HomeMy WebLinkAbout2004-P07542 - land alteration � � � � PERMIT
CI�Y �F ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po�s42
Crysta! Bay, Minnesota 55323 Permit Type: User Defined
(952) 249-4600 Date Issued: 6ili2oo4
SITi E ADDRESS: 1420 Shoreline Dr
Wayzata,MN 55391
PID: 11-117-23-22-0015
DESCRI PTION:
Proposed Use: Residential
Permit Class: General
Permit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu yc
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Driveway construction per attached plan
FEE SUMMARY: Permit Fee: $ 50.00
Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: The Nature Group, Inc. QWNER: David&Archelle Feldshon
420 North Sth. St. 1420 Shoreline Dr
Minneapolis,MN 55401 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.
. `
APPL A T PERMI"CEE SIGNATURE SUED BY SIGNATURE
Copies: 1-File(Si�nitures Repuired), 1-Apnlicant 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
o.00 -G�`� ' �1 -
Total Fee: $ � � Date Received: T— �.3 ��
Entered By: t�S Permit#: _ PQ 75 �..
�
CITY OF ORONO - PE T APPLICATION
US,�r
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: (�Z.C� '�O�QE LI�.lE ��) „_ ZIP: _��I
Will this be a P�de of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes No If yes, a special event permit is required with Police Department and City
Council approva160 days prior to the event. Non permitted events will not
be allowed.
NAME OF OWNER: ���ol.I ' �R�tDV PHONE: (home)
(work)
MAILING ADDRESS: t4za ��I�,ue ��c��: �D ZIP: 55'�i .�t�e�
CONTRACTOR: '� d'�'yrE �U� PHONE: (p�• �Zq-2pg�
CONTACT PERSON: MOBILE/PAGER: (g�Z— q -'�„1��
NiAILING ADDRESS:�� CITY: ZIP: �_
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure
Addition Move
RemodeVAlteration Land Alteration.�
PROPOSED WORK(describe in detai�: '���E WAu LpK4�l►��e�f �Ey►�-Af.1�F�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $
I hereby apply for a building pernut and I aclrnowledge 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 permit;and that the work will be in accordance with
the approved plan.
APPLICANT'S SIGNATURE: DATE:
Sec.13.04 RIGHTS QF SUBJECTS OF DATA
Subd.1. Type of data. The rights of individual on whom the data is stored or W be stored shall be as set forth in thls section.
Subd.2. Information required to be given individual. An individual asked to sapply pricate or conRdential data concerning 6imcelf shali be
informed ot: (a)the purpose and intended use of the requested,data wit6in t6e colleMing state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legally required tb supply the requested data;(c)any known conseqncnce arisiog from his supplytng 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 t6e data. This reqnirement shall
not apply when an lndividual is asked to supply investigative data,pursusnt to section 13.82,subdivision 5,to a law enforcement otticer.
The rnmmissioner of revenue mav olace the notice reauired under this subdi�ision in t6e individual income tax or orooertv tax refund
instruMions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authorih,an indi�idual shall be informed whether he is the subject of
stored data on individuals,and w6et6er it is classitled as publiq private or cootidential. L'pon hLs furt6er request,an Individual who is the subject of
stored private or publlc data on individuals s6a11 be shown t6e data without any charge w him and,ii he desires,shall be Informed of the content and
meaning ot that data. After an individual has been shown t6e private data aad informed ot its meaning,the data need not be disclosed W 6im for sIx
months thereafter unless a dispute or action pursuant to t61s section is pendlog or add(tional data on the individual has been collected or created. The
responsible authority shall provide rnpies of the private or public data upon request by the individual subject otthe data.The responsible authority may
require the requesting person to pay the actual costs ot maldng,certlfying,and rnmpiling the rnpies.
The responslble authority shall comply immediately,if possible,with any request made parsuant to this subdivision,or within f�ve days of the
date of the request,excluding Saturdays,Sundays and legal holldays,if immediate rnmpliance is not possible.If he cannot comply with the request within
that time,he shall so inform the individual,and may have an additional tive days within which to comply with the request,excluding Saturdays,Sundays
and legal6olidays.
Subd.4. Procedure when data is not accurate or rnmplete. Ao individusl may contest the accuracy or completeness oipublic or private data
rnocerning himselL To exercise this right,an individual s6a11 notify in writing the responsibie authority describing the nature of the disagreement.The
responsible authority shall within 30 days either: (a)correct the data found to be inaccunte or incomplete aod attempt to notify past recipients of
inaccurate or inrnmplete data,including recipieats named by the individual;or(b)notify the indicidusl that he believes the data to be correct. Data in
dispute shall be disclosed only If the individual's statement ot disagreement is included w•ith the discJosed data.
The determination of the responsible authoritat may be appealed pursuant to the pro�-icions of the 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 ma�-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 eztent necessary to process
the permit or license.
4. If your requested permit or license requires Council acrion 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 permi�
Scs�- � �l�'1'E-1^
First Middle L.ast �
4�o IJ. ��'" S�- (p�5
Address
1`���nh��s ��r�rJ �'�a z�q2q�2oQ�
City State Zip Phone
I und stand m ights as stated above. -
Signatur
BUII,DING REVIEW CIiECK LIST
�C� �- CONSTRUCTION TYPE: '"--
_ Sq Footage $Per Sq Ftg
Basement . , x _
lst Floor x . _
2nd Floor x _
Garage x _ �
x =
TOTAL
Estimated Construction Value: $ •--
Inspections Required: 1�Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing ` Septic Sewer Connection �
� Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd � (Mfg,) Well (State Permit)
_�L Final Grading/Filling Electrical(State Pennit)
' Other
REMARi�S(IN HOUSE): �
---- -------------------___----------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New .
Access Approval: Date By; �
----- ----------------------------------------------------------
12EMARKS (TO BE NOTED ON PERMI'I'):
8
CHECK OFF LIST FOR ISSUANCE OF PERMITS � '
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: i y w s�rollL��yvP /J2
PID:
DESCRIPTION OF WORK: p R,v� w,�.,, Gc�rv sr�c��_
ZO.vI�Ti G REVIEW BY: DATE APPROVED: s--2�-��
BUII�DING REV�W BY: -- DATE APPROVED:
FEES TO BE CHARGED: � is N es alculated B�° c���� �W
PERMIT Yes ,i No
PLAN REVIEW Yes No SEWER CONNECIZON
STATE SURCHARGE Yes No WATF�CONNECTTON
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CI�CK LIST Zoning District: o
Fire Department: Post O�ce: School District: •
Lot Area: Sq.ft. Acres � Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: �
Front(Lake): Right S' e:
Rear(Street): Left Si e:
Adjacent Structures: Vetland:
Building Height: Def. Hgt. eal:Hgt.
Lot Coverage:
Gradina: Staff Approval Date: S -2�-n�-( By: �_ Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # —" Resolution: # Resolution Date:
Shoreland District: y��
Avg. Setback:r— iv�/� Bluff Setback: N i/1 Lot Coverage: d•/L
Eusting Proposed
Hardcover: 0-75' N•9`1
75-250' Z y•d y
250-500'
500-1000'
Hudcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
� , t�r= E,b T.k. ,`r
� Ti�/E'/v.t Tu�e E GR v�P S—
, - ' ,� �' ; W � �� � �9-oy
, ;
'���'`��� HAItDCOVER CALCULAT10iy 1VORKSII�ET
SETBACK ZONE: (CII2CLE ONE) 0-75 J-2J0' 250-500' S00-1000'
EXISTING HARDCOVER IN ZONE
A. House x = 3738 S.F.
Length �Vidili
_ .� = S.F.
x = S.F.
.. X = S.F.
B. Garage x = S.F.
C. DrivewaY x — ��Rd S.F.—���vfw'��'xin.�l
— PaszKr.uG, Arz�
� � = S.F.
D. Sidewalk x = � p3 S,p,-WA�K npetf�F No�
2S �c � _ �OU S.F.-wAu<so��rroF ya
E. Patio/Deck x =
� `12Z S.F--PAiiD A�zE.c��
_ . _ _ � = S.F. .
F. Landscape x = S.F.
Underiain x = S.F.
By Plastic x = S.F.
Or Fabric
w,���.; aN r�
G. Other x = It�� S.F. — �.,;
�;t.t.- ;5
TOTAL FIARDCOVER IN ZONE - 11 ' S.F. A
TOTAL PROPERTY A�tEA iN ZONE - 4 400 S.F. B
a = B � 100 = 24,oq �io
PROPOSED HARDCOVER 1N ZONE' ..
A. House x = S.F.
-- Length W idth -
X = S.F.
x = S.F.
_ _ x = SF.
B. Garage x = S.F.
C. Driveway x = S.F.
.._... . . _ X = S.F... .
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
X = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabnc
G. Ocher � x = S.F. ._
__ TOTAL HAItDCOVER IN ZONE - S.F. -A
TOTAL PROPERTY AREA IN ZONE - S.F. B
A = B x l00 = %
. i
_.. •
� _ r/�/E /1/./y'GI�P� G�?aup s"i9"o y
� HARDCOVE13..�_ALCUL,ATIUN �VURKS�TEE'T
.� SETBACK ZONE: (CIIZCLE ONE) �7�' 75-2�0' 250-SOU' S00-1000'
EXISTINGHARDCOVER 1N ZONE EAsf_ �,u,��L �"����NETONI<,�4
� A. House x = S.F.
L,ength W idili
_ - x = S.F.
x = S.F.
._. X = S.F.
B. Garage x = S.F.
C. Dnveway x = 233 S.F. —pa�v���Y
• x = 4 s.F.-r����.��Z
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck �c = S.F.
_ ;� = S.F:
F. Landscape x = S.F.
Underlain x = S.F.
� Bv Plastic x = S.F.
� Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - 2 37 S.F. A
- TOTAL PROPERTY A�tEA IN ZONE - 4$00 S.F. B
A = B x 100 = �.9y- %
PROPOSED HARDCOVER IN ZONE' ..
' A. House x = S.F.
Length . Width ___.
x = S.F.
x = S.F.
. . _ . x = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
.._... . _ . _ X = . S.F�: �
D. Sidewalk x = S.F.
x � = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Landscape x = S.F.
Underlain � = S.F.
_ By Plastic x = S.F.
Or Fabric
G. Ocher � x = S.F. _.
_. TOTAL HARDC.OVER IN.ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE - S.F. B
A = B x 100 = %
. �
_. ' , -
• __ T/�F �i,�T�r,cF GRo�r� 5-�9-a y
HARDCOVER CALCULATION WORKSlIEE'T
SETBACK ZONE: (CIRCLE ONE) 0-7�' 7�-2�U' 250-500' S00-100U' .
EXISTING HARDCOVER IN ZONE �,N�ST— TANAC�ER LAKE
• A. House � = S.F.
L,ength W idth
_ x = S.F.
x = S.F.
� x = S.F.
B. Garage x = S.F.
C. Driveway x = S.F. �
• x = S.F.
D. Sidewalk �c = S.F.
x = S.F.
E. Patio/Deck x = S.F.
_ � = S.F: �
F. Landscape x = S.F.
Underlain x = S.F.
� Bv Plastic x = S.F.
� Or Fabric
G. Ocher ;c = S.F.
TOTAL HAFtDCOVER IN ZONE - 0 S.F. A
-� TOTAL PROPERTY AitEA IN ZONE - 30,800 S.F. B
A = B x 100 = ' p %
PROPOSED HARDCOVER IN ZONE' ..
' A. House x = S.F.
.._.. . Length W idth
x = S.F.
x = S.F.
. . _ . _ X = S.F. �
B. Garage x = S.F.
C. Driveway x = S.F.
..�... . .. . _.. . X = . S.F-: �
D. Sidewalk x = S.F.
x � = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
_ By Plastic - x = S.F.
Or Fabric
G. Ocher • �c = S.F. _.
.... . TOTAL HARDC..OVER IN.ZONE - S.F. ��.
TOTAL PROPERTY AREA IN ZONE - S.F. B
A = B x 100 = %
I. •
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DATE t TIME
CITY OF ORONO CALLED IN �����I
INSPECTION NOTICE �( SCHEDULED � jUlvGAt�
PERMIT NO. �D 7��I 2� COMPLETED
ADDRESS ' � .��,�t�'✓�. �r'� �� � �
OWNER CONTR./1l��7/✓'cL C�lJ1//�
TELEPHONE NO. � �� % v���� /
� DESCRIPTION � GL��C � /,���
l� 01 FOOTING 11 MECHANI L RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
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
v 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ORKSATISFACTORY:PROCEED C� PROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED '7 ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR n CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. (952� 249-46��
OwnerlCon n ite:
Inspector.
White Copyllnspector's ile Canary CopylSite Notice