HomeMy WebLinkAbout2003-P05157 - attached deck CITY F R PERMIT
O O ON� Permit Number:
2750 Kelley Parkuvay- PO Box 66 P05157
Crystal Bayf Minnesota 55323 Pe�mit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: ��2i2oo3
SITE ADDRESS: 1875 Shadywood Rd
Wayzata,MN 55391
PID: 17-117-23-24-0029
DESCRIPTION: uBc o��up��y x�
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Pernut Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernrit Fee: $ 83.25
Valuation: $ 2,800.00
Plan Review Fee: $ 54.08
State Surcharge Fee: $ 1.90
TOTAL FEE: $ 139.23
APPLICANT: Owner/Self OWNER' Mark&Gina Kosek
MI`j � 1875 Shadywood Rd
Wayzata,NIN 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 STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLIC T PE EE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Si�nitures Repuired), 1-Aunlicant 1-Monthlv Revorts, 1-Assessin¢, 1-Finance Page 1
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Total Fee: $I J Date Received: f� � � � -�
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Entered bty: � ' I9 ���� � �'�,' C''�ermit#: ��/�' b/' `Z_
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���'�CITY OF ORONO - BUILDING PERMIT APPLICATION
1
� All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNE� OR CONTRACTOR
�'�'v ��JOB SITE ADDRESS: t$�5 �'v� , L "� �� ZIP: s53 y�
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` NAME OF OWNER: N1c�k 1�-osei�. a C�ivla t=.� l�se.l�-PHONE: (home)°!5a-4� I � 07 y
(wark) (c i�-3 u4- �t,.�z
MAILING ADDRESS: t�15 51,�.r ;U��l ��;p . CITY: �;u ZIP: ���y!
CONTRACTOR: S� � PHONE:_ �5�-4-�I - I o�G
CONTACT PERSON: N��1�- ICc�s-�1.� MOBILE/PAGER: � t 2- 9�u �cP�.2
MAILING ADDRESS: �cu,v�e a_� �,��,� CITY: ZIP:
STATE LICENSE: #
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ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration �,.! Land Alteration
PROPOSED WORK(describe in detai�: i�`�L1� � j���� � '�,I��t�Wia,�1
—
STORIES: Z SQ. FEET OF EACH FLOOR: �S� � i 25 " 2� �7� = 2U i
NO. OF BEDROOMS: � GARAGE STALLS: ATT. — DET.— 5f�„�`�
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ L`����' i
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: �. G �
NOTE! Parade of Homes events require separate perntit approval by Police Department and
Ciry Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGATS OF SUBJECTS OF DATA '�
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.
S�bd.2. Informatton required to be given individual. An indivtlual asked to supply private or confidential dara concerning himself
shall be informed of: (a)dre pucpose and intended use of the cequested data within the collecting state age�y,polidcal subdivision,or statewide
sysoem;(b)whether he may refuse or is legally required w supply the requested data;(c)any lrnown consequence arising from his supplying or
refusing ro supply private or wnf�ential data;and(d)the identiry of other persons or enades authorized by state or federal law to receive the data.
This requirement shall not apply when an individuai is asked to supply investigative data,pursuant to section 13.82, subdivision 5,to a law
enforcement officer.
The commissioner of revern�e mav nlace the notice rewired under this subdivision in the i�ividual u►come taz or orocertv tax refund
instrucdons instead of on those forms.
Subd.3. Access to data by indiv[dual. 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 class�ed as public,private or confidential. Upon his further roquest,an individual who
is the subject of stored private or public data on individuals shall be shown the daha wid�out arry charge to him and,if he desires,shall be informed
of the content and meaning of that data. After an i�ividual has been shown the private data and informed of its meaning,the data need�t be
disclosed to him for six months tbereafter unless a dispute or acdon pursuant to this secdon is pending or additional data on the individual has been
collected or created. The responsible authority shall provide copies of the privaoe or public data upon request by the inciividual subject of the data.
The responsible authority may require the requesriug person to pay the.actual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall wmply immediately,if possible,with any request made�rsuant to this subdivision,or within five days
of the date of the request,ezcluding 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 wtuch to comply with the request,
ezcluding 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
privaoc data co�erniag 6imsdf. To ezercise this right,an individual shall nodfy in writing the responsible authoriry describing tha�nature of the
disagreement. The responsible authoriry shall within 30 days either. (a)wrrect the data found W be inaccurate or i�omplete and attempt to notify
past recipieras of i�ccurate or i�omplete data,including recipienu named by the i�Mividual;or(b)notify the individual that he believes the data
w be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
11u determinaaon of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating
w contesud 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�ity 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 fiunish 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 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.
C—��v�a� �—,vt.1� IC.�z�l�
First Middle L.ast
�SS"1 �tile d.tnl �� !.(�
Addross
`Wa�n�r� M.�V �53 q I a5a��"ll- I o7�
Ciry State Zip Phone
I understand my rights as stated above.
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Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
• FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 1 �1 S S la A�Ay w o o� rLp�,� -
PID:
DESCRIPTION OF WORK: ��ca�
ZONING REVIEW BY: DATE APPROVED: -��- z�. o Z
BUII�DING REVIEW BY: DATE APPROVED: -� - Z g • o z
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓� No
PLAN REVIEW Yes � No SEWFR CONNECTTON
STATE SURCHARGE Yes �/ No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning Districr.
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes .� �10 Date of Survey: o�.c ���
Proposed Setbacks:
Fr�nt(Lake): lS' Right Side: �.Zp'
�e�(Street): `S` Left Side: 7 6� '�
Adjacent Structures: hTr-r�-t.t.r�trJ Wetland: �r/r+
Building Height: Def. Hgt. n/ /�- Peak Hgt. --
Lot Coverage: ��k
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: ` By:
Zoning File: # �-27 I, Resolution: # Resolution Date: -1-2z- 0 2
Shoreland District: �,�CS
Avg. Setback: �I /.l�F Bluff Setback: /V/�} L.otCoverage: --
Existing Proposed
Hardcover: 0-75'
75-250' 2�p,.�$
250-500'
500-1000'
Hardcover Variance Required: Yes ( No Date of Council Approval:
REMARKS(in house):
7 �
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BUII.DING REVIEW CHECK LI�T ' +
UBC: �Z-3 CONSTRUCTION TYPE: 1//�l
Sq Footage $Per Sq Ftg
Basement z =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ 2�OC��=
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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)
plFinal Grading/Filling � Electrical(State Permit)
Other
{.
REMARKS(IN HOUSE): -
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMI�:
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C C� _ DATE TIME
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CITY OF ORONO CALL IN 7'
INSPECTION N TICE SCHEDULED 7'� '� � �;�
PERMIT N0. COMPLEiED
ADDRESS /�7..5 ���-���i����
OWNER �1�Z4 IGL�SP� CONTR.
TELEPHONE N0. ���` �7 � �0 7"�/
� DESCRIPTION ��l�1�IS
ly 01 FOOTING 11 MECHANICAL I 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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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 FI AL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTORTOMEETYOU: ' ES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pNOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe nex 'nspection 24 hours in advance. (g52) 249-4600
OwnedContr ct on it :
Inspector.
White Copy/lnspector's File Canary CopylSite Notice
��`�i DATE TIME "
CITY OF ORONO CALLED IN
INSPECTION N �jICE SCHEDULED S-/ -6 //:3D
PERMIT NO. �/S� COMPLETED
ADDRESS �87� � d�
OWNER � 5 CONTR.
TELEPHONE NO. 7SZ T 7� lD 7 /
� DESCRIPTION �� � ���
� 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
�ZA�L BD. 12 WATER HOOK-UP 17 SITE INSPECTION
NAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC IfdSTAI.L. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNEHICONTRACTOR TO MEET YOU:_YES_NO
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUtRED.CALLTO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance. (J52� 249-46�0
OwnedContr n ite:
Inspector. ��,
White Copyllnspector's ile Canary CopylSite Notice
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CERTIFICATE OF SURVEY FOR � a2 � ��� `�"''
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GINA FINK KOSEK � \
IN RLS' s 624 & 1216 & IN SEC. 17- 1 17-23
HENNEPIN COUNTY, MINNESOTA PtLM �
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��LEGAL DESCRIPTION OF PREMISES : \ /(/
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'fl�ut pniY of Guvammcnt Lo17,dc�c�:xd a�follows: Re�im�ing ut u poir.t nn tli: �� . `'•. .... SKo
tiowhcns�trly linn ot'l'rncl F.,Rcgist�rcd I.unA Survey No.G2•1,Fib:s�i thc Itcgis�rar nf ;;•"�` . �� ��O�CQ�3
Tides,107,59 fcet Norlhcuslerly from the mosl Southerly comer ol's�id'I'raci�;ihci�ce N,c:--•�"'" i � .9O ��
Somhcnsledy n(1 righl unyle t0 toid Suulhwsie:ly line 71.R8 ie�r th•:ncc dcfleciing tu i � �
the itft 71 dcgraet 41 roinu�es JO sawndc,n disance of 47:]�F leei;thcnca Nunh a1 n � , � �
righl engl¢32 fcct;ihcnce Bns1 nt o rigbt angle 92.1 I fect,murc or Icss,tu the Wesicrly �,' �1�+. `
lin�n1'Pnrk Sttccl,tui shown nn�ho�lat af•'$hndy Wnod"(now Cnuury Rond No.19): �--"---
Ihn�ca Nonhwt�lcrly,olong Il�e Wes�crly line of said'strenl!o Ihe�onst Lauorly curner nl' "" �'���
'••�..,, _ ::''
saiA Trnct F..;�hcncc Sui,qnves�criy nluny ihc Southeastetly linr of snid l'�ut:t l.'.�n ihe /[� ► N 9°56� 30�� W �25.2 1 .........�
�bim ol'bcginning,in Se:tiun 17,Tu�mship I 17,RonEa 23. �j�� O� ���/Na
$ubjccl In uny roads,highwrys ot�i;,hlaof-�w.ry now ItiJ out ortxixtiuu uo i�r;�aus::��id �/� �ITE PLAN GRADINQ �LAN � � f�"� �p�.K;f
pranixt�ur eny pnniun tbereof,at rel'erted to!n dned Doc.Nn,19a 132,I�il¢s uf p P:``;� ;^h �
Regisltat of 7itles. (Tortens Propem) _,�d_`p4���Q���—� e�-lC Cjvo'r 'f-o su�-6, � ���� ���P�
� �:a� �,��1�,��f�t� t�'IrN R�VIS�ONS
7�hm parl uf Covcmmcnt 1.013,in Sects n 17,Tuwnship 117,Range 23 bounJed 6y a 9 IL, ���^`�� V���
Ilne Jesc�ibed of[ollo�vs: Commenc(n on iha Inko sl:ore uf(,akc t+linnetunkn on tht �,���••
F.ust sid�ol'soid Lot,47 mds Norlh of Ihe Soulh line of s�id Lol 3;Ihcnce Wcst 37 ruJs;
thence Nnnh GB Icet��i tlie acWnl point of be;Inning of troct of InuJ lo be dexcribcJ; ��
thence cuNlmung Nunh 321cat;lhence Cas192.1 I fcet to Ihe Wcsla:ly line of Park hA'�'� --t_ Zq `�Z
Stre�t(now Cuunry Road Nu.19)as laid out a�d dcdicated in llw p�al nl'Shndy Wnnd; �
thenee Soutbeasierly nlunµllie Wes�tdy line of sald rua�l 3JJ Ic^I;i�+encr.W::,,l 102.66
fcei iu tho point nf heginning. (AMtraa Propaiy)
Tnet G,R�yis�ettJ Umd Survey No.624,1'ilrs oF ILcgixirur uf'1'itlex,Id�nurpin Comuy,
Minnayotr. ('Ibrrtns Pwpcny)
Traus 0,C,D a��d fi,Iie�istcrul Lund Survty Nr..1�16,Piica of Ite�islrar ul"I'i:lex, o : denoles iron morker
Hem�cpin Cowuy,Minncsw�. (Tnrru�s Yropchy) Bearings shown ore bosed upon on assumed dotum.
At Je�
Thnt part ot Govarnment Lot �, Suction 17, Tuanstii� 117 North,
Annqa 2� HusC o[ the tith Princlpel Harldian, dnscclbud as
[ollovs:,,�,Comaicnr,l�q on the lekashnre. ot Laka llinnetonl:a,
dlstent A9 rods NOY�h p� tho South llre ot said Lot 7, thai:�n
Nest e dls[ancu oC 23� rodn Co tha polnt ot Ueqinninc�; thonca
North a cll�tenco oC GO taot: thence East a dlstancc r._ 102.6G
teet to tna �+estorly lino o[ county ttoad Numbor lv ac l�id out This survey i�lends lo show Ihe boundories ot lhe above described properly,
nnd dodlcaeod ln tlio plat o[ snndyvoodi thonca s:,utAorlf along the locolion o( on exi,ling house and shed, and the �ocalion of oll visibte "hordcover"
tha Nostorly llno o[ salA road [o its lntarsqctlon with tha -
linu aravn wc•sc trom �ho polnt on tno lakesnorn aLstnn•;. a� lhereon. It does not purporl lo show ony other improvements or encroochments.
rods Horth o[ [ho South !.lna oC oald [.ot 7; tnonco l�ost Co
:hu point o[ beginninq.
DESIGNEO REVI510N DATE �ESCRiP110N 1 HEREOY CERTFY THAT TIIIS FL�N, SPEC�FICA110N, OR REPORT
scnu:
_ ` GROND�RG & ASSOCIAT�S INC, WAS PREPARED UY ME OR UNOCR uY D(iECT SU'ERVISiON AND 1"=F4�
v ) THAT I AA1 A DUIY LICENSED PROFESSIONAL ENGNEEH ANO lA�(1 � �nTF.
SUtvEYOR uD[R ti[LAwS OF TIE SfAiE Of uuf50T�.
URAWN
CONSULTUIC E�IGI�IfERS,IA�A SURVEYORi,SI1E F'IANNCRS G/12/0
445 NORTfI WILLOW DRIVE, IONC LAKE, �N. SSJ56 .7f�� J /�/ JO(3 NO.
GKCKED 952-h73-41h1 FAX 952-A73-4435 a'L--��—���
. - � DATE �-/L-�Z AIN �ICENSE tN�AOER �Z7J�I� 02-265
o2-zs5 � 1��.c.�c� (� -/3-v�3—
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