HomeMy WebLinkAbout2004-P07817 - shed CITY�F ORON PERMIT
O Permit Number:
275b Kelley Parkway - PO Box 66 Po�ai�
Crystal Bay, Minnesota 55323 Permit Type: A��essory st�-u��res
(952) 249-4600 Date Issued: aii2i2ooa
SITE ADDRESS: 141 Hackberry Hill
I.ong Lake,MN 55356
PID: 33-118-23-44-0010
DESCRIPTION: UBC Occupancy U1
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 328
Permit Type: Accessory Structures Permit Sub-type(s): Shed
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
,.,__ ,�, _,__,
FEE SUMMARY: Pernut Fee: $ 66.20 Valuation: $ 1,810.00
Plan Review Fee: $ 43.00
State Surcharge Fee: $ 1.45
TOTAL FEE: $ 110.65
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APPLICANT: Owner/Self OWNER: Marilyn&Micheal Mulvanny
MN 141 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.
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APPLICANT PERMITEE SIGNAT RE [ SUED BY SIGNATURE
Copies: 1-File(SiQnitures Requirecl). 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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� Total Fee: $ Date Received: /�D f���� �
Entered By: Permit#: _�9 /��t/
CI�'Y OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pri�it all i�iformatioii)
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THE APPLICANT IS: (circle o�ie) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ��/ �I�CIC�.�Y'y y ���1. LO��c� �� �1r7 ZIP: �.7..�.��
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes � No If yes, cz special evertt per»iit is requir-ed with Police Depai�tment ar�d City
Council approval 60 days pf-ior to the event. Non per�yiitted everzts will not
be allowed.
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NAME OF OWNER: /"/iL'I7 �-E'� � �L'Q61�L'r� �uhr�r���HONE: (home)
(work) '�L.�.� �T>� 6�1��.�
MAILING ADDRESS: ��� /��,f2�,�h� l�l% CITY: ��a r �� ZIP: �-
,53���
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: 7IP:
NAME: REGISTRATION #
TYPE OF WORK: New Accessory Structure �
Addition Move
Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �/''� ��(-�%f' ��U/c��� ��17L��
STORIES: I SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
F�
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ,S
1
I hereby apply for a building pernut and I aclmowledge 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: �L�L�„�I � DATE: � � �I" ��� �
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.i. Type of data. The rights of individual on rvhom the data is stored or to be stored shall be as set forth in[his 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�vithin 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 shall
not apply when an individual is asked to supply imestigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav �lace the notice required under this subdivision in the individual income tax or aroaertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. L'pon 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 intormed of the content and
meaning of that data. After an individual has been shorvn the private data and informed of its meaning,the data need not be disclosed to him for si�
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
responsibfe 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 ofthc
datc o[thc request,exduding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with thc request within
that time,he shall so inform the individual,and may have an additional five days within which to comply fvith 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 o(public or private data
concerning himself. To exercise this right,an individual shall noti[y in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days eithcr: (a)correct the data(ound to be inaccurate or incomplete and attempt to noti(y 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:
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 licensc.
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.
L ��',,, ''
First Middle Last
Address
City State Zip Phone
I understand my rights as stated above.
3'� '�' �1--
��.-.< <�-�..� � � -, „ ,
Signature
• CHECK OFF LIST FOR ISSUANCE OF PEIt11�1ITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: l y J /lA cx�c_/t/Lt, �-��u
PID:
DESCRIPTION OF`�'ORK: S-��6� sr�c�
ZO�iG REY�`V BY: DATE APPROVED: 8• /Z -o y
BUILDING REVIE`V SY: DATE A.PPROVED; � -r Z-�Y
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERII�IT Yes � No
PLA.��t REVIEW Yes v No SEWER CO�]NECTION
STATE SURCHARGE Yes ,/ No WATERCOiVNECI'ION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZO�II�1G CI-iE.CK LIST Zoning District:
Fire Department: Post Office: School District:
�Pf.�- ���N C.a .
Lot Area: Sq.fr. 21�'061 Acres •5�2 Widch �o � Dep[h 2� 7
Survey Submitted: Yes_� No D� Date of Survey:
USin�Jt s��We-�j ��aw�n or'
Progosed Setbacks: �
Fron[(L-al�e): ��l 1 Right Side: C�
Rear (Sz€�t): I v ` Left Side: 1�
Adjaceat Structures: Z�` f `Vetland: �/A'
Building Hei;ht: Def. Hgt. �• k- Peak Hgt. —
Lot Coveraoe: d 'I�
Grading: Staff Approval Dace: — By: Council Approval Date:
Sepcic: Staff Approval Date: — By:
Zoaing File: # — Resolution: # Resolutioa Date:
Shoreland District: �`�
Avg. Setback: Bluff Setback: L.ot Coverage:
Ezisting Proposed
Hazdcover: 0-75'
75-250'
250-SQO'
SQO-1Q00'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house)•
7
BUII,DING REVIEW CHECK LIST
�C� 11 — � CONSTRUCTION TYPE: �//J
_ Sq Footaje $Per Sq Ftg
Basement x _
lst Floor z =
2nd Floor z =
Garage x =
z —
TOTAL
Estimated Construction Value: $ I��� p ��
Inspections Required: `Vork Requiring Separate Permits:
S ite Plumb ing Fire
Hardcover Removal Mechanical Water Connection
Footing � Sep[ic Sewer Connection
Framino Fireplace Lawn Irrigation
lasulation (Masonry) Other
Wall Boazd (Mfg.) Well (State Permit)
—2�.F�� Grading/Filling Electrical (State Permit)
Other
RENIARKS(Pi i HOUSE): .
-------------------------------
REV�W BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gy;
---------------------------
RENIA.RKS (TO BE NOTED ON PERivII'1�:
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STANt'?Af3D BAR�! EXTRI�HIGH BAt?N OR
° Base price includes: rt S@� (�Ol1�J�S SlZE (4'S/Dc WFtLL) R-FRAME (7`SlDEWALL)
c4aors, 1 wincievv and 2 air ven�s g X g $1,�75 pp i� �,�;
� 4 x 4 pressur� treafe� skids $ x 12 ��,384.�0 $8,�;�L�.�!�
• 2 x � and 2 x � press�are trea�ed ;� x 12 ��,�20.�J0 $�,�%�.�t�
fiaar joists
� �!! frarne wflrk 16" on cen�er �0 x �6��_ _�1,8�O:��E3--`-"' � � �2,095.GQ
a 5/8" thick piyv�r�od fPoori�g �2 x 12 $�,8��.a0 I $2,OJ5.a0
� 2 x 4 sit�ds �i 2 x 16 $2,i 95,0� $2,�8�J.OQ
• 15/32 Durater�p fiir ex�terio� s��i�� �� x 2� $2,685.OQ $2,g1 fl.0(�
� 7l16 OSB roog s3�e��9�a �2 ;; 2� �3,055.OG �3,340.(�0
� 15 year quality painf �choice o�'co(or) �4 X 2� � /R i�FRRhtE ONLY �3,6�O.OG
& 25 year CT snin�fes {choice c�s cclo�;; �4 x 28 �J /,� �!FRA��E ONLY $�,ao�.oa
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WEr���;v�rs 18" x 27" . . . . . . . . . . . . $34.C�� Custamer c�;� choose loc�rio�6 a# doo� ar�d wind�w,
��" � 27" . . . . . . . . . . . . $3�.(�C
, S��utter� . . . $;�.�� �hese p��ia�le buii�li�,�� are compieial}! built, si�ingled
. . . . . . . . . . . . . . . and painted at th� fac�o���. i hen �eiivered to yrour
Flawe� Boxes . . . . . . . . . . . . . . . . . $2�J.Ofl
Doors SinglE . . . . . . . . . . . . . . ��;�.C��, �rcpared leve': sitv.
�o�b�e . . . . . . . . . . . . . ��5.�3� C:�s�c�mer is res�o�sr�ie to buy and supp�Y �locking
Lofts �' wid� at. . . . . . . . . . . . $�.at�/� mater�a?s such as z" anc� �" ca� �locks (patio bfocks).
Shefves 2' wi�� �f. . . . , . . . . . . .`��- ���/� ��-uck, �rniier a�� buildir� re�:,��Y� room to mar�e+.�ver to
F600� � �/4" �9��t��ra . . . ��'��°�oo�ba�e p;ice �[a�� th� �uil�in� at sit� s�lec���. Please ��onsider� .
�loor Joisr� ��" or� cer�����. . . . :�d��°%�af b�se p�ice �#�;�gs s�ac� as s�rub��nr, trees, poErae� i;nes, septic
f�s�alate�r �����e �ocr. . . . . . . . . . �5��.��� i�;��:s, �tc. �
<Si:���I� s�;vi�e �`�c��:r�°�=���,;
I,/��r�� /,�`���.�.,�' -,�' � f' J,�y ; ,l r`�r,� ��,�;� , Page 1 of 2
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, - ��.�a�u�� ����
, , Hennepin County, MN
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READ IMPORTANT DISCLAI�IEK llVl�URNIATION BELOW'
Property ID Approximate Approximate
..-,. - _.,. , r� .� _ :.i::� . �%�t.,-�. ..;_i :y�_,__,.
33-118-23-44-0010 638 ft. 21,867 sq.ft.= 0.502
acres
Property Address Market Value TotaZ Tax (2004)
141 HACKSLRRY HILL $ 201,000 $ 1,638.88
ORONO, 1�1 55356
Clicl: on Property Information Button belt�«� to ��ie��� n�ain
tat inforr " selected
_ _ ----- ---- _.___-- ,
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'i��o�ua���a�n�ioiou ����a�s��ia� .-�..��.u,,.. , s��w-
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The data contained on this page is derived from a compilation of records and maps and may contain
discrepancies that can only be disclosed by an accurate survey performed by a licensed land surveyor. The
perimeter and area (square footage and acres) are approximates and may contain discrepancies. The
information on this page should be used for reference purposes only. Hennepin County does not guarantee the
accuracy of material herein contained and is not responsible for any misuse or misrepresentation of this
information or its derivatives.
Please report any map discrepancies to Bob Moulder(Hennepin County Survey Division) at (612) 348-2618 or
via e-mail at Bob.Moulder(c�co.hennepin.mn.us
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file://C:�DOCi1NIE-1\u 18pu05�L,OCALS�1\Temp�D25ZZEX l.htm 8/4/2004