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2001-P04012 - addn/remodel/repair
! ' _ f �• PERMIT C I TY O F O RO N O permit Number: 2750 Kelley Parkway - PO Box 66 P04012 Crystal Bay, Minnesota 55323 Pe�1711t Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: �i3i2ooi SITE ADDRESS: 3800 Shoreline Dr Wayzata, MN 55391 P�D: 17-117-23-33-0007 DESCRIPTION: UBC Occupancy R3 Construction Type VN Propc�sed Use: Kesicientiai Buildin Census Code 434 Permit Class: g Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution #: Separate permits required: riumoing iviecnanicai Eiecu�icai�siarej NOTIC ES/REMARKS: n rr�nniramant tn rhanna frnm racirlantial tn hncinacc in fiifiira FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00 Plan Review Fee: $ 208.78 State Surcharge Fee: $ 10.00 TOTAL FEE: $ 540.03 APPLICANT: Mark Brewer OWNER: Mark Brewer 3800 Shareline Dr 3800 Shoreline Dr Wayzata, MN 55391 Wayzata,MN 55391 TI IE UNDERS[GNED HEREBY REQUESTS PERMISSION TOMAKE THE REAL IMPROVEMENTS SPECIFIED AN D AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MI NNESOTA BUILDING CODE REQUIREMENTS. � �.. r" 1 ����-- PPLIC'�1 "I PI;RMITEE SIGNATURE SSUEDB SIGNATURE Copies: 1-File (Signitzrres Required), 1-Applicant, 1-MonthlyReports, 1-Assessing,1-Finance Page 1 ., . - . . ., Total Fee: $ '���`f�- �`'� �' Date Received: ;� Entered By: � �, Permit#: �C% ��l_,� ��� �,� , , __ , CITY OF ORONO - BUILDTNG 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:� ���'G' :�/-�G�/�'�G-l/u� �7/�_ Z�• �'��- <��a- `�7� ^' NAME OF OWNER: 1�i9�?� ,���1���� �PHONE: (home) ���S (work) ;�"����'- -;'7�� - ��'�':3� l�IA.ILI�i tG ADDRESS: � � _ ���C����/��'� CTTY: ;��:��;'i?i%> ZIP:_ :�:�. �i n,�; PHONE: " ; ,' _.. ?;? -��=i��'� CONTRACTOR: ' �>�E�� � CO�ITACTPERSON: .:-�� �' 'f' ��IOBILE/PAGER: - �,=� ;�; _Q _Z�/q MAILII�TG ADDRESS• /���,;� �/�'� , 'F:�/' �,�' CITY: �'' �.�.-t i_, ZIP: ���%f STATE LICENSE: # �%!' ARCHITECT/ENGI�Ii EER: PHO\TE: MA,IL�'G ADDRESS: CITY: Z�: N��: REGISTRATION# � TYPE OF WORK: Ne�v Addition Accessory Structure Move Remodel/Alteration�/ Land Alteration ,(f.<z ,�i�l75f= ' PROPOSED WORK(describe in detai�: k'fi1�oDA� r�'/ic-:yEN' � l.�-U.����r' i/ �r��%-�>��s��5 � "/ "ji�l�f% /`L'f ij-�'/S�/` ��'l:E'.+�� y !�T �/�ti''/Z�i!yL�7 LJa�.[-' i'�3/�'/T.�li�7 6.'�..f'K?'lf;� -`LC/C/Gl. � � .�C�T.�.i�✓� � ..sU.�c'�tf� ��.•Gr�.'(C :�C � G� STORIES: =x SQ.FEET OF EACH FLOOR: ,�S`��'� �'�-' ��% /�'��� ���1r'�� NO. OF B�DROOMS: =-- GARA.GE STALLS: ATT�. �_ DET. - - - . ESTII�i LATED CONSTRUCTION VALUATIO� (excluding land): � v�O� d4C� I hereby apply for a buildin� pernut and I acknowled�e 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 Buildin� Code; that I understand this is not a permit and work is not to start without a permit; and that the work will be in ac� rdamce w�?�the approved plan. //� / � ! APPLICA_NT'S SIGNATURE: �� /i��� � < � � � ,---- DATE: �-�° �� � � 1�'OTE! Parade of Homes events`require separate permit approval by Police Deparlment and City Counci160 days prior to the event. Non permitted events will not be allowed. _. .�--- . � � Y r ► Sec.13.04 RIGFiTS OF SCfB.TECTS OF D�T.�, Subd. 1. Type of data. 'Ihe righc�oF individual on whom[he data is sto:�or co be scored shall be as set for[h in this secaon. Subd.2. Information reqirired to be given individual. An ir.di�idual uY�to supply private or con8denual data concerning himself shalt be informed of: (a)�he purpose and imm�ded use of the requesud data wi�in the eoIIecdng rrace agency,poliacal subdivision,or statewide rysrem; (b)whechar he may refuse oY is legally required to supply che tequested dan:(c)any l�owa coasequenco arising from his supplying or tefusing to supply priva�e or conndenaai data;and(d)the idendry of other peaoas otenddes a�chorized by state or fedecal law to receive the data..This tequiremen�shall noc apply whan an indir•idual is asked to suppiv invesagarive daa,purn:�=t to seccoa 13.82,subdivision 5,to a law enforcement o�cer. Tht commissioner of ce��enua mav vlace the nodce rewired erd-r this subdivision in the individual income tax or prooem tax refund instcuceions instead of on those forms. Subd.3. ?,ccess to data by indi.idual. Upon requesc to a reroasible aec�:oriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,privar�or confider.rial. Upon his fur[her request,aa individual who is the subjecc of scorod privace or public data on individuals shall be shown the dara wi�out any c'c�rge to him and;if he desires,shall be info�med of[he concenc and meaning of chac dara. Afcer an individual�s been shown[he priva��an and ic:or�ed of irs meaning.[he dara need not be disclosed to him for six monchs chereaiter unless a dispuce or acuon pursuanc to this secdon is zending or addirional data on the individual has been collec�ed or creaced. The cesponsible auchoriry shali provide copies of ehe privace or public dac�a:on requ�:by[he individual subject of the data. The responsible authoriry may require che requesdng person to pay the acaa!coscs of making,ce.=:;ing,and eompiling the copies. The responsible auehoriry shall cor..ply immedia�ely,if possib!e.wich any r_quest made pursuant to this subdivision,or within five days of the date of the requesc,excluding Samrdays,Sundays and tegal holidays,ii is.mediat:eompliance is not possible. If he cannot comply with the request wiehin chac dme.he shail so infarm ehe individual,and may have an addizeral five days wichin which to cortply wirh�he request,ezcluding Saturdays, Sundays and legal hotidays. Subd.4. Procedure when d�ta is not accurate or complete. �n individual may contesc the accuracy or completeness of public or pri�ate daca eonceming himself. To exercise chis righc,an individual shall norify ia wriang ce respoasible authoriry describing�he nacure of the disagreemenc. The nsponsible auchoriry shall wichin 30 days eirher: (a)correct the dae tcand to be inaccurate or incomplete and aaempc to nodfy pasc recipiencs of inaccurace or incomptete da�a, including recipients named by the individz:al;or(b)codfy che individual that he believes the data to be correcG Dac� in dispuce shsil be disclosed oniy if the individual's sta�emene of disagr:��enc is i.c:ided with�he disclosed daca. The decerminaaon of[he rtsponsible au�horiry may be appea�:3 pursuacc co the provisions of ehe adminisaarive proeedure act relaang to contated cases. . � DATA PRIV�CY AD�ZSORY In accordance wich M.S. 13.04,Subd.2, "Ri;hts of subjects ot data",we would like to inform you that your reauest for a pemuc or license from the Ciry of Orono or any of ia depar.L.ents may require you to furnish certain priva[e or confidencial information. You are notified that: 1, The information you furnish will be used to de:ermine�•our qualif cation for the permit or license requested. 2. You may refuse to suoply data, buc refusal nay require that the City deny the permit or license. 3, The information may be shazed with other loc�l, state or federal agencies to the extenc necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become . .. . public. �, You have cer[ain rights under N1.S. 13.04 (a.ailable upoa reques[) to review private data on yourself. 6, Your full name is required to process this applicacion or permi�. /rIA�X Ev��.U,F �ie���e - Firsc �fiddla �t 70__ z�__���rT .� �2� �3�ov ��o���>�v� .��r ,) D�o�v Address /►1���E��� �rI�J a�s3�� ysa-�Z sy� Ciry State Z►p Phone �So? -L/7f a?S"� ' I under '� ated above. � sig �. - • � � CHECIi OFF LIST FOR ISSUA��TCE OF PERR1'nTS . FOR OFFICE USE Oi1L.Y . ' . ADDRESS ORLEG.4L: 3�00 S�to R•�.L���= '�R — PID: DESCRII'fiI4N OF�ORK: �w�d e�- , � ZOrZti G REVIE�'BY: �Q,�,�_ D�TE APPROVED: G-Z� -n� BUILD1itiTG REV7E�BY: D�Z E APPROYID: �- z�-o � - FEES 'TO BE CH.4RGED: Niisc. Fees Calcuiated By: pEgMI'I' Yes � No -� PLAN REVIEW Yes r/' No SE�F�CONNEG"TION STATE SURCHARGE Yes �/ No �ATERCOi�INEG"TION I'�i,'VESTIG�TION FEE Yes No PARK FEE SAC Yes � No SrTE�tSPECITON Number of SAC�Units OTHER (specify) ZOti�G CHECP LIST Zoning Districc: �v c= «�� . Fire Department: Post Ofnce: Scflool District: • � � Lot Area: Sq.fr. Acres � Widch Depth Surve;� SubL::tted: Yes No Date of Survey: Propased Setoac!cs: Fronc (La'_ce): Ri�ht Si e: ' Rear (Scree:): Left Sid : Adjacent Str�ctures: �Vetlaad: • Buildin� Hzi�ht: D��. H�t. Peak H�t. Lot Coverz��: Gradin�: Stafi App:oval Date: By: Council Approval Date: Septic: Staf[Appro�al Date: By: Zonin�Fil�: m Resolu�ion: � Resolution Date: . Shoceland District: Av�. Setbac:<: Btufi etback: L.otCo�•era�e: E�� j Proposed H�dcover: 0-7�' 7�-250' — ti0-500' 500-1600' Hardcover Variance Required: Yes No Date of Councii Approval: _______ REI�IAR�;,S (in house): 7 'R BUII,DING REVIE�� CHECK LIST usc: /�- 3 - co�rs�zucnoY�E: �rv Sq Fooca�e S Per Sq Ftg Sasement z — lst F1oor z = 2nd �oor z = Gara�e z = x = TOTAL c� Fstimated Construction Value: 5 Z��, c�c�� � Inspections Required: SVork Requiring Separate Permits: Site _�Plumbing ' Fi:e � Hardcover Removal _�Mechanical Water Connection Footing Septic Se•x•er Connection �c Framing Fireplace Lawn Irrigation �Insulation (Masonry) Ot�er _��Vall Board (Mfg.) Welt (State Permit) _�Final Grading/Fil(ing _�Eleccrical(State Perm.it) Other REtiiARKS (I�i 1 HOUSE): � REV�W BY OTHERS: ' DATE: Access: Ezis['Ln� New Access Approval: Date By; RE��L4RKS (TO BE NOTED ON PERMIT�: F��� �2�,�-vt�w R-��Ji �� � C(�4-��r1 (� P C�GC..v,D✓fir�C.0 ['�'s s� �x�V—�10� — t�-S� (�P,�'T'►/�t �-.� (�us(r�C�•5 8 06/26/2620 22: 09 9524727008 PAGE 02 ';' � ;: t � ! •. ' ; � � � � j � y ; � ; :.:' , � , ,...- - -•� -- - - r.,;�__�..;^�... ry . _ _...-�---.-;- - � -;�-�---- --. _.i_... ..1._ __ ...._; --- -- .. _i.__. ; , _�. _.T�._;.. ;: ; � � a: ,. ;,:;. r�� � , ; � �` �i � , ; � ...;...__.�_ . . .. . 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TELEPHONENO. �S � ��� �y�3 0'1 �.St3 �/7/ �_�� � DESCRIPTION 1--e.�t�' O �-�T GQOZI/� � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS 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 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � 2 W � W � � � �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR FEINSPECTION TEMPORARY V BEFORECOVERING PERMANENT O CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector.��.��!�� White Copylinspector's File Canary Copy/Site Notice �� 3 DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI E SCHEDULED Q�� /�3� F'-'�'I _ PERMIT N0. U � --2 � f �"' COMPLETED � � _/�� .S� ADDRESS ���S<C�� ��f�ll� .��� OWNER _ �G�['� c�(I CONTR. C3'Zt,�il. TELEPHONE N0._ -I�� �-) / � �-I 6 d O � DESCRIPTION �/{�(� � �j �� � 01 FOOTING 11 MECHANICAL RI 18 EXCA�//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 OS 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 � C�7MMENTS: a �� � � `�r.�� 7-� ��� `;�' `� � ' << <:.t- ��. �_ L% -1 � / � � ,�L'd l �� � � � . l_ /� ;� ��i i(/�� ,��,(�� ' _ "� � �• 1 , � � p�����ll� _�.� ��rr��i 1 O � W � Q z _ ' 'Y� a�,1 I W � W � � d W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W �ORRECT WORK 8�PROCEED �SSU CERTIFICATE OF OCCUPANCY O ;❑CORRECT WORK,CALI FOR REINSPECTION ,�TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-46�� OwnerlContractor on site: �� � , Inspector. � �=���fi �,�1 , White Copylinspector's File Canary Copy/Site Nofice