HomeMy WebLinkAbout2006-P10304 - addn/remodel/repair PERMIT
CITY OF �ORONO
2750 Kel!�yParkway- PO Box 66 Permit Number: p103o4
Crystal Bay, Minnesota 55323 Permit Type: Addirion/RemodeURepair
(952) 249-4600 Date Issued:
9/19/2006
SITE ADDRESS: 1491 Shoreline Dr Unit#
Wayzata,MN 55391
P�D: 11-117-23-23-0008
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residenrial Census Code 434
Permit Class: Building
Permit T e: Addirion/RemodeURepair Pernut Sub-type(s): Building Undefined
YP
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Pergola&Trellis on Existing 2nd Floor
FEE SUMMARY: Permit Fee: $ 223•25 valuation: $ 13,000.00
Plan Review Fee: $ 145.11
State Surcharge Fee: $ 6.50
TOTAL FEE: $ 374.86
APPLICANT: Peter Allan OWNER: Richard&7anet Krier
1V1N 1491 Shoreline Dr
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.
_���T � /i%Y
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
� ��
Total Fee: $ ��� Date Received: �� ��'������ '
Entered By: ���,j,�1�y�� Permit#: `/�"Cj - .'�'
U
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all infor�nation)
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THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: t �1 i� S�wv�Q��� �2 f "L ZIP: 5���( �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ YeS ❑ No If yes, a specinl event perrnit is r•eqzrirec�i�vith Police Department and City Council a�pr•oval
GO c�ays prior to the event. Shuttle bars service will be requirect zrn[ess applicant demonstrates
szrff cie��t on-site parking is available. Non-per��litted events 1vi/1 not be allowed.
NAME OF OWNER: 1�`� ���� �1 s �e � �r��� PHONE: (home)�S�-�f�.s��S3
(work)�iS� -5°�6 !'�6 Z
MAILINGADDRESS: ( y�Cl ��'l��'�'Q��� �. CITY:��v ZIP: 553 /
CONTRACTOR:���� ���� PHONE:�� - o��l� �s3�s
CONTACT PERSON: .���-� r�'�'r MOBILE/PAGER: c5l 2 �s�7-/339
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: �I t�� PHONE:��� ��6 -176 2
MAILING DRES�S: l�/`'7( ���J��, i�ne '��L CITY:�+{�iyLQ� ZIP:����1 �
NAME: << �Jl �-� r��✓ REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) �_
Any earth movem t may require MCWD review and permits !
P�OPOSED WORK(describe in �letain: R?�p�4 � //������ o1,t C�(�6���t p�`�d tl��t
J�c l�
STORIES: �- SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACH�D DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): � 1.� CDC�
I hereby apply for a building permit and I c�lr�wledge that the information above is complete and accurate;
that the work will be in conformance wit�the -dinances and codes of the City and with the State Building
Code;that I understand this is not a peri�nt and �o�� is not � rt�v' Zout a perm'tt;and that the work�vill be
in accordance with the approved plan. �
. �
APPLICANT'S SIGNATURE: DATE: � � U�
31
�
Sec.13.0�1 RIGEITS OF SUBJECTS OF DATA
Subd. 1. 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. [nformation required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be
infonned 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 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 otticer.
The commissioner of revenue may�lace the notice required under this subdivision in the individual income ta�or propertv taz refund
instructions instead of on those fonns.
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 whed�er it is classitied as public,private or contidential. Upon his further request,an individual who is the subject of
stored private or public data on individuals shall be shown the data�vithout any charge to him and,if he desires,shall be informed ofthe content and
meaning of that data. After an individual has been shown die private data and infonned of its meaning,d�e data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this sec[ion is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the pri��ate 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 d�e copies.
The responsible authoriry shall comply immediately,if possibie,with any request made pursuant to this subdivision,or within tive days of
the date ofthe request,exduding 5aturdays,Sundays and legal holidays,if immediate compliance is not possiUle. [fhe cannot comply with the request
within that time,he shall so inform the individual,and may have an additional five days within which[o 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
concerning himself. To exercise this right,an individual shall notiFy in writing the responsible authority describing the nature ofthe disagreemenL The
responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurare or incomplete data,induding recipfents named by the individual;or(b)notify the individual that he bel ieves the data to be correct. Da[a in
dispute shail 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 the administrative procedure act relating co
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. l 3.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request
for a pennit 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:
l. The information you furnish will be used to determine your qualification for the permit or license
requested.
?. 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 rigllts under NLS. 13.04 (available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
First �liddlc Last
<�^-'V"`C
.4ddre55
Ciiy Siaii i ip Phone
I underst�'d y rights s st e ove.
�,
Signaturc
Reset Form 3?
�HEC�K OFF i�IST FOR ISSU.ANCE OF �E�'VIITS
r FOR OFFICE USE ONLY� . .
AUDRESS OR LEGAL: i�l� I SHc�2�.(.�Nt:., (�2
PID:
DESCRIPI�IO�I OF WORK: C26oth T'+ 2� �.t-�S o,•� — �
ZOYNG REVIEtiV BY: r--- --- ----------------------DATE APPROVED: 9-��l-B�
SUTLDIlV'G REV]EtiY BY: DATE APPROVED; �c -[ V-c�,�� .
FEES TO BE CHARGED:� Misc. Fezs Calculated By:
pgg�T Yes �/ No
PLAN REVIEti�I � � Yes ✓ No SEtiVER CO�TNECTION
STATE SURCHARGE Yes �/ No �VATERCONNECT'ION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SI'TEINSPECTION
Number of SAC•Units OTHER (specify)
ZONi11IG CHE.CS. LIST Zaning District: �O .
Fire Departmenc: Post Office: School District: • �
Lot Area: Sq.ft. Acres � Width Dep[h
Survey Submitted: Yes No Date oE Survey:
Proposed Setbacks: � • :
Froat(Lake): Ri�c S' e: .
Rear(Street): Left ide: 3d�
Adjacent Structures: Wettand:
Buil�lin�Height: Def. Hgt. Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date: '
Septic: Sta#'f Approval Dace: �Y�
Zoaing File: � Resolutioo: # Resolution Date:
Shoreland District:
Av;. Setback: Bluff Setba k: I.ot Covera;e:
E�.isting Proposed
Hardcover: 0-75'
75-250'
2�0-SOQ'
500-10G0'
I�a:dcover Va�iance Required: Yes No Da!e ef Co��il App��v�:
FE��L�S (in house):
t
BLTII�DING 12EY�`V CHECK LIST
��� � � � � CONSTRUCTION TYPE: �!/J
Sq Footaoe $ Per Sq Ftg
� Basement • . .. X _ .
lst Fioor � x . • .
2nd Floor x _ � .
Garage X _ .
x =
TOTAL
Estimated Construction Value: $ 1'3�(�pp�`3
Inspections Requirea: Work Requiring Separate Permits:
Site Plumbing Fire
• Hardcover Removal Mechanical Water Connection
Footing � Septic Sewer Coaaection ��
� Fra.ming . Fireplace Lawn Irrigation
Insuiation (Masonry) Other
Wall Boazd (Mfg.) Well (State Permit)
�F�� Grading/Filling Electrical (State Permit)
Other
REMARKS (IN�IOUSE): . . . .
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RE'VIEW BY OTHERS: DATE:
Access: Ezis[ing New .
Access Approval: Date gy; '
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REI��ARKS (TO BE NOTED 4N PER�I�IIT'):
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