HomeMy WebLinkAbout2008-P12082 - pool � � PERMIT
� `CITY OF ORONO
Permit Number:
; 2750 Kelley Parkway- PO Box 66 P12082
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952) 249-4600 Date Issued:
5/28/2008
SITE ADDRESS: 160 Golden View Dr Unit#
Long Lake,MN 55356
PID: 33-118-23-43-0022
DESCRIPTION: UBC Occupancy U1
Construction Type VN
Proposcd Usc: Residential Census Code 329
Permit Class: Building
Permit Type: Accessory Structures Permit Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate permits required: Mechanical Electrical(state)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 295.00 valuation: $ 17,000.00
Plan Review Fee: $ 191.75
State Surcharge Fee: $ 8.50
TOTAL FEE: $ 495.25
APPLICANT: 7RS Pools OWNER: Kurt&Carol Schmid
1105 Crofoot Ave.NW 160 Golden View Dr
Buffalo,MN 55313 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPEC[FIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
, .__
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� P� , ITEE S N URE I SUED BY SIGNATURE
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Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,([f Septic, 1-Septic) Page l
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521 , 0
Total Fee: $ g�j, 2� DateReceived: S�G''O�
Entered By: ,(��$ Permit#: �Q/2b 9 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 CONTRACTOR
JOB SITE ADDRESS: : C�O �G� ��ti U/�w �4' ZIP: �sS S�s�'
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �10 If yes, a special event permit is reguired with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non permitted evenls will not be allowed
NAME OF OWNER: /� (,t-r f s��' � r�, ��c�i' PHONE: (home) �.� o� � �� dB��
(work)
MAILING ADDRESS: S�J/y, � CITY: c� �j c,�1 " ZIP:
CONTRACTOR: �� $� ����,j PHONE: 76� -G�,��s�:r� 3
CONTACT PERSON: .S��,� c, f(,q�,(n� ,i, MOBILE/PAGER: C��� (�f� S ;,�`�3
MAILING ADDRESS: //o$-'' r�C {�of ,�J c� �v� CITY: ��c�,.L-1�. ZIP:��S `�i 3
STATE LICENSE: # /v �� EXPIRATION DATE:
ARCHITECT/ENGINEER: �� rrt� ,�F .�/,,-v�I PHONE:
MAILING ADDRESS: �, t �,,,-��,�, � �,,,� CITY: ( ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement rnay require MCWD review and permits! .
PRQPOSED WORK(describe in detai�: J'7� I ni �v e�� !���v� ( l�.�c-a
i,?iJ � i� y� — �i�L'� •{ 2 .4 ,��U r v�C
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ / �, U<%u
r
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: �_, ��'�------ DATE: � /�� / D �
3t
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. Information required to be given individual. An individual asked to supply private or confidential data concerning himselfshall be
informed of: (a)the purpose and intended use ofthe 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 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,to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or prooerty tax refund
instructions mstead ofon those 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 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 ofthe 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 section is pending or additionaf 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 ofthe request,excluding Saturdays,Sundays and legal holidays,ifimmediate compliance is not possible. Ifhe cannotcomply 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
conceming 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 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 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:
l. 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
City State Zip Phone
I understand my rights as stated above.
Signature �—�—���_
Reset Porm 32
B UILDING REVIEW CHEC%LIST
UBC: �J—\ CONSTRUCT70N TYPE: �//�
Sg Footage �'Per Sq Ftg
Basement x =
Ist Floor x =
�nd F7oor x =
Garage x =
x =
TOTAL -
Estimated Construction Value: $ / 7,c9c�d —�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal _�Mechanical Water Connection
_�Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
YY'all Board (Mfg.) Well(State Permit)
_�Final Grading/Filling L Electrical(State Permit)
Other
REIKARKS(I1V HOUSE):
REVIEW BY OTHERS: DATE: .
Access: Existing New
' Access,4pproval: Date By:
REMARIiS(TO BE NOTED ON PERMIT):
34
CHECK OFF LIS7'FOR ISSUANCE OF PERMITS
FO�OFFICE USE ONLY
ADDRESS OR LEGAL: _ � L-� (r p 1 �4�;J � ;� �
PID:
DESCRIPTIDNOF WORK
ZONING REVIEW BY.• � DATEAPPROT�ED; � ZZ ��>
BUILDINGREi�IEWBY.• DATEAPPROi�ED: s -2? _,e�
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 SITEWSPECTION
Number of SAC Units OTHER (spec�)
ZONING CHECK LIST Zoning District: ' - �
Fire Department: Post O ce:
� School District:
Lot Area: Sq.ft. • Acres � K�idth
Depth
Survey Submitted.• Yes_� No Date of Survey: �
Proposed Setbacks: ;�c,,���1
Front(`�-uke): ��'1��C� I'(G%S��Side:
Rear(�trae��.• __� Z' LeftSide: �
Adjacent Structures: �l.� r Wetland: �G'�
BuildingHeight: Def. Hgt. C7� peQkH� G1 �
Lot Coverage.•
Grading: Staff'Approval Date: By: Council Approval Date:
Septic: StafJApproval Date: � j`� � gy. ��
Zoning File; # Resolution: # Resolution Date:
Shoreland District: ��(' MCWD Permit:
Avg. Setback: BZuffSetback:
Lot Coverage:
Existing Pro osed
Hardcover: 0-?5' p
75-250'
250-500'
500-1000'
Hardcover I�ariance Required: Yes No
Date of Council.9pproval:
REAIARKS(in house):
33
� 3 li�' C�'v ���� " �AT� TIME "
CITY OF ORONO CALLED IN '� 2-O�
INSPECTION N ICE SCHEDULED (A-Z-v � f�./I/( •
PERMIT N0. �� �0�� COMPLETED
ADDRESS ��r U �flYe_� �/�u �r'/ 1/�-
OWNER_ CONTR.
TELEPHONE NO. � ' —��-S�-3�-3
� _ �ov L.
� DESCRIPTION �v 0 �
� �60TING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PIUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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❑ ORKSATISFACTORY:PROCEED f� PROJECTCOMPLETE
� ❑ ORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
�CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '-� CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContractor on site:
Inspector. � ��s
White Copyllnspector's File Canary CopylSite Notice
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