The URL can be used to link to this page

Home My WebLink About2004-P08001 - add/remodel/repair � � PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 Posooi Crystal Bay, Minnesota 55323 P@fCillt Typ2: Addirion/ItemodeURepair (952) 249-4600 Date Issued: 10/4/2004 SITE ADDRESS: 3680 Jacobs Mill Rd I.ong Lake,MN 55356 P I D: 3 2-118-23-24-0009 DESCRIPTION: UBC Occupancy R3 ConsUucrion Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Porch-Residenrial DETAILS: Approved per resolution#: Separate pernuts required: �i�m�i(siaie� NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 181.25 Valuation• $ 10,000.00 Plan Review Fee: $ 117.78 State Surcharge Fee: $ 5.50 TOTAL FEE: $ 304.53 APPLICANT: Lecy Construcrion OWNER: Timothy&Karen Pratt 15012 Hwy.7 3680 Jacobs Mill Rd Minnetonka,MN 55345 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. P T PERMITEE IGN I SUED BY SIGNATURE 1��. � Covies: 1-File(SiQnitures Required), 1-Acrolicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1 • A • .. .'!: � Total Fee: $_ _;�j C�� c' � Date Received: =Z�- 0 Entered By: ''r�� Pemiit�l: - �U�; ��1�j, Y) t� ' � / �1 , '; l� . CITY OF ORON�- BUII,DING �ERNIIT APPLICATION All information must be submitted in full before plan review will be started. , (please,print all infqrmation) , . TF� APPLICANT IS: (circle'one) OWNER OR C TR.AC"TOR ^ �� --- ___ JOB SITE ADDRESS: _ ��tSU .T�.�>�, //�?/l /7,,,f ZIP: �5�_s� ' NAME OF OWNER: �i,„� .�-��,� ��-�- ' PHONE: (home %>>�- )__ � y�s- Izz�s (work) G � z -�� r--- s2�� MAILINGADDRESS: ��f�-r-�,�,<, ivr,/ll�l CITY: _ CJ��,,.�, ZIP: �� CONTRACTOR: J p�., �. � „�,�,r�.0 � PHONE: �sZ-9yy 5y�y CONTACT PERSON: .9,,,d,, --c�I�„��.,�J MOBILE/PAGER: �;z- �� -Z z. z MAILING A.DDRESS: . . CI'TY: ��,�..v�,--�.� ZIP: s�3.f�- STATE LICENSE: #� ARCHITECT/ENGINEER: �C � PHONE: MA.ILING ADDRESS: CITY: ZIP: NAME: � REGISTRATIOIV�{ TYPE OF WORK: New Addition_� Accessory Structure . Move RemodeUAlteration Land Alteration PROPOSED WORK(describe in detailj. �. ,�p�„� '��r� .,q�i,.��;,� STORIE.S: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DLT. ESTIMATED CONSTRUCTION VALUATION (excludin lan : $� Q � � �� i 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 [he State Building Code; that I��rstand this is not a pernut and w� is not to start without a pernut; and chat the work will be ' ccord ce wi the approv plan. A.PPLICANT'S SIGNATURE: DAT'E: � �� (`S`� ' NOTE! ,F'arade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 9 . � CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 3-64,d �-�w�5 vh,��—z- PID: DESCRIPTTON OF WORK: ZO�IG REVIE`V BY: ` �- DATE APPROVED: /o-r-o-`1 BUILDI�IG REVIE�Y BY: DAT'E APPROVED; i� -r -aY FEES TO BE CHARGED: Misc. Fees Calculated By: PER11�1IT Yes ✓� No PLAiv REVIEW Yes �/ No SEWER CO�]NECI'ION STATE SURCHARGE Yes v No WATERCONNECTION TNVESTIGATION FEE � Yes No PARK FEE SAC Yes No STTEINSPECTTON Number of SAC�Units OTHER (specify) ZOYIl�TG CHE.CK LIST Zoning Districr. �. Fire Department: Post Office: School District: � Lot Area: Sq.ft. Acres � Width Depth Survey Submitted: Yes_ /� No Date of Survey: QN Fi� Proposed Setbacks: ' Froat(Lake): �� Right Side: 6�' � Reaz (Street): 2'I S Left Side: 3/� Adjacent Structures: i47-7'►4ctiw� `Vettand: 2�� t Building Hei�b.t: Def. Hgt. �y.k. Peal:Hgt. Lot Coveraae: N/A Grading: Staff Approval Date: — By: Council Approval Date: Septic: Staff Agproval Date: — BY� Zoning File: # — Resolution: # Resolutioa Date: _ � Shoreland District: A/v Avg. Setback: Bluff Setback: LotCovera;e: E�t�, Proposed 0 Hazdcover: 0-75' . 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 J BUII..DING REVIEW CHECK LIST �C� — R ' 3 � CONSTRUCTION TYPE: V� _ Sq Footage $Per Sq Ftg � Basement . . . x _ � lst Floor x . _ . 2nd Floor x = � Garage x _ � z — TOTAL Estimated Construction Value: $ (0,OOo�= Inspections Required: `Vork Requiring Separate Pecmits: Site Plumbing Fire Hazdcover Removai Mechanical Water Connection D� Footing ' Septic Sewer Connectioa � _p�Fratning Fireplace Lawn Irrigation _�Insulation (Masonry) O[her `Vall Boazd • (Mfg.) Well(State Permit) —2`F�� Grading/Filling �_Electrical(State Permit) Other . RENLA�RKS(ni t HOUSE): � ' . ----------------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Existing New . Access Approval: Date gy; ---- --------------------------------------------------------------- REMA.RI�S (TO BE NOTED ON PERil�II1�: 8 Sec.13.04 RIGHTS OF SUBJECTS OF DATA � Subd. 1. Type of data. The righ[s of individual on whom the data is stored or to be storod shall be as set forth in this secdon. Subd.2. InformaUon nquired to be given indiv{dual. M individual uked to supply private or confidendal data conceming himseif shall be informcd of: (a)the pu�pose and intcndcd use of the roquested data withur the coUecting State agcacy, political subdivision,or s[atewide rystem; (b)whether he may retuu or is legally required to supply the'rcquested data;(c)any known consequence arising frotn 6is supp(ying or reCusing�o,;upp►y � private or confidential data;and(d)the identiry of other persons or endaes'authorized by stace or fcde�al law to rcceive the data. 'I1�is iequirement shall not apply when an individual is asked to supply invesdgative data,pursuant to secuon 13.82,subdivuion S, to a law enforcemenf officec. The commissioner of rsvenue ma lace the noace re uircd under this subdivisioa in the individual incoma tax or ro taz refund inswcrions instead of on those focros. Subd.3. Access to data by individual. Upon request W a respocuiblo auchoriry,an individual s6all be iaformed whether he is the subjece of storcd data on individuals,and whether it is classified as public,private or confidential. Upon his furrher request,an individual who is the svbject , of storcd private or public data on individuals shall be shown[he data without,any charge to him u�d, if hc desires, shall be informed of the content and meaning of[hat data. Afu�'an individual has been shown�he priva[e daq and informed of its meaning,the data need aot be disclosed ro him for siz monehs chereafter unless a dispute or acdoa pucsuant to this secrion is pending or addirional data on the i�ividual 6as been collected or creaced. The responsible authority shall provide copies of the private or public data upon requese by che individual subject of the data. 'Ihe responsiblc auchoriry may require the requesdng person to pay the actua!costs of making,cerrifying,and compiling che copies. Thc rosponsible sud�ority shall comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of �he date of thc request,excluding Saardays,Sundays and legal holidays,if immediace compliance is not possible. If he cannot comply with the requcsc wiehin that time,he shall so inform the individual,and tnay have an additional five days within which to comply with the requesc,excluding Saturdays, Sundays and Icgal holidays. � Subd.4. Procedure whea data Ls aot accurate or complete. Aa individual may contest the accuracy or completeness of public or priva[c data conceming himulf. To exer�cise this right,an individual shall notify in writing the responsible authoriry des�ribing the oatute of tho disagoeemen�. The responsible authoriry shall within 30 days either: (a)correct rhe data found to be inaccurate or incomplete and aaempt to notify pasc recipienu of inaccurate or incomplete data, including recipients named by the individual;or(b)notify the indi�•idual that he believes the data to be correct. Data in dispuce shall be disclosed only if thc individual's statement of disagreement is included with the disclosed data. The determinaaon of the responsible authority may be appealed pursuant to the provisions of che administradve procedure act«ladng �o contestcd cases. DATA PRNACY ADVISORY [n 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 pemut br license. 3. The information may be shared with other local, state or federal agencies to the eztent 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 youcself. 6. Your full name is required to process this application or permit. � S r� � Firsc Middle� �t ; ) S'�b ) Z � �. � _ Address Y� �' .� � an �� rv�nJ SS'� �12-�3 z2s 3 C�ry State ZiP Phone [ understand rights as stated above. Signa�ure C� � , DATE/ TIME �/ CITY OF ORONO CALLED W ��ls !d� INSPECTION NOT CE SCHEDULED ' � �'`{ � ��O PERMIT NO. � ��d � COMPLETED ADDRESS �� $ � ��C��S �/ �� OWNER CONTR. ��'�i/- TELEPHONENO. ��J�� q�f�—��q� � DESCRIPTION /- �U��VC-J �-�.C'/�.. ,�� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W C � � O � � O � W � Q � Z W � W � j d W WORKSATISFACTORY:PROCEED Cl PROJECTCOMPLETE � ❑ CORRECT WORK&PROCEED I� ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. G PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the xt inspection 24 hours in advance. (952� 24J-46O0 Owner/Contr�erp site: Inspector. White Copyllnspector's ile Canary CopylSite Notice ✓ / DATE TIME CITY OF ORONO CALLED IN INSPECTION I SCHEDULED fD-a�Q�-t'�S` n7_'Oy� PERMIT NO. I COMPLETED ADDRESS 3G�D �JL�:t:G[1� �� OWNER CONTR. TELEPHONE NO. O� a a�0 � DESCRIPTION � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 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:_YES_NO y COMMENTS: � W a � J 0 � � 0 � W � Q � Z W � W � � d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�0 OwnerlContractor 'te: Inspector. White Copyllnspector' File Canary CopylSite Notice � / DATE TIME V CITY OF ORONO CALLED IN a I3 INSPECTION NO IC SCHEDULED ��-0 3;3 D PERMIT NO. 0 O COMPLETED �' �' ADDRESS 3CD g0 !��CO'�J M�t� � OWNER CONTR. TELEPHONE NO. �v l 2 70 3 Z.2-53 � DESCRIPTION '�� ^" ��-�''` �� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPIAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 WARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q � 2 W � W � � d W RK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR Will REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next ins tion 24 hours in advance. (952) 249-4600 OwnedContract Inspecto White Copyll�spector's File Canary CopylSite Notice