HomeMy WebLinkAbout2007-P11737 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p11737
Crystal Bay, Minnesota 55323 Permlt Type: Addition/RemodeURepair
(952) 24Q 4600 Date Issued:
� . 12/18/2007
SITE ADDRESS: 1749 North Farm Rd Unit#
Long Lake,MN 55356
PID: 27_118-23-41-0003
DESCRIPTION: UBC Occupancy R3
Consri-uction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits rcquired: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 3,352.50 Valuation: $ 525,000.00
Plan Review Fee: $ 2,179.13
State Surcharge Fee: $ 265.00
TOTAL FEE: $ 5,796.63
APPLICANT: A1 Hirsch&Sons OWNER: Mr. &Mrs. Quiram
PO Box 633 1749 North Farm Rd
Delano,MN 55328 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.
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APPLICANT VGRMITEE SIG. ATURE ISSUED BY SIGNATURE
�ies: ]-Filc(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,([f Septic, 1-Septic) Page 1
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Total Fee: $ 9[O� �� Date Received: ��a�7 �
_ � Entered By: Permit#: �}I��,37 --�
CITY OF ORONO - BUILDING PERMIT APPLICATION �
�
All information must be submitted in fuil before plan review will be started. ,�
(please print all information) �
------------------------------------------------------------------------------------------------------------------------ �
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR �
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JOB SITE ADDRESS: i 7Q� ��,�-�-.�} r,��� �,�� zIr: ��; 3� I �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? �
_._l-
❑ yes �NO Ifyes, a special event perrrait is reguired with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates �
suff cient on-site parking is available. Non permitted events will not be allowed d
1�--
NAME OF OWNER: ��F� � J��j ����� PHONE: (home)9�2-�-�34�3 �
(work) -
MAILING ADDRESS: 1�74� No F}�2i`�i ���ll CITY: Q�v� ZIP: ��53� 1 �
CONTRACTOR: �,L ��iE�� � S��S: (t�IC PHONE:`7(�3--77z_�'71�
CONTACT PERSON: �U A 1�1 E fii i�Z�'i-} MOBILE/PAGER: (�� 'Z-7�y -g���
MAILING ADDRESS:$;p� ��x � 3� CITY: Da./�Jp ZIP: �� �
STATE LICENSE: #_ t Z�a EXPIRATION DATE: ZC�c'��, �
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ARCHITECT/ENGINEER: �.iC:}�A�.i� ��r� PHONE: (,��Z.-�5�-�17 Z d
MAILINGADDRESS: 3i5 EASi 50� S��-€�C CITY: F�� ZIP: ���}t�j �
NAME: �iC:r�i}�p G Qp t� ,�.C��T-�T'S REGISTRATIO : # d
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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 detain: ��.3�OQ:�( ,Q-fl0�710�.11 ��:;M?" �L`�k�,��'�t�tol �
M101 i�4 F�t�� �T��C lo t,l talo � �r2 �+p'T ?�� q�' `7!�IS i t M�� S1
STORIES: �, ° SQ.FEET OF EACH FLOOR: �
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �Z� p�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 permit and work is not to start without a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: �ce�� �,,�,� DATE: l Z.` � p
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
i
Subd. 1. 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 required to be given individual.An individual asked to supply private or confidential data conceming himselfshall be
informed of. (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known consequence azising 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 shall
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 may nlace the notice required under this subdivision in the individual income tax or propertv 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 of the private or public data upon request by the individual subject of the data. The responsible authority
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. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an additional 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
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,including recipients named by the individual;or(b)notify the individual that he believes the data to be cotrect. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
'Che determination of the responsible 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 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 required to process this application or permit.
Dt��CJ� C�D���1� 4�-t�5�1-� _
First Middle Last
�.o. r�ax c�33
Address
I,�L�� l�l�l �S�zS -7��-9�2-271(.v
C�tY State Zip Phone
I understand my rights as stated above.
J �
Signature
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32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
F R OFFICE USE ONLY
ADDRESS OR LEGAL: � ���C�
' PID: .
� DESCRIPTION OF WORK.• /}�f / �iy/S' £.
ZONING REVIEW BY.• DATEAPPROT�ED:_ h..����Q 1
BUILDING ItEi�IEW BY.• �� DATEAPPROi�ED: �2-
=~-v-- � -
FEES TO BE CHARGED: Misc. Fees Calculated 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.r L,�- �
Fire Department: Post Off ce: School District:
Lot Area: Sg.ft. Acres Z•�Z Width Depth
Survey Submitted: Yes � No Date of Survey:
Proposed Setbacks: S�y�..
Front�Zrkej: Tl , �,� �ighz Side: �{ �
Rear ���/� S�� /
���� .�eftSide: � K /! �lI�`'1GuC GJ G�t��2.7f�
/ �p�.S�S r/1'I P.�'iv�
Adjacent Structures: _�� Wetland: /��J Lot L� �oaK�ne� q j.
Buildin Hei ht: De. H �'�°� -So��s �ps L.
g g l �• O� PeakHgt. Qb//��e,��v/r�IS:{�,a.Y
Lot Coverage:�f� �S no�hnd 0�,��
Grading.• StaffApproval Date: By: Council Approval Date:
Septic: StaffApproval Date: �� �IC�'�� By. �—
Zoning File: # Resolution: # Resolution Date:
Shoreland District: /Vp MCWD Permit:
Avg. Setback: BluffSetback: LotCoverage:
F�isting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required.• Yes No Date of Council Approval:
REMARKS(in house):
33
B UILDING REVIEW CHECg LIST � ,
UBC: R'� CONSTR UCTION TYPE: V L�
Sg Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
0
Estimated Construction Value: $ $ZS.D�c7 �
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
Wall Board (Mfg.) Well(State Permit)
�L Final Grading/Filling _�Electrical(State Permit)
Other
REMARKS(INHOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval.• Date By:
REMARKS (TO BE NOTED ONPERMIT):
J.�QcI� no�- I�cGv d.��, ►r� �tS �¢r✓M��
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� �CITY OF ORO O CALLED IN �
INSPECTION ICE�f SCHEDULED
PERMIT NO. / COMPLETED
ADDRESS �
OWNER CONTR. r ` �'
TELEPHONE N0. (�_��-- �T��
�� SCRIPTION ��� "�
OOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING
❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER y�00K-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector. � , r Tr
White Copyllnspector's File Canary Copy/Site Notice
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D TEO _„• TIME
CITY OF ORO O CALLED IN ��S _
INSPECTION OTICE SCHEDULED �
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� DESCRIPTION �r�2i�2�� l�IC�L� �
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y ❑ 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
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU. YES_NO
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL flETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
�INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspector. ��
White Copyllnspector's Flle Canary CopylSite Notice
� TE G TIME �
`\���
CITY OF ORONO CALLED IN 6 �
INSPECTION I �j SCHEDULED � r
PERMIT NO. �v � COMPLET D K
ADDRESS `
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OWN ER CONTR.
TELEPHONE NO. � � � —
� DESCRIPTION
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL 0 LAKESHORE/WETLANDS
y ❑ 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
2 OWNER/CONTRACTOR TO MEET YOU: YES_NO
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor o
Inspector.
White Copyllnspector's File Canary CopylSite Notice
/�--/ ,�et W�/�e ✓
CITY OF ORONO CALLED IN �� � U7 TIME
INSPECTION TIC SCHEDULED � D � :��
PERMIT NO. � COMPLETED -
ADDRESS
OWNER CONTR. �
TELEPHONE NO �-� ` �O�— ��% —����7
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� DESCRIPTION
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Q ❑ FRAMING ❑ MECHANICAL FI ❑ LAKESHORFJWETLANDS
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❑ 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
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL � �� ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS:
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Whlte Copyllnspector's File Canary CopylSite Notice
D E TIME "
CITY OF ORONO CALLED IN /�"
INSPECTION N TICE SCHEDULED 2 �•�4`�
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ADDRESS
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� DESCRIPTION
� OTING ❑ ME HANICAL RI ❑ EXCAV/GRADING/FILLING
❑ FRAMING ❑ MECHANICAL FINAL p LAKESHORE/WETLANDS
❑ 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
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INSPECTOR WFLL RETURN
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❑STOP ORDER POSTED.CALL INSPECTOR
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White CopyllnspectoPs File Canary CopylSfte Notice