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HomeMy WebLinkAbout2002-P04892 - addn/remodel/repair PERMIT � CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: Po4s92 Crystal Bay, Minnesota 55323 PeC'1711t Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 2�2i�2oo2 SITE ADDRESS: 185 Crystal Creek Rd LONG LAKE,MN 55356 PID: 33-118-23-32-0003 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Buildin Census Code 434 Permit Class: g Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: i'iumbing iviecnanicai Eiecuicai(staiej NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 562.95 Valuation: $ 42,000.00 Plan Review Fee: $ 365.97 State Surcharge Fee: $ 21.00 TOTAL FEE: $ 949.92 APPLICANT: Hilloway Homes LLC OWNER: KEN MELROSE 106 Broadway South 185 CRYSTAL CREEK RD Wayzata, MN 55391 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. � �—�- � L ���C1� � � C�� f'l�l�S�C '' � �- '� 2l�: `—����� ��� � �� � P ANT PERMITEE SIGNA E [SSL'ED BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant. 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 s � ' Total Fee: $ %���, �,� Date Received: � -��� -,�(�j� � � Entered By: �'�•2Z- Permit#: ��� �/,k��'� ���v,/ ''1� � CITY OF ORONO - BUILDING PERNIIT APPLICATION 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: ' ��; L,�yS��L C/I�E,� ZIP: S S35 l� NAME OF OWNER: �;� -�;,,,(rC I�EZ�2�.sE PHONE: (home) G/SZ 5/G�/�yg 75- (work��6,c:� �l SZ-��7 •��/ MAILING ADDRESS: /�� ('�u�y�/ �'�K CITY: L ZIP: �� . CONTRACTOR: f-�i �I�Y.�;� N�'Y► .S C,L. PHONE: cjs`Z- y�7:3- /��j�l CONTACT PERSON: �juC� `T'e�� MOBILE/PAGER:_SSZ- �Z�C �--zC /C MAILING ADDRESS: /� '$,��ujj4y �,t;fit, CITY: ��_ZIP: S5��� STATE LICENSE: # P�- Zo3��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 detain: �;,.�;s�,��, L��;E� (.��;�L . � STORIES: L,L, SQ. FEET OF EACH FLOOR: �C� 7� �F NO. OF BEDROOMS: _� GARAGE STALLS: ATT. DET. �c� ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �/Z Q�v, 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: Z- 1_3•- O� ���I C.�.% �C'r+�►C-"`-� L�--L NOTE! Parade of Homes events require eparate pernzit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 � � 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 forrh in this secdon. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecdng 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 confidendal data;and(d)the idendry of other persons or entities authorized by state or federal law to receive the data. This requiremen[shall not apply when an individual is asked to supply imestigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax or orooertv 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 whe[her it is classified as public,private or conf'idential. 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 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 disdosed to him for six months thereafter unless a dispute or action pursuant to this secuon is pen�g or addiqonal data on the individual has bee❑ 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 authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any�equest 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 request within that time, he shall so inform[he 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 notify in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy 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 disdosed only if the individual's statement of disagreement is included with the disdosed data. The detercnination of the responsible authority may be appealed pursuant ro the provisions of the administrative procedure act relating ro 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 �ity 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 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 Ciry State Zip Phone I erstand my r' state above. __ `�, � � � L� t�� � G vl C 5 � L C� Signature - 6 .� . ' CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: � �b S G 2y srr�c_ G+-Z�fc PID: DESCRIPTION OF WORK: Q/�SL M��� ��n,!�5�-4 ------------------------------------------------------------------------------------------------------------------------ ZONTi�iG REVIEW BY: DATE APPROVED: z- �s -r�2 BUILDING REVIEW BY: ,,,.._- DATE APPROVED: Z- �S�'-02 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes �/� No PLAN REVIEW Yes �/ �10 SEWER CONNECTION STATE SURCHARGE Yes � No WATER CONNECTION INVESTIGATION FEE Yes No �� PARK FEE SAC Yes No �/SITEINSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------------------------------------------------------------------------------ ZONING CHECK LIST Zoning District: /U'n C���t!(�-P Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front (Lake): Right Side: Rear (Street): Left Side: Adjacent Structures: Wet d: Building Height: Def. Hgt. Pe �Hgt. Lot Coverage: Grading: Staff Approval Date: B • Council Approval Date: Septic: Staff Approval Date: By Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setback: L,ot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 . �. BUILDING REVIEW CHEC� LIST UBC: )2' �j CONSTRUCTION TYPE: V/�J Sq Footage $ Per Sq Ftg Basement x = lst Floor ' x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ �f 2,tl O�°`�'' Inspections Required: Work Requiring Separate Permits: Site _�Plumbing Fire Hardcover Removal _�Mechanical Water Connection �.,Ecet-i;�g— Septic Sewer Connection �Framing Fireplace Lawn Irrigation �Insulation (Masonry) Other �Wall Board (Mfg.) Well (State Permit) c, Final Grading/Filling �c Electrical (State Permit) Other REMARKS(IN HOUSE): ------------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ------------------------------------------------------------------------------------------------------------------------ REMARKS (TO BE NOTED ON PERMIT): 8 � � DATE TIME CITY OF ORONO �� CALLED IN INSPECTION NOTIC aSCHEDULED v ' �U PERMiT NO. �U � v COMPLETED --� '7 ADDRESS_ ` g S "/'(,/� /-� � �/�Fp�pi; OWNER CONTR. � �� TELEPHONE N0. ��� �4 �.3 - /`'l�' A�� � DESCRIPTION �r�' -,/�'�i ✓1 � , � � 01 FOOTING 11 MECHANICAL RI 18 EXCA�//GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPI.ACE 34 TREE REMOVAL Z04 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 J 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/CONTRACTOH TO MEET YOU: YES_NO � COMMENTS: � a �/L�".51T>'� /f�5 ,�i S Lv S s—c� J �^' C9-C� � ��v-� O a � O � W � Q � Z W � W � � d W� NORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED u ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. 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