HomeMy WebLinkAbout2004-P07586 - pool CI�"Y OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Po�ss6
Crystal Bay, Minnesota 55323 Permit Type: A��essory s�u��es
(952) 249-4600 Date Issued: 6/25/2004
SITE ADDRESS: 1005 Hunt Farm Rd
I.ong Lake,MN 55356
PID: 30-118-23-42-0006
DESCRIPTION:
Proposed Use: Residential
Pernut Class: Building Census Code 329
Pernut Type: Accessory Structures Pernut Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate pernuts required: Eiecuicai�siaiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 307.25 Vatuation• $ 19,000.00
Plan Review Fee: $ 199.68
State Surcharge Fee: $ 10.00
TOTAL FEE: $ 516.93
APPLICANT: Peterson Pools&Spas Inc. OWNER: Steve&Kathy Persian
13110 Excelsior Blvd 1005 Hunt Farm Rd
Minnetonka,MN 55343 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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NT ITEE SIGNATURE SUED BY SIGNATURE
Covies: 1-File(SiQnitures Required). 1-Apnlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
Total Fee: $ ��(�- � g� Date Received: ,�l'� 9l v�/
Entered By: �-�/� Permit#: �Qp '75 �„
�Y���' � �`"� ���`���`�
CITY OF OR(�NO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pri�it all informatio�z)
-------------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: /'��� ,�,��i��.� ��.� zTp: J�;���,
Will this be a arade o�_Homes, Remodelers Showcase Home or other Display Home?
❑ Yes o If yes, a special event permit is reqziired with Police Department and City
Council approva160 days prior to the event. Non permitted events will not
be allowed.
NAME OF O«'\'ER: ST���- •'��s_c,'�n/ PHONE• (home) y�Z -`�7G �-�c� �
(work)
NIAILING ADDRESS: �r�-� �= CITY: ZIP:
CONTR.ACTOR: ���� �,,.., �o��, �,.,5�rs:���� PHONE: � �z -2-z� -3;�f,.S
CONTACT PERSON: J «-� MO�ILE/PAGER:
1VIAILING ADDRESS: /3«� zK�z����- 8�v� CITY: � ��-.� ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure �
Addition Move
RemodeUAlteration Land Alteration
PROPOSED WORK(describe i�z detai�: _�,v5��y� ���,��, �i,,%� ,�'o
STORIES: ""��� SQ. FEET OF EACH FLOOR: _ 7 C�� X � G �
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ t �10 W�
I hereby apply for a building pemut and I aclrnowledge that the information above is complete and accurate; that the
work will be in conformance with the ardinances 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. �
�I�'� /
APPLICANT'S SIGNATURE: %J � %�s DATE: lv � G'�
A `i
Sec13.04 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. Information required to be given individual. An individual asked to supply private or confidentiai data concerning himself shall be
informed of: (a)the purpose aad intended use of the requested data within the collecting state agency,politicai 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 refusiag to supply
private or contidential data;and(d)the identity ot 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 i�vestigative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofCcer.
The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income tax or oroaertv tax refund
lnstructions 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 pubiic data on individuals shall be shown the data without any charge to him and,if he desires,shali be informed of the content and
mea�ing of that data. After an individual has been shown the private data artd 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 coilected or created. The
responsible suthority 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 shali comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of thc
date of the request,excluding Saturdays,Sundays and legal holidays,if immediate comptiance is not possible.If he cs►nnot comply with the request within
that time,he shati so inform the individual,and may have an additional flve days within whtch to comply with the request,exciuding Saturdays,Sundays
and Iegal holidays.
Subd.4. Procedurc 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 s6all notify in writing the responsible authorlty describing the nature of the dlsagreement.The
responsibie suthority shall withtn 30 days either: (a)correct the data found to be inaccuratc or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the[ndividual 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 dlsclosed data.
The determination of the responsible suthority 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 nsed 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.
��l�' /�i�� o����irSaN /'ov�1 �—SL'`tS f !'��
First Middle Last
13�� �zcc��1�� o.� �c �. v
Address
,,✓�T1Gs�f— i'���c/ S'�3 �3 G�2—z 2�--3.S�S—
City State Zip Phone
I understand my rights as stated abo .
T� e� �� �<<�-�� ���
Signature
� �
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: r o d 5 �1 u N T r=�R-w� �2�R.� �
PID:
DESCRIPTION OF WORK: o�I
ZOY�TG RE'VIEW BY: DATE APPROVED: 6 - 23-6y
BUII.DING REV�`V BY: ,�ir3 DAT'E APPROVED;
FEES TO BE CHARGED: Misc. Fees Calculated By:
PER11�iIT Yes ✓ No
PLAl�T REVIEW Yes �/ No SEVPER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECITON
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CHE.CK LIST Zoning District: .
Fire Department: Post Office: School District: �
Lot Area: Sq.ft. Acres � Width Depth
Survey Submitted: Yes�c _ No Date of Survey: o•� -���
Proposed Setbacks: �
Front(Lake): �oo� �' Right Side: `Zo�` �'
Rear(Street): �3S � t Left Side: �'yv� f'
Adjacent Structures: (b � Netland: N�►9�
Building Hei�ht: Def. Hgt. — Peak Hgt. —
Lot Coveraoe: �
Gradine: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Agproval Date: -- By:
Zoning File: # — Resolution: # Resolutioa Date:
Shoreland District: rN
Avg. Setback: Bluff Setback: LotCoverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variaace Required: Yes No Date of Council Approval:
REMAR��S (in house):
7
� �
BUILDING REVIEW CHECK LIST
�C� � CONSTRUCTION TYPE: '�
_ Sq Footage $Per Sq Ftg
Basement . . . x =
lst Floor x _
2nd Floor x =
Garage x = �
x =
TOTAL
Estimated Construction Value: $ ��, ��'o�
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
, � F���� � Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board � (Mfg.) Well (State Permit)
—�F�� Grading/Filling _fY'Electrical(State Permit)
Other
REI�ZARKS(IN HOUSE): .
-----_-------------------------____-------_____---__
REV�W BY OTI3ERS: DATE:
Access: Ezisting New .
Access Approval: Date gy;
-------------------------------------------------------------
REMA RKS (TO BE NOTED ON PER1vIIZ�:
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� ��Ora�vn5�� � � � �Date�
i � STR-001 � February 19�1
Steal Steo Inctali�ion�
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CITY OF ORONO ca��Eo iN
INSPECTION NO ICE scHEou�Eo ��,�q��— �
PERMIT NO. � COMPLETED
ADDRESS �' � � � /� •
OWNER CONTR. ��=��J(SY! �'C��S
TELEPHONE NO. �'�� - a�i LO�`��g��
� DESCRIPTION �OT//�VC�, �d D� —
ly� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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`� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNERICONTRACTOfi TO MEET YOU• YES_NO
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED !1 ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
i 1 STOP ORDER POSTED.CALL INSPECTOR
' I INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
Owner/Contracto n i :
Inspector. -
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