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HomeMy WebLinkAbout2002-P05568 - addn/remodel/repair , , ITY F R I� PERMIT C � � � � Permit Number: 2750 Kelley Parkway- P4 Box 66 Poss6s Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 9i2oi2oo2 SITE ADDRES$: 2170 Shevlin Dr Wayzata,NIN 55391 PID: 03-117-23-34-0018 � DESCRIPTION: UBC Occupancy x3 Proposed Use: Resident�al Permit Class: Building Census Code 434 Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: Eiecgicai(siaie� � — NOTICES/REMARKS: FEE SUMMARY: Permiit Fee: $ 153.25 Valuation• $ 8,000.00 Plan I�eview Fee: $ 99.58 State 5urcharge Fee: $ 4.50 i I � TOT�I.FEE: $ 257.33 I APPLICANT: Georgayn Kra�mer OWNER: Mr.&Mrs.wiens 2990 SomersCt Lane 2170 Shevlin Dr Long Lake,N�N 55356 Wayzata MN 55391 T�IE UNDERSIGNED HEREBY NEQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WOI�K IN STRI COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIRE ENTS. � � C LICAN PE EE SIGNA RE �SSUED BY SIGNATURE Conies: 1-File(Signitures Requiredl, 1-At�vlicant, 1-Monthlv Renorts, 1-Assessing. 1-Finance Page 1 . `' .� _ .� .z,, � � Total Fee: $ Date Received: ,�-:.L� �'.- � Entered By: � ��'�j Permit#: j�j��' ' :f"��' , ; ���. . . � CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER�R CONTRACTOR JOB SITE ADDRESS: ��-1(� �h e�I i h ZIP: ��`��3�� 1 NAME OF OWNER: �� (' ' �-, vY12� PHONE: (home) "�--�,Z-�-��-d�� �" (work) MAILING ADDRESS: �'��, �p��'5�.�- �1 . CITY: („(�,.�' ZIP:��Z�? �(� CONTRACTOR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAIVIE: REGISTRATION# TYPE OF WORK: New ddition Accessory Structure Move Remod lteration�_ Land Alteration PROPOSED WORK(describe in detai�: ��t,; ; �{"'y��,1 � p� �-; �•' ' � � �R,�d (i`�t1'1�,t+C.��' _ _ ���me n, t -S�.� STORIES: � SQ. FEET OF EACH FLOOR: I� T�3�� �Z''— /L� �� NO. OF BEDROOMS: � GARAGE STALLS: ATT. � DET. � ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ 1 �'C�,DUC� �— 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 start without a permit; and that the work will be in cordance with the a roved plan. APPLICANT'S SIGNATURE: � DATE: �_ l , 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. 5 ^ / 1 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stored or ro be stored shall be as set forth in this section. Subd.2. Inforcnation required to be given individual. An individual asked ro supp►y private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide sysrem;(b)whether he may refuse or is legally required ro supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idenuty of other persons or entities authorized by state or federa]law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant ro section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace the norice 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 a responsible authority,an individual shall be infornted whether he is the subject of stored data on individuals,and whether it is classified as pubiic,private or conf'idential. 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 6e desires, shall be informed of the con[ent 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 thereafrer unless a dispute or action pursuant to this section is pending or additional data on the individual has been coliected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,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 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 ro comply with the request, excluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contes[the accuracy or completeness of public or private data concerning himself. To exercise 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 ro 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 authoriry may be appealed pursuant to the provisions of the administrative procedure act reladng 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 �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 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. �.->�'C�,�' " C� , L� First Middle Last -�y�� �mc����- � ;-� �. Address ��'1 C" C �'J/L I .��� J,�-�l'���-'%� Ciry State Zip Phone I understand my 'ght as stated above. Signature � 6 , * . ` ► CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: _ zti-t � s►-��v�i i•.� - PID: DESCRIPTION OF WORK: (k„�,,��z /IC►T G[�t-P..� f 2 �.4rws �___w������ �-�-��� ____���____������__��__����___�_��__�����_�����_��.._�_�_����_��_ ZONING REVIE'W BY: DATE APPROVED: �/� BUII.DING REVIEW BY: DATE APPROVED: q.�g-�Z. FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes � No PLAN REVIEW Yes !� No SEWER COrfNECTTON STATE SURCHARGE Yes _� No WATERCOrfNECTION INVESTIGATIOI� FEE Yes No . PARK FEE � SAC � Yes No SITEINSPECTION Number of SAC Units � . � OTHER (specify) _____________________________________________��---------------------------------------------------------------- ZONING CHECK LIST Zoning District: No G/.�6� Fire Depaztment: Post Office: School District: Lot Area: Sq.R. Acres dth Depth , Survey Submitted: ! Yes No ate of Survey: � Proposed Setbacks: ; Front(Lake): ; Right Side: Rear(Street): � Left Side: Adjacent Struc�ures: Wetland: Building Height: Def. �$gt. Peak Hgt. Lot Coverage: Grading: Staff Approva�Date: By: Council Approval Date: Septic: Staff Approval l�ate: By: i, Zoning File: #_� Resolution: # R solution Date: Shoreland District: I Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hazdcover: , 0-75' ' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS(in housd): 7 � , , ' , � BUII..DING REVIEW CHECK LIST ' � ' UBC: �' 3 � C01�ISTRUCTION TYPE: �/� Sq Footage $Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ i'9.Oc�c�°�' — �°�t°`'° Z�o o a O Vz.lc /u`r i ��'`��iv�Q'c"Q Inspections Required: Work Requiring Separate Permits: � P1. ��� Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection � Framing Fireplace Lawn Irrigation _�Insulation (Masonry) Other �o Wall Boazd (Mfg.) Well (State Permit) _�-Final Grading/Filling oC Electrical (State Pemut) Other REMARKS(IN HOUSE): � REVIEW BY OTHERS: DATE: Access: Eusting New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMII�: 8 • �ug 28 02 06: 47a Countertop Classics 612-7848336 p. 2 � �_ ---- � \� '.� ,� ��." :'� �g � ` / � � ���� V�� � `� _� �/"� t t 1� --� _ _._.____ 5 _ -_ _ . _ . . _ L � _ � . , , _.. _...__..__ _ _ ; , ----�- -•-- -.. . _ � _/ (�� ... _ , � c � , �+ �J 1 . � � , _....__...__..____ ___..___._. __. i� - - - -- _ _ .. _ ._ .. .. -- - -�'� � � - � - -------� -- - -- � ... -- . . _ _ .__ _ � ----- --- �__..._ .__. _ � �. _ . ....- - - - - - � C _. _ ... 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