HomeMy WebLinkAbout2007-P10751 - plumbing r PERMIT
CITY �F ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p1o751
Crystal Bay, Minnesota 55323 PefT711t Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
2/16/2007
SITE ADDRESS: 3675 7acobs Mill Rd Unit#
Long Lake, MN 55356
PID: 32-118-23-24-0012
DESCRIPTION:
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: Plumbing Mechanical Fireplace Electrical(state)
NOTICES/REMARKS:
Lower Level Finish
FEE SUMMARY: Permit Fee: $ 776•�5 va►uation: $ 68,500.00
Plan Review Fee: $ 504.89
State Surcharge Fee: $ 34.25
TOTAL FEE: $ 1,315.89
APPLICANT: Trim Masters Inc. OWNER: Jeffrey&Kari R Ament
1767 Wildhurst Lane 3675 Jacobs Mill Rd
Mound,MN 55364 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 BUILD[NG CODE REQUIREMENTS.
�
APPLICANT ERMITEE SIGNATURE SUED[3Y SIGNATURE
Copies: 1-Fi]e(Signatures Required), 1-Applicant, 1-Monthly Reports, l-Assessing,(If Septic, ]-Septic) Page 1
. _�
]����
Total �ee: � -- f �� D�teRec.cave : � (1 oZ�JU�
Entcred 133r; ��� I'erniit#: ;� � C� 5
�'I'I'�' O� ORQPr�O - �3U��T3��NG PEI21l�IIT APPLICATIOI�
All infol-niation tniist be sub��iittcd iii fiill before j�lan review will be started.
(please pri�it ccll i�ifof��aicitio�z)
------------------------------------------------------------------------------------------------------------------------
�'EI,I+, �PYLICANT IS: (cir�cle oiac) �'VVN��I;IZ O C'ONTRAC�'OI2 � �
JOI3 STTI+�AllD12��S: Z� R-c C�S v��LL �•��_ ZIiP: �S_�_
� �Vill this be � a'arade of IIoaa�es, I�ex��odelers Shorvcase Iiome or other Dis�►lay I3onie?
❑ �es �I�ro lf��es, a,s�ecrnl e��uzl pernril is�•eqrrrred��i�itl�Poli�e l�epar•U���e��l ar�d Cilv Cor�i�cil ap�r ni�al
6�cic�vs prror to ihe ei�ent. Shirtt/e bus ser��ice�i�il/be requrred�u�less crp��/ieant de�uorr.�ir�,te.r
szr�ficreni ofz-siie pai ki��g rs ai��iiicrbi�. P�a�-perv�iiiled�i�eriis iril/iro�!�e��rlloi����:1
� �v�e��,or ow�v�;�z: ,�fi�� -Aw��-r- rxoN�: <<,��»e��s�-_�o�-�v�t�(3
��vork�(�tZ�Z t -��cPo
1V�AILING AllDI2r,sS: ���-�5- ��� vtir L�..b �'�TY� C�L�l�U� Z���': S�3�p
CO1�,'7['ItACTOIa:��vZ�� V�/i�:Tz iJ I+-�C. PHON�: S'�l Z.�'�Z��1 t{�(`-�'
C()N'I'�C'1'P�RS()1�`: c�v�c��q 1!�[Ol�ti��/I'AG�R � Sl�wti� �S c^�.��..,
Ii�lAIL1Nl��i�liilii;SS: i'7Cv'�, S�-��c_.�ol--�W���r' tt�t i.ii Y: l�f��.E/� %ii': ���
���eTrlr��c��s�;: #� ,. �.���i� ���i�iz���rlo�v�����,:��� ,�o�__
�RCI�I'TEC�I'/CNGIllr�LR: IPFION�:
IVIAII�:l�1i�G Al)1)I2�'.SS: '��'�'�': �I��':
Ii��lt'��: �G��'�'l�A'�'IOI�: #
'�'��� ��' ��V��d��; 1�Iew Honie �dditioi� �\ecessocy Structure
� Move Home P�emociel/�lter�tio�� (ie: Siding, Windows) �—
Any earth movement may require NICWD review and permi�s !
�'flZ��'����',� �/O��i�(�lebca•ibL isi c�'�t�ei�: �_Oc-vz2 L� 1�_�'�N�� f-r-
�_1f1�._ F�t-e�-� ���J----
�T'��2I��S: ��.����'�`O��'l�.�I��+�.0�1�: _
� I�1�. O�� �F�)I��(3I�S: ���2�G�': �'T��,�,�: rS�'��C��h�:�➢ �����'�C�-IE��_
�
�;��'�N�:�r�'k�;��C'�I�1�,'�'��.�T�;�'���I�I ����,�1.�r6'��i�T{����i�c�n��U 8�.�c�c�): :3 ��_
1 hereby apply for a buildin�}aermit and I acl:nowledge th�it the information above is complete and��ccuratc;
thzt tl�e�vorl: ���ill l�e in conl-orman�e ��vitl�� tl�e ordinaiic�s and codes oft'hc City ancf wiih the Si�te Buiicling
Code;th��t [ understai�d tl�is is not a}�ermit and worl:is i���t to start�vithout a permit;and th�it tl�c�-vorl:�vil I be
in accorciance �vit�h th� approvcd plan.
--_..
�-1�'�'����`�'d''�����1��'��U�2���: _ -- u����:: z �� ���--
;�
�. .
Sec.13.04 RIGHTS OF SUBJLCTS OF DATA
Subd. l. Type of data. Thc ri�hts of individual on whom the data is stored or to be stored shall be as sct forth in this scction.
SuUd.2. Information required to be given individual. An individual asked to supply private or contidential data concerning himselfshal I be
infonned of: (a)the purpose and intended use of the requested d�ta���ithin the collecting stafe agency,political subdivision,or statewide system;(b)
whefher he may rcfuse or is Icgally required to supply the requested data;(c)any kno��n conscquence arising from his supplyino or refusing to supply
private or confidential data;lnd(d)the idencity ofother persons or entities authorized by state or federal law to recci��e[he data. This requirement shall
not apply���hen an inditi�idual is asked to supply investigative data,pursuant to section 13.32,subdivision 5,to a la�m�enforcement officer.
The commissioner of revenue may�lace the notice required under this subdivision in lhe individual income tax or properlv ta�refund
instructions instead ofon those fonns.
Subd.3. Access to data by individual. Upoii requesf fo a responsible authority,ln individual shall be intonned�vhether he is the subjectof
stored dafa on individuals,and whether it is classified as public,private or contidential. Upon his further request,a�individual who is tl�e subject of
storcd private or puUlic data on individ�u�ls shall bc sho�vn the d�ca�vithout any charge to him and,if he desires,shall be informed ofthe content and
melning of that d1ta. After an individual has been sho�vn the private dala and infonned of its mcaning,the data need not be disclosed to him for six
months thereatter unless a dispute or action pursuaix to'hhis seccion,is.pending or additional.data on fhe individu�l has been wllected or created. The
responsible authority shall provide copies of the private or public data upon rcquest by[he individu:�l su�ject of the data. 'Che responsible authority
may require the rcquesting person to pay the actual costs of making,certityine,and compiling the copies.
TI1e responsible authority shall comply immediltely,if possible,with any request made pursuant to this subdivision,or�a�ithin tive days of
the date of the request,e�cluding Saturdays,Sundays and leeal holidays,iFimmediate compliance is not possible. It'iie cannot comply with the request
within tha[time,he sha�l so inform the individual,and may have an addiiional tive days within which to comply with fhe requesc,excludinr S.�ti irdtp�s,
Sundays and legal holidays.
Subd.d. Procedure when data is not accurite or complcte. An individual may contest the accuracy or completeness of public or private data
conceming himself. To e�ercise fhis right,an individual shall notity in writing the responsible authority describing the nahire ofthe disagreement.The
responsible authority shall�vithin 30 days either: (a)correct the data found to be inaccurate or incomplete and attcmpt to notify past recipicnts of
inaccurate or incomplete data,inch�ding recipients named by the individual;or(h)notify the individual that he believes lhe data fo be correct. D�ta in
dispufe shall Ue disclosed only if die individual's statement of disagreemcnt is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act rel�ting fo
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.0�,Subd.2,"Rigllts of subjects of data",�ve would lilce to inform you that yolu•request
for a pennit or license from tl�e 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 tl�e 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 youc requested permit or license requires Council action to approve, some infoitina'tion may become
pttblic.
�. You have certain rights under NI.S. 13.04(available upon request)to review private data on yoursel£
6. Yuur full name is required to process this application or permit.
�p a1�c.�J �-LC._"t-� ���
r��-sr ,�t�ddi� L�sc
t`Z� ���E-lv�2g T �P�-��,
r�ddress
1N��� ' H�►� �3��` �I 2�7 Z'3 l�l�(�j'
City� Srace Z�p P�,one
I understnnd m���•ights as stated�bove.
_._____ 2.. -.�
s��r�ar�����
Reset Ponu 32
. , _ . .
� �C�IE�� OFF i,IST FOR ISSUANCE O�' �ERMxTS
FOR �FFICE USE ONLY� � .
A,pDRESS OR LEGAL: �5 S�C.o C3S �n � �-�- �zo�D
PID:
DESCRIPT'ION OF WORK---���z L-�--�`-'�`---���s'�-------------------------------------
ZO�IG REVJE�V BY: N � � DATE APPR.OVED:
- DATE APPROVED: 2 -�z.- �
o �
BUII�DIi�iG REVIE�Y BY: • .
FEES TO BE CHARGED:� Misc. Fees Calculated By:
P�g�T Yes ,/ No
PLAN REVIEtiV � � Yes ✓' No SEti�TER CONNECTION
STATE SURCHARGE Yes �/ No �VATERCONNECTTON
INVESTIGATION FEE Yes No �/ PARK FEE
SAC Yes No, �/ SITEINSPECTION
Number of SAC•Units OTHER (specify)
�pY�TG�CHE.CK LIST Zani.ng Districr. N o G t-�A�Ge .
� Post Office; Scl�ool District: • '
Fire Deparcment: •
I,oc Area: Sq.ft. Acres ' Width peP�
Survey Submitted:� Yes No Date oE Survey:
Proposed Setbacks: . • ;
Froac(Lake): Ri�t Side: ,
Rear(Street): Left 5ide:
Adjacent Structures: �Vetl .
auil�lin�Hei�it: Def. Hgt, Pe - Hgt.
Lot Covera�e:
Gradina: S�aff Approval Date: By: Council Approval Date: '
Septic: 5taf[ Appcoval Da[e: By:
ZQ�? ��e. R _ Resolution: Resolution Date:
Shorelzr:d District: �t Covera�e:
Avg. Setback: BluEf S back:
E:cistino Proposed
Hzdcover: 0-75'
75-2�0'
2�Q-5Cb' -
soo-icc��
�,• �f�'ni��ril 4nI;;0Y�:
�i��::cote: V�:ar:c.� v�yu!rec: ':es •�'o " ' �
F.E�L:�;S (inhouse):
,. _ . ,
EUILDING �ttEVIEti� CHECK LIST
UBC: 12' 3 ' CONSTRUCTIONTYPE: �(�( .
Sq Footage $ Per Sq Ftg
' Basement • . . .. X _ .
lst Floor � � . x • _ . • . � �
2nd Floor x _ • �� .
Garage x _ ,
x =
TOTAL
Estimated Constructioo Value: $ !o Q�,S pc�'°
Insgections Requirec�: VYork Requiring Separate Permits:
Sice �_Plumbing Fire
• Hardcover Removal �c Mechanical Water Coaaection
Footing ' Septic Sewec Connection �•
` _�Framing . _�[ Fireptace Lawn Irrigation
_ (�Insutatioa (Masonry) Other
o( Wall Boazd �g(Mfg,) Wetl (State Perm.it)
°` F�� Grading/Filling _�Etectrical (State Permit)
Other
REMAR.KS (!N�IOUSE): . . '. --. --
--------------------------------------------------------
REVIE�V BY OTHERS: DAT'E:
Access: Existing New .
Access Approval: Date � gy; �
REbJARh'S ('I'Q B� NQ'I'ED Qti,r pERl�rm� - -----------------------------------------------------------
L :
�
� �J�./� T I��'] TIME �
C�Y OF ORONO CALLED IN � ` 1
INSPECTION NOTI E SCHEDULED � �
PERMIT NO. � O�S� COMPLETED
ADDRESS �J �O �� -�C�C c�h� ��I �
OWNER CONTR. �T�I YY1 -���f�,.S
TELEPHONENO. D��' �a��� ��"`�'� �� •
� DESCRIPTION ` r 4 � Y '�--'��
ly� 01 FOOTING 11 MECHANICAL RI 18 EX AV/GRADING/FILLING/ �
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS��
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEP IC 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
�
Z
W
�
W
�
�
d
W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance. (J52� 249-46��
OwnerlContractoro site:
Inspector.
Whiie Copyllnspector's Fil Canary CopylSite Notice