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Home My WebLink About2007-P11477 - exercise room finish c ' PERMIT CITY OF ORONO � 2750 Kelley Parkway- PO Box 66 Permit Number: p11477 Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 Date Issued: l 0/2/2007 SITE ADDRESS: 2750 Kelley Pkwy(Admin Offices) Unit# Long Lake,MN 55356 PID: 33-118-23-12-0007 DESCRIPTION: UBC Occupancy B Construction Type VN Proposed Use: Other Census Code 437 Permit Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Mechanical Electrical(state) NOTICES/REMARKS: Exercise Room Finish at Police Dept. FEE SUMMARY: Permit Fee: valuation: $ 48,000.00 Plan Review Fee: TOTAL FEE: $ 0.00 APPLICANT: GDS Design&Build OWNER: City of Orono 222 West Main St 2750 Kelley Parkway Waconia,MN 55387 P.O. Box 66 Crystal Bay,MN 55323 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. � , �� --- ! • ., ' . ..� - G��. c� �'''�� ,� APPLIC P RMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � • G� C 2S.� �t' Total Fee: $ ,� Date Received: ��'�Q-07 Entered By: Permit#: ,�j�l�"]`j 1 CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ -- ------_. THE APPLICANT IS: (circle one) OWNER O CONTRACTOR� � JOB SITE ADDRESS: �.�7 5�c-' /c��<<� �%��i� c.�.'�9 j ZIP: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS �NO /f yes, a specia!event permit is reguired lvith Police Depariment and City Council approval 60 days prior to the everzt. Shuttle bus service will be reguired unless applicant demonstrates suffcient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: c�r o� O,�E'C��U �� '�� c�c� � y PHONE: (home) :� (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: �/�S j:�f S�G�C. .�- �;c i�•LD �i S� - �%�'i�. " � `f�;' 'L PHONE: ��'"��'W�"�� CONTACTPERSON: C�/� i�- S��-lv� Tr�' MOBILE/PAGER �,�� - ��i � - ,� ,�� MAILING ADDRESS: ��-�� U�s T �hr,�; Si� CITY: �;�/�C'c��,�.�'} ZIP: 5 5-3:�1�7 STATE LICENSE: # ,�� _: j � 5-..;? `� EXPIRATION DATE: �3 -� - L� �� 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 detai�: .� x F:l'_s i z�.� ,�'��c�vr� �i/�.'/S i�' STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION (excluding land): $_�, �%n�> � 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 SIGNAT�RE: _� � � ;�; DATE: �C> �'j _ � 31 . � 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 req�ired to be given individual. An individual asked to supply private or confidential data conceming himself shall 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 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 shal I 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 ma�place the notice reauired under this subdivision in the individua]income tax or pro e�rtv 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 shall 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 to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authoriry 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 of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [f he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which[o 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 authority 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,inciuding recipients named by the individual;or(b)notify the individual that he bel ieves 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 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 rec�uired to process this application or permit. First Middle Last Address City State Zip Phonc I undersfand my rights as stated a ove. ._.___ � �s' ignAfL �.,,,r. � �» �'r Reset Form 32 � • CHECIC OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 21 tj ,et��,,, PID: DESCRIPTION OF WORK ExC 2.5�2 L �200.►� Fi•�is F! ZONING REVIEW BY.• � DATEAPPROVED: BUILDING REi�lEW BY.• DATEAPPROVED: 5-ZY-o� FEES TO BE CHARGED: M�sc. Fees alculated By: � PERMIT Yes . No PLAN REVIEW Yes No �/ SEWER CONNECTION STATE SURCHARGE Yes No ..� WATER CONNECTION INVESTIGATION FEE Yes No_� PARK FEE SAC Yes No � SITEINSPECTION Number of SAC Units OTHER (spec�) ZONING CHECK LIST Zoning District: _�'� G N'�Gy� O � Fire Department: Post Off ce: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes Na Date of Survey: Proposed Setbacks: Front(Lake): Right Si e. Rear(Street): Left Side: Adjacent Structures: W tland: Building Height: Def. Hgt. Peak Hgt. Lot Coverage: Grading: Staff Approva/Date: By: Council Approval Date: Septic: StaffApproval Date: By: � Zoning File: # Resolution: # Resolution Date: Shoreland District: MCWD Permit: .4vg. Setback: Blu Setback: LotCoverage: Fxi ting Proposed Hardcover: 0-75' 75-250' 2.i 0-.i 00' .i 00-1000' Hardcover variance Reguired: Yes Date of Council Approval: REMARKS(in house): 33 , . BUILDING REVIEW CHEC%LIST UBC: � CONSTRUCTIONTYPE: yIJ Sq Footage $Per Sq Ftg Barement x = 1 st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ `/�,a0� � Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal _,�Mechanical Water Connection Footing Septic Sewer Connection _�Framing Fireplace Lawn Irrigation Insulation (Masonry) Other oC Wall Board (Mfg.) Well(State Permit) _�Final Grading,'Filling oC Electrical(State Permit) Other REMARKS(INHOUSE): REVIEW BY OTHERS: DATE: Access: Fxisting New Access Approval: Date By: REMARKS(TO BE NOTED ON PERMIT): 34 DATE TIME � CITY OF ORONO CALLED IN '� INSPECTION NOTI�j E SCHEDULED � O "� PERMIT NO. 11 �� co LETED ' ADDRESS I C- � --' � ��-/ OWNER CONTR. � TELEPHONE NO. � a ' CPI � DESCRIPTION Vc�t� � -��-r�J�/l j � ❑ FOOTING ❑ MECHANICAL RI EXCAV/GRADING/FILLING y ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � w a o —� T A ��Q � V � (1� 1�0� '' B A �r;e.�. � 0 � w � Q � z W � W � j d W� ❑WORK SATISFACTORY:PROCEED L PROJECT COMPLETE W ❑CORRECT WORK&PROCEED '- ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR W4LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR � INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call forthe next inspection 24 hours in advance. (952� 249-46�� Owner/Contractor on s't�e: Inspector. W �� White Copyllnspector's File Canary CopylSite Notice