HomeMy WebLinkAbout2004-P08054 - re-side ,
' � PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 Pososa
Crystal Bay, Minnesota 55323 Permit Type: MinorAlterarions
(952) 249-4600 Date Issued: io�ii�2ooa
SITE ADDRESS: 2024 Shadywood Road
Wayzata,MN 55391
P I D: 17-117-23-31-0011
DESCRIPTION:
Proposed Use: Residenrial
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Building-Re-Side
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 139.25 Valuation: $ 7,000.00
State Surcharge Fee: $ 4.00
TOTAL FEE: $ 143.25
APPLICANT: Sun Contractors and Home Improvement OWNER: Pamela Willette
6130 Hillsdale Dr 2024 Shadywood Rd
Minnetrista,MN 55364 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATU ISSUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Avnlicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1
t .�
Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pri�zt all infarmatio�z)
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THE APPLICANT IS: (circle o�:e) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �C� J� U� �r.� ZIP:
Will this be a Para 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 approva160 days prior to the event. Non permitted events will not
be nllowed.
NAME OF OWNER: �,�yv�_ (�J t (I�i�i°i PHONE: (home) �
(work)
MAILING ADDRESS: �� � CITY: arar�.0 ZIP:
CONTRACTOR: ��-�►'� (��T�'���'f` PHONE: Y � ���-
CONTACT PERSON: w MOBILE/PAGER: �R� O/ 5�
MAILING ADDRESS: ' CITY: n� � ZIP: �$-3G
STATE LICENSE: # ,,.;2v2 cI�1335�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure
Addition Move
RemodeVAlteration� Land Alteration
PROPOSED WORK(d cribe 'n detai�: (/G J � ��/�
i'1 S� � r�K ` ,�
STORIES: � SQ. FEET OF EACH FLOOR: I�ll�
NO. OF BEDROOMS: s,� GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ?d�� f
I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate;that the
work will be in conformance with codes of the City and with the State Building Code; that I
understand this is not a permit work is not to start withou rnut;and that the work will be in accordance with
the approved plan.
APPLICANT'S SIGNATURE: DATE: I6 �� �
. �. . �
Sec13.04 RIGHTS OF SUBJECTS OF DATA
Subd.i. Type ot 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 requtred to be given individual. An individual asked to supply private or confidential data concerning himself shall be
intormed of: (a)the purpose and intended use ot the requested data within the collecting state agency,political subdivision,or statewlde system;(b)
whether he may refuse or fs legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
� private or confdential data;and(d)the identity of other persons or entities authorized by state or federal Iaw to receive the data. This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivlsion 5,to a law enforcement ofTicer.
The commissioner of revenue mav alace the notice reauired under this subdivision in the individual income tax or nropertv 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 ciassitied as publ[c,private or conTidential. Upon his further request,an individual who is the subject ot
stored private or publtc dsta 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 pend[ng or additio�al 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 oithe data.The responsible suthority may
require the requestfng person to pay the actual costs of making,certifying,snd compiling the copies.
The responsible authority shali comply immediately,if possible,with any request made pursuant to this subdivision,or within 6ve 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 datn
concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagrcement.The
responsible authority shall within 30 days etther: (a)correct the data found to be inaccurate or Incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including reclplents named by the individual;or(b)notify the individual that he believes the dsta to be rnrrect. Data in
dispute shall be disclosed only if the Individual's statement of disagreement is included with the disclosed data.
The determination of the responsible suthority may be appealed pursuant to the provisions o[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.
First Middle Last
Address
City State Zip Phone
erstand my rig ated above.
Signature
V
DATE TIME
CITY OF ORONO �N . �� ,b D
INSPECTION SCHEDULED
PERMIT NO. S COMPLETED
ADDRESS �
OWNER CON . /� �
TELEPHONE NO. � Z Z-4 Z �l�.�
.
� DESCRIPTION � �
�y 01 FOOTING 11 MECHANICAL RI 18 EXC RADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti
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 NOOK-UP 06 PHOGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLPJNT
� 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
h COMMENTS:
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W ORKSATISFACTORIFPROCEED PROJECTCOMPLEfE
� ❑CORRECT WORK 8 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
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� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call forthe ne t inspection 24 hours in advance. (952) 249-460�
Owner/Contra �te:
Inspector.
WhHe Copyllnspectors File Canary Copy/Site Notice