HomeMy WebLinkAbout2003-P07068 - attached deck - � PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 P07068
Crystal Bay, Minnesota 55323 P@1'fYllt Typ@: Addition/RemodeURepair
(952) 249-4600 Date Issued: i2ii��2oo3
SITE ADDRESS: 601 Minnetonka Hgld La
L.ong Lake,MN 55356
PID: 06-117-23-41-0091
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 237.25 Valuation: $ 13,445.00
Plan Review Fee: $ 154.18
State Surcharge Fee: $ 7.25
Misc.Fee: $ 237.25
TOTAL FEE: $ 635.93
APPLICANT: Owner/Self OWNER: M�� &Mrs. Curtis Lee
M� 601 Minnetonka Hgld La
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 ORDINANCFS AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1
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Total Fee: S �J�)�y � % DateReceived: la-�-v �
Entered By: �'Vt� Permit#: �-�,���(9�
� ^ L`' CITY OF OROti O - BLZLDL�IG PERIVIIT APPLICATION
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1 y � All information must be submitted in full before plan review will be started.
(please prinl all information)
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THE APPLIC�'�1T IS: (circle one) O�`1�ER OR CONTRACTOR
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JOBSITEADDRESS: CvC' � ��. nne�";,��GC2 ��,;•�,/�n.� � '-,�._ ZIP: � 7 .? �C
Will this be a Parade of Homes, Remodelers Sho�-case Home or other Display Home?
❑ Yes � I�ro If yes, a special event permit is required with Police Department and City
Coi�rtcil approl�al 60 days prior to the event. Non permitted events will not
be allowed.
C�. C�-
NAME OF O«NER: u. ;�, S L�E� � PHONE: (home) %��� ` �73 -S�lJ
(work) `l�1. `f 7S= �-' 3�c`��
�IAILING ADDRESS: �,C 1 i►f �/,��. /{.;��,��. !_.� CITY: �,,:.,�, L<-�, r ZIP: ;�5 3�S�-
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CONTRACTOR: L. `� � L;�,,� >��� �,.�/ �.,, PHONE: 7�=3 4: �,5- �.��7
CONTACT PERSON: L ��I r�L s f�c� �IOBILE/PAGER i� �z- 'Z?Z - ��,�, .�
NTAILING ADDRESS: L,'�c � �� r.�a �3� :�c CITY• :��� r a-�� �
. . �'✓�.i ZIP: '�� 51_�
STATE LICE�SE: #
ARCHITECT/ENGINEER: PHONE:
i�IAILING ADDRESS: CITY: ZIP:
NA1�IE: REGISTRATION #
TYPE OF�VORK: New Accessory Structure
Addition Nlove
RemodeUAIteration Land Alteration
PROPOSED «'ORK (describe in detai�: �`�._;=�/��< < �� �- c i� --,�- (�.,, � ,-�-. ! �� �,� �?r F
��'f'z �i j ��`4c'�� t �� �
STORIES: SQ. FEET OF E�CH FLOOR:
NO. OF BEDROOIIS: GARAGE S�I'�I.LS: ATT. DET.
ESTI`I_ATED CONSTRUCTIO\VALUATIO\ (excluding land): S / 3f h/�a � �
I hereby apply for a buildina permit and I acl�o�rled�e �_at the information abo�-e is complete and accurate; that the
work will be in conformance «-ith the ordinances and .odes of the City and wzth the State Building Code; that I
understand this is not a permit and work is not to s•�rt�;=:.2out a pernut; and that the work will be in accordance with
the approved plan.
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APPLICANT'S SIG�'ATURE: � � ��ti�.� _:� �l:< DATE: / � � C��5
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Sec.13.04 RIGHTS OF SUBJECTS OF DaTA
Subd.i. Type of data. The rights of indi�idual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information required to be given individaal. An indi�idual asked to supply private or confidential data concernine himcelf shall be
informed o[: (a)the purpose and intended use o[t6e requested data within the collecting state agencc,political subdivision,or statewide system;(b)
whether he may refuse or is legally required ro supph the requested data;(c)a�y known consequencn irising from his supplying or reCusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federii taw to receive the data. This requirement shall
not apply when an individual is asked to supply in�esti;ati�e data,pursuant to section 13.82,subdicision 5,to a law enforcement officer.
The commissioner of revenue mav lace the noh'ee re uired under this subdivision in the individual income tax or ro ertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by indicidual. tipon request to a respoosible authority,an individu�l shal!be informed whet6er he is the subject of
stored data on individuais,and whether it is classified as public,private or confidentiaJ, lipon his furt�er request,an individua!w ho it the subject of
stored private or pubiic data on individuals shall be shown the data without any cha se to him and,if he desires,shail be informed of the content and
meaning o[that data. After an individual has been shown the private data and informed of its meani�-the data need not be disclosed to him for six
months therea[ter 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 of the private or public data upoo request b}�the individua!snbject of the data. The responsibie authority may
require the requesting person to pay the actual costs of maldne,certifying,and compilins the copies.
The responsible authority shall compiy immediatef}�,if passibie,w ith any request made pursaint to this subdivision,or w ithin five days of the
date of the request,excluding Saturdays,Sundays and le;al hofidays,if immediate compliance is not poss�le. If he cannot compl}�with the request within
that time,he shall so inform the individual,and may hace an additional five days within which to comph-.�ith the request,excludina Saturdays,Sundays
and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An iodividual may contest the acaaracy or completeness of public orprivate data
concerning himself. To esercise this right,an individuaJ shall nod[y in writiog the responsible authoritp dacribin;the nature of the disagreement. The
responsibie authority shall within 30 days either: (a)correct the data[ound to be inaccurate or incoaplete and attempt to noti(y pasi recipients of
inaccurate or incomplete data,including recipients named b�-the individual;or(b)nodfy the individual[hat he believes the data to be correct. Data in
dispute shaii be disclosed only if the indi�idual's statement of disaareement is included with the disclosc�data.
The determination of the responsible authority ma��be appealed pursuant to the provisions of the administrative procedure act relating to
contested cases.
D�T�PRIVACY AD�TSORY
In accordance with NI.S.13.04,Subd.2,"Ri�hts of subjects of data",we�vould li�:e to inform you that}-our request
for a permit or license from the City of Orono or any of its departments may reqaire you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine�-our qualification for the permit or license requested.
2. You may refuse to supply data,but refusal may require that the Cit�-deny the permit or license.
3. The information may be shared�vith other local,state or federal agencies to the estent necessar�-to process
the permit or license.
4. If your requested permit or license requires Council action to approi-e, some information may become
public.
5. You have certain rights under�I.S. 13.04(a��ailable upon request) to re�-ie�r•private data on�•ourself.
6. Your full name is required to process this application or permit.
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First �Iiddle Last
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Address �y v� "� t-
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Ci L�` 't � ' r �l�� 5.S j r�f % i -=' - Ll �r j _j L j
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State Zip Phone
I understand my rights as stated above.
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Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: _ 6 D 1 �M ��nt��N icq H t bK t�.4rv,p c,��r�
PID: '
DESCRIPTION OF WORK =c�c '?.�P� T F'�R �r� ��c.s �.
ZONING REVIEW BY: DATE A.PPROVED: /2-IS-o3
B UILDING REVIEW BY: DATE APPROVED: �z- r S-o)
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ,/ No
PLANREVIEW Yes � No SEWER CONNEC770N
STATE SURCHARGE Yes �/ No WATER CONNECT70N
�INVESTIGAT70N FEE Yes—� No PARK FEE
SAC Yes No_� SITE INSPECT70N
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: /V o G�G'e
Fire Depamnent: Post O�ce: School District:
Lot Area: Sq;ft. Acres rdth Depth
Survey Submined: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetla :
Building Height: Def. Hgt. Peak t.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution:# Resolution Date:
Shoreland District:
Avg.Setback: Bluff Setback: � Lot Coverage:
F.xisting Proposed
Hardcover: 0-75'
75-250'
zsasoo�
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
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BUILDING REVIEW CHECK LIST
UBC: 12',3 CONSTRUCTION TYPE: �N
Sq Footage $Per Sq Ftg
Bnsement x
lst Floor X —
2nd Floor z =
Garage x —
x
TOTAL
Estimated Construction Value: $ �3 y�i S ��
Inspections Required.• Work Requiring Separate Permus:
Site Plumbing Fire
Hardcover Removal Mechanical
_�C Footing Water Connection
Septic Sewer Connection
Framing Fireplace Lawn Irrigasion
Insulation �� � (Masonry) Other
Wall Board
�_Final '�a�...P (Mf8•) Well (State Permit)
Other ���� Grading/Fil[ing Electrical(State Permit)
REMARKS(INHOUSE): �
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REVIEW BY OTHERS: DATE:
Access: Existing N��,
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Access Approval: Dcue
�Y�
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REMARKS (TO BE NOTED ON PERMIT): _�Ntl __ __ _____ -
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