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Home My WebLink About2004-P07689 - addn/remodel/repair ` CITY OF ORO O PERMIT N Permit Nu ber: 2750 Kelley Parkway- PO Box 66 P07689 Crystal Bay, Minnesota 55323 Permit Typ : Addition/RemodeURepair (952) 249-4600 Date Issue : 7/26/2004 SITE ADDRESS: 2135 Shevlin Dr Wayzata,MN 55391 PID: 03-117-23-34-0004 i } DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Pemut Class: Building Census Code 434 Permit Type: Addition/�emodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolurion#: Separate permits required: riumoing iviecnanicai r,iecmcai�siaiej NOTICES/REMARKS: t,:.-�---- �-----�_, � �_.�.,..�....�....,..�. � _ i FEE SUMMARY: Pernut ee: $ 391.25 Valuation• $ 25,000.00 Plan R view Fee: $ 254.28 State S�rcharge Fee: $ 13.00 ' i � TOTA�,FEE: $ 658.53 APPLICANT: Prairie Home emodeling LLC OWNE : Eric&lennifer Martinuzzi 9830 Balmorali Ln. 2135 Shevlin Dr Eden Prairie,I�N 55347 Wayzata,MN 55391 � THE UNDERSIGNED HEREBY R�QUESTS PERMISSION TO MAKE THE IMPROVEMEN'TS SPECIFIED AND AGREES TO DO ALL WORI�IN STRICI'COMPLIANCE WITH ALL CI OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE PIEQUIREMENTS. APPLICANT PERMITEE SIG TURE ISSUED BY SIGNATURE � i Covies: 1-File(SiQnitures Required), 1-Aunlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1 Um .�-,,a-o'� ` . TotalFee: $ �05+8. S.3 DateReceived: �'8�� `� Entered By: Permit#: , 67�o�S� CITY QF ORONO - BUILDING P RMIT APPLICATION All inform�tion must be submitted in full b ore plan review will be started. (please pri�zt all iizfo mation) ----------------------------------------------------------------------- ----------------------------------------------------- THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS � � �- "v� U�� - ZIP: `✓�� ` I � Will this be a ar de df Homes,Remodelers Showcase ome or other Display Home? ❑ Yes No If yes, a special event permi is required with Police Department and City Council approva160 days pr or to the event. Non permitted events will not �'"�r�[!11�1 e . 3 L.�.� �Z NAME OF OWNER: ln'1 Ft, ►�I�ZZs PHONE: (ome) - Z��-'�� (work) MAILING ADDRESSi 1�J� ��US� �� CITY: _� ZIP: �5��9 I �� C CONTRACTO PHONE: �SZ' �GI'� `��Z`'� ( CONTACT PERSON. 1 OBILE/PAGER: �1 Z- ZtC� ��-4-SS MAILING ADDRESS� � � t� CITY: � ZIP: sZ�� U '� ! STATE LICENSE: # � 'r/3 r7 �!' ��, ' �,` 1 �c � j�j � -z- 3 --3� ARCHITECT/ENGIN�ER: ��'� �V.. �`��G�PHO E: � J � I MAILING ADDRESS; l��nl » �y�,�- 5c� CITY: � ZIP: /O NAME:��' �,F�.i� REGISTRATI N# TYPE OF WORK: N�w Accessory Structure Akldition Move R�modeVAlteration� Land Alteration PROPOSED WORK(describe in detain: � 5��u��. STORIES: � SQ. FEET OF EACH FLO R: NO. OF BEDROOMS:' GARAGE STALLS: ATT. DET. ESTIMATED CONST�tUCTION VALUATION (exclu ing land): $ �i�.� I hereby apply for a buildinqg permit and I acl�owledge that the i ormation above is complete and accurate;that the work will be in conforma�ce with the ordinances and codes of e City and with the State Building Code; that I understand this is not a per�Ziit and work is not to start without a p 't;and that the work will be in accordance with the approved plan. ! . APPLICANT'S SIGN T . DATE: O i . � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.l. Type of data. The rights ot fndividual 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 suppty private or contidential data concerning himself shall be informed of: (a)the purpose and intended use ot the requested data within the collecting state agency,political subdiviston,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence aristng trom his supp►ying or refusing to supply private or confidenttal data;and(d)the identity of other persons or entittes suthorized by state or federal law to receive the data. This requirement shall not apply when sn individual is asked to supply investigative dsta,pursuant to section 13.82,subdivision 5,to a law enforcement oificer. The commissloner of revenue mav olace the notice reauired under this subdivision in the individual income tax or orooertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to s responsible authority,an individual shall be informed whether he is the subject of stored data on indtviduals,and whether it is classifled as public,private or confidential. Upon his further request,an indtvidual who is the subject of stored prlvate or public data 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 thls section is pending or additional data on the indlvidual has been rnllected or created. The responsible authority shall provide copies of the private or public dsta upon request by the indlvidual subJect of the data.The responsible authority may require the requesting person to psy the actual costs of making,certifying,and rnmpiling the rnpies. The responsible suthority shall rnmply Immediately,if possible,with any request made pursuant to this subdiv(sion,or within live days of the date otthe request,excluding Saturdays,Sundays and legal holidays,if immediate rnmpliance is not possible.If he csnnot comply with the requestwithin that time,he shall so inform the individual,and may have an additional five days withln which to rnmply with the request,excluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is aot accurate or complete. An individuai may rnntest t6e accuracy or completeness of public or private data concerning htmself. To exerctse this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify paat recipients of inaccurate or inrnmplete data,including rectpients named by the individual;or(b)notlfy the individusl that he belleves the data to be correct. Data in dispute shall be disclosed only if the indiv[dual's statement of dissgrecment is included with the disclosed data. The determination of t6e responsible suthority may be appealed pursuant to the provisions of the adm(nistrative procedure act relating ta 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 rivate data on yourself. 6. Your full name is required to process this application or permit. L� � � �� First Middi Last ��`� ��.�,�� l�� ,� . �Y�J ��3�`� �'sZ -��-�.�� City State Zip Phone I r nd my right stated above d . . CHECK OFF LIST FOR ISSU CE OF PERMITS FOR OFFICE USE NLY ADDRESSORLEGA.L: 2135 SNc�t�.�iv �2 � PID: DES CRIPTION OF VVORK: 1�+�w�o cz- �t��- Q rv ZOL�IT.t IG REVIEVV BY: �._ � DATE APPROVED: 7• Zn-rri-t BUII.DI1i IG REV�`V BY: DATE APPROVED; -� .z:o.o`{ FEES TO BE CHARGED: Misc. Fees Calculated By: PER11�1IT Yes ,� No PLAi�T REVIEW Yes ,/ No SEWE.R COi�]NECTION STATE SURCHARG� Yes �/ No WATERCONNECI'ION INVESTIGATION F�E � Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC�U�its OTHER (specify) ZOYlNG CHE.CK LIST Zoning District: /lr v �i ni e . Fire Department: Post Office: School District: � L.ot Area: Sq.ft. Acres � Width Depth Survey Submitted: !Yes� No Dat of Snrvey: Proposed Se[backs: � Front(Lake): ' Right Side: —�--- Reaz (Street): � Left Side: Adjacent Structu$�es: Vetlaad: Building Hei�ht: Def. Hgt. Peak Hgt. Lot Coveraoe: Gradino: Staff Approval Date: Council Approval Date: Septic: Staff Approval Uate: B : Zoning File: #_� Resolution: 1� Res lutioa Date: � Shoreland District: � Avg. Setback: ! Bluff Setbac : L.ot Covecage: Eaistin; Proposed Hardcover: ' 0-75' I, 75-250' � I 250-500' �' S00-1Q00' Hazdcover Vari�nce Required: Yes N Date of Council Approval: REI�ZARI�S (in hou�e): 7 BUILDING REV�W CHECK LIST �C� - � ' 3 � CONSTRUCTION TYPE: �//� _ Sq Footage $Per Sq Ftg Basement . . , x _ lst F1oor x � _ . 2nd floor x _ Garage x _ � x = TOTAL Fstimated Construction Vaiue: $ Z.S,'p0o`� Inspections Required: `Vork Requiring Separate Permits: Site _�plumbictg Fire Hazdcover Removal .� Mechanical Water Connection Footing ` Septic Sewer Connection � _�Fr�g Fireplace Lawn Irrigation �_Insulation (Masonry) Other �Wall Boazd � (Mfg.) Well (Scate Permit) F�� Grading/Filling _�Etectrical(State Permit) Other . REMARKS(IN HOUSE): , ------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Ezisting New . Access Approval: Date gy; ---------------------------------------------------------------------- REI�Z�iRKS (TO BE NOTED ON PEIt1vII7�: 8 DATE IME `� CITY OF ORONO c�o�N 7-a.6 � INSPECTION T CE SCHEDULED 7-o27-d�! 3'� PERMIT NO. COWLPLETED ADDRESS o�!3 �/C��_�J OWNER CONTR. � � TELEPHONENO. ��Z �� DESCRIPTION � � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADIN /FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/W LANDS y 03 INSULATION 24/25 WQOD BURNER/FIREPLACE 34 TREE REMOVA Z04 WALL BD. 12 WATEPR HOOK-UP 17 SITE INSPECTI Q OS FINAL 14 SEWEAt HOOK-UP 06 PROGRESS � 07 DEMO-S�TE 27 SEPTI�MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTI�INSTALL. 22 FOLLOW-UP i�LUMBING RI 23 SEPTI�FINAL 35 WARD COVER MOVAL J 10 PLUMBING FINAL 36 FOUNDATION/ MOVAL � OWNER/CONTRACTOR TO MEET YOU:_,.,YES_NO � COMM N : � � =-- u � --- � o 0 L t a � ,A � I.J�V L O � W � Q � 2 W � W � � � d � W� ❑ KSATISFACTORY:PROCEED i ❑ PROJECTCOMPLETE W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF O CUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECT�R � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRI4NGE ACCESS. Call for the next i pec1ion 24 hours in advance. (g52) 249 4600 OwnerfContra s te: Inspector. ` White Copyllnspector's Fil Canary CopylSlte Notice D IME � � �� CITY OF ORONO CALLED IN INSPECTION N SCHEDULED — � PERMIT NO. COMPIET�D ADDRESS a�3S OWNER � CONTR. �� TELEPHONE NO. �� ' �� 5 r � � DESCRIPTION l� 01 FOOTING 11 MECHpNICAL RI 18 EXCAV/GRADIN /FILLING � 02 FRAMING 13 MECH NICAL FINAL 19 LAKESHORE/W LANDS y O 03 INSULATION 24/25 W D BURNER/FIREPLACE 34 TREE REMOVA Z 04 WALL BD. 12 WATE HOOK-UP 17 SITE INSPECTI N Q 05 FINAL 14 SEWEIh HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTI MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTI INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTI FINAL 35 HARD COVER MOVAL J 10 PIUMBING FINAL 36 FOUNDATION/ MOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � � O � W � Q � 2 W � W � � d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF O CUPANCY W � ❑CORRECT WORK,CALL FOR REINSPE"G)TION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTmR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next'nspection 24 hours in advance. (952) 24 46�� OwnedContra s't Inspector. White Copyllnspector's Filq Canary CopylSite Notice � c�� jE'-"� DATE TIME CITY OF ORONO CALLED IN INSPECTION TI�E SCHEDULED l � / � �' _J� PERMIT NO. ��' � �� COMPLETED ADDRESS �/ �� ;� ; n L�►-C'_. OWNER CONTR. / � ��'n-'�- TELEPHONE N0. � �a ��'��f� �-� �� DESCRIPTION /��-j - /L � �(C�6��'' � � .,�� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h 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 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 FINAL 35 HARD COVER R�MOVAL J 10 PLUMBING FINAL �/ 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�(..YES_NO !l � COMMENTS: a �i/�,U. � � � � 0 � �,C�775 I �fec� ✓ � Po7� �s 2 �(ec1` � W � Q � PD�733 (�Cu�m$ z w � W � � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED != ISSUE CERTIFICATE OF OC�UPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALI INSPECTOR , ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-460� OwnerlContr ite: Inspector. � White Copyllnspector' File Canary CopylSite Notice