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Home My WebLink About2004-P07653 - addn/remodel/repair CITY OF ORONO PERMIT 2750 Kelley Parkway- PO Box 66 Permit Number: Po�6s3 Crystal �ay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 ' Date Issued: �i�i2ooa SITE ADDRESS: 480 Russell Ave Wayzata,MN 55391 P I D: 02-117-23-31-0003 DESCRIPTION: uBc occupancy R3 Construcrion Type VN Proposed Use: Residenrial Perxnit Class: Building Census Code 434 Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: n-"._�n._.�_ e� o- n_�-r.'-`.--�-'---�--'-- .'.::::��:::.:�.. .w:,:�c:�.::.:f �:G"'.."b FEE SUMMARY: Permit Fee: $ 111.25 Valuation• $ 4,500.00 Plan Review Fee: $ 72.28 State Surcharge Fee: $ 2.75 TOTAL FEE: $ 186.28 APPLICANT: Hansen Hometech Inc. OWNER: 7osephine Carpenter 7920 Kerber-P.O.Box 1009 480 Russel Ave Chanhassen,MN 55317 Wayzata MN 55391 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 SI'ATE OF MINNESOTA BUILDING CODE REQUIREMENTS. �� C` - �Z�'tc,9� d� �YYl�l,/� �� APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE Couies: 1-File(SiQnitures Re4uired),1-Anplicant, 1-Monthlv Revorts, 1-Assessine, 1-Finance Page 1 Total Fee: $ �� . ��° a�ti Date Received: � �� -�� En�ered By: ��. � `� Permit#: �o'�7toS3 CITY OF ORONO - BUILDING PERMIT APPLICATION L � All information must be submitted in full before plan review will be started. �� (,'►_-_________ (please print all i�zformation) ',' -- ----------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTR.ACTOR JOB SITE ADDRESS: `�$� RvSS��, �V� . ZIP: �S�°I � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Non permitted events will not be c�llowed. NAME OF OWNER: �65 ��K�k� �-C*�� PHONE: (home) �SZ- �$Z'v��`t��' (work) MAILING ADDRESS: ��*�I� , CITY: � ZIP: CONTRACTOR: T�h►s�� M,�j'�C,� l ti C, . PHONE: �S� "9'J�"^O�S�' CONTACTPERSON: G�.2.0 t�-At�s�� MOBILE/PAGER: f�Z-3(oq- ��o MAILING ADDRESS: "79'20 K�Rt�CR��.d. to05? CITY: cl�A�.1 ZIP: SS3tZ STATE LICENSE: # 12(c 1 ARCHITECT/ENGINEER: �-�.��y �+�Ns�� PHONE: , MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Accessory Structure �J�Q � Addition Move RemodeUAlteration� Land Alteration PROPOSED WORK(describe in detai�: �R.p�Z' ��P�.`� `�, S,'p� �1.i`T'e.�/ 0J E�,�-�,� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ '�, �b0 I hereby apply for a building pemut and I aclrnowledge 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 pernut and work is not to start without a permit;and that the work will be in accordance with the approved plan. h APPLICANT'S SIGNATURE: DATE: ��2$ d Sec.13.04 RIGHTS OF SUBJECTS OF DATA r Subd.l. Type of data. The rights of individual on whom the data is stored or to be stored shali be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to suppty private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,politicai subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known 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 data. This requirement shall not apply when an individual is asked to suppiy investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement otficer. The commissioner of revenue mav �lace the notice reauired under this subdivision in the individual income tax or proaertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responslble authority,an indivtdual shall be informed whether he is the subject of stored data on i�dividuals,and whether it is classiCed as public,private or confidential. Upon his further request,an tndividual who is the subject of stored private or public data on individusls 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 disciosed to him for six months thereafter ualess a dispute or action pursuartt 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 publlc 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 Cve days of thc 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(ndividual,and may have an additional five days within which to comply with the request,excluding Saturdays,Sundays and legal holidays. Subd.4. Procedurc when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himselL To exercise this right,an individual shall notity in writing the responsible suthority describing the nature of the disagreement.The responsible authority shall within 30 days either: (a)correct the data found to be insccuratc or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the i�dividual that he believes the data to be correct. Data in dispute shall be disclosed only if the(ndividual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions ot 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 nsed 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. First Middle Last Address City State Zip Phone I understand my rights as stated above. Signature � ' CHECK OFF LIST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: �/430 /2 v ss c:� i4.�-a PID: DESCRIPTION OF WORK: —nr T Z0�1G RE'VIE`Y BY: DATE APPROYED: 7-6 -�° `� BUII.,DI�iG REVIE'4V B : DAT'E APPROVED: � -6 •fl 7 FEES TO BE CfIARGED: Misc. Fees Calculated By: PERMIT Yes i/' No PLA�v REVIEW Yes � No SEWER CONNECTION STATE SURCHARGE Yes � No WATERCONNECI'ION INVESTIGATION FEE � Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) ZOYING CHE.CK LIST Zoai.ng Discrict: �vo C/-�e a/L C�-k ✓ Fire Department: Post Office: School District: � Lot Area: Sq.ft. Acres � Width Depth Survey Submitted: Yes No ate of Survey: Progosed Setbacks: Front(Lake): Right Side: Rear (Street): Left Side: Adjacent Structures: Netl d: Building Hei�ht: Def. Hgt. Peak gt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Re olutioa Date: � Shoreland District: Avg. Setback: Bluff Setback: I.ot Coverage: Existine Proposed Hazdcover: 0-75' 75-250' � 250-500' 500-1000' Hazdcover Vaciance Required: Yes No Dace of Council Approval: REI�ZARKS (in house): 7 r Bi.TII,DING REVIEW CHECK LIST '�� ' � � CONSTRUCTION TYPE: �ti _ Sq Footage $Per Sq Fto Basement . . . x _ lst F1oor x � _ . 2nd Floor z = Garage x = � x = TOTAL Estimated Construction VaIue: $ �-{, ��v� Inspections Required: `York Requiring Separate Permits: Site Plumbing Fire Hazdcover Removal Mechanical Water Connection Footing ' Septic Sewer Connection • D� Framing Fireplace Lawa Irrigation Iasulation (Masonry) Other Wall Boazd • (Mfg.) Well(State Permit) �F�� Grading/Filling Electrical (State Permit) Other . 12EMARKS(IN HOUSE): . -------------------------------------------------------- REVLEW BY OTHERS: DA'I'E: Access: Ezisting New . Access Approval: Date gy; -------------------------------------------------------------- REI�T�.RKS (TO BE NOTED ON PERivIIT�: 8 �"'' � _ � � _ .... � - - .� �� _ � � ��^ �'' ; � � � �� :� � �, � �� :-, `: �. ; � ,� , .; ^ : � � � `/' -� - J Z �;� < t�.� � : ,�t � � o cn r= , p� 7: c_ p; �.• `�� Y. C_ �' � ;- i f.i� � ; ., i� t: . � (f C) J f;, . . d. W U: „� �T '?7 = f_ o. j_ L: '" T_ - - � � C�' c�; U L!„ - - �� r, _ � ' til i� 41 �� U �- .�� .�. .i) _ `� ��_- �. •4 �i : � � �' n �' �� `. . � - _ F.. Q V� f ll � ,n ... " _ -� � � OC� �'. c !;� �'- - - v � O `L - (n 1- .,_ [�. � - U r'. J � p `� l-7 L..J►�._cc� d� V Z � � � V � �� N _�� m � m Z•'�~ � Wm � � � v No�� J 2Z � � � � na�'. U ...� � °� '..{ - � . , � � . T � � I { i i = ,_ _ _ _ _ __ __ � ' ---�_ t - - - --- - - - - - - - - - - - - - - - - - - - - - - - - - - - ___ r - - - - - - - i � � 1640 3008 1640 � � � 2436 � I I rn � I I � i i � _ - � � I I � � I I o �- �7�� 5'-5 7/8�� _ 5�_5�� 7�� FRONT ENTRY t L� � Z � I �c�a..� HANSEN HAMETECH INC. 7920 iCer'aerBlVd. P.O.Box 100A Chanhassen,MIV 55317 �s�2� s;�-os�. � l�iP� License#1261 vi '' I I � � � � � � w � ,; 1�-_ 4'-1 15/16" -.�� ' ; .-- � � � Q . � i � � �� - \ 1 , -- l� � � 1�- � , � I I � � � . m � , i (� � w ��I �I n ; � � � � I ' I � = I o ; I � i � �� 2 5/1�" ' �� , -__ ,� 7 _p . _ �\� � ,�, ' _ _ i i � � __ ��; , _ -- - -- _ r � � - - � ; � Z ,� �. � � �� N �� *" � � � � Z�! � � W � �'' v t�Y�� W •- p �NJ =z � � naU ,.� �. - � 07l01/2604 08:23 952-934-4603 PAGE 03 ' f �_ . v �� . ? � • � . `• N � 1 � r -� ( i � 1 � � •� � *� � � ' � � f �� . :..L� � � � � � � � � � � � � • � '�' � � . . � 1 � � � � rM � • o ,� � . � 9 � r � " �fi �� . �� 6 ' �A �O � � � � �� . . � � � • 07/01/2064 68:23 952-934-4603 PAGE 02 • �� —.. � ' '��- _ , . ; 1 � ., � � .� .�- - � � • / ,. ..Y • � . , � . • • �, . � . r� � ' � � r� ��~ � ; '. �/ $ �� — � � ♦ .�-�__�—^��r� _ti.� . . � .�+��^ ^�� '�\ n-�=��\ �' �'.�., �: � � ��'�.�, �' ' ' fr�- � ��' � __ `: p "` r ! ��,L• � � :f �a ' - .•,�; 6 ,� - C ,,�,� � � 1 . � - _ �r- � e � � � � � � � � � m .�-r ! � �� . . � DATE TIME � CITY OF ORONO CALLED IN O � ��__`'�� INSPECTION NO CE SCHEDULED PERMIT N0. ��S� C PLETED ADDRESS � OWNER CONTR. �n�� 7-I L�"K-�� TELEPHONE N0. �� -- ' J � DESCRIPTION � `- �-- l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/ RADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 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 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � �YL�- c', ��= W a � J O � � O � W � Q � Z W � W � � � �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 24J-46�0 OwnerfContr on i : Inspector. - White Copyllnspector's File Canary CopylSite Notice