HomeMy WebLinkAbout2004-P07685 - sports court PERMIT
C I TY O F O RO N O Permit Number:
2750 Ke:-',�y Parkway - PO Box 66 P07685
Crystal Bay, Minnesota 55323 Permit Type: A��essory stru�tures
(952) 249-4600 Date Issued: 9i1��2ooa
SITE ADDRESS: 1749 North Farm Rd
I.ong Lake,MN 55356
P I D: 27-118-23-41-0003
DESCRIPTION:
Proposed Use: Residential
Pernut Class: Building Census Code O/S-Building
Permit Type: Accessory Structures Permit Sub-type(s): Sports Court
DETAILS:
Approved per resolution#:
Separate permits required: Eiecmcai�statej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 209.25
Valuation: $ 12,000.00
Plan Review Fee: $ 135.98
State Surcharge Fee: $ 6.50
TOTAL FEE: $ 351J3
APPLICANT: Bulldog Athletic OWNER: Mr.&Mrs. Quiram
232 Queen Avenue S. 1749 North Farm Rd
Minneapolis,MN 55405 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 ER ITEE SIGNATURE SUED BY SIGNATURE
Conies: 1-File(SiQnitures Required). 1-Avnlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
- , s
� Total Fee: $ ��j/. ��3 Date Received: ��C�' ����k,�`-�
Entered By: ,,:{}���—. Permit#: __�/���/
� CITY OF ORONO - BUILDING PER.i1�IIT APPLICATION
/� All information must be submitted in full before plan review will be started.
J �^� ��a
l (please priizt all iitfor�r:atioit)
----------------------------------------------------------- --- ---------------------------------------------------
THE APPLICANT IS: (circle oiae) OW�1E OR CONTRACTOR
JOB SITE ADDRESS: I`� �I'� ���,;�('-�1 t- Lf'Y�JI �C L���C;1";L ZIP: ����r"1 �
Will this be a Parade of Homes, Remodelers Sho�vcase Home or other Display Home?
❑ Yes � No Ifyes, a special eventperr�iit is requit�ed with PoliceDepartment and
City Couracil approval 60 c�ays prior to the event. Non perrnitted
everzts will not be allowe�l.
NAMEOFOWNER: ;�(���,Q, �4 TC�fY�V�1lUI1�� PHONE: (home)���J�z ��–�3���
,n � !v���i r'(� (�) (;; :�G - ��'1 �
MAILING ADDRESS: ��`-�`� ILJ 0��'{� t-�(.u'Vl'lk� CITY: �,����e���; ZIP: e;"s�s�
CONTRACTOR: l���C��'G �cv PHONE: (�I� ��( – �q�
CONTACT PERSON: �NIOBILE/PAGER:
MAILING ADDRESS: �.3�� C�� �C:Yl V�� • c�_CITY: N\ � 1 � ZIP: ���
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGII�EER: PHONE:
VIAILItiG ADDRESS: CITY: ZIP:
N�1�IE: REGISTRATION#
a�TYPE OF WORK: New Addition Accessory Stnicture
Move Home Remodel/Alteration
�,,y;2; PROPOSEDWORK(descri eiadetain: =, �� , � Y. • ('- . �) ' � �C�� � �.
cJ c(' ' �' � ' C�` 1 • % (; ".' i. � C
���' ��
.4��\�� STORIES: SQ.FEET OF EACH FLOOR:
�� NO. OF BEDROOMS: GARA.GE STALLS: ATTACHED DETACHED_
a
ESTINIATED C0�ISTRUCTION VALUATION(excluding land): $ � ��-, (_ C �
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work wi11 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 pernlit; and that the work will be
in accordance with the approved plan, �
APPLICANT'S SIGNATURE:��� � l�L G�.l�t� � DATE: � ' .� � �
► . , .
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA � �
Subd. l. 1'ype of data. The cights of individual on whom the data is stored ar to be stored shall be as set forth in this section.
Subd.2. [nformation required to be given individual. An individual asked to supply private or confidential data conceming himself shall be
informed of: (a)the purpose and in[ended use of the requested data within the collecting sta[e agency,political subdivision,or statewide system;(b)
whether he may refuse or is legaily required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private o�contidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall
not appiy when an individual is asked to supply investigative data,pursuant to section 13.32,subdivision 5,to a(aw enforcement officer.
The commissioner of revenue may place the notice reouired under this subdivision in the individual income tac or oropertv tac refund
instructions instead of on those fortns.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shatl be informed whethcr he is the subject of
stored data on individuals,and whether it is classified as public,private or confidential. Upon his fuRher request,an individual who is the subject of
stored private or public data o�individuals shall be shown the data without any charge to him and,if he desires,shall be infortned of the content and
meaning of tha[data. After an individual lias been shown the private data and informed of its meaning,lhe data need not be disctosed to him for si�c
months thereafter unless a dispute or action pursuant to this section is pending or additional da[a on the individuai has been collected or created. The
responsible authority shall provide copies of the private oc puUlic 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 comp{y immediately,if possible,with any request made pursuant to this subdivision,or within five days ofthe
date of the request,ercluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply wi[h the request
within that time,he shait so infortn the individual,and may have an additional five days wichin which to comply with the request,ercluding 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
concerni�g himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days either: (a)coRect 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 coirect. Data in
dispute shali be disclosed oniy if the individual's statement of disagreement is included with the disciosed data.
The determination of the responsible autliority 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 pernut or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential infoimation.
You are notified that:
1. The informarion you furnish will be used to detemune your qualification for the permit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the pernut or license.
3. The informarion may be shared with other local, state or federal agencies to the extent necessary to
process the pemut or license.
4. If your requested pernut or license requires Council action to approve, some information rnay become
public.
5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
� You 11 name is required to process this application or permit. �
l � Cl �
First�� hliddle Last
�1 �-� ' r ,M d Gl�
�re1 V�V �„' �� �� �� ��-F _
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City State Zip hone � � �
nderstand m�r ri t s ated above.
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,�� � '� � l,/�.�l.�i!!�-�
ture
10
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' CHECK OFF LIST FOR ISSUANCE OF PERMITS
, FOR OFFICE USE ONLY
ADDRESS OR LEGAL: /7`� 9 /Uvi2 n�f ,=�9 iz.rn �Z�/�-�
PID:
DESCRIPTION OF yVORK: Qws�u-�'O aw C��•c�
ZONING RE VIE W B Y:cf�,�[o�--------------�r-------DATE APPRO YED:_7-L�-�Y
BUILDING REVIEW BY� N�� DATEAPPROVED:
--------------------
FEES TO BE CHARGED: Nlisc. Fees Calculated By:
PERMIT Yes f No
PLAN REVIEW Yes �/ No SEWER CONIVECTION
STATE SURCHARGE Yes_� No WATER COMVECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Na�mber of SAC Units OTHER (specify)
ZONING CHECK LIST Zoxing Dismict: �
Fire Deparhnent: Post Office: School Dist�•ict:
Got Ar•ea: Sq.ft. Acres Widtl: Depth
Survey Subrnitted: Yes� No Date of Scavey: a�" 1=�t.0
Proposed Setbacks: ,
F�-ont(Lake): �� Riglit Side: ��
� �
Rear(Sh•eet): Z�V � Left Sic{e: 3 v
Adjacent Su•uctures: fe0� 6Yetic�nd.•
Builcling Height: Def. Hgt. -- Peak Kgt.
Lot Coverc�ge: �"
Gi•acfing: Staf)`'Approval Date: � By: Coz�ncil Approval Date:
Septic: Sraff�(pproval Date: 7 -2�' '-�"l BY. �^'�-�'
�!� Zoni�zg File: # Resolution: # Resolution Date:
Shoreland Disd•ict:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Harcicover: 0-75'
75-250'
150-500'
500-!000'
Kardcover• variance Reqa�i�•ed: Yes No Date of Courscil Approval.•
REMARKS(in house):
31
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CITY OF ORONO CALLED IN �"/�
INSPECTION N E� a SCHEDULED -Z �
PERMIT NO. ��b 5 OMPLETED
ADDRESS �77-/ �• ��K �
OWNER CONTR. �������iP � �
TELEPHONE NO. ��Z 3�3 �3��p
� DESCRIPTION � � ���
� 01 FOOTING 11 MECHANICAL �^�--� 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL ���,� � 9 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: �
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� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED L! ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITtONWITHIN HOURS. � pHOTOTAKEN
�NSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for e next inspection 24 hours in advance. (J52� 249-460�
Owner/Con on site:
Inspector.
White Copyllnspect s File Canary CopylSite Notice
� � �
DATE TIME
CITY OF ORONO CALLED IN I��Z�"vS!
INSPECTION NOTICE � SCHEDULED i����-G�S� 9•'.3C>�}'�iJ
PERMIT NO. ��rJ LP�� COMPLETED
ADDRESS � � f`•A"�� � �
OWNER � r 0.� CONTR. ��' 1� A-�t��'�
TELEPHONE N0. ���,�i V1��(r'' `��S �, �-I C3�I �'1 ��( �
�` �"12 2c.�`� �j S 7 I
� DESCRIPTION � �s-����,;��
� 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
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 FI 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
MBING FINAL 36 FOUNDATION/REMOVAL
OWN ONTRACTOR TO MEET YOU: YES_NO
� MMENTS:
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W� �''WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. u PHOTO TAKEN
INSPECTOR W4LL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIOIV REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance. (J52� 249-4600
OwnerlCon n�site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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