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Home My WebLink About2004-P07179 - addn/remodel/repair PERMIT C1TY �F ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: Po�1�9 Cryst�i Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 2/3/2004 SITE ADDRESS: 1590 Long Lake Blvd L,ong Lake,MN 55356 PID: 26-118-23-33-0026 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Construction Type VN Census Code 434 Permit Class: Building Pernut Type: Addition/RemodeURepair Pernut Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate pernuts required: iviecnanicai Eiecaicai�staie� NOTICES/REMARKS: n"-'-t-i"-""---`' ---`'-"`:--- � �--�'---'-- °- � c-'--'i-'"--'-- '.::::J::::.:GG:::w:.�:.::.:J.::.::.::::b ' ::G::::::::::1::. ' :.:.'..'J FEE SUMMARY: Pernut Fee: $ g3•25 Valuation: $ 3,000.00 Plan Review Fee: $ 54.08 State Surcharge Fee: $ 2.00 TOTAL FEE: $ 139.33 APPLICANT: Owner/Self OWNER: �chard Engman n'IN 1590 Long Lake Blvd 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. � i� � '� � .._� �., �, � ��„ �� .. :�e (�y�V� c �. � i"?� APP ,"�NT PERMITEE SC NAT ISSUED BY SIGNATURE I � Conies: 1-File(SiQnitures Required), 1-Annlicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1 Total Fee: $ �.� �� -� Date Received: /,z2"�rj'� Entered By: � /� Permit #: A07/79 �1`� �/ j�� 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) QWNE OR CONTRACTOR �____.._. JOB SITE ADDRESS: /�j"`�� (�r')c;�� V(� ZIP: 55�35� NANIE OF OWNER: ,+�'�.�'�1�� L.►' r.tJ I E S ��'t��J� �� PHO'�IE: (home) ��I�-��13 _�DC�� (work) ' � `- r �"� ...�,I�— 1[Li ~ � ),;. MAILING ADDRESS: I Szl G (..�►1` �c�.0 ►�j14�� CITY: L�,�� l..c JLL ZIP: �-5 � CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHOl��: MA aLING ADDRESS: CITY: ZIP: NA��IE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration ;� Land Alteration PROPOSED WORK(describe in detai�: �-r��►��,��<, ��Sr e�Vt� -, ��'15-1� �:�►r�t� ��'t:C%►,'1 `c 1 _i�ur Y\�1 �; 'v"�;c;nr1 STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��. �� 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 b�-t acc rdance witY� the approved plan. � �..(� T ; APPLICANT'S SIGNATURE:�! �(�,�,� � DATE: j � � � , NOTE! Parade 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 Sec.13.04 RIGHTS OFSUBJECTS OFDATA , Subdivision 1. Type ojdata ?he rights of individua!on whom the data is stored or to be stored shall be as set forth in this sectroh. Subd.2. Injormatiort required m be given individuaL An irrdivrdval asked to supply private or confidential data concerning himself ; shal!be informed of (a)the purpose and uuended use of the requested data xithin the co[lecting state agency,politica!subdivision,or stalewide system;(b)whether he may refuse or is legally required to supply the requesred data;(c)axy known corrsequence arising from his supplying or refusing to supplyprivate or confrdential data;and(d)the identity of other persoru o�entities authorized by state or federa!law to receive the data. This requirement shall not apply when an urdrvidua!is asked to supply imiestigative data,pursuant to section 13.82, subdivision S, 10 a law enfo�cemenl o�cer. The commissioner of revenue mav place the notice renuired under this subdivision in the individual income tax or oropertv tax refund instructiorrs instead of on those torms. Subd.3.Access to data by indinzduaL Upon request to a resporuible au�hority,an individual shall be rnformed whether he is the subject of stored data on indrviduals,and whether it is classified as publrc,private or confidential. Upon his further request,an individual who is the subjecl of stored prrvate or public data on individuals shall be shown the daJa without arry charge to hrm and,rf he desires,shall be informed oJ the content and meaning of that data. After an individua!has been shown the private data and informed ojits meaning, the data need not be disclosed to hrm for six manths thereafter roiless a dispute or action pursumrt to this section is pending or additional data on the individual has been collected or created The responsible authority shall provrde copies of the prrvate or public data upon sequest by the individual subject of the data. The responsrble authority may require the requesting pe�son to pay the actual costs of making,cert�ing,and compiling lhe copies. The responsib/e authority shall comply immediately,if possible,w-ish any request made pursuant to this subdivision,or within five days oJthe date of the request,excludrng Satu�dvys,Sundays and legal holidays,rf immediate compliance is not possible. If he cannot comply with the request withrn that time,he shall so inform the indivrdual,and may have an additional five days wrthin which to comply with the request,excluding Saturdays,Sundays and legal holidays. Subd.4. P�ocedure when data is not accurate or complete An individual may contest the accuracy or completeness ofpublic or prrvate data concerning himseff. To exercise this right, an individual shall not��in writing the responsible authority describrng the nature of the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to not� pas�recipients of inaccurate or incomplete data,includrng recipients named by the individuaf;or(6)not�the individual that he believes the data to be correct. Data in drspure shal!be disclosed only rf the indrvidual's statement of disagreement is included with the disclosed data. The determination of the responsible authorrty may be appealed p�vsuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY�IDVISORY In accordance wrth M.S./3.04,Subd.2,"Rights ofsubjects of data".k�e would like to inform you that your requestfor a permit or license from the City of Orono or a�ry of its departments may reqaire you to furnish cestain private or confrdential rnformation. You are notrfred that: 1. The rnformation you farnish will be used to determiire��our qualification for the permit or license requested. 2. Y'ou may refuse to supply data,but refusal may require that!he City deny the permrt or license. 3. The information may be shared with other local,state or federa[agencies to the extent necessary to process the permit or lrcerue. 4. Ij}�our requested pernrit or license requrres Council action to approve,some information may become publrc. S. Y"ou have certain rights under M.S. 13.04(see follo»•vrg page)to review private data on yourself. 6. }'our fu!!narne is required to process this applrcatiorr or permit. P EAS�(tlV�1� C rrJ�I � ��e�5 �.• C�-�-�b�11 First Middle Last 1Sil C� l..�a�n� 1�sZ 1►3\vC� Address 1s.M� LG�-� �/Y�� S�iSCO Ciry State Zip Phone qsa -u�3-�� I u rsta my r h a tated above. , � � . Sigrrature IO CHECK OFF LIST FOR ISSUANCE OF PERMITS ' FOR OFFICE USE ONLY A,�DRESS OR LEGAL: 1 Sti O L.c�N C� LAIcc: E��U� PID: DESCRIPTIONOFWORK: �qs�.MCN-r I—�n�isH ZOr�1G REVIEW BY: 1�1 DAT'E APPROVED: BUILDI1ti G REVIE`� BY: DATE APPROVED: /- 2�• o Y FEES TO BE CHARGED: Misc. Fees Calculated By: PERl�IIT Yes ✓ No PLAN REV�W Yes r/' No SEWER CONNECTION STATE SURCHARGE Yes �/ No WATERCONNECITON INVESTIGATION FEE Yes No �/ PARK FEE SAC Yes No �/ STTEINSPECTION Number of SAC-Units OTHER (specify) ZO\7�1G CH�CK LIST Zoning Dis�ict: N O e f�-+�►n��E. Fire Department: Post O�ce: School District: � L.ot Area: Sq.ft. Acres W th Depth Survey Submitted: Yes I�o ate of Survey: Progosed Setbacks: Front (Lake): Ri�t Side: Rear (Street): Ixft Side: Adjacent Structures: �Vedand: Buildin�Hei�t: Def. Hgt. Peak Hgt. Lot Coverage: Grading: S:aff Approval Date: By: Council Approval Date: Septic: Staff Appro�•al Date: By: Zonin� File: # Resolution_ r Re lution Date: Shoreland District: Avg. Setback: B:uff Setback: L.ot Covenge: E.iistinQ Proposed a Hardcover: 0-75' 75-250' 250-500' 500-1000' Ha.:�cover Variance Required: Yes No Date of Council Approval: � RE�1ARbS (in house): 7 BUII,DING REVIEW CHECK LIST ' �C' - R' � CONSTRUCTTON TYPE: �(1�( _ Sq FootaSe $Per Sq Ft; Basement x _ lst Floor z — 2nd Floor x _ Garage z — z = TOTAL Estimated Coastruction Value: $_3,OOc� °—" Inspections Required: `Vork Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal _�Mechanical Water Connection Footing- ' Septic Sewer Connection _ �( Framing Fireplace Lawn Irrigation _�Insulation (1�Iasonry) Other �Wall Boazd (l�ifg.) Well (Scate Perm.it) F�� Grading/Filling _�Electrical(State Permit) Other RENL4RKS(Ivi HOUSE): � --------------------------------------------------- REV�W BY OTHERS: DATE: �� Access: Ezisting New ---_ Access Approval: Date By. ------ ----------------------------------- -------------------------- KENIA.RKS (TO BE NOTED ON PERivIIT�; 8 � DATE TIME CITY OF ORONO CALLED IN INSPECTION �OTICE pD717Q SCHEDULED �'Z=-" ° �= 3-d PERMIT NO. e�"'��►'� 6 COMPLETED ADDRESS l59U l�a�GC�� /��v/, OWNER �pN��x }C�-1�u.��ONTR. c�w n�UZ TELEPHONE NO. `{�3� �o�t� � DESCRIPTION rr nr �r!-�� s ,�s -f� ,c, o � � 01 FOOTING 11 MECHANICALRI 18 XCAV/GRADING/FILL G�NiS/y Q 02 FRAMING 13 MECNANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a , � 1�� l S� � �� C � ��S � 0 � W � Q � 2 W � W � � � �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlConUactor on sit� Inspector. White Copy/lnspector's File Canary Copy/Site Notice i � � � DATE TIME CITY OF ORONO CALLED IN 3 �0-'�'�( INSPECTION N TI SCHEDULED `�- Il-Gy %� PERMIT NO. � COMPLETED ADDRESS �� CU� �G�' ''' (�' ' .� � . OWNER i� � CONTR.�;�-��i1.E=u"� TELEPHONENO. l.� '1 �� C.FUI� � DESCRIPTION l� 01 FOOTI 11 MECHANICAL RI 18 EXCAY/GRADING/FILLING � 2 fRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y O ION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SfTE INSPECTION 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 = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � � � �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�� OwnerlCont��r d�site: Inspector. s1��3�� White Copy/lnspecto's File Canary Copy/Site Notice ,// L t/ DAT TIME CITY OF ORONO CALLED IN 3��- INSPECTION N ��/ �� SCHEDULED ' �' � PERMIT N0. COMPLETED ADDRESS I S D �� L I/ L OWNER o�t C�D,q CONTR. TELEPHONE N0. l g5� `�7-3 �pU� C�' � DESCRIPTION ��'1-�p�ti� � Ot 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 Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTAIL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED OINSPECTIONREOUIRED.CALLT� RRANGEACCESS. Call for th xt i s ction 24 hours in advance. (952� 249-4600 OwnedCon it - Inspector. 4 White Copyllnspector's File Canary Copy/Site Notice �' � /�J/(�/ AT TIME ` CITY OF O O �� — INSPECTION NOTICE SCHEDULED ��_ PERMIT NO. �D7/�7�I COMPLETED ADDRESS �%�'=� OWNER CONTR. TELEPH E NO. �' -�"��l � DESCRIPTION J��1� '' �L �.-p/J�L��%�1' � 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 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 = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o , � � (��'P �S.S V l� c�v�J D K � � \ � �. ) I` ( � �• � � �i-NPc-� � W - - � Q � 2 � /�U ST laA cl-P S�o�P TJ��e<i�o�S � '=/ll �A e i� j��n � a W �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY �J CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE CAVERIN PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on site: Inspector. 4 ��J �� White Copyllnspector's File Canary CopylSite Notice