HomeMy WebLinkAbout2002-P05350 - accessory structures � �
TY F R N PERMIT
�'( O O O O Permit Number:
2750 Kelley Parkway- PO Box 66 P05350
Crystal Bay, Minnesota 55323 Permit Type: Accessory srructures
(952) 249-4600 Date Issued: 9i26i2oo2
SITE ADDRESS: 3880 Shoreline Dr
Wayzata,MN 55391
PID: 17-117-23-33-0151
DESCRIPTION: UBC Occupancy S2
Construction Type VN
Proposed Use: Commercial
Permit Class: Building Census Code 327
Pernut Type: Accessory Structures Permit Sub-type(s): Building Undefined
DETAILS:
Approved per resolurion#: 2776
Separate pernuts required:
NOTICES/REMARKS:
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FEE SUMMARY: Pernut Fee: $ 3,065.75 Valuation• $ 470,000.00
Plan Review Fee: $ 1,992.83
State Surcharge Fee: $ 235.50
TOTAL F'EE: $ 5,294.08
APPLICANT: Rochon Corporarion OWNER: Hennepin County
3650 Annapolis Lane N. Attn:Marcia Wilda M/C 608
Plymouth,MN 55447 3880 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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T RMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-At�nlicant 1-Monthlv Renorts, 1-Assessin¢, 1-Finance Page 1
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Total Fee: $ � G`� Date Received: G"��' �� =�
Entered By: ✓ ./�J;� � Permit #: L� I � �o�.-
CITY OF ORONO - B LDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ��Q� .�����,�������IP: ,.�� � �
NAME OF OWNER ���/G�/U��/v � (',+l/�� PHONE: (home)
(w k ,
MAILING ADDRESS: CITY: � ZIP:
CONTRACTOR: G/�D/� (�.�j��� PHONE: � '-��I R�-���
CONTACT PERSON: �" OBILE/PA ER: — -/
MAILING ADDRESS: �' � CITY: Q � IP: ��
STATE LICENSE: # L �
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ARCHITECT/ENGINEER: ��GD • PHONE: — `,�--DD
MAILING ADDRESS: � � :! ITY: �� IP: �
NAME: C ZL� L_� REGISTRATION#
TYPE OF WORK: New� Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROP SED W RK( e c 'be in detain: ������ ��G�-�����_
��������
STORIES:�_ SQ.FEET OF EACH FLOOR: � ��
NO. OF BEDROOMS: � GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $� �l�Q
I hereby apply for a building 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 with
the State Building 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 acc rdance with the approved plan.
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APPLICANT'S SIGNATURE: ' DATE: �a y 2�
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
9
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Sec.13.04 RICHTSOFSUBJECTSOFDATA +► � �`
"�
Subdivisron 1. Type af data. The righls of individual on whom the data is stored or Jo be stored shal!be as set jorth rn this section.
Subd.2. Injormation required to be given individuaL An indivrdual asked to supply private or confidenlral data concerning himseff
shall be informed of.• (aJ 1he purpose and intended use of the requested data withrn the collecting stafe agency,political subdrvrsion,or statewide
system;(bJ whether he may refuse or is legally required to supply the requested data;(cJ any known consequence arrsing from his supplying or
refusrng to supply prrvafe or conf:dential data;and(dJ the identity of other persons or entities authorized by state orfedera![aw to receive lhe data.
This requirement shall not apply when an indivrdua!rs asked to supp/y investigative data,pursuant to section /3.82, subdivrsion 5, lo a Imv
enforcement o�cer.
The commissioner ofrevenue mav place the notice required under thrs subdivision in the indivrdual income tax or Droperty tax rejund
rnstructions instead oton those torms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shal!be rnformed whether he is the subject
of stored data on individuals, and whether it is classifred as publrc,private or confidential. Upon his further request,an individual who is the
subject of slored private or public data on rndividuals shall be shown the data wrthout any charge to him and, if he desires,shall be informed oJ
the conlent and meaning of lhat data. After an individua!has been shotivn the privale data and informed af its meanrng, the data need not be
disclosed to him for six months lhereafter unless a dispute or action pursuant to thrs section is pending or addilronal data on the individual has
been collecled or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of
the data. The responsible authorrry may require the requesting person to pay the actual costs of making,cert�ing,and compiling the copres.
The responsible authority shall comply immediately,rfpossible,with any request made pursuant to this subdivrsion,or withrn five days
of the date of the reques�,excluding Saturdays,Sundays and lega!holidays,if immediate compliance is not possrble. If he cannot comp[y tivith the
request withrn that time,he shall so inform the individual,and may have an addrtional frve days withrn which to comply with the request,excludrng
Saturdays,Sundays and legal halidays.
Subd.4. Procedute when data is not accurate or complete.An individual may contest the accuracy or completeness ofpublic or private
data concerning himselj. To exercise this righl, an individual shal!not�in writing the responsible authority describing the nature of Jhe
disagreement. The responsible authoriry shall within 30 days either: (aJ correct the datafound to be rnaccurate or incomplete and attempt to notify
past reciprents ojinaccurate or incomplete da1a,includrngrecipients named by the individual;or(b)not�the indrviduaf that he believes the data
to be correct. Data in dispute shall be disclosed only if the indrvidua!'s statement oJdisagreement is included with the disclosed data.
The determination of the responsible authority may 6e appealed pursuant to the provisions of the administrative procedure act relating
to contested cases.
DATA PRNACYADVISORY
In accordance wilh M.S.13.04,Subd.2, "Righfs ofsubjects ofdata",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 confidentia!information.
You are notifred lhat:
1. The information you furnish will be used to determine your qualification for Ihe permit or license requested.
2. You may rejuse to supply data,but refusal may require that 1he Crry deny the permit or license.
3. The information may be shared with other local,state or federa!agencies to the extent necessary to process the permit or
license.
4. I,f yaur requested permit or license requires Council action to approve,some information may become public.
S. You have certain rights under M.S. 13.04(see following page)to review prrvate data on yourselj.
6. Your full name is required to process this appllcation or permit.
PLE9SE PR1NT
�/
First Middle Last
Address
Ciry State Zip Phone
I rst d m r hts as stat d ab
G'
s,g„� ' �C���
10
r , y
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ���g U ��-k�2c��►v2 �J 2�v�e. .
PID•
DESCRIPTION OF WORK: (}cc�sso s�wc�rn� - s . s�o
ZOYPi TG REV�W BY: DATE APPROVED: 9-2 Y•�Z
BUII..DING REVIEW BY: DATE APPROVED,• g- Z�Y-�-z
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes c/ No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes �/No WATERCONNECITON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No �. SITEINSPECTTON
Number of SAC�Units N� � �,� ��6 OTHER (specify)
ZONING CH�CK LIST Zoning Districr. .
Fire Department: Post Office: School District: �
Lot Area: Sq�.ft. Acres (,.{.S Width Depth
Survey Submitted: Yes / No Date of Survey:
Proposed Setbacks:
Front(Lake): c�-(� Right Side: I�5
Rear(Sueet): SO I.eft Side: O.IL
Adjacent Structures: c�.k-- Wetland: �v�/L
Building Height: Def. Hgt. Peak Hgt. --
Lot Coverage: N/�-
r P� c�...�,� ,�,,�,��.
Grading: Staff Approval Date: 5- vy- o Z By: �v� Council Approval Date: � �- Zo - 02
Septic: Staff Approval Date: N e� By:
Zoning File: # o2-Z-tZ�, Resolution: # y 5 Resolution Date: G-Lt - o Z.
Shoreland District: v�e 5
Avg. Setback�� n�l/�- Bluff Setback: nr /.�- Loc Coverage: �v/,a
Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000' > 3 S°7 0
Hazdcover Variance Required: Yes_� No Date of Council Approval: �•"2 e-0 2
REMARKS(in house)•
7
..-- . . .
BUII.,DING REV�W CHECK LIST
�C� S�Z. CONSTRUCTION TYPE: V/J
�. Sq Footage $Per Sq Ftg .
Basement x = --� .
lst Floor x _
2nd Floor x =
Garage x _ �
x —
TOTAL
Estimated Construction Value: $ �170, OC�O `�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connecdon
J� Footing � Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
_�F�� Grading/Filling _�Electrical(State Permit)
Other
REMARI�S(IN HOUSE): .
_________- -----------__�_____�__�____
REVIEW BY OTHERS• DATE:
Access: Existing New
Access Approval: Date gy;
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REMARI�S (TO BE NOTED ON PERMII�:
8
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(�I`'. DATE TIME
CITY OF ORONO �iN
INSPECTION NOT CE SCHEDULED � _��T�•J2
PERMIT NO. � � 3� � COMPLETED
ADDRESS �� �� �� �2 `� � �
OWNER CONTR. 'l'1
TELEPHONENO. I .� -- �� CJ�j -' 7g,��
� DESCRIPTION \ � l� S t C.�lt' �"��.�
� 01 FOOTING 11 MECHANICAL RI 18 E AV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � r
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTIONI J�� ��
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 FOILOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES�NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED �PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCYf
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY Uj
V BEFORECOVERING � (/�
PERMANENT / �
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN � �/
INSPECTOR WILL RETURN �
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION�SSUED
�INSPECTION REQUIFiED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� Z49-46��
Owner/Contractor on si�e:
Inspector. �1
White Copyllnspector's F e Canary CopylSlte Notice
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N ICE �J� SCHEDULED / / a
PERMIT N0. S J `� COMPLETED
ADDRESS J��0 ���'e- ����-- b��l •
OWNER CONTR. •
TELEPHONE NO. (�l� .'��P � ��5��v �i i�
� TION CS��dr'
ly 1 FOOTIN 11 MECHANICAL RI 18 EXCAV/GRADING/fiLLING
� 02 G 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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O 03 INSULATION 24/25 WOOD BURNER/FIREPIACE 34 TREE HEMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC AAAINT. 21 COMPUUNT
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 FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
ti COMMENTS:
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W� YVORK SATISFACTORY`.PROCEED ❑PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance. (952) 249-4600
Owner/Con r ite:
Inspector. _ .
Whits Copyllnspector's ile Canary Copy/SNe Notics
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI� SCHEDULED 1�•Il��-(1Z .� i.��
PERMIT NO. J"C� S.3S`�U COMPLETED
ADDRESS ,����-�VP I/�c.
OWNER CONTR. ��2..
TELEPHONE NO. �s��� 3 l0 ,� �S+U� � �i�
� D��s;R�ION � � �G:.� �
� 01 "FO u1�G � 11 ME NICAL RI 18 XCAV/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
� 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
� COMMENTS:
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W� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next ins tion 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector.
White Copy/lnspector's File Canary CopylSite Notice