HomeMy WebLinkAbout2004-P07553 - addn/remodel/repair C�T'Y�`OF ORONO PERMIT
2750 Kelley Parkway- PO Box 66 Permit Number: Po�ss3
Crystal Bay, Minnesota 55323 Permit Type: Addirion/RemodeURepair
(952) 249-4600 Date Issued: 6i3i2ooa
SITE ADDRESS: 3745 Shoreline Dr
Wayzata,MN 55391
PID: 2o-i i�-23-2i-oo2s
DESCRIPTION: UBC Occupancy A1
Construction Type VN
Proposed Use: Industrial
Permit Class: Building Census Code 437
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: vuier-�woric siaried wiinoui permii-invesiigaiion iee�
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 542.75 Valuation: $ 40,000.00
State Surcharge Fee: $ 20.50
Misc.Fee:
TOTAL FEE: $ 563.25
APPLICANT: Owner/Self OWNER' Good Shepherd Lutheran Church
M� � 3745 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.
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ICANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Covies: 1-File(SiQnitures Required), 1-Atrolicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1
� � �(03.21� R�o 753o a���
� Total Fee: $ � Date Received: `�� ���' < < AD75�3
Entered By: Permit #: -' `���y b/-o�{
�eenfer��.
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please prrnt all information) �
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THE APPLICANT IS: (circle one) OWNER OR CO�TRACTOR
JOB SITE ADDRESS: -� 79 S �U'"'�-���^�F= �%�- ZIP: � ,S .� �/' /
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, f�-'''�.-C''!�-
NAME OF OWNER:��� �k(�`�t�� ��'���HONE: (home)
(�vork) `�S-Z -- �' 7/ -- ���%.��'
MAILINC ADDRESS: �^7�S- �2�-:,��r CITY: 1�/�-y �s�- ZIP: /��� SS.�9/
�z�vE:
CONTRACTOR: �/�� r��%/�-�`
� t�'LS ��e_. PHONE: 7�Z-472 — S-� �7 c�
CONTACT PERSON:v� �`i.�°n��.�-i�.MOBILF.�PAGER: (��/ —�j'(P�' - Z-�F 2 S
MAILING ADDRESS: ��-S C� ����-��.� .�--�. CITY: /�74� �n�J ZIP: ��1.� -f
STATE LICENSE: # /_�/ O
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure ______ _
Move Remodel/Alteration Land Alteration
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PROPOSED WORK (describemdetai�: �f�`L��- ��--��"�'�r��=�`2 /���' ��'i�.,.�,,.,-(J-._.._
w,i7�- /'z1�=3� /��r`=, vs��-G�- c.��(G,���r��r� /�-:�L��,ir-Sc� �s �-_�
�-�'�L-�C-FI-57 0�i J�'z �,v�//-� •T i.,^.���/-�L_ cJ S E= 1�t�'�-�/J"'
STORIES: Z- SQ. FEET OF EACH FLOOR:
N0. OF BEDROOMS: GARAGE STALLS: ATT. DET.
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ESTIMATED CONSTRUCTION VALUATION (excluding land): S �C� U�u �!
I hereby apply for a buildin; 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 w�ith the
State Building Code; that [ understand this is not a permit and work is not to start without a permit;
and that the work will be in accordance �vith the approved plan.
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APPLICANT'S SIGNATURE: ��,,�' DATE:
��r �����.,� �. ���`l"U�'s T 7�'� ��� �ff1--�/f�� �i7fr-��'�'���- ��7'L/�C��
NOTE. Parade of Homes�vents requi�e separate permit appro va1 by Po/ice Department and City
Counci/60 days prior to the evenf. Non permitted events �s�ill not be aUowed.
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1 �
Sec.13.04 RIGNTS 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 sa fort6 m this section.
Subd.2. Information required to be given individuat. An individual asked to suppiy private or co�de�al data concerning himself shall be
informed of: (a) the purpose and intended use of the requested data within the collecting state agency, politi�l subdnition, or statewide system; (b)
whether he may refuse or is legally required to supply the requested data; (c) any known consequence arising Svm iis snpplying or refusing to supply
private or confidential data; and (d) the identity of other persons or entities authorized by state or tederal law to receive tbe data. This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivisian 5,to a law e�forcement officer. '
The commissioner of revenue mav place the notice reauired under this subdivision in the ind'ni�nal imcvme tax or oropertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority, an individual shaQ be �ormed whether he is the subject
of stored data on individuals, and whether it is classified as public, private or confidential. Upon his further re�vest, an mdividual who is the subject of
stored private or public data on individuals shall be shown the data without any charge to him and, if he des�s, sln➢ be informed of the content and
meaning of that data. After an individual has been shown tf�e private data and informed of its meaning, the dua 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 ind'ni�al hzs been collected or created. The
responsible authority shall provide copies oF the private or public data upon request by the individual subject of�he data The responsible authority may
require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately, if possible, with any request made pursuant to ttis subdnision, or within five days of the
date of the request, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If�e caanai comply w�th the request within
that time; he shall so inform the individual, and may have an additional five days within which to camply with thz req�est, excluding Saturdays, Sundays
and legal holidays.
,, .. Subd. 4. Procedure when data is not accurate or complete. An individual may contest the acc�acy or completeness of public or private
_ _data concerning himself. To exercise this right, an individual shall notify in writing the responsible authority dacribing the nature of the disagreement.
_ 'Tfie responsible authority shall within 30 days either: (a) correct the data found to be inaccurate or incompleSe and auempt to notify past recipients of
inaccurate or incomplete data, including recipients named by the individual; or (b) notity the ind'nidual that he believes the data to be correct. Data in
dispute shall 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 pro�uions of the sdmi�trafive procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", w•e 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 ��ou 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�license.
3. The information may be shared with other local, state or federal agencies to the e�ent 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 prir�ate data on yourself.
6. Your full name is required to process this application or permit.
First Middle Last
Address
City State Zip P6one
I understand my rights as stated above.
i��
Signature
� � CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �"7�-15 �f+�2t;LiN� pR.
PID:
DESCRIPTION OF WORK: (1,�P�au n�� �-c�T ��.o n �, ��-,-� -T'�,-�s.�c� tZo�
------------------------------------- --------------------------------------------------------�--------�---------------
ZONING REVIEW BY: L��-- DATE APPROVED• S s--oy .
BUILDING REVIEW BY: DATE APPROVED: 5-z,�o�
,
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes No � SEWER CONNECTION
STATE SURCHARGE Yes � No h�1/ATER CONNECTION
•���INVESTIGATION FEE Yes�- No a�/� 7�PARK FEE
SAC Yes No SITE INSPECTION
-_Number of SAC Units OTHER specify)
-------------------------------- � ----��—��-`-'-��=��.£L�-- -- -'�'-�--'s�- -
ZONIN('i CHECK LIST Zoning District: No c�wr►r.c„Q (,R-1� �/�'�`�
G�--
Fire Department: Post Office: School District: �/—v�
Lot Area: Sq.ft. Acres �-/.0 3 Width Depth
Sur��ey Submitted: Yes � No Date of Survey: 11-26•a,(,
Proposed Setbacks:
Front (Lake): Right ide:
Rear (Street): Left Si e:
Adjacent Structures: Wetlan :
Building Height: Def. Hgt. Peak gt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # oH -Z9�� Resolution: # s�o� Resolution Date: i-Z�-o y
Shoreland District:
Avg. Setback: Bluff etback: L o t C o v e r a g e :
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
� � '�d� �Ls —(�c� X S�/Ur�.'Y� C� D c�;Y�t_T'
/
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BUILDING REVIEW CHECK LIST
UBC: A- CONSTRUCTION TYPE: _�(/�
Sq Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ �-(C��C�o`'—"
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
c Framing Fireplace Lawn Irrigation
x Insulation (Masonry) Other
\�'all Board (Mfg.) Well (State Permit)
o�Final Grading/Filling Electrical (State Permit)
Other
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REMARKS (IN HOUSE): 1_�J��I< Si74�TL� W�p ,D Cv'�� i-
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REVIEW BY OTHERS: DATE:
access: Existing New
access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMIT):
� AT TIME �
CITY OF ORONO c,a��E�uv �'
INSPECTION �ICE SCHEDULED - D-D /D.,3a
PERMIT NO. � COMPLETED
ADDRESS 37�-5 � �
OWNER � CONTR. el� `�
TELEPH NO. 9 2 �� 2. S/ 7 D
� DESCRIPTION r ���
� 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
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CO�,RECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p 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 irt advance. (952) 249-46�0
OwnerlCo r site:
Inspector. �
White Copyllnspector's F e Canary CopylSite Notice