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Home My WebLink About2005-P08629 - re-side ` PERMIT C11�Y OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Pos629 Crystal Bay, Minnesota 55323 Permit Type: M�noraicerarions (952) 249-4600 Date Issued: 4�2o�2oos SITE ADDRESS: 35 Crystal Creek Rd L.ong I.ake,MN 55356 PID: 33-118-23-33-0002 DESCRIPTION: Proposed Use: Residential Buildin � Census Code O/S-Building Permit Class: S Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: n- ��--- � n---�- FEE SUMMARY: Permit Fee: $ 783.75 Valuation: $ 70,000.00 State Surcharge Fee: $ 35.50 TOTAL FEE: $ 819.25 APPLICANT: Roncor Construction OWNER: Steven&Anne Koehler 10470 Lyndale Ave S - 11 E 35 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 SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. �i y.�:. e_ �:_,�� z� v� V'� APPLICAN"T Pf:KMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Aoolicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 � Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all i�tformation) ----------------------------------------------------------------------------------------------------------------------- -- �-------_.. THE APPLICANT IS: (circle one) OWNER O CONTRACTO C^Y_ � -� . JOB SITE ADDRESS: S `� � ��l� �� ZIP: S 5 -S � c� --� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO If yes,a special event pe�-rnit is required with Police Department and City Council app�roval 60 days prior to the event. Shuttle bus service will be�-equired unless applicant demonstrates sufficient a�-site parking is available. Non yeri�zitted events will not be allotived. NAME OF OWNER:�✓� � �''� K G e� � �'�- PHONE: (home)��—�7� --�5�, (work) MAILING ADDRESS: ��C-r�S tzf � C``�-K l��f'Y: �J�-yLfl ZIP: �� CONTRACTOR: �O N Gl� ' PHONE: c/ So1-��• S'S 7� CONTACT PERSON: ,�� ?j E • �--� �O�ILE/PAGER: MAILING AIyDRESS: j U y7b L�'i��,g L.��i 1.� 5 l f�'ITY:�C;.y17-71� ZIP: �� Z� STATE LICENSE: # �� ,� EXPIRATION DATE: o ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration � � PR POSED WORK(describe in detai�: � �vrwc.� �z-4� — � �'� L�� K STORIES: � SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: �--� GARAGE STALLS: ATTACHED DETACHED_ J� ESTIMATED 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 accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: r �' '�� 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 himselfshall be informed of: (a)the purpose and intended usc of the requested data within[he 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 authorized by state or federal law to receive the data.This requiremenl 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 mayplace the notice required under this subdivision in the individual income tax or oroperry tax refund instructions ins[ead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authoriry,an individual shafl 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,shall be infonned 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 o£the private or public data upon request by the individual subject of the data. Thc responsible authority may require the requesting person to pay the actual costs of making,ceRifying,and compiling the copies. The responsible authority shall comply immediately,if possible,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[he 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 lega!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 himsel£ To exercise this right,an individual shall notify in writing the responsible authority describing the nahire 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 indttded with the disclosed data. The determination of the responsible attthority may be appealed pursuant to the provisions of[he 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 pnvate 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 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 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. First Middle Last Address City State Zip Phone I understand my rights as stated above. Signature 32 � /� n^ i�X�-- ✓ �� l ��.� DATE TIME CITY OF ORONO CALLED IN �' �� INSPECTION NOT , C SCHEDULED -J�L�J�'/c-`� PERMIT NO. �� Z � COMPLETED ADDRESS S _ft/S tQ� ��- /� OWNER CONTR. �(�ytL t�✓� L�cS3'Y1} • TELEPHONE NO. �l� �1—/�� DESCRIPTION r �� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIL�ING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 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 J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP T09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:.�YES_NO / � COMMENTS: ��lLC'�Y��-� �D /�/� yL�� W � � � � 1 � > � � � ,1� � ;� � f� I ., � �, K � W � Q � z W � W � � d W ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: � � Inspector. � ! .� � � ��'' White Copyllnspector's File Canary CopylSite Notice �� d —� DATE�> TIME � CITY OF ORONO CALLED IN l . - LJ INSPECTION NOTIC SCHEDULED ��a %('. _�C' PERMIT NO. G � "L C/ COMPLETED ADDRESS <�cy �'G�r_/S y C� l ��i2 ,L'-- -�-�--! OWNER CONTR. l��'*yr l �,^�c� TELEPHONE NO. G`� '� � r� � "� �� DESCRIPTION � ��'� ��` � l�1�" � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILIING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 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 FI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL lI 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU: �L YES_NO /1 � COMMENTS: � � W 0. � J O � � O � W � Q � 2 W � W � j d W WORKSATISFACTORY:PROCEED f i PROJECTCOMPLETE � ❑ CORRECT WORK 8 PROCEED '-' ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR flE1NSPECTION TEMPORARY V BEFORE COVERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN �CITATION ISSUED ❑STOP ORDER POSTED.CAIL INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call forthe next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor or��te: Inspector. V White Copyllnspector's Fi e Canary CopylSite Notice �� AT E TI M E `� CITY OF ORONO CALLED IN � INSPECTION N TIC SCHEDULED .Sa?�3�,� o�•'� PERMIT NO. �O COMPLETED ADDRESS .3 S Cih�'�C G�- C�� OWNER CONTR.�,lj-i� TELEPHONENO. ��G� �01 � � SdoZ-� � DESCRIPTION W I�(L� wS � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADWG/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 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 O6 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 � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � J O � � O � W � Q � Z W �c W � j d W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑ CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN 7 CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next in ection 24 hours in advance. �952� 2Q9-46QQ OwnerlContract sit Inspector. White Copyllnspector's File Canary CopylSite Notice