HomeMy WebLinkAbout2007-P10725 - kitchen remodel PERMIT
CITY OF ORONO
2750 KPll�y Parkway - PO Box 66 Permit Number: p10725
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
1/29/2007
SITE ADDRESS: 1200 Phillips Dr Unit#
Long Lake, MN 55356
PID: 27-118-23-32-0009
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residenrial
Census Code 434
Permit Class: Building
Permit T e: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
Yp
DETAILS:
Approved perresolution#:
Separate permits required: Plumbing Mechanical Electrical(state) � •�U ��� ���.�-v�--.—v--�
NOTICES/REMARKS:
Kitchen Remodel
FEE SUMMARY: Permit Fee: � 542.75 valuation: $ 40,000.00
Plan Review Fee: $ 352.79
State Surcharge Fee: $ 20.00
TOTAL FEE: $ 915.54
APPLICANT: Owner/Self OWNER: Christian&Beth Johnson
MN 1200 Phillips Dr
Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRtCT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
�• • � � G��C���
L[CANT PE ITEE SIGNATURE ISSUED BY S[GNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page ]
V�
t �
. �
'Total Fee: $ Q � � Date Received: l�a�6-O�
]Entered By: Permit#: iq/07,Z.5^
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) WNE �OR CONTRACTOR
JOB SITE ADDRESS: I ��'� P�l I I yt(�_S I�� ZIP: � � �5 b
Wili this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes � �10 If yes, a special event permit is reguired with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be reguired untess applicant demonstrates
su�cient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: C �r"�y r«xr� �J o k�.,���� PHONE: (home) `15 Z-Z vu --�t t c v
(W�� �a- �7� �!y`f�o -�
MAILING ADDRESS: t 2�� P�����af Dr. CITY: U���►� ZIP: S 5 3 5�.
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration(ie: Siding,Windows) X
Any earth movement may require MCWD review and permits!
PROPOSED WORK(describe in detain: r�.���v I K i 4-c,��., - �z���.� � <<-����c ts
e�,�<kr_�� � - - �.,ce„��1;s� v,3d pn.�+-,-�,
�
STORIES: I +�t�� +�=.�+-- SQ.FEET OF EACH FLOOR: �,3�=>
NO. OF BEDROOMS: S' GARAGE STALLS: ATTACHED� DETACHED_
ESTIMATED CONSTRUCTION VALUATION(ezcluding land): $ 4�� ���'
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: "��� DATE: �+2�'�� �
31
. �
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. 7'he 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 himself shall be
informed oE (a)the purpose and intended use of the 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 lrnown consequence arising 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 dats.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 mayplace the notice required under this subdivision in the individual income ta�c or procer_tY tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual.Upon request to a responsible suthority,an individuai shail be informed whether he is the subject of
stored data on individuals,and whether it is classified as public,privaLe or confidential. Upon his further request,an individual who is the subject of
s�tored private or pubiic data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed ofthe content and
meaning of that data After an individual has been shown the private daia 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. T'he
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 pe�on to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,ifpossible,with azry request made ptusuant 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 ar�d 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 au[hority shall within 30 days either: (a)coriect 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 correct. Data in
dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
1'he 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
i'or a permit or license from the City of Orono or any of its departments may require you to furnish certain private or
<;onfidential information.
You are notified that:
1. T'he 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 appmve,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 L.ast
Address
City State Zip PhoAe
1[understand my rights as stated above.
�- �,cti '�1�
Signature
Reset Form 32
, �CHEC� OFF �IST FOR ISSUANCE 4F �'ERMITS
� FOR OFFICE USE ONLY� . ,
.A.DDRESS ORLEGAL: IZc�o PH«-�-�PS p�
PID:
DESCRIPTIO�4F WORK: I��TCK��+,� 42� w��r L
ZONNG REV7E`V BY: --------fa -------- - J�ATE APPROVED:
$UII�DING REV7E�V ]3Y-_ �_ �--------------DAT'E APPROVED___�__ �b _��.—
FEES TO BE C�-IA.RGED: Misc. Fees Calculated By:
PERMIT Xes ✓ No
PLAN REVIEtiV � Yes �/ No SE�VER CONNECTION
STATE SURCHARGE Xes �/ No tiVATERCONNECTTON
II�IVESTIGATION FEE Yes Na PARK FEE
SAC Yes No STTEINSPECTTON
Number of SAC�Units ^___M-_____ OTHER (specify)__-_-______-r__-_-___^__
Z ~ cxE.cx LisT Zoning District �vv ��-���� .
o�rc�
Pos[OfFice; School District: • �
Fire Departmeat: �
L,ot Area: Sq.ft. Acres ' Width Depch
Survey Submitted:� Yes No Date oE 5urvey: __
Proposed Setbacks: • :
Frvat(Lake): Ri�t Side: .
Rear(Street): Laft Side:
Adjaceot Structures: Wet d:
Buil�lin�Hei�t: Def. Hgt. P �`Hg�•
Lot Cvvera�e:
Gradino: Scaff Approva.t Date: By: Council Approval Date: =::� ,
Szp�ic: Staf� Approval Date: �Y:
Zoaing File: n Resolutio : � Resolution Date:
. Shorelas:d District: I..,ot Covera�e:
Avg. Setback: B uff Setback:
E. 'stino Proposed
H�dcover: 0-75'
75-250'
2�0-SC�'
soa-ioc��
.i ✓,:_ nF r'C?i,n�i1 A,q�n•'0'vZ:
il��l:�l7Y�: t1��:2.L:C� V�Y�:�:�C. C'� •�l!
F.£�L�R.��S (ir.house):
BUILDING REVIEti� CHECK LxsT
�C� �Z'3 ' CONSTRUCTION TYPE: �� .
� Sq Footage $ Per Sq Ftg
' �asement � . . .. X _ . ,
lst Floor � � • _ . . ' �
2nd Flaor x = � �� .
Garage X = ,
z =
To�rAL
Estimated CoDstruction Value: $yO,vOD °o
I.nspections Requirec3: Work Requiring Separate Pertnits:
Site _�Plumbing Fire
� Hardcover Removal _�_Mechanicai Water Coaaection
Footing ` Septic Sewer Connection �
� Fr��° � Fireplace Lawn Irrigation
oc Insutatioa (Masonry) Other
�Vall Boazd (Mfg.) Well (State Ferm.it)
—�F�� Grading/Filling K Electrical (State Permit)
Other
REMA�R.K� (IN HOUSE): � . '
-------------------------------------------------------------
RE'VIE�V SY OTHERS: DAT'E:
Access: Ezisting New .
Access Approval: Date gy; �
------------------------------------------------------------------------------------------
REI�JARh'S ('I'O BE NQ�'E�D Qv pER11�tI'I�; .
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DATE TIME
CITY OF ORONO CALLED IN 1 � `�'�
INSPECTION N TICE SCHEDULED ��� __���.�.
PERMITNO. �� ��a5 COMPLETED
ADDRESS ��� ��1/ I I/�S �2
OWNER � hv�C�i'� CONTR.
TELEPHONE N0. ��� " •��'-���
� DESCRIPTION /�CZ-�
t� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
y
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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPT C FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ ORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED
G tNSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (95Z) Z49-46�0
OwnerlContractor on site:
Inspector. �.� � ���
White Copyllnspector's File Canary CopylSite Notice
� I (//(eo- �
� ��/1 ! i V D��/T� TIME
CITY OF ORONO CALLED IN ��
INSPECTION NOTI � .� scHE�u�E� ��� �
PERMIT NO. ' /�� COMPLETED
ADDRESS /�7�1.�-� �i 1 ����� ����
OWNER �-�`��� �����',-.CONTR.
TELEPHONE NO. —��-�`� � �� ��' � ( ��
�
� DESCRIPTION ��� �� �__c i _ ✓�i�Y�' I�
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 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 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 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTHACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
��ORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V EFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (J52� 24J-46��
OwnerlContractor on site:
tnspector. l� � t ��
White Copyllnspector's File Canary CopylSite Notice