HomeMy WebLinkAbout2006-P10089 - plumbing PERMIT
CITY OF ORONO
Permit Number:
2750 Kelley Parkway- PO Box 66 P10089
Crystal Bay, Minnesota 55323 Permit Type:
Addition/Remodel/Repair
(952) 249-4600 Date Issued:
8/10/2006
SITE ADDRESS: 2280 Devin La Unit#
Long Lake, MN 55356
P��� 03-117-23-22-0016
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
Bathroom Addition
FEE SUMMARY: Pernut Fee: $ 111.25 Valuation: $ 5,000.00
Plan Review Fee: $ 72.31
State Surcharge Fee: $ 2.50
TOTAL FEE: $ 186.06
APPLICANT: Owner/Self OWNER: Kirk&Judy Nelson
MN 2280 Devin La
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.
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APPLICANT P.RM[TEE S[GNATURE J
ISSUED BY SIG]VATURE
Copies: l-File(Signa[ures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
,
Tota( Fee: $ /�$(,� . L C, Date Received: � �G G��j
Entered By: ' Permit#: �// //O(a
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please priizt al[information)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ���� ��v�-� L,•t.J ZIP: �S 3��
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ NO !f yes, a specia/event permit is required with Police Departrne��t and Ciry Council npproval
60 dn��s prior to the ever�t. Shuttle bus ser•vice�vil!be reguired unless applicant dentonstrates
sarfficient orrsite pnrking is nvailable. R'on-peri�rreted events will not be allowed.
NAM�OF OWNER: li�j k `� J,�.c� N�--�`x�,� PHONE: (home) `1 S�-`{�6~ Gj6�-o
(work) �i,2- 30� - sa�$
MAILINGADDRESS: .���0 17�z�,--� L•� CITY: Qr���� ZIP: SS 3s,(>
CONTRACTOR: 5�.1� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: 541� PHONE:
1V1H1L11\TV�L WJJ. �l i 1: uiL:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteratio�i (ie: Siding, Windows)
Any earth movement may require MCWD review and permits !
PROPOSED WORK(describe iri detain: �a��f�f: ` ���c�;� :�—
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ���C���
I hereby apply for a building permit and I acknowledge that the infonnation 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��-ork will be
in accordance �vith the approved plan.
APPLICANT'S SIGNATURE: �j� ` - DATE: � 1� c�,�
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Sec.13.0�1 RIGHTS OF SUBJECTS OF DATA
Subd. l. Type of data The rights of individual on��hom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Infonnation required to be given individual. An individual asked to supply private or contidential data concerning himselfshall 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 inay refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or contidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data. This requiremeiit shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision�,to a law enforcement officer.
The commissioner of revenue mav place die notice required under this subdivision in the individual income tar or pro�ertv 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 infonned whether he is the subjectof
stored data on individuals,and whether it is classitied as public,private or confidentiaL Upon his fuRher request,an individual who is dle 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 ofthe content and
meaning of that data. After an individual has been shown the private da[a and intbnned of its meaning,the data need not be disclosed ro 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 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,certitying,and compilin�the copies.
The responsible authoriry slial I comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of
the date ofthe request,excluding Sa[urdays,Sundays and legal holidays,if immediate compliance is not possible. [fhe cannot comply with the request
within that time,he shall so inform the individual,and may have an additional tive days within which to comply with the request,excludine Saturdays,
Sundays and le�al holidays.
Subd.4. Procedure when data is not accurate or complece. An individual may concest the accuracy or completeness of public or private data
concerning himself. To e�ercise this right,an individual shall notify in�vriting the responsible authority describing the nature of die disagreement The
responsible authority shall within 30 days either. (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)notifv the individual thai 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 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 inforni you that your request
for a pern�it or license from the City of Orono or any of its deparnnents may require you to furnish certain private or
confidential information.
You are notified tliat:
1. The information you furnish wilf 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 infornlation 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.
K�
First Aliddle Last
Address
City State Zip Phone
I understand my rights as stated above.
y(.� %� -
Signature
Reset Farm 32
CHEC� OFF i,IST FOR ISSUANCE OF PER.�l�1ITS
� FOR OFFICE USE ONLY
A.DDRESS OR LEGAL: �z.z e� p�v,�v ��n��
PID:
DESCR�TION OF WORK: (,o�,,•eti �-�vc� ���P�
ZO.�ti G REVrE`V BY: I ✓-� DATE APPP�OVED:
BUII�DING RE'VIEtiV BY: DATE APPROVED: � - i 3-o s.
FEES TO BE CHAI2GED: Misc. Fezs Calculated By:
PERMIT Yes _,�' No
PLAN REVIE`V � Yes _,� No SEtiVER CONNECTION
STATE SURCHARGE Yes _L/ No �VATERCONNECTTON
INVESTIGATION FEE Yes No �� PARK FEE
SAC Yes No � SITEINSPECTTON
Number of SAC�Units OTHER (sgecify)
-------------------------------------------------------------------------------- -
ZONTi�IG CH�CK LIST Zoning Districc: �v� __�/aNC e ,
Fire Deparcment: Post Office: School District: �
I,ot Area: Sq.ft. Acres idth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Fron[(Lake): FZight Side:
Rear (Stre�t}: Lef�Side:
Adjaceot Structures: Wetl d:
Buildin� Hei�c: Def. Hgt. Pe ' Hgt.
Lot Covera�e:
Grading: Scaff Approval Date: B : Council Approval Date:
Septic: Staff Approval Date: O.� B, ' �.3 C?
Zonin� File: m Resolutioa: � Resolution Date:
Shoreland District:
Av�. Setback: Bluff Setback: I.ot Coverage:
E�isting Proposed
Hardcover: 0-75'
75-250'
2�0-Sd0' �
500-1000' ,'
E-Iardcover Va:ia_nce Required: Yes No Da�e of Council Appro�z�:
R.E`L�RI�iS (in house):
BUII�DING REVIEtiy CHECK LIST
�C: tZ' 3 CONSTRUCTION TYPE: V/V
Sq Footage $ Per Sq Ftg
Basement X =
lst Floor z � _ �
2nd Floor x =
Garage X =
z =
TOTAL
Fstimated Cons�ruction Value: $ �_�00 ��
Inspections Required: �Vork Requiring Separate Permits:
Site _�Plumbing Fire
Hardcover Removal __�Mechanical Wacer Conaection
Footing ` Septic Sewer Connectioa
__�Framing Fireplace Lawn Irrigation
_�Insuiacion (Masonry) Other
Wall Board
�F�� . (r'1fg.) Well (State Permit)
—� Grading/Filling � Electrical (Stace Permit)
O cher
REI�ZARKS (IN HOUSE): _ -- �-
--------------------------------------
REVIE�V BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
-----------------------------------------------
REI�TARKS ('I'O RE NQTED QN PEF.iti1I'I'):
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NELSON NEW BATHROOM �
2280 DEVIN LN. ., r
7/10/06 REV, 6/30/06 O PTI O N 1 "��� �'� ���t--��4 p �
SCALE: 1/4"=1'-0" �?;�!D1NG P^ P1'I7 �' r,�•J h=;_`,/�[4/IJ�
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It�Ei'i H15 FLAN SE i ON $I i E Ai ALL TlM�`.i
�� � � �(�f� � _ DATE �/ � TIME ✓
CITY OF ORONO CALLED IN T �
INSPECTION N TICE SCHEDULED - �
PERMIT NO. } � COMPLETED
ADDRESS 2 ��G ��C ' �.. ,l � ^l �CC�' �
OWNER i I IL-- I�:�L���l�l CONTR.
TELEPHONE NO.___ LG � � - ���� — :���
� DESCRIPTION l�� I l�c��"��i7i�'1
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
O ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
? � PLUMBING RI ❑ SEPTI FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED i PROJECTCOMPLETE
� ❑ CORRECT WORK 8 PROCEED �. SSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
Owner/Contractor on sit
Inspector_
White Copyllnspector's File Canary Copy/Site Notice