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Home My WebLink About2004-P07868 - addn/remodel/repair ITY OF ORONO PERMIT C . :�'5� Kelley Parkway - PO Box 66 Permit Number: Po�s68 Crystal Bay, Minnesota 55323 Pef1711t Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 9�3o�2ooa SITE ADDRESS: 3333 Shoreline Dr Wayzata,MN 55391 P I D: 20-117-23-11-0024 DESCRIPTION: Proposed Use: ��3 � / Pernut Class: Building Census Code `y Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: riumoing Eiecuicai�staiej NOTICES/REMARKS: !'�_"""1__ _ /'�_Cl'__ T/___1_ 1�Tll (�T A TT1�T/� A T T/l\S1TT FEE SUMMARY: PernutFee: $ 593.25 Valuation: $ 45,000.00 Plan Review Fee: $ 385.68 State Surcharge Fee: $ 23.00 TOTAL FEE: $ 1,001.93 APPLICANT: Carlson-LaVine,Inc. OWNER: Lunds,Inc. 2965 Parnidge 3948 W. SOth Street-Suite Roseville,MN 55113 Edina,MN 55424 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 MINNESOT BUI�, ODE UIREMENTS. PPLICA PER IT IGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signitures Required). 1-Anplicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 Ll�t 8'31-°�' Total Fee: $ /Od/. �'�j Date Received: B'�' D �7 . Entered By: Permit#: /�p��pg CITY OF ORONO - BUILDING PERMIT APPLICATION 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: �3`3� 5��,�,2 � ziP: �S�`1, i Will this be a Parade 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 approval 60 days prior to the event. Non permitted events will not be allowed. NAME OF OWNER: ��C2-t 6`�G� Gc>(��'��= PHONE: (home) (work) '7�'�' S`1Z. -�� t� MAILING ADDRESS: CITY: �'�'�.�7�..� ZIP: N'�N _ CONTRACTOR: Gt��,,� �� ,.J � PHONE: (..�5 � - — �� CONTACT PERSON: �-(�✓ _-�`"�,.�T7c:.?+�MOBILE/PAGER: � MAILING ADDRESS: ` � ' ; CITY: ��J�t.-t�- ZIP: �I i � STATE LICENSE: # � cf�_ (�(� ARCHITECT/ENGINEER: • l � �i � PHONE: � I2— �? j- �7 pi� MAILING ADDRESS: �� ' CITY: �(�C�S ZIP: �S � NAME: REGISTRATION # c� TYPE OF WORK: New �_ Accessory Structure Addition Move RemodeUAlteration Land Alteration PROPOSED WORK(describe in detai�: �7 • �� (�r S� No 56'HT]n!G �l c.�o�v� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ "i5� C�� I hereby apply for a building permit 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 pern-ut 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 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 torth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use ot 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 suppiying or refusing to supply private or confidentisl data;and(d)the identity of other persons or entities authorized by state or federal law W 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 officer. The commissioner of revenue mav alace the notice reauired under this subdivision in the individual income tax or aroaertv tax refund instructions instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible suthority,an individusl shall be informed w6et6er he is the subject of stored data on individuals,and whet6er it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data oo iodividuals shall be shown the data without any charge to him and,if 6e desires,shall be informed of the content and meaning of t6at data. After an individual has been shown the private data and informed ot its meaning,the data need not be disclosed to him for sia� months t6ereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been colleMed or created. The responsible authority shall provide rnpies of the private or public data upon request by the individual subject of the data. The responsible authority may require t6e requesting person to pay the actual costs ot making,certifying,and compiling the copies. The respoosible aut6ority shall comply immediately,itpossible,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 t6e request within that time,6e shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest t6e accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify fn writing the responsible authority describing the nature of t6e disagreement The responsible authority s6a11 within 30 days either: (a)correct the data found to be inaccurate or fncomplete 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 correcG Data in dispute shall be disclosed only if the individual's statement of disagreement is included with t6e disclosed data. The determination of t6e responsible suthority may be appealed pursuant to the provisions ot 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 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 egtent 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.5.13.04(available upon request)to review private data on yourself. 6. Your fuli name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand my rights as stated above. Signatu e . ' CHECK OFF LIST FOR ISSUANCE OF PERMITS ' FOR OFFICE USE ONLY A.DDRESS ORLEGAL: 3333 .s tto�tx—t.��v� �p�t, ' PID: DESCRIPTION OF WORK: Co,FF�,� �L� os ic ZO�IG REV�W BY: sb . DATE APPROVED: BUII,DI�i(G REVIE`V BY: „` . DATE APPROVED; E3 -31-oy FEES TO BE CHARGED: Misc. Fees Calculated By: PERII�IIT Yes � No PLAl�t REVIEW Yes �/ No SE�YER CONNECTION STATE SURCHARGE Yes ✓ No WATERCONNECTION INVESTIGATION FEE � Yes No PARK FEE SAC Yes No STTEINSPECTTON Number of SAC�Units OTHER (specify) ZOYING CHE.CK LIST Zoning District: ,�d c,�Aivae . Fire Department: Post OfFice: School District: � Lot Area: Sq.ft. Acres � Width Depch Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Right Side: Reaz(Street): I.eft Side: Adjaceat Structures: ` etland: Building Hei;ht: Def. Hgt. P al:Hgt. Lot Coveraoe: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: f� Resoluiioa Date: � Shoreland District: Avg. Setback: Bluff Setb ck: L.ocCovera�e: Eaisting Proposed Hardcover: 0-?5' 75-250' 250-SQO' 500-1000' Hudcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 � � � � o � BUILDING REVIEW CHECK LIST �C� 1J � GH�— CONSTRUCT'ION TYPE: ' _ Sq Foota�e $ Per Sq Ftg Basement x = lst Floor x _ 2nd Floor z = Garage z = z — TOTAL Estimated Construction Value: $_ �-(S, 000`� Inspections Required: tiVork Requiring Separate Petmits: Si[e p< Plumbing Fire Hazdcover Removal Mechanical Water Connection Footing ` Septic Sewer Connectioa _�Framing Fireplace Lawn Irriga[ion Insula[ion (Masonry) Other � F��Boazd (Mfg.) Well (State Permit) Grading/Filling _�Electrical (State Permit) O[her REl�LARKS (I�'HOUSE): . ------------------------------------------------------- REV�W BY OTHERS: DATE: Access: Existing New Access Approval: Date gy; �--------------------------------------------------------------------------------------------------------------- REMARKS (TO BE NOTED ON PER�tiII'1�: /Vo ,5�,4 ,—,�v6 ,4c�ow�� 8 � /�DAT,�� TIME CITY OF ORONO CALLED IN a` INSPECTIONN I SCHEDULED /D D� � %3D PERMIT NO. � COMPLETED ADDRESS 33 3 3 (�i , OWNER CONTR. �1�%c.Q.d-DY� LP,Q��Q TELEPHONE NO. ��I �JD3 O�� DESCRIPTION 1'Y� � �� S '�- � 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 Z 04 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O a � O � W � Q � 2 W � W � � O W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONOITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WFLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor o� i�e: �� a Inspector. White Copyllnspector's File Canary CopylSite Notice �-, � �' �" ;�' DATF� TIME CITY OF ORONO CALLED IN � r' �'`� INSPECTION NOT CE G scHE�u�E� �,UJ� �G,vy� �' 3��ti� PERMIT NO. �G��, 4 �G�y COMPLETED ADDRESS �:�� LU��es �i Pti� I�Y2 _ � (Sf l Y� OWNER CONTR. ��s� � �>�'I'� TELEPHONE NO. Lf�S I �L' '� ��p� � � DESCRIPTION ��.i��t��'Y�i� C_o��_ `i;1 ;� c''�._ ��c-(-�S � 01 FOOTWG 11 MECHAN�CAL 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�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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � d W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-Q6QQ OwnerlContra�o �site: Inspector. � � White Copyllnspector's File Canary CopylSite Notice