HomeMy WebLinkAbout2001-P04101 - attached deck ~ PERMIT
G�i`TY OF ORONO Permit Number:
275� Kelley Parkway - PO Box 66 P04101
Crystal Bay, Minnesota 55323 P2Pt111t Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: �i2ai2ooi
SITE ADDRESS: 2171 Shadywood Rd
Wayzata,MN 55391
PID: t7-117-23-42-0022
DESCRIPTION: UBC Occupancy x3
Proposed Use: Residential Construction Type VN
Census Code 434
Permit Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 139.25 Valuation• $ 6,500.00
Plan Review Fee: $ 90.48
State Surcharge Fee: $ 3.25
TOTAL FEE: $ 232.98
APPLICANT: Shep's Construction OWNER: Jacquelyn Robertson
5450 Shoreline Drive 2171 Shadywood Rd
Mound„MN 55364 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SfRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT P TEE SIGNATURE IS UED BY SIGNATURE
Coaies: 1-File(SiQnitures Repuired). 1-Annlicant 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
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Total Fee: $ ��� � � ` Date Received: 7'/�!v/
✓ E:}tered By: -��1_, Permit#: � �`v`f/v/
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICAlvT IS: (circle one) OWNER�ONTRACTO
JOB SITE �DDRESS: �t�7 L ������ ��(�j� �'t�ZIP: �`���} �'
N��IE OF OWNER: c� �C�,�,c, F���.2i��� PHONE: (home)�.7( - �C3 j g
. (work)
MAIL�i IG ADDRESS: �l'7l 5�5��`►9c�o.� �e�CITY: V�.3-���'zf�� ZIP: �'�3 �
CO\�'RACTOR: �t-� �c� S ��5-�- PHOI�'E:_��"L � .�72� .�p 3
CO��TACT PERSON: h-tC�2c,� 1VIOBILE/PAGER: tn�Z •- Li�7� `j 5 Zfo
�LAII..Pi TG ADDRESS: �"<(.�c1 ;�F-{�:E.r��;F_cj2CITY: f�c.oc.�1�.�c� ZIP: �'S �o�
ST�iTE LICENSE: # 2Z 3 3
ARCHTI'ECT/ENGINEER: PH0�1E:
NIAII.I�i iG ADDRESS: CITY: ZIP:
�'A_`IE: REGISTRATION#
a
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration_� Land Alteration
PROPOSED WORK(describe in detai�: iQ�c��c�G�. t� �G.� r' S E��"t�
�L 'Z'� � �-- �C..�'<t�� � 1�9c�c�� i�c�"--t[� c�GS�!'�'� ����c�Gc=�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOVIS: GARAGE STALLS: ATT. DET.
ESTL�IATED CONSTRUCTION VALUATIO�i (escluding land): $. �o�S �C"`� .
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I hereby apply for a buildin� permit and I acknowledge that the information above i� complete and
accurate; that the work will be in conformance with the ordinances and codes of the Ciry and with
the State Buildin� Code; that I understand this is not a permit and work is not to start without a
permit; and that the work wilI be in accordance with the approved plan.
APPLICAI�iT'S SIGNATURE: /�iz1� DATE: �I�� '7� - � �
NOTE! Parade of Homes events require separate permit approval by Police Department and
.
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGI3TS 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 ut for[h in this secaon.
Subd.2. Information required to be given individual. An irMividual asked ro supply private or confidentia!data conceming himself
shall be informed of: (a)the purpose and in[e�Med use of the requested data within the coilecting state agency,polidcal subdivision,or sratewide
rysum:(b)whecher he may refuse or is legally required to suppty the requested data;(c)any lrnown consequence arising from his suppiying or
refusing m supply privare or confidenaal dara;and(d)the idenary of other pecsons or endaes auchorized by sta[e or federal law ro receive rhe data.
This requirement shall not apply when an individual is asked ro supply invesrigadve data, punuant to secdon 13.82, subdivision 5, to a law
enforeement officer.
'Itu commissioner of revenue mav olace the norice reauired under thi subdivision in the individual income taz or�ro tax refund
instructions mstead of on choss formc.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the
subject of sWred data on individuals,and whether it is classified as public,private or co�denaal. Upon his further request,an individual who
is the subject of stored private or public daa on individuals shall be shown the dara without any charge to him and,if he desires,shail be informed
of the concent and meaning of that data. Aher an individual has been shown[he private data and informed of iu meaning,the data need not be
disclosed to him for six mon�s thereafrer unless a dispute or acaon pursuant w this section is pending or addirional data on the individual has been
collected or created. 'Ihe respor�cible authoriry shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible au[horiry may require che requesting person to pay the actual cosu of making,cerufying,and compiling the copies.
Tha responsible au[horiry shall comply immediately,if possible,wirh any request made pursuant to this subdivision,or withia five days
of the dace of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with
the request wi[hin that time,he shall so inform[he individual,and may have an addiaonal five days within which to comply with the request,
excluding Samrdays,Sundays and legal holidays.
Subd.4. Procedure when data is aot accurate or complete. An individual may contest the accuracy or completeness of public or
private data co�eraing himself. To eze�ise this right,an individual shall notify in wridng the responsible authority describing the nature of the
disagreement 'Ihe responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and aaempt to noafy
past recipiencc of inaccucate or incomplete data,including recipients named by the individual;or(b)norify 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.
The dererminadon of the responsible authoriry may be appealed purruant to the provisions of the adminis�auve procedure act relaang
to contested cases.
DATA PIZTVACY ADVI ORY
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 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 Ciry 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.
(`'iC�Qf� 5 C�-F�c�C—f/�F-�I'
F�rsc M�ddle
Last
��.� �C.-,:�—:.��� ,l r.C�� t
Address
t�C7-f�1-JE 9� C`G�U c 2 � � `��Zr �CZ'C. C� ,�
C�ry' Stace Zip Phone
I understand my rights as stated above.
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Signature "
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f CHECK OFF LIST FOR ISSUANCE OF PERMITS
� � . FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: 211 � 5 H-F��y W 00►� (2�p A,�U
PID:
DESCRIPTION OF WORK: �3L�c ,?�>,Pt,4cxn�,=rv r
ZO�TING REVIEW BY: DATE APPROVED: 7-'Z Y- o�
BUIIrDING REVIEW BY: DATE APPROVED: 7-z y�01
_----------- --- -------------------------------------__----__----___----
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes % No
pLAN REVIEW Yes �G No SEWER CONNECTION
STATE SLTRCHARGE Yes c� No WATER CONNECITON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
Z4r�1G CHECK LIST zoning Districc: �u o c H�p
Fire Department: Post Office: School District:
Lot Area: Sq.fr. Acres W dth Depth
Survey Submitted: Yes�_ No Date of Survey: 0nf E=�� '7-Z,-� t
Proposed Setbacks:
Front(Lake): ��/� Right Side: '70� t
Rear(Street): Zo�: Left Side: S� � 't
Adjacent Structures: /�l//}- Wetland: /�R
Building Hei;ht: Def. Hgt. � Peal:Hgt. —'
Lot Coverage: 0.��
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date: . .
�p,� Shoreland District:
���� Avg. Setback: Bluff Setback: L.ot�overage:
Existing Proposed
Hardcover: 0-75'
75-2�0'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RE1I�IARKS (in house):
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BUII.DING REV��V CHECK LIST � �
�C� - IZ'3 CONSTRUCTION TYPE: ' V/J �
Sq Footage $Per Sq Ftg
Basement . x _
lst Floor x _
2nd Floor x _
Garage x _
a =
TOTAL �
Estimated Construction Value: $ bf �—avtl�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical • R/ater Connection
��— Septic Sewer Connection
d�C Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board . (Mfg.) Well (State Permit)
—�-��� Grading/Filling Electrical (State Permit)
Other
.
RENIARKS(IN HOUSE): . �
------- -------- --------________________ --------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gy;
---- ----------------------------------------------
REMARKS (TO BE\OTED ON PERMIT�:
8
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DATE TIME
CITY OF ORONO CALLED IN �/}�
INSPECTION NOT CE �^ SCHEDULED /� �
PERMIT NO. �O��I L�� COMPLETED � �S
ADDRESS � � � � 5�'�C.�G�� �L! �C'/� (--�"
OWNER CONTR. � � '� �`�'�
TELEPHONE NO. ��"� `��� J��'�
� DESCRIPTION ��C�� ���n�'��
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 1A'�AL�- D. 12 WATER HOOK-UP 17 SITE INSPECTION
�F 14 SEWER HOOK-UP O6 PROGRESS
� 7 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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��ORK SATISFACTORY:PROCEED �ROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
p ❑CORflECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
Owner/Contr on site-
Inspector.��d���, U�S
White Copyllnspector's Ffle Canary CopylSite Notice
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PROPOSED SUBDIVISIO N FOR
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OF LOTS 9 a 10, W I L EY 'S PARK �`''� �'�'`'�'�`O��
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� ; , ❑ �PPf;OVEU W;TH REVISIONS
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� �' I hereby certi!'y tlaat this i� a true
and correct repr�sentation of' a survey
� of the boundari�s o1' Lots �j and lU,
/ ?�loc'�c :', �';��1ey's i'�.Lr��� La'.c ;'ir.nutorilc��, and
I the locat,ion oi' all exis tin�; t�uil�3in�;:; thereon.
/ Ii, doc:s not purport to SI101J other improvements or
cr.cra•�chlr,ent;,.
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CITY OF ORONO
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