HomeMy WebLinkAbout2008-P11922 - addn/remodel/repair — ✓
* � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P11922
Crystal Bay, Minnesota 55323 Permlt Type: Addition/RemodeURepair
(952)249-4600 Date Issued:
4/8/2008
SITE ADDRESS: 725 Sixth Ave N unit#
Wayzata,MN 55391
PID: 25-118-23-33-0004
DESCRIPTION: i UBC Occupancy B
���' Construction Type VN
Proposed Use: Resi rial Census Code 328
Permit Class: Building
Pernnt T e: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
YP
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
16"x 48"sonotube frost footings for future pergola
FEE SUMMARY: Permit Fee: $ 38.00 valuation: $ 849.55
Plan Review Fee: $ 24.70
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 63.20
APPLICANT: Outdoor Environments Inc. OWNER: Spring Hill Golf Club
12488 Xenwood Ave. S.
Savage,MN 55378
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.
----.—_
AP I T ERMI E SIGNATURE ED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
! �
, .
G�'`" 'D�
3 zs�
Total Fee: $ ro3.ZO Date Received: 3��T��
Entered By: Permit#: ���0�2�2.
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(p[ease print all inforrriation)
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THE APPLICANT IS: (circle one) OWNER O CONTRACTO
�pRrNv Nh�•�. Go�
JOB SITE ADDRESS: 'tZ� C,pblhlTy IZGI4 p V ZIP: 55�1 I
d�oNo ,MN
Will this be a Parade of Homes,Remodelers Showcase Home or ot6er Display Home?
❑ Yes �NO If yes, a special event permit is required with Police Department and City Counci/approval
60 days prior to the event. Shutt/e bus service will be required unless applicant demonstrates
sufficre on-site parking is available. Non permitted events wil/not be allowed.
J�P1�.�Pt1�N p�` cFt�lcl,
NAME OF9�Y�E�: 1 I�l ,J01�1�I�4N PHONE: (�e�e) q51•�'13. �5��
Gtw (werk) I�It•812.03'1�}
MAILING ADDRESS:']Z5 L't`� (�p �o CITY: bRONlO ZIP: S� 39 I
CONTRACTOR: Ot�tT'flpp� �NV I I�NM�MS (�iL . rxorr�: 952•�tq Co, It�o
CONTACT PERSON: y SG�I lkN D Mkl2kr MOBILE/PAGER: g52�TJl Z�N l l a
MAILING ADDRESS: �Zi{$� WOOb �t1lC',. S• CITY:�VhCUC%i ZIP: �
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure �
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may require MCWD Lreview nd permits! r�—
PROPOSED WORK(describe in detain• �5 � x � v'M �I�C'I�
' J
5i oF f� w 'Y�,
Gu � •
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��� • 5�
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 accordance with the approved plan.
APPLICANT'S SIGNATURE: ATE: � O�
31
f ,
Sec.13.04 RIGHTS 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 set forth in this section.
Subd.2. Information required to be given individual.An individual asked to supply private or confidential data conceming himself shal I be
informed of. (a)the purpose and intended use of 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 azising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shall
not apply when an individuai is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or propem tax refund
instructions instead of on those forms.
Subd.3.Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of
stored data on individua(s,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of
stored private or publ ic data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of the content and
meaning of that data. After an individual has been shown the private data and informed of its meaning,the data 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 individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the individual subject of the 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 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 the request
within that time,he 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 the accuracy or completeness of public or private data
conceming himsel£ To exercise this right,an individual shall notify in writing the responsible suthoriry describing the nature of the disagreement.1'he
responsible authority shall within 30 days either: (a)cortect the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bel ieves 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 detemrination of the responsible authority may be appealed pursuant to the provisions of 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 perrr►it 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 extent 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 private data on yourself.
6. Your full name is required to process this application or permit.
Al.y sow Lou��� t�t�Ntl�r.l�.
First Middle Last
109Zq 5��1'(�� �E. S.
Address
BLooM1�1G�'�'DN MN �5� q�t.?�IZ•41t�
City State Zip Phone
I understand my rights as stated above.
�`` ��
Signature
' I�� � � I I �' � 32
�
CHECK OFF LIST FOR ISSUANCE OF PE I S� N •
FOR OFFICE USE ONLY S��
ADDRESS OR LEGAL: .�� � ,j �f, i� � N • � I — Cl V�2hCu.S�
PID: -
DESCRIPTION OF WORK: P ��G d/� � �A�
ZONING REVIEW BY.• � Y' DATEAPPROVED.'� f �
BUILDING RE i�IEW BY.• DATEAPPROTtED:_3-�-��,
FEES TO BE CHARGED: M Misc. Fees Calculated By.• � ���� � �
PERMIT Yes ,/ No
PLAN REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes � No N�ATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZOMNG CHECK LIST Zoning District wN Y �� � ���M�� ~ ��rN
Fire Department: Post Offrce: School District.•
Lot A�-ea: Sq.ft. Acres N�idth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbaclrs.•
Front(Lake): Right Side:
r!o se.�6�.K,�ss�,es
Rear(Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def Hgt. G�� Peak Hgt.
Lot Coverage: h�
Grading StaffApprovaT Date: � �' By.• Council Approval Date:
,—,
Septic: StaffAppiroval Date: �S � 1 � `�gy• �—
Zoning File: # Resolution: # Resolution Date:
Shoreland District: 1�/� MCWD Permit
Avg. Setback: B1uffSetback.• LotCoverage.
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Ha�•dcover Variance Required: Yes No Date of Council Approval:
�IP�v�GvS�� �
REMARKS(inhouse): �Q:EA�✓/'►l/�.e.C1� �q� (O �( Of � U!G'2J
_ rp.v�s r�► � �h
33
� .
B UILDING REVIEW CHECg LIST
UBC: C3`1 CONSTRUCTION TYPE: V►'v
Sg Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ �`��•S�
Inspections Required: Work Requiring Separate Per»uts:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_�Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
�C Final Grading/Filling Electrical(State Permit)
Other
nENraRx.s�nv�rousE>:
REVIEW BY OTHERS: DATE:
Access: Fxisting New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMI7�:
34
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