HomeMy WebLinkAbout2006-P09932 - pool PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: po9932
Crystal Bay, Minnesota 55323 Permit Type:
(952) 249-4600 Accessory Structures
Date Issued: 7/25/2006
SITE ADDRESS: 2920 Fox St Unit#
Long Lake,MN 55356
P��� 04-117-23-31-0018
DESCRIPTION:
Proposed Use: Residential ������
Census Code �329 '
Permit Class: Building
Permit Type: Accessory Shuctures Permit Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 993J5 Valuation: $ 100,000.00
Plan Review Fee: $ 645.94
State Surcharge Fee: $ 50.00
TOTAL FEE: $ 1,689.69
APPLICANT: Dolphin Pool&Spa OWNER: Mr. &Mrs. Chad Abraham
3405 Highway169 North 186 Seminary Dr
Plymouth,MN 55441 Meulo Park, CA 94025
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. [
U�
��.
r Y
j��
��
APPLICANT PGRMITEE SIGNATIJRE ISSUED BY SIGNATURE
Copies: 1-File(SignaturesRequired), I-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
PERMIT
-CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P09932
.Crystal Bay, Minnesota 55323 Permit Type:
Accessory Structures
(952) 249-4600 Date Issued:
7/25/2006
SITE ADDRESS: 2920 Fox St Unit#
Long Lake,MN 55356
PID: 04-117-23-31-0018
DESCRIPTION:
Proposed Use: Residential
Census Code O/S-Building
Permit Class: Building
Permit Type: Accessory Structures Permit Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 993.75 valuation: $ 100,000.00
Plan Review Fee: $ 645.94
State Surcharge Fee: $ 50.00
TOTAL FEE: $ 1,689.69
APPLICANT: Dolphin Pool& Spa OWNER: Mr. &Mrs. Chad Abraham
3405 Highway169 North 186 Seminary Dr
Plymouth,MN 55441 Meulo Park, CA 94025
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.
��___ -
'� ���. � ����---���y "�
APPLIC NT PERMITEE S NATURE SUED BY S►GNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
- , �(�2�,v 1�
�'
Total Fee: $ � �B 9.lo�7 Date Receiv d: �,\1
Entered By: � Permit#: �� �'
c�1`-`� '�',�,
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan revie�v will be started.
(please print all iizfornzation)
------------------------------------------------------------------------------------------------------------------------
- �----------�_-.�_..�
THE APPLICANT IS: (circle o��e) OWNR,'tR OR�ONTRACTOR
e
JOB SITE ADDRESS: Z�Zd ��� �t-- ZIP: ,"��SS`
Will this be � Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ��,vo If yes, a speciaf event per�i�iit is reqarired with Police Dep�u�tnierat and City Coz�ncil approvn!
60 dnys prior•to the event. Shtdtle bzrs ser•vice 1a�ill be required i�nless applicant dernonstrates
sufficient on-site pnrking is available. No�v-per•rnittecl eve��ts wrll��ot be allo�ved.
NAME OF OWNER: ��14� /'�:pzt/�-CZZ,�,� PHONE: (home)(�a � - ��—
MAILING ADDRESS: ` ZB -r't", CITY: �'��a W�ZIP: �� �
.
CONTRACTOR: � e `�'� PHONE:''Z"G�3-� Zr-�E�p o7
CONTACT PERSON: M BILE/PAGER: '�?�03 �op pps
MAILING ADDRESS: D S o� CITY: ZIP: S �
STATE LICENSE: # G� 20 Z EXPIRATIO bATE: Zoe-T
ARCHITECT/ENGINEER: �cvlFii� PHONE:��Z-�1S—(�'��
MAILING ADDRESS: CITY: ZIP:
NAME: =�� 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 !
PROPOSED WORK(describe i�t let�
���;�c��vc av -�- !o,
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
o-p
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �dO,E�E�o
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�vock is not to start without a permit;and that the work will be
in accordance with the approved plan.
aPPLIcalvT�s s�GNaT DaTE: �0 1 d�
31
.
Sec.13.Od RIGHTS OF SUBJECTS OF DATA +
Subd. L Type of data. The rights of individual on whom the data is srored 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 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 da[a;(c)any known consequence arising from his supplying or refusing to supply
private or confidentiai 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 investieative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mayplace the notice required w�der this subdivision in the individual income tax or property tax refund
instructions instead of on tl�ose 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 whether it is classified as public,private or contidential. Upon his further request,an individual who is dle subject of
stored private or public data on individuals shall be sho�m 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 infonned of its meaning,the data need not be disclosed to him for sie
mondis d�ereafter unless a dispure or ac[ion 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 authoriry
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,�vith any request made pursuant ro this subdivision,or within tive days of
the date ofthe request,ezcluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply���ith the request
within that time,he shall so inform the individual,and may have an additional tive days within which to comply with die reques[,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 authoriry describing the nature of tlie 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,induding recipients named by the individual;or(b)no[ity the individuaf that he bel ieves the data to be correcC Daca in
dispute sl,zll�P disclosed only if the individuai's sratement of disa�reement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions ofthe administrative procedure act relating to
contes[ed cases.
DATA PRIVACY ADV[SORY
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 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 Nliddle Last
.4ddress
Cif�� State 7,ip Phone
I understand�r1y rights a stated above.
Signaturc
Reset Form ��
� � ' �HEC� OFF i.�IST FOR ISSUANCE OF PERNIITS
- FOR OFFICE USE ONLY
� ADDRESS OR LE%AL: Z i Zo �o X sT -
T.'ID:
DESCRIP'TI41I OF WORK: oo �
ZOYI�IG REVIE`V BY: ---��. DATE APPROVED: —7- Z�- a 4-
$U]ZDII�IG REVIEtiV BY: DATE APPROVED: �- �-o-�
FEES TO BE CHARGED: � Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW � Yes _� No SEtiVER CONNECTION
STATE SURCHARGE Yes _� No WATERCONNECTION
INVESTIGATION FEE Yes No t/ PARK FEE
SAC Yes No � STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONI�IG CT:i�CK LIST Zoning Discricr. �.
Fire Department: Post Office: School District: �
Lot Area: Sq.ft. Acres Widch Depth
Survey Submitted: Yes �_ No Date of Survey: 0�.1 1�l �
Proposed Setbacks:
Front(Lake): Right Side:
CX �� ��^�
Rear (S[reet}: Lef:Side:
Adjacea[ Structures: Wetland:
Building Height: Def, Hgt. ^� �/A Peal:Hgt.
Lot Covera�e: n���
Grading: Staff Approval Date: � By: Council Approval Date: '
Septic: Staff Approval Date: � �y�
Zoain� File: n ` Resolution: # Resolution Date:
Shoreland District: 0�`�
Av�. Setback: $luff Secback: Loc Coverage:
E�istin� Proposed
0
Hardcover: 0-75'
75-250'
2�0-500'
50a-100fl'
Ha:dcover Va;iance Required: Yes No Da�e of Council Approvz!:
R.E�L�S (in house):
BUILDING REVIE�y CHECK LIST
�C� ' CONSTRUCTTON TYPE: --
Sq Foo[age $ Per Sq Ftg
Basement X _
lst Floor z _ �
2nd Floor x =
Garaoe x _
z =
TOTAL
Estimated Construction Value: $_ �O�, o o� °—"
Inspections Required: tiVork Requiring Separate Permits:
S ite Plumbing Fire
Hardcover Removal Mechanical Water Connection
�_Footing ` Sepcic Sewer Connec[ion
Framing Fireplace Lawn Irrigation
Insulation (Masoory) Other
Wall Board (Mfg.) Well (State Perm.it)
�F�� Grading/Filling Electrical (State Permit)
Other
REMA]2K1S (]N�iOUSE): " -- --
----------------------------------------------------------------------------------------------------
REVIE�V BY OTHERS: DATE:
Access: Existiag New
Access Approval: Date By:
------------------------------------------------------------------------------------------------------------------
REI�TARKS (,TO RE NOTED Q�I PEF.��IIT;:
8
��� IDATF�i TI � o
CITY OF ORONO CALLED IN • J � M�/
� �� ,
INSPECTION N TICE SCHEDULED -1�--�4 -���"I
PERMIT NO. � ` COMPLETED�
ADDRESS E���� C.-' /�t1 X '
OWNER CONTR. �`��1�h��.n �oo I
TELEPHONE NO. U u-I`l.� �,P l� �lC /�J�' ��J
� DESCRIPTION 1 n ��7.( ./lt � �d I
l� FOOTING 11 ME ANICAL RI 18 EXCAV/GRADING/FILLING
� G 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 OS FINAI. 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING F�NAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
�
j Q
O
�
�
O
�
W
�
Q
�
2
W
�
w
�
�
a
W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CI�RRECT WORK,CA�L FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. �95Z� 249-46QQ
OwnerlContra s e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice