq Footage $ Per Sq Ftg Basement x _ lst Floor z _ 2nd F1oor x = Garage z = z — TOTAL Estimated Construction Value: $ '-r0� °= Inspections Required: `Vork Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechaaical Water Connection Footing ` Sep[ic Sewer Connection _�Framing Fireplace Lawn Irrigation Insulation (Ivlasonry) Other Wall Board (Mpg.) Well (State Perm.it) � F�� Grading/Filling Electrical (State Permit) Other REi�IARKS (IN HOUSE): ---------------------------------- REV�`V BY OTHERS: DAT'E: Access: Ezistin� New Access Approval: Date By; ----------------------------- REI�LARKS (TO BE NOTED ON PERil�1I'1�: 8 . . � .. ' . �_ . . � .., * l:S' �, ° E TM�r a }� ,�,,�: � � _ ,__ - __ � _ _ � �� . � � � iii , �__ �_ - I �Ip _ �____f_ � ! � _ �_ l__�_�_:_ 5,7 N —DN—j .� �+ �✓'oPOS�� C.10.5�� TY AF l)(R��L3 BUIt_v^li,r /�-'� 1 �' .r:s�; r.;�`JI'��! !N?PECTCR--�1qJfr C�----- D;;;�_�I I�I- - , td.;--- � . . - -,,,..: _ .- : _ , /�:�':-"��'. ❑ �.='?i:_ . . _ , ;..:� . ..i. ^ .'.E, �:., ,r� LIVING AREA ❑ ► . '-;', , .' : : -� ,� �' :.., .:,� 2704 sq ft ;t� � , :;, :} , , _. s ��a�e �,. �r ,.. �:,,�. , . . ._ . _� ;l 3 cncie ';��a_ � .. .., ,•:,eJ in iL�S r:;view. IC'Et�'Tr�-i;� F'�_.�,,"1 :��1 JiV `�iiTE AT ALL TfML�y 6r/er� /4S Q�SC.a/SS�� oN S � L � _ — � , � -- � ,_ . , j I r_T � } ' . UP ' -�� _....L_ . � 5'9 N r__-DN---..� r 1 r 1 _______...__ __.___, G U rre,v�,"'�- �(o S��" LIVING AREA 1950 sq ft ` �. •Y \ DATE TIME '' CITY OF ORONO CALLED IN >��- /� 'v S� INSPECTION NOTIC�^7 SCHEDULED � -/3� �`� �/�M PERMIT NO. f�� / �� COMPLETED ,j,_ ADDRESS /OS CU C�X �l iz'1 /�-�' OWNER �= ��'� Zc��'� CONTR. G�L'l�r^ TELEPHONE N0. ��S �� 5 �S �� . �Cf 9 � DESCRIPTION l� 01 FOOTING 11 MECHANICAL RI �' 18 EXCAV/GRADING/FILLING �" 02 FRA 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS O� 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 O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 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 OWNE CONTRACTOR TO MEET YOU:_� YES_NO � COMMENTS: � W a � J O � � O � W � Q ti Z w � W � � d W WORKSATISFACTORY:PROCEED [� PROJECTCOMPLEfE � ❑CORRECT WORK R PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION RE�UIRED.CAIL TO ARRANGE ACCESS. Call for the e�t inspection 24 hours in advance. (952� 249-4600 OwnerlConiQi�act s�i . I Inspector. White Copyllnspector's Filel Canary CopylSite Notice � � DATE TIME � CITY OF ORONO CA LED IN �S G'.� INSPECTION N TICE HEDULED ��"'L_ PERMIT NO. -��MPLETED ADDRESS �� C'X f �/Zh11� /�`Cl� OWNER /,.�ri a. �1.v� CONTR. TELEPHONE NO. �! ��' �� 7 `�' � DESCRIPTION ;�P��7� 5�%y�,LD ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WO00 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 COMPIAINT J 07 DEMO-FINAL 15 SEPTiC INSTALL. 22 FOLLOW-UP = 09 PLUMBING R� 23 SEPTIC,FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � � W � j ,/� � ' 1✓�S Gu S� gv nrt a�+'f' �'.Lu�� v`�7'� �/d�� — O l<. r � Tb Q c-�!l ��s� o� �l--v�i-�S � O `� s� r�� R�' W � Q � Z W � W � � � d W ❑WORKSATISFACTORY:PROCEED Il PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal1 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor o ' e- Inspector. White Copyllnspector's File Canary CopylSite Notice