HomeMy WebLinkAbout2003-P06417 - attached deck PERMIT
C i T�Y O F O RO N O Permit Number:
�750 Kelley Parkway - PO Box 66 P06417
Crystal Bay, Minnesota 55323 Pel'fTllt Type: Addition/RemodeURepair
(952) 249-4G�0 Date Issued: 6i26�2o03
SITE ADDf�ESS: 3075 Farview La
Long Lake,MN 55356
P I D: 04-117-23-33-0006
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Pernut Type: Addition/RemodeURepair Pernut Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMi4RKS:
FEE SUMMARY: Permit Fee: $ 349.25 Valuation: $ 22,000.00
Plan Review Fee: $ 226.98
State Surcharge Fee: $ 11.50
TOTAL FEE: $ 587.73
APPLICANT: Bridgewater Construction OWNER: Martin&Kimberly Lymn
4001 Monterey Ave 3075 Farview La
Edina,MN 55416 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI-IE 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.
C��l�'VL
APPLICANT PE EE GNATURE ISSUED BY S[GNATURE
Copies: 1-File(SiQnitures Required), 1-Annlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
►- � -13 � �� � ��� �
, otal Fee: $ --�� Date Received: �
` Entered By: �a� Permit#: �< < I� � �
�.-i�,�S� l.r I 2`_� / �' 3
CITY OF ORONO - BUILDING PERMIT A.PPLICATION
All information must be submitted in full before plan review will be started.
(please print all information) �
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SIT'E ADDRESS: �o�(� �"i'�ZV' (�;1� i,.t�i�3�. ZIP: 5�j��`'� �
9 5�-
NAI«E OF OWNER: (`{{���"� L�' � � PHONE: (home) � �'f'S�'"�� ��
: � (work)
1�IAIL .]1i IG ADDRESS: 3��`' T 1�1��J'����� �ITY: 0�=�� ZIP: S 5 �-t I
Z'�_ ,
CO\�'RACTOR: f�l������ r�,��►� ��1�5-� �� PHOl�'E:���91`�-S�Z��
COr�TACT PERSON: (�1�-1� �,� '�:; �NiOBILE/PAGER: N,/�
NLAILING ADDRESS:�{Po i N�.�tJ"f'���'�' i�� CITY: �\' ��� ZIP: S� `f 1%�
ST�iTE LICENSE: # ��� �� ���
ARCHITECT/ENGItii'EER: t� �� PHO�,TE:
MAII.,I�i 1G ADDRESS: —T CITY: ZIP:
NA...tiIE: REGISTRATION#
TYPE OF WORK: New �t/ Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK (describe in detai�: ('�-,j j(�G� ��� � \ 1�i�__p EC�
STORIES: SQ. FEET OF EACH FLOOR:
1�T0. OF BEDROOMS: � � GARAGE STALLS: ATT. DET.
��z�
EST�IATED CONSTRUCTION VALLTATION (eYclud.ing land): $ '��,-C� �� •
—�
I hereby apply for a buildinJ permit and I acknowledje 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 BuildinJ Code; that I understand this is not a permi[ and work is not to start without a
perm.it; and that the work wiR be in accordance 'th the a�proved plan.
APPLICANT'S SIGNATURE: �� DATE: l� `�� '�i�
NOTE! Parade o Homes events require separ te permit approval by Police Department and
City Counci160 days prior to the event. Non p rmitted events will not be allowed.
5
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type oF data. The righu 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 confidendal data conceming himself
shall be informed of: (a)[he purpose and intended use of the requested data within the collecdng state agency,polidcal subdivision,or statewide
rystem;(b)whzther he may refuse or is legally required to supply the requested data;(c)any la�own consequence arising from his supplying or
refusing m supply private or confidenaal dara;and(d)the idenary of other persons or enddes au[horized by sate or federal law to receive the data.
This requirement shall not appiy when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
"I1ie commissioner of revenue mav lace the notice re uired under this subdivision in the individual income tax or ro ertv tax refund
instrucrions instead of on those forms.
Subd. 3. Access to data by indiridual. Upon request to a responsible auchoriry,an individual shall 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 pubiic data on individuals shall be shown the data without any charge to hirn 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,che data need not be
disclosed to him for six months thereafrer unless a dispute or action pursuant to this secdon 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 auchority may require the requesring person to pay the actual costs of making,certifyin�,and compiling che copies.
The responsibie authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or wi�hin 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 addirionai 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 dara concerning himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the nature of the
disagreement. The responsibte authoriry shall within 30 days eithe;: (a)correct the dara found co be inaccurate or incomplete and attempt to nodfy
past recipients of inaccunte or incomplete dara,including recipiencs named by the individual;or(b)norify 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 included with the disclosed data.
The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
to concested cases.
DATA PRIVACY ADVISORY
In accordance wi[h N1.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 Ciry 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 tha[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
C��' Srate Zip Phone
I underst d my rights as st d above.
Signature
6
. ~ CHECK OFF LIST FOR ISSUAi�TCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �o� 5 F A r�v��w Lw n,c
PID:
DESCRIPTION OF WORK: C� c�K �2�:—w ��.�;w��T
-----------_—_------------------------�� �-------�----------------------------------6---------------
ZO�tG REVIEW BY: `�' DATE APPROVED: zY-�3
BUILDI�i 1G REV�W BY: DATE APPROVED: c.•z� - 03
F EES TO BE CHARGED: Misc. Fees Calculated By:
PERIVIIT Yes ,/ No
pLA1�I REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes _� No WATERCONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify)
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ZOti�ING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes � No Date of Survey:
Proposed Setbacks:
Front (Lake): �I t�' '� Right Side: 50' *
Rear (Street): Z37' '�' Left Side: �do� t
Adjacent Structures: — Wetland: —
Building Hei�ht: Def. Hg[. — Peal:Hgt. —
Lot Covera�e: N I/�-
Gradin�: Staff Approval Date: N f A By: Council Approval Date:
Septic: Staff Approval Date: N /� By:
Zoni.ng File: # ` Resolution: # — Resolution Date:
Shoreland District: No
Av�. Setback: Bluff Setback: L,ot Coverage:
Existing Proposed
Hardcover: 0-75'
7�-2�0'
2�0-500'
Sd0-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REl�1ARKS (in house): __
7
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BUILDING REVIEW CHECK LIST
�C: -1z'3 CONSTRUCTION TYPE: �L N
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor R =
2nd Floor x =
Garage x =
R -
TOTAL
Estimated Construction Value: $ 2Z.,C�oo�='
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
�- Footin� Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Ocher
Wall Board (Mfg.) Well (State Permit)
� F�� Gradin;/Filling Electrical (State Perm.it)
Ocher
REMARKS (ni 1 HOUSE): ---------
-----------------------------------------------------------------------------------------------
REVIE`V BY OTHERS: DATE:
Access: ExistinQ Ne�;,w
Access Approval: Date gy;
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REv1ARKS (TO BE NOT'ED ON PERMIT�:
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��y��J� DATE TiME
CITY OF ORONO CALLED IN O�
INSPECTION NOTICE SCHEDULED � �
PERMIT NO. '='� ���i � COMPLETED
ADDRESS 3�� ?S Fn�� �,X-�-� Ln,'.
OWNER CONTR. �� � d�'�-���-�'��-
TELEPHONE NO. LL�l� � /�/ - � 3�� C�c%�f -
� DESCRIPTION �'� �<t� - �J�_ l'�
tl� 01 FOOTING � 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
`�RAMING D 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
o INSULATIOf� 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS INAL � 14 SEWER HOOK-UP 06 PROGRESS
� DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FI AL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YE NO
� COMMENTS: L��� ��l{�����,,�k'_.
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W WORK SATISFACTORY:PROCEED PROJECT COMP�ETE
� ❑CORRECT WORK&PROCEED ❑ SSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOUFIS. p pH0T0 TAKEN
INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR O CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the n inspection 24 hours in advance. (952� 249-4600
OwnerlContra on i e-
Inspector. �
White Copylinspector's File Canary CopylSite Notice