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Home My WebLink About2007-P11391 - addn/remodel/repair PERMIT C1TY,OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p11391 Crystal Bay, Minnesota 55323 Permlt Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 9/7/2007 SITE ADDRESS: 80 Hackberry Hill Unit# Long Lake,MN 55356 PID: 33-118-23-44-0022 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Addition/Remodel/Re air Permit Sub-type(s): Addn/Remodel/Repair Permit Type: p DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Replace windows-enlarge openings-siding FEE SUMMARY: Pernut Fee: $ 83.25 valuation: $ 2,500.00 State Surcharge Fee: $ 1.25 Misc. Fee: $ 1.50 TOTAL FEE: $ $6.00 APPLICANT: Owner/Self OWNER: 7ames Mock � 80 Hackberry Hill 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. � ,. % - �� '� � _,%��-u-�- � ��_- �� . �-�F C �'�'1 C-�' �� / APPLICANT PERMITEE SIGNATURE [SSUED Y SIGNATURE �'(,,� 1 Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 . � 9 , Total Fee: $ ��•�� Date Received: g�3(-0"l Entered By: Permit#: A f 13g 1 CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (p[ease print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �O �/c^V`��N �� j( ZIP: ��3 � � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ yeS '�NO Ifyes, a special event permil is reguired with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be requirect unless applicant demonstrates su�cient on-site parking is available. Non permitted events will not be allowed NAME OF OWNER: � c�,vy�.c� �l� C-� PHONE: (home) `�S1Z�`/ 7�=`i �t 3 � (work) (�l 2� 3(�;' -?l j�J MAILING ADDRESS: 5�� 1��c rf-� 4��U CITY: p�a �� ZIP: CONTRACTOR: S� PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: __ CITY: ZIP: STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: 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 in deta��: '�'j,�� u}1�t��j5 — �.� � STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � �� '' G " 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: '' G'�j�`r"� DATE: � -' � I — �� 31 , Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. l. 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. lnformation required to be given individual. An individual asked to supply private or confidential dataconceming himselfshall be informed of. (a)the purpose and intended use of the requested data within the collecting state agency,pol itical 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[o 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 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 may place the notice required under this subdivision in the individual income tax or prooerty tax refund instructions instead of on 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 shal I 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 to him for six months thereafter unless a dispute or action pursuant[o 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 s}iall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the reques[,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. 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 au[hority 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[he 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 maybecome 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 understan rights as stated above. � ��!/G'L � Signature Reset Form 32 BUILDING REVIEW CHECK LIST UBC: �Z'� CONSTRUCTIONTYPE: V� Sg Footage $Per Sg Ftg Basement z = 1 st Floor x = 2nd Floor x = Garage x = x = TOTAL Q.a Estimated Construction Value: $ 2,50� —r Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hai•dcover Removal Mechanical YY"ater Connectiort Footing Septic Sewer Connection __�Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) YY'ell(State Permit) �Final Grading/Filling Electrical(State Permit) Other REMARKS(INHOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ONPERMIT): 34 CHECK OFF LIST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: c�(� (-�AC..��3 L(L�Z� (-�� PID: DESCRIPTION OF WORK: _�,,N n o w s -� s ��4�ni� ZONING REVIEW BY.• N�A w Y DATEAPPROVED:� ��Y____ BUILDING REVIEW BY.• DATEAPPROT�ED: `T-I-�� ---------------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes No f SEWER CONNECTION STATE SURCHARGE Yes � No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Numbe��of SAC Units OTHER (spec�) ZONING CHECK LIST Zoning District: /VU C f..��g ti� � �� -'_____________ Fire Department: Post O�ce: School District: Lot Ar�ea: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Right Sid � Rear(Street): Left Side: Adjacent Str-uctures: W tland: Building Height: Def Hgt. Pe Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Appi-oval Date: Septic: StaffApproval Date: gy; Zoning File: # Resolution: # esolution Date: Shoreland District: CWD Permit: Avg. Setback: BluffSetback: LotCoverage: Existing Proposed Hardcover: 0-75' 75-2.i�' 2�0-.i 00' 500-1000' Har�dcover Yariance Required: 3'es No Date of Council Approval: REMARKS(in house): 33 � DAT TIME V CITY OF ORONO C"� GALLED IN � INSPECTION NOTICE SCHEDULED 7 � ---�� PERMIT NO. }� I I 3q� COMPLETED ADDRESS_�� C �( ��1L�1� � I � ( OWNER �-�'��S ��Y-- CONTR. TELEPHONE NO. �� ' -y ��j �� J� r 1 r � DESCRIPTION �� -'L �-'l-�'� �� l� 01 FOOTING 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 WAIL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS 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 RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:�ES_NO � COMMENTS: � W a � J O � � O � W � Q ti Z W � W � � d W WORK SATISFACTORY:PROCEED �I PROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W � C CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION flEQUIRED.CA�LTO ARRANGE ACCESS. Call for the ne t inspection 24 hours in advance. (952� 249-4600 OwnerlContra te: Inspector. White Copyllnspector's File Canary CopylSite Notice