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Home My WebLink About2007-P11507 - addn/remodel/repair PERMIT G�TY�OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p11507 Crystal Bay, Minnesota 55323 Permit Type: (952) 249-4600 Addirion/Remodel/Repair Date Issued: l0/3/2007 SITE ADDRESS: 2248 Shadywood Rd unit# Wayzata,MN 55391 P�� 17-117-23-43-0126 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residenrial Census Code 434 Permit Class: Building Permit Type: Addirion/RemodeURepair Pernvt Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Sepazate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: Move walls,build new walls,new kitchen,floors,fireplace FEE SUMMARY: Permit Fee: $ 993.75 Valuation: $ 100,000.00 Plan Review Fee: $ 645.94 State Surcharge Fee: $ 50.00 TOTAL FEE: $ 1,689.69 APPLICANT: Mark D.Williams Custom Homes OWNER: T Nordlie&E Sedor 102 West Sth Street 2248 Shadywood Rd Chaska,MN 55318 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 STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � � APPLICANT PERMITEE SIGNATURE I D BY SIGNATURE /`C�� Copies: 1-File(SignaturesRequired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, I-Septic) Page 1 f • � �y -7 Total Fee: $ I � �� ' � G d, DateReceived: `7 "2'�� J Entered By: � � � � Permit#: f}��p 7 _�� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (p[ease print al! information) ------------------------------------------------------------------------------------ ------------ ------------------- -- � THE APPLICANT IS: (circle one) OWNER O CONTRACTOR 1 , Q n �� JOB SITE ADDRESS: o�� .o,a�t,y��po�' Q� ZIP: / - Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YeS � NO If yes, a special event permit is reguired with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates suff cient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: ,�� ? �,,,,.o�� `�n�Pc�� PHONE: (home) ��']q�` �'�, -� (work) MAILING ADDRESS: CITY: ZIP: CONTRACTOR: ►111��r1c �. ��,�\;a�,,,,5 C�s��°�'PHONE: (p�d ��1- q�f o CONTACT PERSON: �•-�� MOBILE/PAGER: MAILING ADDRESS: (o a �,.?es}- S"�'`-� S'�-�k CITY: C(n�.Sfc°� ZIP: S� / STATE LICENSE: # 10 y p�{�-1 n 2 EXPIRATION DATE: 3�3//a�d ARCHI'. � Y�� ,k ,� �.¢S i � C�;C I� PHONE: ('p 1�t - �j/0 -�b�8 MAILIl� � �"- `� CITY: ZIP. NAME: REGISTRATION: # TYPE O� �J�� \� _ Addition Accessory Structure �,� ��;��.�'ji�- _ Remodel/Alteration (ie: Siding, Windows) �� ,,n'�-C ''� nent may require MCWD review and ermits! PROPOSF ___�u��crcbe in detuin: �Qv:v� �°�q,\�S, �,.py�.,,,� ,��„� ��1�5"�� ,;�-rl��./��d �joors l �,,n.l — �P .� � „-� fl(a�.-Q STORIES: a. SQ.FEET OF EACH FLOOR:� 1 - �3�S S C�' - �(o � NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED DETACHED�C ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � �d` o c� � 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 art without a pe nd that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE: - ATE: ,1 �_ 31 � � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd:1. Typc of 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 required to be given individual.An individual asked to supply private or confidential data conceming himselfshall be informed of: (a)the purpose and intended use ofthe requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence azising 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 supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or pronerty 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 classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed ofthe content and meanin�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 thueafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected ot created. T'he responsible authority shall provide copies of the private or public data upon request by the individual subject ofthe data. The responsible authority may require the requesting person to pay the actual cosks ofmaking,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe 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 data conceming himsel£ To exercise this right,an individual shall notify in writing the responsible authoriry describing the nahue ofthe disagreement.The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients 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 the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of Ihe 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. 1'he 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�t�s application or permit. e v�,.e G S First Middle Last Address C��Y State Zip Phone � I understand my rights as stated abo ature �� , 32 � . � . �CHECK OFF i�IST FOR ISSUANCE OF �ER112'iT5 FOR OFFICE USE ONLY� . p,UDRESS OR LEGrAL: �.� c6 S LZ �1 C� Cx� ct R� PID: DESCT21FrI'I��T OF W�RK__ (Z�_ vw�Q<:.Z----------------------------------------------------------- ZOVNG �2EVIEtiV BY: /� DATE APPROVED: �Y BY: ' . . DATE APPROVED; ��-2,-o— B'(TII�AIN�-- ------ ---- ---=-----------------------=-----------------------t----- �'EES T4 BE CHARGEA: Misc. Fees Calculated By: p�RMIT Yes � No PLAN REVTEtiY � � Yes � No SE�VE�CO1�II�TECTION STATE SURCHARGE Yes __�/ No tiVATE.RCONNECTION INVESTIGATION FEE Yes No —�� PARK FEE SAC Yes No _1� SITEINSPECTTON . Number of SAC�Units OTHER (specify) . ZOYI��tCr CHE.CK LIST Zoaing Districr. �a c�f�� . - � Fire Deparcment: Post Office: School District: • � L.ot Area: Sq.ft. Acres � Width Depth Survey Submitted:� Yes No Date of 5un�ey: Proposed Setbacks: � . : Front(Lake): Right ide: _ Rear(Street): Left ide: Ad;acent St�-uctures: SVetla�d: Suildin�Hei�t: DeE. Hgt. Peal:Hgt. Lot Covera;P: Gradin�: Staff Approval Date: By: Council Approval Date: ' Szptic: Staff Approvai Dzte: aY� � Zoain� File: � Resolution: R Resolution Date: Shoreland District: Av;. Setback: E!u `SetSack: Lo!Cove2;?: ��5f o Propased Ha�ecover: G-7�' 7�-250' 2�J-��.��' �uQ-!QC�J' /'�_i'_ A� �y.._I,. �?�CtO'':Z' VZl%C2 F2�1:'.i2`: i�2� �+ J::= v• L.v_::: n•.:=. �- ;c.EZL��-�S �.i.�h0��e): � . � SLTILDING REVIE�Y CHECK LIST . UBC: R ' � ' CONSTRUCTION TYPE: VN . Sq Footage $Per 5q Ftg ' Baserneat � . . ,. X = � . lst Floor � x • _ � • • � � , 2nd Flaor x = ' ' � • Garage X — • x = TOTAL Estimated Construction Yalue: $ �t�p,�p •_° Inspections Requirea: tiYock Requiring Separate Permits: S'tte _e�Plumbing Fire • Hazdcover Removal _�_Mechanical Water Connectio❑ Footing ` Septic 5ewer Coaaectiaa �� __�Fr��° � � Fireplace Lawn Irriga[ion _ e�Insulation ('tylasonry) Other `Vall Board Well (Mfg.) (State Pecmit) _�C Final GradingfFillinp _�Electrical (State Pecraic) Other REMARKS(fN HOUSE): . . . -� — .. - REV�'4V SX �THERS: DATE: Access: Ezist'ing New • Access Approval: Date By: � REI�IARKS (TO EE NOTED 4�i PER1tiII'I'}: � C� D (� TIM ✓ CITY OF ORONO CALLED IN __�� `7 I5� INSPECTION NQT'/�D 7 SCHEDULED �I-S--a� Ib� PrW1 PERMIT NO. f' COMPLETED ADDRESS 224� ��h�d,U c;�c�od 1�(� OWNER CONTR. ..�r� I.�• w'�IlQV1� TELEPHONE NO. �� Z Z 5� `�7� � DESCRIPTION I — � ❑ FOOTING ❑ MECHANICAL I ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHAN INAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�S_NO � COMMENTS: � � � � 'I�I � � � , a � SG�I�- a i,l�;a �Ur��. 0 � 0 � W � Q � 2 W � W � j a W WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDEF POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CA L TO ARRANGE ACCESS. Call for the n t inspection 24 hours in advance. (952� 249-46�� OwnerlCont c r on i : - inspector. White Copylinspector's File Canary CopylSite Notice � � \. ��T� J /�Q� T I M E CITY OF ORONO ALLED IN b �" INSPECTION NO CE SCHEDULED C' . �� PERMIT NO. I< ` coM�TED ADDRESS � OWNER CONTR. �'1, �. . � �) l I.I� TELEPHONE NO. (� � r�C� I `�—I� � � DESCRIPTION �4�I �-1� 1�� • � ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT J ❑ DEMO-FINAL ❑ SEPTIC I�ISTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI ❑ SE TIC INAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � a - � J O - a � � -��SC,I� � c W - . � Q � z W � W � � d W WORKSATISFACTORY:PROCEED PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED _n. ISSUE CERTIFICATE OF OCCUPANCY W Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING �pERMANENT ��-ZO'VO ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the ne t inspection 24 hours in advance. (J52� 24J-46�� OwnerlContra n te: � Inspector. White Copyllnspector's File Canary CopylSite Notice