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Home My WebLink About2003-P06715 - addn/remodel/repair PERMIT CITY OF ORONO 27�0 Kelley Parkway- PO Box 66 Permit Number: Po6�is Crystal Bay, Minnesota 55323 Pel'1711t Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 9i2�2oo3 SITE ADDRESS: 1600 Long Lake Blvd Long Lake,MN 55356 PID: 26-118-23-33-0032 DESCRIPTION: Proposed Use: Residential Pernut Class: Building Census Code 434 Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: T_"______ ".__l____�_"__ O ""_'_1___ "____"_"]"___ __—.��v�iv ivv�.s.._._... ._. ._..... _ .._.., _ a�v� �u�v��w�vrauvv��v�� vav��b FEE SUMMARY: Permit Fee: $ 125.25 Valuation: $ 6,000.00 Plan Review Fee: $ 8138 State Surcharge Fee: $ 3.50 TOTAL FEE: $ 210.13 APPLICANT: Moynihan Builders OWNER: Carol Cajacob 10344 Colony Court 1600 Long Lake Blvd Eden Prairie,MN 55347 Long Lake MN 55356 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � , �. 9 ��1��'-�'t �� APPLICANT ERMITEE SIGNATURE ISSUED BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Revorts, 1-Assessine, 1-Finance Page 1 Total Fee: $ Date Received: � Entered By: Pemut#: CITY OF ORONO - BUILDING PERNIIT 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 CONTRACTO JOB SITE ADDRESS: �� G � �,¢.�� ZIP: NAl�� OF OWNER: l � S PHONE: (home) (work) MAII..ING ADDRESS: / � U 0 �,-. 1,9` CITY: C�2 o-••U Z�P: CO��RACTOR: � PHONE:_ 9S`a-�5y! 6 0 �(� COI�ACT PERSON: -K � ..� MOBILE/PAGER: !� 2 MAII.ING ADDRESS: lQ 3YY Co c►�v C y' CITY: �j,�.. .e.R�n►� ZIP: 3 � ST�,TE LICENSE: # /v�-� � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NA:tiIE: REGISTRATION# � TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: � --� ..� c� � I_ , ,lR tA f �n� w� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: � � GARAGE STALLS: ATT. DET. ESTL�IATED CONSTRUCTION VALUATION(excluding land): $ � �G O. 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 pemut and work is not to start without a permit; and that the work wi�be in a ordance ith the approved plan. APPLICANT'S SIGNATLTRE: � DATE: ( s. 3 .. 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 allowetd. 5 . . Sec.13.04 RIGIiTS OF SLJBJECTS OF DATA , Subd. I. Type of data. The rights of individual oa whom the data is stored or to be swred shall be as set forth in this secaon. ` Subd.2. Information required to be given individual, pn i�ividual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or sratewide system;(b)whether he may refuse or is legally required to supply the requesud data;(c)any lmown consequence arising from his supplying or refusing w supply private or confidendal dara;and(d)the identiry of other persons or enaties aurhorized by sate or federal law to receive die data. This requirement shall not apply when an individual is asked to supply investigadve data,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of revern�e mav�lace the notice rewired under this��bdivision in the individual income taz or r ertv qx refund instrucrions mstead of on those forms. Subd.3. Access to data by indiridual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is class�ed as public,private or co�dendat. Upon his further request,an individual who is the subject of stored private or public data on individuals sha11 tk shown the data without any charge to him and,if he desires,shall be informed of the content and meaning of that data. Aher 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 acaon pursuant w this secaon is pending or addidonal data on the individual has been collected or creared. The responsible authoriry shall provide copies of the private or public dara upon request by the individual subject of the data. The responsible au[hority may require[he requesting person to pay the actual cosu of making,certifying,and compiling the copies. Tha responsible authoriry shall comply imcnediacely,if possible,with any request made pursuant to this subdivision,or within five days of the dau of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request wichin that time,he shall so inform the individual,and may have an addiaonal five days within which to 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 concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the flature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and aaempt to notify past recipie►us of inaccurate or incomplete data,including recipients named by the individual;or(b)noafy the individual that he believes the data [o be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determina6on of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating W 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 �ity of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified that: , 1. The information you fiimish 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 perm.it or license. 4. If your requested permit or licease 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. First Middle Last Address C�ry Srdte Zip Phone I understand my rights as stated above. . Signature 6 . , CHECK OFF LIST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY AD�RESS OR LEGAL: f 6 0 o L c�vG' �r� �� PID: DESCRIPTIONOFWORK: Ncw (t.00�n s�-n.�c.r�-�t.�= o� 6�M-�C ZOi�TING REVIEW BY• DATE APPROVED: q-Z- o S BUII�DING REVIEW B . DATE APPROVED: Q-z-�3 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes �� No PLAN REVIEW Yes No ✓' SEWER COrfNECTION STATE SURCHARGE Yes � No WATER CONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITETNSPEC"lTON Number of SAC Units OTHER (specify) ZOtiTNG CHECK LIST zoning Districr. Q,� C��O Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Widch Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Right Sid Rear(Street): Left Side: � Adjacent Structures: W tland: Building Height: Def. Hgt. Pe �Hgt. Lot Coveraae: Grading: Staff Approval Date: B : Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: . . . Shoreland District: Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Vaziance Required: Yes No Date of Council Approval: REMARI�S (in house): �. 7 . . BUILDING REVIEW CHECK LIST � . �C: ' V- ( CONSTRUCTION TYPE: __�j/v Sq Footage $Per Sq Ftg Basement x _ lst Floor R = 2nd Floor x = Gazage x _ R = TOTAL Estimated Construction Value: $ (�,�oa Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal Mechanical � Water Connection Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) _�F� Grading/Filling Electrical(State Permit) Other RENIARKS(IN HOUSE): . ------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Eacisting Ne�✓ Access Approval: Date gy; � ----------------------------------------------------------------- REMARKS (TO BE NOTED ON PERMIT�: 8 '' m j s� �, v Q' �' �c `•" '-,' -- � � � � � � .Z�Z (/1 � ' �� + � � t� � '`�° 6'�-� T� rCo o° � �i`— � � "0 C)S � �. �^ ,t-�c o i- �� 0 ^ �-- � `"� � � �. � ��z �• � _.. �� A. 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O � S COMPLETED ADDRESS I�D�O �.01�1�c � � OWNER CONTR. _ .�� TELEPHONE NO. �SZ I�I— CD�� DESCRIPTION +'�� — ��'��"'�X � 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 MAINL 21 COMPUUNT v 07 DEMO-FINAI 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W � � , 0 � � 0 � W � Q � z W � W � � d W� WORKSATISFACTORY:PROCEED O PROJECTCOMPLETE ❑CORRECTWORKBPROCEED ❑ISSUECERTIFICATEOFOCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT O CORRECT UNSAFE CONDITION WITNIN HOURS. p pH0T0 TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next ins tion 24 hours in advance. (g52) 249-4600 Owner/Contra it Inspector. WhNe CopyllnspectoPs File Canary CopylSfte Notice