HomeMy WebLinkAbout2007-P10928 - remodel master bath/bedroom - new bay window - PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p1o928
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
5/1/2007 �
SITE ADDRESS: 155 Golden View Dr Unit#
Long Lake,MN 55356
PID: 33-118-23-43-0014
DESCRIPTION: UBC Occupancy R3
� Construction Type VN
Proposed Use: Residential � Census Code 434
Permit Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
remodel master bath and bedroom area-new bay window
FEE SUMMARY: Pernut Fee: $ 593.25 Valuation: $ 45,000.00
Plan Review Fee: $ 385.61
State Surcharge Fee: $ 22.50
TOTAL FEE: $ 1,001.36
APPLICANT: Lemmerman Const. Inc. OWNER: Douglas Smith
9037 Cty.Rd 17 SE 155 Golden View Dr
Delano,MN 55328 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISS(ON TO MAKE THE REAL]MPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
APPLICANT EE SIGNATURE UED BY SIGNATURE
��
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
• •
. 1 (�i�l �
n
Total Fee: $ � Date Received: 7—�—b 7
Entered By: ��T/ �� � Permit#: �j /D g�
CITY OF ORONO - BUILDING PERMIT APPLICATION
.. '
� All information mast be submitted in full before plan review wilt be started.
� (plense print all informatio�z)
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THE APPLICANT IS: (circle one) OWNER O CONTRA TC OR '
JOB SITE ADDRESS: 155 C��.�N �;��,; �r�►�� Z1P: S'a 3 5�
�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ No /f j�es, a specia!event permit rs r•eqi�ir•ed ivit/z Police Depai•tment and City Coirncil nppr•oval
' 60 days prror to the event. Shuttle bi�s service will be reyuired unless applicant dernonsdrates
szrfficient on-site parking is available. h'on-permitted events tivill not be allowed.
NAME OF OWNER: �nn �o Ic�Sh�►°�-Pn � pc�vc� S�'n��-I� PHONE: (home)
(work)
MAILINGADllRESS: '�5 (;o�c�eh �ei�,.� �tZ CITY: ���o ZIP: 553 S
CONTRACTOR: �E N'�MC i2�ktv ��t��'t". �(% PHONE: 74�3���-2�1 -23�U
CONTACT PERSON: 'tLfJ� MOBILE/PAGER: �,� v �
MAILING ADDRESS: �1G3'T C,;:. (��� i� �L CITY: `DE,i��O ZIP: �2�
STATE LICENSE: # � .��-�� EXPIRATION DATE:��� 2.cr�',
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: ' CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WO1ZK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) �
Any earth movement may require MCWD review and permits !
PROPOSED WORK(clescrihe in detuin: '�,�MCt)E� ��7L1� �-TH � P��n 4�A
I�`r.�ti ��{ i,i;iN�cl�v �x iST�t��. �'xTf_�aCi� La;:a-����
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
�
ESTIMATED CONSTRUCTION VALUATION(excluding land): � �5�L�Z� J
I hereby apply for a building permit and I acknowledge that the information above is complete and acc�u�ate;
that the�vork will be in conformance���ith the ordinances and codes of the City and���ith the State Buildin�
Code;tllat I understand this is not a permit and work is not to start witho�it a permit.and that the work will be
in accordance with the approved plan.
, �
APPLICANT'S SIGNATURE: DATE: �!.}��v��
�%
31
Sec.13.0�1 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The ri�hu oti individual on whom the data is stored or to be stored shall be as set forth in this section.
5ubd.2. InFormation required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be
infonned 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 shail
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 mav nlace the notice required under this subdivision in the individual income tax or properri tax refund
instructions instead of on those forms.
Subd.3. Access to data by individuaL Upon requestto a responsible authority,an individual shall be infonned whether he is the subject of
stored data on individuals,and�vhether it is cfassified as public,private or contidential. Upon his further request,an individua!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 show�n 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 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 shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within Yive days of
che date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [f he cannot comply with the request
within that time,he sltall so inform the individual,and may have an additional tive days within which to comply with die request,excluding Saturdays,
Sundays and legal I�olidays.
S ubd.4. Procedure�ahen data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
conceming himself. To exercise diis right,an individual shal I notifj in writing the responsible authority describing the nature of the disagreement. The
responsible authori[y shall within 30 days eithec (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplere data,includin�recipients named by the individual;or(b)notify the individuaf 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�lisclosed data.
The determination of the responsible authonty 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 infornl 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:
I. 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 N(iddle LAst
Address
Cit�' Statc 7.ip Phonc
1 understand my rights as sta d ove.
� ��
Signatur
Reset Form ��
, �HEC�K OFF i�IST FOR ISSUANCE O�' PERIVIITS
FOR OFFICE USE ONLY
A.T�DRE�S OR LEGAL: I SS (o�.oe.rvv�c w n2�v e
PID:
DESCRIPTZON OF WORK: �Ino�sr��z r3+�o a 3A-�rrt,�e►� L—�d��-
ZO�IG REVZE�V BY: ----------------- DATE APPROVED: iv��
BUILDII�IG REV'IT'tiV BY: DA7�`E APPROVED: y�z'7-o�
FEES TO BE CHARGED:� Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIE`V � Yes ✓ No SEtiVER COVNECTION
STATE SURCHARGE Yes � No `VATERCONNECTION
INVESTIGATION FEE Yes No _,�/ PARK FEE
SAC Yes No ✓ S�'I'EINSPECTTON
Number of SAC�Units OTHER (specify)
ZON'1�lG CT�E.CK LTST Zoning Discric�: /vo CH.�►n/M �.
Fi.re Department: Post Office: School District: �
I.ot Area; Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Secbacks':
Fron[ (Lake): Ri�t Si e:
Reae (Sirez[}: Lef:Si P:
Adjaceat Structures: 1�Vetland:
Buil�lin� Hei�t: Def, Hgt, Pe ' Hgt.
Lot Coverage:
Grading: Scaff Approval Date; By: Council Approval Da[e: '
Szpcic: Staff Approval Date: "1 '� �"�� �Y� �' "
ZoainQ File: 7 Resolutioa: n Resolution Date:
Shoreland District:
Avg. Setback: Bluff Secback: I.ot Coverage:
E�istin� Proposed
a
Hzrdcover: 0-75'
7�-250'
2�0-SOfl'
�caiaco�
i-i�:dco�er `.'�i�ce P.��.:i;��: �'�es L:o Da:e e` Cc:�a��� APP=ova_':
F.E�L=�RIzS (in howe):
BUILDING REVIEti�' CHECK LIST
UBC: R•3 CONSTRUCTIONTYPE: �!�
Sq Footage $ Per Sq Ftg
Basemen[ z _
1st Floor z =
2nd Floor z _ .
Garaoe X _
z —
TOTAL
Estimated Construction Value: $ <lSa000`�
Inspections Required: Work Requiring Separate Permits:
Site �c_Plumbing Fire
Hardcover Removal _�c Mechanical Water Connection
Footing ` Septic Sewer Coaaectioa
—�.Fr��° Fireplace Lawn Irrigation
�_Insuiatioa (Masoary) Other
�Vali Board (Mfg.) Well (Scate Perm.it)
_�F�� Grading/Fillin� _�Electrica( (State Permit)
Other
REI�ZARKS (IN HOUSE): " -- --
-----------------------------------------------------------------------------------------------------
REVIE�v BY OTHERS: DATE:
Access: Eusting New
Access Approval: Date gy;
-- -----------------------------
REI�TARKS ('I'O RE NQ'r'�'L� Qv P�F.� �� :
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DATE TIME
CITY OF ORONO CALLED IN ��s ��7
INSPECTION NOTICE p SCHEDULED �-� � //%��
PERMIT NO. � I V 9 aZ'4 COMPLETED
ADDRESS l,S� �5�-�-�E^� (�—�-�t' �,r/✓
OWNER .�i��� CONTR. v����Lt NY��y�
TELEPHONE NO. 7�3 � a�' `> — �3 � �
� DESCRIPTION ��?���-
lL 0 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING � 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING Rt 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 ORKSATISFACTORY:PROCEED (� PROJECTCOMPLETE
� ❑ CORRECT WORK&PROCEED ^ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �, PHOTOTAKEN
INSPECTOR W4LL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cal1 for the next in ection 24 hours in advance. (952� 249-4600
OwnerlContractoc.et�site.
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Inspector. �.�
White Copyllnspector's File Canary CopylSite Notice