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Home My WebLink About2005-P08502 - addn/remodel/repair � PERMIT . ClTY OF ORONO Permit Number: �2750 Kelle y Parkwa y- PO Box 66 Poaso2 Crystal Bay, Minnesota 55323 P@I'1711t TyP@: Addirion/RemodeURepair (952) 249-4600 Date Issued: 3�29�2oos SITE ADDRESS: 1265 Shoreline Dr Wayzata,MN 55391 P I D: 02-117-23-34-0010 DESCRIPTION: UBC Occupancy �t3 Construction Type VN Proposed Use: Residential Permit Class: Building Census Code 434 Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: riumoing iviecnanicai Eieciricai�siaieJ vuier-(See Hiiacned i,eiier rrom nui ac Tem ropp 3/17/OS-Approved By MPG) NOTICES/REMARKS: A d]L_`T_"�___""�i):.'�___"_ � ^'-- n'---�i i iuuuib ii v�:a:v: ••••u�uv i��s . •••— FEE SUMMARY: Pernut Fee: $ 713.75 Valuation: $ 60,000.00 Plan Review Fee: $ 464.03 State Surcharge Fee: $ 30.50 TOTAL FEE: $ 1,208.28 APPLICANT: Steiner&Koppelman OWNER: Terri 7enstad&Gary Petersen 18340 Minnetonka Blvd 1265 Shoreline Dr Deephaven,MN 55391 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENT'S SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � � � C�) APPLICANT PERMIT SIGNATURE ISSUED BY SIGNATURE Cot�ies: 1-File(SiQniCures Required), 1-Avnlicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1 n `l 1 Total Fee: $ ; ��;� -�'� � DateReceived: �� `�`?�� . Entered By: � }� �� '1,�'��? �b'� Permit#: ��° ="�" � �� -' ��,{ � CITY OF ORON• - BUILDING PERMIT APPLICATI�N All information must be submitted in full before plan review will be started. (please priiit all i�zformatio�z) ------------------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle o�ze� OWNE&OR CONTRACTOR JOB SITE ADDRESS: �� .�«ti`6�C�L��l,�. ��'`� ZIP: ��% / Will this be a P rade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes, a special event permit is required with Police Depart�nent and City Council approval 60 days prior to tlze event. Non permitted events will not be allowed. NAME OF OWNER: ��I �}�%�� PHONE: (home) �IZ"�� '��U� work) �J�? - 4 ��j�, MAILING ADDRESS: ��(i�7 ��1✓��✓l�i-� �✓� CITY: ��2�, ZIP: ��/ CONTRACTOR: `3I'� �� {� '� �/1'.Yi� PHONE: CONTACT PERSON: � � '� �� MOBILE/PAGER: MAILING ADDRESS: ! CITY: ZIP: STATE LICENSE: # �j�,,�'�r� �S �5 ��t'l� 1�1�'�(�' ARCHITECT/ENGINEER: ��d�I � 6��lYJ��"�� PHONE: ��< '`1�'� � � �� MAILING ADDRESS: � �� ,✓� �� ''CITY: ,I'Y;��`C;�i;,�'�� ZIP: ��`��, � NAME: _ (��'t 4�I ��G�-��;��- REGISTRATION # ' TYPE OF WORK: New Accessory Structure Addition Move RemodeUAlteration �%� Land Alteration PROPOSED ORK(describe a�i detai�: -t�vd� ��)�1,� �7�� /� �r�i. �' �' !� ' � ✓��'f�� '�,� �1 � '�l``� G�i�.2 < ��( i.� �`lYl�l l� ��' �'j Il � -�" �/L'll/1 G U✓YI,�� G�G'i�('�/ C �C�1,1� �� il/I''�s'� GrYt (/�/-f'�j �lG �C STORIES: SQ. FEET OF EAC FLOOR: ,1 �GC� /�� NO. OF BEDROOMS: �_ GARAGE STALLS: ATT. � ET. � ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��>> ��v 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 pernut and work is not to start without a pernut; and that the work will be in accordance with the approved plan. ,�� ,� / � � 1 APPLICANT'S SIGNATURE: �,_ .� ,%1�t�/�� DATE: � � ��'� (/ � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.l. Type 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 suppiy private or confidential data concerning himself shall be intormed of: (a)the purpose and intended use of the 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 arising from his supplying or refusing to suppiy private or con�dential data;and(d)the identity of other persons or entities authorized by state or federal law to recefve 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 en[orcement officer. The commissioner of revenue mav olace the notice required under this subdlvision 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 informed whether he is the subject of stored data on individuals,and whether it is classitled as public,private or con�dential. Upon his turther request,an individual who is the subject of stored private or public data on individuals shalt be shown the data wtthout 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 this section is pending or additional data on the individual has been collected 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 requtre the requesting person to pay the aMual costs of making,certifying,and compiling the copies. The responsible suthority shall comply immediately,if possible,with a�y 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 rnmply with the request within that ttme,he shall so inform the individual,and may have an additional five days within which to compiy 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 publlc 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 to be inaccurate or incomplete and attempt to notify past reciplents of inaccurate or inrnmplete data,including recipients named by the individual;or(b)notify the(ndividual that he believes the data to be correct. Data in dispnte shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the respons(ble authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S.13.04,Subd.Z,"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 private data on yourself. 6. Your full name is required to process this application or permit. �/,��Y�i,Q First Middle Last Address City State Zip Phone I understand my ri s as stated above. Signa[ure � CHECK OFF LIST FOR ISSUAIYCE OF PERcti.fITS FOR OFFICE USE ONL Y � A.DDRESS OR LEGAL: 1 Z(o5 s H�2c��N� d��v�. PID: DESCRlPTXONOF Yl�ORK: �Zrc.ww v�e�- r �'O� �OR'`"'��" ` - -- ---�-/-�- ------ ---------------=----------------------------------------------- - ------------------------------- -- U�W-- ZOtVI�VG REVIEW BY: DATE.4PPROV.ED: 3-Zi - a s � BUILDIIVGREVIEYYBY: DATEA.P.P'R06'ED: 3- 2-i -os -------------------------------------- ----- FEES TO BE CHARGED: 1�'Iisc. Fees Cnlccciccted By: PERttitIT Yes c/ No PLAtV R.EVIEGV Yes � tVo SEYYER GOtVtVEGTIOtV ST.�I.TE SURCHARGE Yes-� tVo tiV�1TER CONt�IECTlOtV . ItUVESTIG.4TlO1V FEE Yes tV° P��F'EE Sfl G .Yes No SITE INSPECTION Ncunber of SAC Units OTHER (specify) ------------------------------------- ZO�YIIYG CH�ECh'LIST Zoning Dish•ict: /UO C(�� Fire Depn�•hnerrt: Post Off ce: Sc/tool DfsA•ict: _.. Got.�irea: Sq.jt. Ac�•es GYidth Depth Suivey Subrnitted: Yes No Date of Suivey: Proposect Setbactis: F�•o►►t(Gal.e): Right Side Renr•(Str•eet): Left 5ide. Adjacent Str•uctur•es: tlnnd: Building Height: Def. Hgt. Pe 'Kgt. Lot CoverRge: � _ G1•ading: StRfft�pp►'aval Date: Byr Cauncil�lpprovnl DRte: Septic: Staff Approval DRte: Y� Zoning File: # Resolutian: # Resolc�tion Dnte: _ Shoreland Disd•ict: v�S _ �,e{vg.SetbncT o•\�. Bluff Setback: Lot Coverage: � Existin J Proposed Hai•dco�e�•: 0-75' 75-250' � 250-5�0' � . � 500-!000' ' Hardcover Variance Required: Yes Dcite of Couneil Approval: ' . i .REt1�ARKS(in liouse): y�,.,' �,�,,,;� �, +ti+o s e �+M,�;� . �';�•1�,-"+'� '�'..,1•1��tg�"' ' �:�eatik*,. �3;;>�=..�. '�� .�'o: 31 ' ° "� �"i. �,� �n �;i` 'F . ^ B UtLDItYG RE VXE tV CHECh'LIST � UBC: IZ '3 � CONSTRUCI"IOcV TYPE: �� Sq Footage .�Pe1•Sq Ft� Basenient t = I st Floor .r = ?nd Floor x = Garcge x x = TOT�tG Estiatated Catstrccction Value: S (�0,OOd� Inspectio�es Requir�ed: 6F'ork Reqc�iru�;Separate Pern�its: Site _Q�,Plum6ing Fire Hardcaver Removal �„Nlechanica! YYater Co��nection Footing Septic Setive�•Connection �_Fl•ami��g Fireplace La►wi!r�-igatioii �_lnsulc�tion � (Masonr}�) Otlie�• � fYc�ll Board (h�lfg.) �Vell(State Permit) Fina[ Gradiug/Fillin,; �[ Electrical(State Pern►it) _�__ Odier ' RENIARI"*S(INHOUSE): � RE[�IE W B Y OThCERS: DATE: Access: Existing iVew Aceess�{pproval: Date By: REl1�IttRKS (TO BE NOTED O�V PE1tt1�ilT): 32 � ' � _'.'°��'�� . I4ECEIVE� MAR 2 2 2p05 CITI'OF �jRONC 3/17/2005 Orono City Offices 2750 Kelley Pkwy 0 Orono, MN 55356 - 9387 Attention: Lyle, Building Permits This letter is regnrding a permit request for Terri Jenstad, owner of property located at 1265 Shoreline Drive, Wayzuta. They have our permission to improve their property per the pinns adding two dormers submitted to the City of Orono. Sin ly, p� � � �/U � . � Bill & Teri Popp ✓ DATE TIME CITY OF ORONO CALLED IN ��G-� INSPECTION N�� SCHEDULED �:��D C"i 1�-• ��h PERMIT NO. d COMPLETED ADDRESS �� Gt'� �.S/1�,?c'� l/�/1.,;_. .I�iC� . �— _�-�--_� OWNER �l�s2s!-LcQ- /� �t�s�+.--CONTR. TELEPHONE NO. �-F�� v�dD � S / C� � �c��rv Jcicksv,� � DESCRIPTION �rr��-�vr'G�'� ��.-� � 01 FOOTWG 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z 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 REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � - VL D� f�Q��. 0 � � 0 � w � Q � z W � W � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTIOtJ TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIONREQUIRED.CALITOARRANGEACCESS. Ca11 for the n t inspection 24 hours in advance. (952) 249-4600 OwnerlContrac ite: Inspector. - White Copyllnspector's Fil Canary CopylSite Notice � � ATE TIME CITY OF ORONO CALLED IN � D� INSPECTION NOTICE b� SCHEDULED 5�� PERMIT NO. � COMPLETED ADDRESS �� J �1•�i�'2 l �i"\Q l.�J� � OWNER CONTR. i ° TELEPHONE NO. C�✓ �� ` 7� � � DESCRIPTION �f" � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z 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 REMOVAL J 10 PLUMBING FINA� 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU�YES_NO � COMMENTS: � W � � J O � � O � W � Q � Z W � W � � � d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. C pHOTO TAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. Cail for the next ins ction 24 hours in advance. (Q52� 249-4600 OwnerlContr or on e ' Inspector. White Copyllnspector's File Canary CopylSite Notice � DAT� TIME � CITY OF ORONO CALLED IN �L_ INSPECTION N TIC SCHEDULED 7r�J�� Q� PERMIT NO. � COMPLETED ADDRESS �a6S � °�� OWNER CONTR. .5-�-�c�l _ TELEPHONE NO. � �� Z ��-� 7�� DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP O6 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 REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c� COMMENTS: � W a j � ` O a � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the n xt i spection 24 hours in advance. (g52) 249-4600 OwnerlCon o n ite Inspector. � White Copyllnspector's File Canary CopylSite Notice