HomeMy WebLinkAbout2006-P10578 - addn/remodel/repair �' PERMIT
,CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: p1o578
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 11/27/2006
SITE ADDRESS: 3405 Eastlake St Unit#
Long Lake,MN 55356
P��� OS-117-23-13-0032
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:
Approvcd per resolution#:
Separate permits required: Plumbing Electrical(state)
NOTICES/REMARKS:
expand bathroon
FEE SUMMARY: Permit Fee: $ 69.25 valuation: $ 2,000.00
Plan Review Fee: $ 45.01
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 115.26
APPLICANT: Troy Kennedy OWNER:
3403 Eastlake St
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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APPLICAIJT ERMITEE SI NATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
Total Fee: $ Date Received: ��-a0 -d�
Entered By: Permit#: �iQfDSZ�
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please p�•int all ififormatio�i)
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THE APPLICANT IS: (circle one) OWN�Ij:bR CONTRACTOR
JOB SITE ADDRESS:��U 5 �1��'(�ti�=� ���eT ZIP: �S���
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ I�eS �NO Ifyes, n specinl evenl peiv�tit is r�eqzrrred��vlth Police Deparir�rent and Crty Coirncil nppr•ova!
60 days pr•ior to lhe ever7t. Shi�ttle bais ser•vice i��ill be reqarirecl unless applicant demonstrates
suf�cient a�-site parlcing is available. Non-pern�iitted eveirts�vil!i7ot be allorved.
NAME OF OWN�R:��o �� �� �✓�✓` ��� � PHONE: (home)`��2'�� G " �i� �
� (work) �( _ � - 1 �31
MAILIN�G ADDRESS: �`��S G��/����-e ��c��� CITY: ��r�nu ti'�'1�ZIP: �
CONTRACTOR: PHONE:
CONTACT PERSON: r� e n�." MOBILE/PAGER: �-�z=�,�c,� c )o E
MAILING ADDRESS: _�_1� _ CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIY:
NAM�: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure _
Move Home Remodel/Alteration (ie: Siding, Windows) �_
Any earth movement may require MCWD review and permits !
nP.�p�SrT��I�R�;rles�rsb�ser �detcca�: �k������ ��1�r��M S��� � ��'��k -�tX�✓�1.
STORIES: i SQ.FEET OF EACH FLOOR: ����
NO. OF BEDROOMS: 1 GARAGE STALLS: ATTACHED DETACHED
�STIIVIATED CONSTRUCTION VALUATION(excluding land): � i. v u �
I hereby apply for a buildinQ permit and I acknowledae 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 peri�lit and�vork is not to start without a permit;and that tlle work�vill be
in accordance ��vith the a�proved plai�.
APPLICANT'S SIGNATURE: DATE: / I � � .�
3�
Sec.13.04 RIGIITS OF SUBJECTS OF D 1TA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored sllall be as set forth in this section.
Subd.2. Infonnation required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be
intormed of: (aj the purpose and intended use ofthe requested data wi[hin the coliecting 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 requirement shali
not apply wfien an individual is asked to supply investieative data,pursuant to section 13.52,subdivision 5,to a law enforcement officer.
The commissioner of revenue ma�lace the notice required under this subdivision in the individual income tax or properry ta�reTund
instructions instead of on those fonns.
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 classitied as public,private or contidential. Upon his Yurther request,an individual who is the subject of
stored private or public data on individuals shall be shown the data��ithout any charge to him and,if he desires,shall be infonned of the content and
meaning of that data. After an individual has been sho�vn the private data and informed of its meaning,the data need not be disclosed to him for six
months thereatter wiless a dispute or action pursuant to this section is pending or additional data on the individual has been coilected 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[he requesting person to pay the actual cos[s of makine,certifying,and compiling the copies.
The responsible authority shall comply immediately,ifpossible,�vith any requcst made pursuant to this subdivision,or within tive days of
the date ofthe request,excluding Saturdays,Sundays and legal holidays,if iinmediate compliance is not possible. If he cannot comply with the request
�vithin that time,he shall so infonn the individual,and may have an additional ti��e days within�ahich to comply with the request,eacludine Saturdays,
Sundays and legal holidays.
SuUd.4. Procedure when data is not accurate or complete. An individual may contest Nie accuracy or compieteness of public or private data
conceming himselt. To exercise this right,an individual shall notify in�ariting the responsiUle authority describing the nature of the disagreement. The
responsible authority shall�vithin 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notiPy past recipients of
inaccurate or incomplete data,indudine recipients named by the individual,or(b)notify the individual that he believes d�e 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 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 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 infonnation.
You are notified that:
1. The informatiai you furnish will hP �ised to detennine your qualification for the Permit or license
requested.
2. Yau nlay refiise t-v su};ply datn;but r2fiisal may require iilni LiiC Cli'y'Ci��y the permit Oi licerse.
3. The information may be shared �vith other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license rec�uires Council action to approve, some information may become
public.
�. Z'ou have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Yow•full name is required to process this application or pennit.
r C L �f�� ��C r� E V"\D��-:L"
First �9iddlc Last
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:�ddr�ss
���nu /�lu'� � S 3�p '�5 �-' ���--���'�
City Statc "I,ip Phonc
[understlnd mr' rights as stated above.
�
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Sign turc
Reset Form .i�
� -CHECK OFF i�IST FOR ISSUA.NCE OF PE�'VIIT5
FOR OFFICE USE ONLY
A.DDRESS OR IIEGAL: �y(�S ��S% GA/� si�r.c� T
PID:
DESCR�'�ION OF�VORK: �H-n-+ �oa�. (��^.A�o-ec_ -
__-�______--- __�___.._----
-----------
ZOYPi tG REVIEtiV SY: ----- I f� DATE APPROVED:
S U�L D L N G R E V I E ti V B Y: ' . . DATE APPROVED: /� L1-U G '
k`EES TO BE CHARGED: ^ Misc. Fees Calculated By:
PE�IT Yes � No
PLAN REVZEti�T � Yes -� No SE�VER CO�ECTION
STATE SURCHARGE Yes � No �VATERCONNECZION
INVESTIGATION FEE Yes No ,/' PARK FEE
SAC Yes No -� SITEINSPECTION
Number of SAC�Units OTHER (specify)
- --- N
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ZpN1�G CHE.CK LIST Zoaing Discric�: ' v C l-/�-N� .
Fize Dep:rsuent:
Post Office: School District: •
jAr p,rea: Sq.ft.
Acres Wid�h Depct�
Survey Submitted: Yes Iv`o ace oE Survey:
Proposed Setbacks`. �
Froat(Lake): Rioht Side: ,
Rear(Streetj: Left 5ide:
Adjacent Struch!res: Vetland:
Buil�lin�Hei�t: Det, Hgt, Peak Hgc.
Lo[ Covera�e:
Grading: Scaff App_ov�l Date:
F�+y: ��.,Gi:u::Cii n�a:CV:,t na(�; .
Szptic: Staf� Approval D3ce: �:��
Zoain� F:le: R Reso?utioe: n Resolution Date:
She�et�^.d Distr'cc� Lot Covecage:
�v;. Setback: Bluif Setb ck:
E�st�o P;oposed
Hz�Ccover; 0-75'
7�-L�0'
2�0-5�'
�oo-.�;���
_ n�.� �.= �'c����,�;i a;�-�•.z: ---
�_�a.rr�,;°' �,�_;,�`� ��.eti'!ti��:: :e� . �- • . r• _
�.�.�L:�,.�;5 (�nhouse):
1
EUILDIN� REVLEtiy CHECK LIST
�C� �� � � CONSTRUCTION TYPE: �/�
Sq Footage $ Per Sq Ftg
Basement • ,. x _
Ist Floor x _ .
2nd Floor � _
Garaoe x V
x —
T�TAL
Estimated Constructioo Value; $J�.��� �
Inspections Requirec�: �York Requiring Separate Pecmits:
Si[e _�Plumbing Fire
Hardcover Removal Mechaaical Water Coaaectio❑
Footing ' Septic Sewer Coanectioa
� Framino
�_ o �ireplace Lawn Irriga[ion
Insulacion (Masonry) Ocber
�Vall Boazd (Mfg.) Well (State Permic)
_�F�� Grading/Fi11in� _�Elec[rical (State Permit)
O the r
R.EMARK� (Li�T HOUSE): - -- --
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REVLE�V$X OTHERS: DAT'E:
Access: Existing New
Access Appcoval: Date gy:
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REI�IARKS f,TO �F Nn'�En nv PEF.�� �� :
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�� DATE TIME "�
CITY OF ORONO CALLED IN
INSPECTION NO�CE _ SCHEDULED //� '�'Jd /�f1:c�✓/f,l�
PERMIT N0. /�'S 7� COMPLETED
ADDRESS � J�� G>>� � �t s f%ti /�
OWNER_ �'�2��/ ��. ������ CONTR. OLti►'�-r.y'
TELEPHON E NO. Cl � ,� -�C.�C_% ����C�� G
� DESCRIPTION
� 01 FO 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 2 FRA ING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 3 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 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 P�UMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑Ct�RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP OFDER POSTED.CALL INSPECTOR ^�CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the xt inspection 2a hours in advance. (952� 249-46�0
OwnerlCo r site:
Inspector. .
White Copyllnspector' File Canary CopylSite Notice
� DAT TIME ✓
CITY OF ORONO CALLED IN /� ��
INSPECTION NO�ICE SCHEDULED /� (Z7 0� � �
PERMIT NO.�,�D_�_ COMPLETED
ADDRESS �3��jS Y�SZ`L�e ��
OW N ER_�/�fll�!'2 il���t,/ CONTR.
TELEPHONE NO. ���' �b �7��
S�s<p-!���s-��
� DESCRIPTION G7L ���+ �� i,vrD
LL 01 FOOTING 11 � ECHANICAL RI 18 EXCAV/GRADIN /FILLING
� 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 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� WORK SATISFACTORY:PROCEED ROJECT COMPLETE
� ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �; pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ':CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 2a hours in advance. (J52� 249-46�0
OwnerlContr - s�t�: �
Inspector. �����` J �
White Copylinspector's File Canary CopylSite Notice