HomeMy WebLinkAbout2001-P04290 - retaining wall ' • PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Poa290
Crystal Bay, Minnesota 55323 P@f1711t Typ2: User Defined Surc Building
(952) 249-4600 Date Issued: 9i2oi2ooi
SITE ADDRESS: 2240 Shadywood Rd
Wayzata, NIN 55391
P I D: 17-117-23-42-0001
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Type: User Defined Surc Building Permit Sub-type(s): Retaining Wall
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Valuation: $ 7,000.00 '
Plan Review Fee: $ 90.48
State Surcharge Fee: $ 3.50
TOTAL FEE: $ 93.98
APPLICANT: To Do List Home Services OWNER: Christine Freeman
1428 Baulder Park Rd 2240 Shadywood Rd
Wayzata,MN 55391 Wayzata 1VIN 55391
THE UNDERSIGNID 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 BUII,DING CODE REQUIREMENTS.
. �
ISSUED BY SIGNATURE
Copies: 1-File(Signitures Required), 1-Applicant, 1-MonthlyReports,1-Assessing, 1-Finance Page 1
t
•
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS ORLEGAL: Z2.�-{O SNz4d�wc��✓J (Lb�Q
PID:
DESCRIPTION OF WORK: (Z.1�,�iN�,� �,yq.�,L
ZO�iG REVIEW BY: N M � DATE APPROVED: �'i-/9—o f
BUII�DING REV�W BY: �/�- DATE APPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes (/ No
PLAi�t REVIEW � Yes !//' No SEWER CONNECfION
STATE SURCHARGE Yes (/ No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CH�CK LIST Zoning District: iv o e��
Fire Department: Post Office: School Districr. �
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No �C Date of Survey:
Proposed Setbacks: � ` /
Froat(Lake): Right Side: (j,�ti+�,.��r►S p�,,�,4�-�- v� �
�,,� �-o �,�.'�cac-� c3x�5 r,«.�
Rear(Sueet): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
L.ot Coverage:
Grading: Staff Approval Date: 9' �`l —G( By: � Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland Disuict: � �7
Avg. Setback: Bluff Setback: Lot Coverage:
Eusting Proposed
Hardcover: 0-75' ����
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
i
BUILDING REVIEW CHECK LIST �
�C� � CONSTRUCTION TYPE: �
` Sq Footage $Per Sq Ftg
Basement x =
lst Floor x _
2nd Floor x =
Garage x =
z =
TOTAL
Estimated Construction Value: $ �7,('�O��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hudcover Removal Mechanical Water Connection
Footing ' Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boud (Mfg,) Well(State Permit)
�F�� Grading/Filling Electrical(State Permit)
Other
REMARI�.S(IN HOUSE): .
____---- ---------------------------_���_---__
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
- -- ----------------------------------- ---
REMARKS (TO BE NOTED ON PERMIT�:
8
Total Fee: $ ��- Date Received: �-y-(�/
Entered By: /,��-' Permit#: - �/a��j
l�
CITY OF ORONO - B ING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
----------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: Z2�(� SVIC�I�/(,�fOC}�-(� �GQ ZIP: �3� �
NAME OF OWNER: �(�.S. ���� PHONE: (home)
� �Q (work)
MAILING ADDRESS: 2Zi-f(� ,�'tG�G��J(}-�`O�C CITY: �(1.z ZIP:_�'���'C�
CONTRACTOR o D� Ll.11' l�ZM� S-�Zf�L�S' PHONE: c�`� -��Z-����
CONTACT PERSON: MOBILE/PAGER:
MAII.ING ADDRESS: ��� ��� �(�( CITY: �,�6..� -� ZIP: , � �
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
� �
TYPE OF WORK: New Addition Accessory Structure �
Move Remodel/Alteration Land Alteration
P OPOSED WO (describe in etai�: t;U�'C_ �,ts� (.�%lill�
Nu��� �. ��
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
� �
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��%� ��. ����
,
I hereby apply for a building permit and I acknowledge that the information above is complete and��f�-�
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 ccord ' h th approved plan.
APPLICANT'S SIGNAT r DATE: G�
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
Sec.13.04 RIGHTS OF SUBJECTS OF DATa
Subd. 1. Tvpe of data. The rights of individual on whom che data is stored or to be stored shall be as set fonh in this secrion.
Subd.'_. Information required to be given individual. An individual asked to supply private or co�dendal data concerning himself shall
be informed of: (a)the purpose and intended use of the requested data wichin the collecting"stat�ageocy,poli6cal subdivision,or sracewide system;
(b)whether he may refuse oY is legally requiced to suppiy the requested data;(c)any laiown coasequence arising from his suppiying or refusing to supply
priva�e or confidential data;and(d)the idenrity of o[her persons or enriries au[horized by sta[e or federal law to receive the data. This requir.menc shall
not apply when an individual is asked to supply invesdeadve data, pursuant to secaon 13.82, subdivision 5, to a law enforcement office:.
The commissioner of re e�ue mav plac the nodce reauired under this subdivision in the individual income tax or propem tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whe[her he is the subject
of stored data on individuals, and whe[her i�is classified as public, privace or confidenrial. Upon his fu�ther request, an individual who is rhe subject
of stored private or public data on individuals shall be shown che data wichout any cnarge to him and, if he desires, shall be informed oi rhe content
and meaning uf[hat data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to hun for
six months thereafter uriless a dispute or acrion pursuan�to this section is oending or additional data on the individual has been collected or crea�ed.
The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual coscs of makinz, certifying, and compiling the copies.
The responsible auchoriry shall comply immediacely, if possible, wich any request made pursuant to this subdivision,or wichin five days ot
the date of the request,excluding 3aturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply wi[h the request
within that time,he shall so inform che individual,and may have an additional five days within which to comply with the request,excludin�Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of pubiic or pri��ate
data concerning himself. To exercise this rieht,an individual shall nodfy in wridng rhe responsible authori[y describing�he nature of[he disagreement.
The responsible auchoriry shall within 30 days either: (a)correct the data found to be inaccurate or incompiete and attempt to nodfy pas::ecipiena 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[he disclosed data.
The determination of the responsible authoriry may be appealed pursuan[to the provisions of the administrarive procedure acc relacing to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Riahts of subjects of data", we would like to inform you that your reauest
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 pemut or license.
4. If your requested pernut or license requires Council action to approve, some informa[ion mav become
public.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on ��ourself.
6. Your full name is required to process this application or permit.
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