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Home My WebLink About2000-P02997 - addn/remodel/repair • PERMIT C I TY O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 P02997 Crystal Bay, Minnesota 55323 PeCCTIIt Typ@: Addition/Remodel/Repair (612) 249-4600 Date Issued: ioi13i2o SITE ADDRESS: 125 Golden view Dr LONG LAKE, MN 55356 PID: 33-118-23-43-0013 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Buildin Census Code 434 Permit Class: g Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Porch DETAILS: Approved per resolution#: Separate permits required: Eiecvicai(sia�e j NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 23�•25 Valuation: $ 13,900.00 Plan Review Fee: $ 154.18 State Surcharge Fee: $ 6.95 TOTAL FEE: $ 398.38 APPLICANT: ASHLANN BUILDERS OWNER: JAMES C&CARRIE D HEYERDAHL PO BOX 42l 114 125 GOLDEN VIEW DR PLYMOUTH,MN 55369 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. i�, � /// J! � �' � - �( /'�--c' (.y?'1!<i'� ' � ; / �'17_ A PL CAN ERMI EE NATURE ISSLTED BY SIGNATURE Copies: City,Applicant,Assessor,Finance Page 1 , Total Fee: $ �''`��' '�- Date Received: �� =� -' �' EnteY d By: �- _ Permit#: /a�>�z�� 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 OR C TRAC R JOB SITE ADDRESS: �� v�cl�n 1��r�L' �,z,��* ZIP: 5535 lo 4 NAME OF OWNER: p ` / �� _ � PHONE: (home) (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: �Shlzr�n 1�;,,�`lcicn,� PHONE: S3/ oj 2.� 0 CONTACT PERSON: ,�v�e � ��h� MOBILE/PAGER: cpA.� a�a��i 9.3 MAILIl�TG ADDRE : p v� �o x y ai�i N CITY: r��y m u��c, ZIP: 5'S��U Z STATE LICENS # a. p Q �, z� � v � O..�n�.�= �e�i'v1u � r�u��cle�� c.�,�.�,, ,��al�I i�i:�, ARCHITECT/ENGINEER: �� PHONE: MAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION# TYPE OF WORK: New Addition � Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �� x �`� ,�(�� pd�^r6. STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $�, y�� 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 work is not to start without a permit; and that the work will be in accordance with the approved plan. � . APPLICANT'S SIGNATURE. .� � rl DATE: NOTE! Parade of Homes events require separate permit approval by Police Deparlment and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 � � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Y 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. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision, or statewide sysrem;(b)whether he may refuse or is legally required to supply the requested data; (c)any known consequence arising from his supplying or refusing ro supply private or confidential data;and(d)the identiry 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, ro a law enforcement officer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax or nrooertv 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 informed whether he is the subject of stored data on individuals,and whether it is dassified as public,private or confidential. Upon his further request,an individual who is the 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 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 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,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,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. Proeedure 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 the disagreement. The responsible authority shall within 30 days either. (a)correct the data found ro 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 that he believes the data to be correcL 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 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 Middle Last Address C�h, State Zip Phone I understand my rights as stated above. Signature 6 � , - CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY . ADURESS OR LEGAL: 125 C��x-b�1v v t Gw +�R�`r2 PID: DESCRIPTION OF WORK: Sc�.n._e�.r o✓t..c.�.� -t �ec.�� -------------------------------------------------- -------------------------------------------------------------------- ZONI1�iG REVIEW BY: DATE APPROVED: �-Z� -a� BUILDING REVIEW BY: DATE APPROVED: � -2_.:c -�� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes f No PLAN REVIEW Yes v No SEWER CONNECTION STATE SURCHARGE Yes �� No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------------------------------------------------------------------------------ ZONING CHECK LIST Zoning District: �v� c��,v� Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes � No Date of Survey: c�e� Proposed Setbacks: Front (Lake): ►2 b` +' Right Side: 'r!`�(� �' Rear (Street): �� Left Side: I u'2-. � Adjacent Structures: r4Ttv�+�t-4-`.`vJ Wetland: N �� Building Height: Def. Hgt. t9��- Peak Hgt. — Lot Coverage: N � /� Grading: Staff Approval Date: -- By: Council Approval Date: Septic: Staff Approval Date: — By: Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): � . � - 4 . � BUILDING REVIEW CHECK LIST � UBC: IrZ • � CONSTRUCTION TYPE: V/J Sq Footage $ Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ I 3, 9 vd °= Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection _�Footing Septic Sewer Connection o( Framing Fireplace Lawn Irrigation �Insulation (Masonry) Other �_Wall Board (Mfg.) Well (State Permit) .L Final Grading/Filling oC Electrical (State Permit) Other REMARKS(IN HOUSE): ------------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ------------------------------------------------------------------------------------------------------------------------ REMARKS (TO BE NOTED ON PERMIT): 8 DATE / T�2��,. M CITY OF ORONO CALLED IN ---�`�� INSPECTION NOTIC ' C� SCHEDULED —�� ' ' PERMIT NO. �� COMPLETED � � ADDRESS -� � OWNER ,� C'{'�� / CONTR. G7 �G'r,�'�/J ��. TELEPHONE NO. �-- �� n �� DESCRIPTION �� -�� ''�� lV 01 FOOTING 11 MECHANICAL RI J 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANOS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 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 Q = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a (��1� � � J O a � O k W � Q � Z W � W � j d W �1NORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL RETURN Cl STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-460� OwnerlContract n site: Inspector. ��?� ��•t/1� Whiie Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTIONN OT.I,C�G .r J= SCHEDULED l � � �� y PERMIT NaE`� `'` � l / COMPLETED L ADDRESS � �-� �� U/ �� '� / �' �-�' .G�f , OWNER CONTR.�� h✓� ��-S TELEPHONE NO. �'�� j � �: - /�o O / /�/ :, 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS h 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL �.I Q OWNER/CONTRACTOR TO MEET YOU:_YES_NO Z � COMMENTS: z w a � � / S o , a o � C��lj. W � Q � Z �u � W � j d �ORKSATISFACTORY:PROCEED I PROJECTCOMPLETE W � [; CORRECT WORK 8 PROCEED �-1 ISSUE CERTIFICATE OF OCCUPANCY W � Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 BEFORECOVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. . pHOTO TAKEN INSPECTOR WILL REfURN f7 STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED C; INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. 249-46�� OwnerlContrac on si Inspector. ��C��- White Copyllnspector's File Canary CopylSite Notice DATE TIME // CITY OF ORONO CALLED IN - � �� v �7 �� INSPECTION NOT E SCHEDULED �C —��`J _fN►'► PERMIT NO. � � COMPLETED —�`�� ADDRESS f�.� ��ic l�:ic=n ✓�� !�� . OWNER CONTR. A`. �- f<}�-�� i�� TELEPHONE NO. ->�l " C-'v37�� DESCRIPTION �" � �� ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION • OS FINAL 14 SEWER HOOK-UP 06 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 � C 1�1QMENTS: � ' ��' ;' /� . -� .� C / C Gt. " Ll Cc � J O >. � O � W � Q � Z W � W � � d W� �ORK SATISFACTORY:PROCEED �OJECT COMPLETE i — W ❑ CORRECT WORK 8 PROCEED ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN INSPECTOR WILL RETURN C'STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-4600 Owner/Contractor on site: Inspector. //,�/l.s� ��--�1 S White Copyllnspector's File Canary CopylSite Notice i �;, ,_ - �___ r-- , � ' , . � i�� .. . �. �� 1 _Z" f� "-r> �,_, � � N : � lJ� � . � C� -� � � I ,, � v� ,/ N U1 ,r, � �'� Vi O� '"' '� A�� \ � W ,. , , ��r `� -. . � � ' �', �� '� �� i� �r � � ' , /�f ' � ITl I / • � W i �, f �=l=o�;� l. ., ' 4 �.. �9 �_ . �:� . ��.. I , .�, h^ � '. '��'� � "�� ° � -� ,, � � rx ' %. �� x 1033 lp r l 035. 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