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Home My WebLink About2005-P09010 - addn /remodel/repair P . � PERMIT CITY OF ORONO 2750 F�elley Parkway- PO Box 66 Permit Number: p09olo Crystal Bay,"Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 8/22/2005 SITE ADDRESS: 4030 Elm St Unit# Long Lake,MN 55356 PID: 06-117-23-41-0072 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/RemodellRepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: Finish Basement Per Plan I� FEE SUMMARY: Permit Fee: $ 522.55 valuation: $ 37,500.00 Plan Review Fee: $ 339.66 State Surcharge Fee: $ 18.75 TOTAL FEE: $ 880.96 APPLICANT: Robert Craig Homes OWNER: Mr&Mrs George Roscoe 565 Big Woods Blvd 4030 Elm St Chanhassen,MN 55317 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 fLDING CODE REQUIREMENTS. / �� ' �. �- t '� '�� APPLICANT PERM[TEE SIGNATURF, 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: Entered By: ?l� � Permit#: � c��,/ C� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: �U-�D �G m s�' C%f2.l��1'�� ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes, a special event permit is regarired with Police Department and City Council approval 60 days prior to the event. Shuttle ba�s service will be required unless applicant demonstrates sufficient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: �GO/�C l�-��'i �1'L�'L pHONE: (home) ,� (work) MAILINGADDRESS: 7� 30 �Lm ST CITY: ��'ti� ZIP: CONTRACTOR: /��Qr C��f� ��s PHONE: �s� "`��3`� CONTACT PERSON: ��h MOBILE/PAGER: �/,� ��o-?/7�' MAILING ADDRESS:�� S" r�/��,,,,�.,c,�; /�i�✓`d CITY: ��-��N��r�-Z P: �.��3� STATE LICENSE: # g�'�,(� EXPIRATION DATE: y �s" e � ARCHITECT/ENGINEER: � '�� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration 'X PROPOSED WORK(describe in detain: y�-%�✓i 5� r.9-1��Y � ��Z..� STORIES: �� SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ „3� �cx Q I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the wark 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 pla , ,. APPLICANT'S SIGNATURE: DATE: 7oZ9 � ' 31 �t 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. InYormation required to be given individual. An individual asked to supply private or confidential data conceming 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 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 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 may place the notice reguired under this subdivision in the individual income tax or prooerty tax refund instructions instead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shal I 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 shal]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 disclosed to him for six months thereafter unless a dispute or action pursuant to this sectio�is pending or additional data on[he individual has been collected or created. The responsible authority shall provide copies of the private or publ ic 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,ceRifying,and compiling the copies. The responsible authority shall comply immediately,ifpossible,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 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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe 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)notify the individual[hat he be]ieves 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 determination of the responsible authority may be appealed pursuant to the provisions of the adminisuative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S. 13.04,Subd.2,"Rights of subj ects 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 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. Li.04(available upon request)to review private data on yourself. 6. Your full name is required to process this application or permit. First �,s,�,r,�� Middle Last Address C�ty State Zip Phone I u my rights as stated above. " �, ignature 32 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: �0 3� C��►� s r PID: DESCRIPT'ION OF WORK: ��„s�.� (�,q��rvt,�iJT�' ZO.�tI�i i G REV�W BY: N �� DATE APPROVED: BUII�DING REVIEW BY: DATE APPROVED: � -Y-o 5 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes � No SEWER CONNECTION STATE SURCHARGE Yes � No WATER CONNECTION INVESTIGATION FEE Yes No ,/' PARK FEE SAC Yes No � SITEINSPECTTON Number of SAC Units OTHER (specify) ---------------------------------------------------------------------------------------------------------------------- Z0�1IVG CH�CK LIST Zonin; Districc: �Jo G I Fire Departmeat: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Dace of Survey: Proposed Setbacks: Front (Lake): Right Side: Rear (Street): Left Side: Adjacen[ Structures: �Vetland: Building Height: Def. Hgt. Peak Hgt. Lot Covera�e: Grading: Staff Approval Date: y: Council Approval Date: Septic: Staff Approval Date: B : Zonin� File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Biuff Setback Lot Coverage: ExistinQ Proposed ..7 Hardcover: 0-75 7�-2�0' 2�0-SGO' SOC-10aa' Hardcover Variance Required: Yes No Date of Council Approval: �tE�fARKS (in house): BUILDING REV�W CHECK LIST �C� - �' 3 CONSTRUCTIONTYPE: \(� Sq Footage $ Per Sq Ftg Basement x _ lst Floor x = 2nd Floor x = Garage x = z — TOTAL Estimated Construction Value: $ "3'�f500 �� Inspections Required: `Vork Requiring Separate Permits: Site _�Plumbing Fire Hardcover Removal _�Mechanical Water Coanection Footing ` Septic Sewer Connection _�Framing Fireplace Lawn Irrigation �_Insulation (Masonry) Other _�Wail Board (Mfg.) Well (State Permit) '�" F�� Grading/Filling �_Electrical (State Permit) Ocher RENIARKS (ni 1 HOUSE): - ------- ------------------------------------------------------------------------------------------------------------ REV�W BY OTHERS: DATE: Access: Existing New Access Approval: Date gy: ------------------------------------------------------------------------------------------------------------------ REI�IA.RKS (TO BE NOTED ON PER��II'I�: 8 ��'_' � V� D / �/vS TIME CIf OF ORONO CALLED IN < < INSPECTION , TICE SCHEDULED � _/.��U PERMIT NO COMPLETED ADDRESS C� OWN ER CONTR. (� TELEPHONENO. �S � �� CO r�J S C.O � � DESCRIPTION `--�� 1'c'��,`Y) � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 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 RI 23 SE I FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU: ES_NO � COMMENTS: � W � � J O � � O � W � Q ti Z W � W � � d W� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED '-' ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice �� A TIME � CITY OF ORONO CALLED IN �� INSPECTION N TIC SCHEDULED -D � PERMIT NO. � � COMPLETED ADDRESS �ZJJO ��-r� �� OWNER CONTR./�"7'��QC�1' TELEPHONE NO. �-C��a �a �aa8 � DESCRIPTION � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 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 OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 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/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � d W ORKSATISFACTORY:PROCEED f7 PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY W � Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDlTIONWITHIN HOURS. u PHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR G INSPECTIONREQUIRED.CALITOARRANGEACCESS. Call for the n t inspection 24 hours in advance. (952� 249-4600 Owner/Contract ite: Inspector. White Copyllnspector's ile Canary Copy/Site Notice �� DAT TIME � CITY OF ORONO CAL�ED IN �$��'�S INSPECTION NOTIC � SCHEDULED I l-Z-�� :U O � PERMIT NO. � ^ COMPLETED ADDRESS L�U 3l J ��/Yl ;S�7� • OWNER CONTR. �Ud.�l'-�'�` C/-�u�i'�/l�fJ. TELEPHONE N0. �� -� �� G' �v�c�� DESCRIPTION � � lA.-��til.��,U� ��(-l�h � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 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 �, 5 FINAL 14 SEWER HOOK-UP 06 PROGRESS � O-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 J 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � ti � Q � Z W � W � � d � ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE W ❑ CORRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. r� pHOTOTAKEN INSPECTOR W{LL RETURN � CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-4600 OwnerlContractor on site: � Inspector. � ,c.� �/ � White Copyllnspector's File Canary CopylSite Notice � . . � �� a�� C�TY OF ORONO SpECIAL ��E �BUiLDING R/ tv1 PU'tiJ ;iEV(�W , . -��;�`^,�:; 'JNOPECTOR_�W`O L BE� -��t�?��'i :'�'�:ti�F:F�.: . ._ , ATTACH�� 9-i��T l�ATc $-�-o� Fr��,rrr, � C 5vui'v1i I i C�� . ,:-.� - �r�-��..��.�._._:� , . �EE _�� . Fi r x•� EX:�'s � r:....� .. . -i`.� i �' t7�. � F,�� R VED/?S � '= f� '` FOR `'` �. �` `�� '� i ' v �,? { �i �ri '�1,�� l. � _.. � l./'iV �1'�TiJ {"nr;�-�-1 � � � `i`r-11 � L�� '�'!1� ;�,1�� '� �T��.,•Eur;..�� GG r:c��!�'��l�ASNOiED ��„ � �< <-o�;-� h� �.. p� R , r� .� � � r. Q U" � � ❑ t � 1l,G'�h�iv'�_�---�`.nr=Lg�� ! ` r;:• iJ `��1iT 5.7 SC�_ := �. N!?iV. `)t �t`� i��.a Tra . : .. , a �� ,r.; ^n s a,-� fp(��J: f�frdf�tin. :L'I v:�rk shap b�dorre � 44" PA�aX. 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