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Home My WebLink About2004-P07210 - addn/remodel/repair ITI�'` F R N PERMIT C � � � O Permit Number: 27�0 Kelley Parkway - PO Box 66 Po�2io Crystal Bay, Minnesota 55323 P@CCYIIt Typ2: Addition/RemodeURepair (952) 249-4600 Date Issued: 2/13/2004 SRE ADDRESS: 3465 Shoreline Dr Wayzata,MI�155391 P I D: 20-117-23-12-0033 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Permit Class: Building Census Code 434 Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: riumoing NOTICES/REMARKS: T_�I_""__"__= T_"'_.1_1 ._...."""" ' _....... . FEE SUMMARY: PermitFee: $ 9�•25 Valuation• $ 4,000.00 State Surcharge Fee: $ 2.50 TOTAL FEE: $ 99.75 APPLICANT' Chris Nelson OWNER' A&I Overson � 3455 Shoreline Dr. � 3465 Shoreline Dr Wayzata,MN 55391 Wayzata MN 55391 TI�UNDERSIGNID HIItEBY REQLTESTS PIItMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF 1VIINNESOTA BUII,DING CODE REQUIREIVIENTS. , ��ti LICAN ITEE SIGNATURE D BY SIGNATURE Conies: 1-File(Siunilures Reauired), 1-Anqlicant, 1-Monthlv Renorts. 1-Assessine, 1-Finance Page 1 s Total Fee: $ R9•7S Date Received: ,��,�j�U� �Entered By: '`�/L'�-�' Permit#: � ,;-�� - y�b� � 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 CONTRA.C_T.O!12_- 'T�i 6-1��`! �� --�;.�, �� v < <7 �"2 3 i z. -c.�c`�� r�� -5��+r��l��;��, JOB SITE ADDRESS: ��yc.:�,�°�-�t-/M�' .� ZIP: ,�4=7 i/ ��'�r'S � � ��, � r .� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [✓�l�'o 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. NAN1E OF OWNER: c!rc.�'�:�'�� /�'pf�=:a��'�7�,�;:,, PHONE: (home)_'�G�-•�;;'""�- `�,� �� (work) 1�IAILING ADDRESS:��Z� �GY'�t��ri' Ln/ � CITY:y�y�i'Y?G�v'%*;f ZIP: � ,' %';'.- �'/,J;,�;"-' C--��F�'R-4�C�'�-R: �/��'. ',�., /i/�-i "=�'�.�;' PHONE: ��2 �-,�,,� f�! — �r7;,,;/�, � ,}.r_. CONT��CT PERSO\: MOBILE/PAGER: !f MAILING ADDRESS: �� %°.,�, ,� CITY: ZIP: ST'ATr LICEPISE: # �j/� r ARCHITECT/ENGI\EER: /J�I',�- PHONE: MAILING ADDRESS: � CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Accessory Structure �ddition Move RemodeUAlteration_� Land Alteration PROPOSED WORK (describe in detai�: �``�=�� fiT'�:�°,�-%��"��.,�; STORIES: -2 SQ. FEET OF EACH FLOOR ��'��f� ,�4•��:��-:�'�'."�%�: , NO. OF BEDROONIS: � ' GARAGE STALLS: ATT. � DET� ESTINIATED CONSTRUCTION VALUATION (excluding land): $ `f0�� I hereby apply for a building pernut and I acl�owledge 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 pernut;and that the work will be in accordance with the approved plan. '' APPLICANT'S SIGN�TURE: f�� ' � DATE: Z-�I-�`l � Sec.13.04 RIGHTS OF SUBJECTS OF DaTA � Subd.1. Type of data. The rig6ts of Indf�idual on w�Lom t6e data is stored or to be siored shall be as set forth in t6is section. Subd.2. Informstion required to be given individnal. An individual asked to supply prnate or rnnfldential data concerning himself shall be informed of: (a)the purpose and intended use of the requesie�data within the collecting state agency,political subdivislon,or statewide system;(b) whet6er he may refuse or Is legally required to supplv the req�ested data;(c)any knowo conseqaeace arising from his supplying or re[using to supply private or rnnfidenHai data;and(d)t6e identlty of other persoes or entities authorized by stste or fedenl law to receive the data.Thls requtrement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement ofticer. The rnmmissioner of revenue mav olace the ootiee reautred under this subdivision in t6e individual income tax or orooertv tax refund instructlons instead of on those forms. Subd.3. Access to data by indi�idual. Upon request w a respoosible authority,an indl�idual shall be informed whether he ls the subject of stored data on individuals,and whet6er it is classiRed u pubGc,private or contidential. Upon his farther request,an individual who Is the subject of stored private or public data on individuals s6a11 be s6own tLe data without any charge to him and,if 6e desires,shall be intormed of the content and meaning of that data. After an individual has been shown tLe private data and Informed ot its meaning,the data oeed not be disclosed to him for six months thereafter unless a dispute or actioo pursuant w this sedion is pending or addltional data on the individual has been collected or created. The responsible authority shall provide rnpies of the prlvate or pub6e data upon request by the individual subJect otthe data.The responsible aut6ority may require the requesting person to pay t6e actual costs of makI�,certifying,and compiling t6e copies. The responsible authority shall comply immediateh,if possible,with any request made parsuant to this subdivision,or withln fve days ofthe date of the request,excluding Saturdays,Sundays and legal6obdays,if immediate compliance is not possible.If he cannot comply with the request within that time,he shall so iniorm the individusl,and may hace an additional�ve days wit6in whlch to compiy with the request,excluding Saturdays,Sundays and legal6ol(days. Subd.4. Procedure w6en data is not accunte or complete. Aa individual may contest the accuracy or rnmpleteness of public or private data concerning himself. To exercise this rig6t,an individual shall wtity in writing t6e responsible authority describing the nature of the disagreement The responsibie authorlty shall wlthin 30 da}•s either: (a)correct t6e data found to be lnaccurate or incomplete and sttempt to notlfy past recipients o[ inaccurate or incomplete data,including recipients named b�tLe Individual;or(b)notify the ind'nidual that he believes t6e data to be correM. Data In d(spute shall be disclosed only if the indi�idual's statement of disagreement is included with the diuJosed data. T6e determination of t6e responsible authority mac be appealed pursuant to the procisions oi the administrative procedure aM relating to contested cases. ' DAT�PRIVACY ADVISORY In�ccordance with M.S.13.04,Subd.2,"Rishts 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 v�ill be nsed 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 rI.S.13.04(available upon request)to review private data on yourself. 6. Your full name 4s reqiared to process ttus application or permi� ri S rt�l ,�l.s� Fl �liddle �t _��lss �s�a��.1,�� 1,�. Address � . ��✓ar✓P Y�I h ��Sy 1/ 9S� �cJ�7 t- 086 ( City State 7�p Phone I understand m 'ghts a stated above. . c Signature . BUII,DING REV�W CI�Cg LIST �C' - �2 � 3 CONSTRUCTION TYPE: �//� _ Sq Footage S Per Sq Ftg Basement x _ lst Floor x - 2nd F1oor x _ Garage - z = . x = TOTAL Fstimated Construction Value: $_y,ppa°`� Inspections Required: �Vork Requiring Separate Permits: Site _�Piumbing Fire Hardcover Removai Mechanical Footing ` Water Connection Septic Sewer Connection � Framing Fire lace _�Insulation P. , ��igation � Wall Board �Final R ;: Other — ��'��,��.�.��,. ��x � _�a : ��.::�: °�` � REI�IARKS(L�T HOUSE):__ � �� _______ - ._____ V�W BY OTIiERS: � __.__._ --- -- - � ._ _-- _ .��-�T_� � _,_._�/E��.__ _ Access: Ezistin '' Y�� g __ ._��,�__, _ _��.-u..�-.--� � - ___. ___ ___ Access Approval: Date ---------_____�� . __� __ ----___._________. -- REILARKS (TO BE NOTED ( � -�--�- _�.�._��'c�.G�..--� _.��-� :�J��%e� � _� �/f) - w p 2l c i s � �,�, a� /'r� C�( C�,�-e� /(�--J v i� _.._o --- — ��_`_,_. �� CHECK OFF LIST FOR ISSiJANCE OF PERMITS � FOR OFFICE USE ONLY � ADDRESS OR LEGAL: 3�{6 S S N�i.tZw� �� . PID• DFSCRIPTION OF WORK: Q�-�- (Lo on,.� — (L.r,w�-o r�e� ZO�tG REVIE�V BY: N (� DATE APPROVED: BUII.DI�i IG REVIEW BY: -.�_ DATE APPROVID; Z-c�-o�j FEES TO BE CHARGED: i�iisc. Fees Calculated By: PERNIIT Yes �No PLAl�T REVIEW Yes No ✓ SEWF�COrfNECTION STATE SURCHARGE Yes f No WATF1tCOrfNECTION INVESTIGATION FEE � Yes No ✓� PARK FEE SAC Yes NO � STTEINSPEC"TION Number of SAC�Units OTHER (specify) ZONING CH�CK LIST zoning District: N � G/-1�/V� Fire Department: Post Office: School Disuict: - Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: � Front(Lake): Right Si�: Reaz(Street): Left Side: Adjacent Structures: Netl . Building Height: Def. Hgt. Peak �. Lot Coverage: Gradino: Staff Approval Date: By Council Approval Date: Septic: Staff Approval Date: By:l Zoning File: # Resolution: # i Resoludon Date: � Shoreland District: Avg. Setback: Bluff Sewack: Lot Covera�e: Eus�iug Proposed Hardcover: 0-75' 75-250' 250-500' � 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: � RENIARKS(in house): 7 + . 1 ` ' 1. /eEi'UGtJ-� �'�{ /�i�}�,1�/��"L�� I7�'D/!'I �Gl�p,� �� $ �� 'KG�i�'J- fI�'�v�t/'1� �,8� /}-NO 7��N �iJ� ?b� �.c 77//�i 7b � `' f}��r/E' 2 , �LA� C'E*�H�i� 'Ti� mn/ �V�iy `1/��rer.� � �E�L/�CE " '� A�1/ F'LG?�Ji� rT, �/1/��'TffLL /J/�'�,�/ Bf�Th`-T-U,B s� "7��7- a ��f2 l�'/I/ir� �, � 8� L', .a f3�i�ieo�' �0�= � f i�o o. o 0 7°G�/�Bi/I/Ej � (��,,g,��-� ��!'-� �