HomeMy WebLinkAbout2004-P07377 - add/remodel/repair * � .
PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07377
Crystal Bay, Minnesota 55323 Pel'CYllt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: 4i26i2ooa
SITE ADDRESS: 649 Minnetonka Hgld La
LONG LAKE,MN 55356
PI D: 06-117-23-44-0005
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Pernut Type: Addition/RemodeURepair Pernut Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate pernuts required: riumbing iviecuanicai Eiecuicai�staiej
NOTICES/REMARKS:
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'••vi�vi uv"_" f��v... ....... .."'_ vv"v:v Y .v�. �
FEE SUMMARY: Perxnit Fee: $ 1,105.75 Valuation• $ 120,000.00
Plan Review Fee: $ 718.83
State Surcharge Fee: $ 60.50
TOTAL FEE: $ 1,885.08
APPLICANT: Metro Prairie Homes OWNER: LIVING TRUST SWANTEK
275 lst Avenue East 649 MINNETONKA HGLD LA
Shakopee,MN 55379 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.
, ) G���L�)���
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ANT PERMITE SIGNA URE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Anulicant, 1-Monthlv Renorts, 1-AssessinQ, 1-Finance Page 1
Total Fee: $ � ��y� d� Date Received: �-7-d�
Entered By: � Permit#: _ RD�377
CITY OF ORONO - BUILDING PERNIIT APPLIC�TION
All information must be s�:>>.nitted in full before plan revie�ti-will be started.
(���.�nse print all information)
------------------------------------------------------------------------ ---_�------------------ -
THE APPLICANT IS: (circle one) OWNER O C01��TRACTOR
,
JOB SITE ADDRESS: � y�� �/I//�L��T'/?YtJ/��' I�� L�¢n/i� �w�LIP: 5 � 3�
Will this be a Parade of Homes, Remodelers Showcase Home or other Displa�-Home?
❑ Yes �No If yes, a special event permit is reqt�ired with Police Department and City
Council approva160 days prior to the event. Von permitted events will not
be allowecl
NAME OF OWNER: ST�(/� ���� 5�✓✓�y✓ T��� , PHO\E: (home)��5�-t/�73 --��7 rI
,
, . (work)
MAILINGADDRESS:��9 }Vj��N1��/v�� �//(,rUG/1,(,�'jCITY: �/1p�c7, ZIP: s..g".3��
L!�NG
•- �
CONTRACTOR: �f�n� �i��121 F� f��yp�5 PHO��: y�,'� - y�;� --G1 �7 �$—
CONTACT PERSON: � /�(rF-'n �, vi�C�'c�' MOBILE/PAGER: -��Sa - 270 --�'7SU �
MAILING ADDRESS: ,�75' - I 5/' /-lc�ri �s��T CITY: �Ni4 l�o /�rli� ZIP: ,5"3 '1 y
STATE LICENSE: # y�y(
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0 �S(,(�-�vl�� �T�tG �zvs(e'$�S
- . PHOti�E: ��- '� `�GI� � 2�S �
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATIO� =
TYPE OF WORK: New Accessory Structure �--
Addition Mo��e
RemodeVAlteration �_ Land Alteration
PROPOSED WORK(describe in detain: __p��p {Q W� +�1=�D ��/�/12� L C��iJ r�
ZF v �� A� „/�2 r4��� - ,�� �o�.��t� ��✓J �wST�z-� rvl��✓ m -c,sl�� t ` � �Qvt�'�t-„�+
/�' E�OG✓�-7'� ,� �� �!q ���' - r���Sll� L L �i��v 1..C�r'w 1'JOG�J S . /-}�✓J j'-��J I� C o ��r r2 �r� ��,2C1�
STORIES: �o��sn 4��;��.- SQ. FEET OF EACH FLOOR:��jYy }��T''� �'�7� i�'
NO. OF BEDROOMS: �_ GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /a�; p o�a. c�t�
I hereby apply for a building permit and I aclrnowledge that the information above is corr�lete and accurate;that the
work will be in conformance with the ordinances and codes of the Ciry and with the S�te Building Code; that I
understand this is not a permit and work is not to start without a pernut;and that the work�-ill be in accordance wzth
the approved plan.
APPLICANT'S SIGNATURE: D�TE: ��«'(,�
Sec.13.04 RIGHTS OF Si�CBJECTS OF DATA
Subd.1. Type ot data. The rig6ts of lndividual on w6om the data is stored or to be stored shall be ss set forth In this sectioo.
Subd.2. Information required to be given individual. An indlvidual ssked to supply private or conIIdential data concerning hlmself s6all be
informed of: (a)t6e purpose and intended use of the requested data withio the collecting stste agency,political subdlvision,or statewide system;(b)
whether 6e may retuse or ls legally required to supply the requested data;(c)any knowo rnnsequence arising from 6is supplying or refusiag to supply
private or rnntidential data;and(d)the identity of other persons or entities suthorized by state or federal law to receive the data. This requtrement s6a11
not apply w6en an individual is asked to supply investigative data,pursuant to section 13.82,subdivlsion 5,to a law enforcement otticer.
The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income tax or orouertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by indivldual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it ls classified as public,private or contidential. 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 6e desires,shall be informed of the content and
mesning of that data. After an tndividual6as been shown the private data aad informed of lts meaning,t6e data need not be disclosed to him for sta�
months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been colleMed or created. The
responsible authority shall provide rnples of the private or public data upon request by the individual subject ot the data.The responsible author(ty may
require t6e requesting person to pay the actual costs of making,certifying,and compiling the copies.
T6e responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivislon,or withln five days of the
date ot the request,excluding Saturdays,Sundays and legal holldays,if immediate compliance is not possible.If he cannot rnmply with the request within
that time,he shall so inform the individual,aad may have an additional five days within which to comply with the request,excluding Saturdays,Sundays
and legal holidays.
Subd.4. Procedure w6en data is not accurate or complete. An individual may contest the accuracy or completeness of public or privste data
concerning himselL To eaercise this right,an individual shall notify in writiog the responslble authority descrlbing the nature of the disagreemenG T6e
responsible aut6ority s6a11 wit6in 30 days either: (a)correct t6e data found to be ioaccurate or incomplete and attempt to notify past reclpients of
inaccurate or inrnmplete data,lncluding recip(ents named by the individual;or(b)notify t6e individual that 6e believes the data to be correct. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the dlsclosed data.
The determination of the responslble authority may be appealed pursuant to the provisions of the 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 quaGfication 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 eztent 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 required to process this application or permit.
�0 �'� '�'1 �FG/�L�'
First Middle Last
02�� 1 � 7' b�� ��vv,� ��SP'
Address
,�l�o �� � 1'yi�/. �"s 3 C�( �s� � Yo� -- 9,7 S'
C�tY State Zlp �— Phone
I understand my rights as stated above. �
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: (��{� �n-T-�cq µi�N C�,,,,�DS
PID: '
DESCRIPTION OF WORK �rv�ov�L (,o�.. c�e,�C.._
ZONING REVIEW BY.• DATE APPROVED: y-a � -c,Y
BUILDING REVIEW BY: DATE APPROVED: �-Li- o�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes _L/' No
PLANREVIEW Yes �/ No SEWER CONNECTION
STATE SURCHARGE Yes v` No WATER CONNECT70N
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECZ70N
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: /vo G���p
d�
Fire Department: Post Office: School District.•
Lot Area: Sq ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wet .
Building Height: Def. Hgt. P ak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Sta,�'Approval Date: By:
Zoning File: # Resoluti.on:# Resolution Date:
Shoreland District:
Avg.Setback: Bluff S tback: Lot Coverage:
Existi g Proposed
Hardcover: 0-75'
75-250'
zsasoo� .
500-1000'
Hardcover Variance Required: Yes \�No Date of Council Approval: �
REMARKS(in house):
32
B UILDING REVIEW CHECK LIST
UBC: 2`3 CONSTRUCTION TYPE: t/�
Sq Footage $Per Sq Ftg
Bnsement x _
Ist Floor X _
2nd Floor X _
Garage z =
x =
TOTAL
Estimated Construction Value: $ ���oo�
Inspections Required: Work Requiring Separate Permits:
Site �Plumbing Fire
Hardcover Removal ol Mechanical Water Connection
_�Footing Septic Sewer Connection
_�Framing Fireplace Lawn Imgation
_�Insulalion (Masonry) Other
�_Wall Board (Mfg.) Well (State Permit)
e� Final Grading/Filling �_Electrical (State Permit)
Other
REMARKS(INHOUSE):
--------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing Neyy
Access Approval: Date �,;
REMARKS (TO BE NOTED ON PERMIT): w -~�M�_M�_�___ __�
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CITY OF ORONO CALLED IN Y-2�' �`�
INSPECTION NOTICE SCHEDULED �-Z G��C�`I �M
PERMIT NO. �O7.3T1 COMPLETED
ADDRESS�L��'� �iI��✓I f1.�-�h_.-/�c. J�I��i�a I��� ��� .
OWNER CONTR.���"fij'a Prc�!��'e �'�►'� S�.
TELEPHONE N0. � 5�' 2 7 C% �-��
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-k`� OTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q - I G 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 INSTALL. 22 FOILOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-46��
OwnedContractor ' e:
Inspector.
White Copylinspector's ile Canary CopylSite Notice
�""' D TE TIME �
CITY OF ORONO CALLED IN C,� O
INSPECTION NOT CE SCHEDULED7�i� �
PERMIT NO. �� �7 COMPLETED
ADDRESS_ U1�� /YI-�"�� HCa I� L-/V
OWNER CONTR. �ef7�?1 /�l.t�/'� �
TELEPHONE NO. g"�Ja"���C� � 7 JG ��S
� DESCRIPTION --�-'1����Q-� � �JC��%-�1/l�i'tf
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Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE FiEMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 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
� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOIJRS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALI INSPECTOR
❑ INSPECTION REQUIRED.C L,LTOARRANGE ACCESS.
Call for the n x inspection 24 hours in advance. (g52) 249-4600
OwnerlC tr or o i
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Inspector.
White Copyllnspector's File Canary CopylSite Notice
� �� DATE TIME V
CITY OF ORONO CALLED IN �'��
INSPECTION NO/�TICE2 SCHEDULED (,� - i 3
PERMIT N0. �'U7.>�7 COMPLETED
ADDRESS �/� �� y k. '
OWNER CONTR. /?� /�Ct�( S
TELEPHONE NO.__ `1 S O� c��D -��s O
� DESCRIPTION �VII�U� � �,��'Q,���� /-'�iJn�
ty 01 F ING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC INAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next� spection 24 hours in advance. (952) 249-4600
OwnerlContra i e
Inspector.
White Copyllnspector's File Canary CopylSite Notice