HomeMy WebLinkAbout2006-P09638 - addn/remodel/repair � � PERMIT
CITY (�F ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: po9638
Crystal Bay, Minnesota 55323 Permit Type:
Addition/Remode 1/Repair
(952) 249-4600 Date Issued: 5/4/2006
SITE ADDRESS: 20 Crystal Creek Rd Unit#
Long Lake, MN 55356
PID: 33-118-23-33-0007
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit T e: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair
YP
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Electrical(state)
NOTICES/REMARKS:
Remodel kitchen and master bath and basement
FEE SUMMARY: Permit Fee: $ 643.75 Valuation: $ 50,000.00
Plan Review Fee: $ 418.44
State Surcharge Fee: $ 25.00
TOTAL FEE: $ 1,087.19
APPLICANT: Roncar Construction OWNER: Heike&CNeil Maglaque
10470 Lyndale Ave S- 11 E 20 Crystal Creek Rd
Bloomington,MN 55420 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 CO E REQ IREMENTS.
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APPLICA PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, 1-Septic) Page 1
. . 3 q�o�
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Total Fee: $ /Dg 7, �9 Date Received: 3-3-O(o
Entered By: � Permit#: �9b9/�3g
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR ;
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JOB SITE ADDRESS: �- � f,;� ;_-:.; L ;:�e,` � i�;�j. ZIP: `��.�C ��
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes � NO If yes, a special event permit is regurred i��ith Polrce Depa��tment and Crty Councrl approi�al
60 days prior to the event. Shuttle bus se�vice i��ill be reqidr�ed unless applicanl demonstrates
s�r�cient on-si/e parkrng is avai/able. Non-pern:itted events i��ill not be a!loi��ed.
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NAME OF OWNER: �'�c:�.( �� ���, ,��L ,G�C' ,������; PHONE: (home) i �:�` ��C� "U�j��
(work)
MAILING ADDRESS: ��L �i y�� �.� ( ; r t' ���i'ti��CITY: i� �,•�. ,-,, ZIP: ';�:��1L?���
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CONTRACTOR: ���`; i�� C C-;�> �� PHONE: '�G'� `���`'= ` i ::.'
CONTACTPERSON: „�: (� MOBILE/PAGER: r� � � � � �� g` I I
MAILINGADDRESS: �, y� l.�,,, _ �,� � � ,��CITY: ��� � ;�- ��
f.-.�� �� � ZIP: S ��
STATE LICENSE: # ;,��e; j EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) �
PROPOSED WORK(describe in detai�: ��r,���k;r'r' - � �� �� ; , a�v;1� ,.,. � '• � �
:,
�. .�I./ �. _
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �` ,Q'�� �---
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 nat to start without a permit;and that the work wi I I be
in accordance with the approved plan. � �
APPLICANT'S SIGNATURE: i l - ,' DATE: � � `- ��
31
, CHECK OFF i.IST FOR ISSUAI'r'CE �F PERMITS
� FOR OFFICE USE ONLY
A.DDRESS OR LEGAL: zo G 2�s�� C.�r.c_�=�c R-cs.
PID:
DESCRIPTION OF WORK: �'Lcwt.���z
ZO.�tI�i G REVIE`V BY: �(� DATE APPROVED:
BUILDING RE'�tiV BY: DAT'E APPROVEA: .�- 9 �v (�
FEES TO BE CHA.RGED: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW Yes �/' No SEWER CO�iNECITON
STATE SURCHARGE Yes _� No WATER CONNECTION
INVESTIGATION FEE Yes No ,/ PARK FEE
SAC Yes No �/ STTEINSPECTION
Number of SAC�Units OTHER (specify)
----------------------------------_--_-------------------------------------------------------------------------
ZONI�IG CI�CK LIST Zoning Districr. �v v C�H�
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Widch Depth
Survey Submi[ted: Yes No Date of Survey:
Proposed Setbacks:
Froat (Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: W tland:
Building Height: Def. Hgt. eal:Hgt.
Lot Coveraje:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoaing File: # Resolution: Resolution Date:
Shoreland District:
Avg. Setback: Blu Setback: L.ot Coverage:
E�is inQ Proposed
�
Hardcover: 0-75'
75-250'
2�0-SQO'
500-1000'
Hardcover Variance Required: Yes No Date oE Council Approval:
RE`�LARKS (in house):
�
BUII.,DING REVIE`V CHECK LIST
�C� iz' � CONSTRUCTION TYPE: �(�I
Sq Foo[age $ Per Sq Ftg
Basement x _
lst Floor z _
2nd Floor x _
Garaoe z _
z =
TOTAL
Estimated Construction Value: $ SC9,C�� �
Inspections Required: �Vork Requiring Separate Permits:
Site _�Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing � Septic Sewer Connectioa
� Framing Fireplace Lawn Irrigation
�Insulation (Masonry) Other
�Wall Board (Mfg.) Well (State Permit)
F�� Grading/Filling _g Electrical (State Permit)
Other
REMARKS (TiV HOUSE): ~
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REVIE`V BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date By:
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RE�IARKS (TO BE NOTED ON PER11�II'1�:
8
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. [nfonnation requircd[o be given individual. An individual asked to supply privatc or confidential data conceming himself shal I 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 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 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or propertv tax 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 contidential. Upon his further request,an individual who is the subject of
stored private or publ ic data on individuals shall be shown the data�s ithout 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 sis
months thereafter unless a dispute ur action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible authorit}shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making certifying and compiling the copies.
The responsible authority shall comply immediately,ifpossible,with any requestmade pursuant to this subdivision,or within five days of
the date of the request,eacluding Saturdays,Sundays and legal holidays,if iirunediate compliance is not possible. If he 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
conceming himself. To exercise this right,an individual shall notity in writing the res�nsible authoriry describing the nature ofthe disagreement. "Ilie
responsible audiority shall within 30 days eithec (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 detennination ofthe responsible authority may be appealed pursuant to the provisions ofthe 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 inform 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 inf'ormation.
You are notitied that:
I. 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 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.
�. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Y ur full name is required to process this application or�permit.
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CITY OF ORONO CALLED IN ��
INSPECTION N I SCHEDULED 5•3/-0�i 3��
PERMIT NO. � COMPL,ETED
ADDRESS a� «�l�l�� �%�-�-� �-�L
OWNER CONTR.T
TELEPHONE NO. l� `��� �7D I
� DESCRIPTION ✓� 1 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 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
= 09 PLUMBING RI��".�, 23 SEPTIC FINA� 35 HARD COVER REMOVAL
J 10 PLUMBING FI � �� 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. J PHOTO TAKEN
INSPECT'OR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
OwnerlContractgx or�s t�:
Inspector. � � �
White Copyllnspector's File Canary Copy/Site Notice
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