HomeMy WebLinkAbout1993-005704 - replacing sashes . PE1��IIT .
CITY OF ORONO +,. 1� PERMIT TYPE: �;���E �.}�_���
2750 Kelley Parkway • P.O. Box 815 Permit Number: -
Orono, Minnesota 55356-0815 '-`='��'`-'�
(612) 473-7357 Date Issued: � � ;'i_;i/_�;=;
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY: � " _`
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CONTRACTOR: -- ����°� i=����� — '=��3 . !�{_� .OWNER:
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APPLICANT/PE MITEE SIGNATURE ISSUED BY:SIGNATURE
y� qo`�� � 'Z�,
(' . CITY OF ORONO - BIIIL ING PERMIT APPI,ICATION �
9 � �
Total Fee: $ ��v v Date Received:
Date Approved:
Entered By: permit�: ���U �
AT•T• INFORMATION MIIST BS SIIBMITTED IN FIILI� BEFORE PI,AN RE�7IEW WII,L B$ STARTED
(See Check-off List Enclosed)
---------------------------------- --------------
THE APPLICANT IS: (circle one) O��TNER orCONTRACTO
JOB SITE ADDR$SS: ZIP' h � � /
(work)
NAML� OF OWNER:
PHONE: (home) �
MAILING ADDRESS: CITY: ZIP:
TIMN CtTY S'r'ORM SASH CO. p$o�:�!�'����
CONTRACTOR: 1 fl�1S�_�`��t
PlAILING ADDRESS: � �NNETONKA, MN 55305 �I�: zip:
STATE LICENSE: # ����
ARCHITECT/ENGINEER: pH��'
MAILING ADDRESS: CITY: ZIP:
N�: REGISTRATION �
TYPE OF WORK: New Addition Accessory Structure Move �
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : `�ST��1� �d� 0�
l�
STORIES: SQ. FEBT OF EACH 1�LOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
�
ESTIMATED CONSTRIICTION VALIIATION (eacluding land) : $ Y aa
I hereby apply for a building permit and I acknawledge 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 SIGNATTORE: ` DATE: `� 'a����
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CITY of ORONO
Post Office Box 66•Crystal BaY,Minnesota 55323•Municipai Offices
•
� � � � On the North Shore of Lake Minnetonka
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 f rom 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 permit or license requested.
.�,, '�'',�'' �R'"JT�YTi3
2. You may refuse to supply da�a�, b��-�#�}�� �aY require that
the City deny the permit or license. ,;:v,y;�fh1
3. The information may be shared with other local, s�ate or
federal agencies to the extent necessary to process the permit or
Iicense.
4. If your requested permit or Iicense requires Councii ac�ion
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review private
data on yourself. .
6. Your full name is required to procsss this application or
permit.
First Middl.e Last
55
Address
✓���
City State Zip
'�"/�(�.'���j -
Phone
I understand my rights as stated above.
Signatu e •
BUILDING&ZONING—473-7357
• ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
PERMIT
CI�Y OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 4�_ ��� �-�f�;.a
Permit Number: ;:�';'��:�;:W:
`'Crystal Bay, Minnesota 55323 -
(612)473-7357 Date Issued: _�,;��_;,r;��:_;
SITE ADDRESS:
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DESCRIPTION:
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_=.'���L�I:.-s l�3�fi�l-= �t:i.i.} t-;��: , r`I�:�r���;(;f�4:-�i_
REMARKS:
FEE SUMMARY:
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)NTRACTOR: -- r��=.r—�i _j,.�a��. — ==a . .__ e .OWNER:
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TH� il��1C���'�.':: i t;t.�L� Fd��'i�.���� �-.�.i��.���:!�: �'����1��'�'.�;���� �'�at i��-�t���= �}-:�: �-;�:��. i=°}�- �_�k'_.,:�rt,� . _
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APPLICANT�PERMITEE SIGN URE ISSUED BY:SIGNATURE �'
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Total �ee: $ Date Received: �
E�tered By: t/f Permit#: // 9 '
CITY OF ORONO - BUILDING PERMIT APPLICATION
A.11 information must be submitted in full before plan review will be started. .
(please print all information)
1'�iE APPLICAI`'T IS: (circle one) OWNER CONTRACTO . �
JOB SIT'E A.DDRESS: oZC��.5� S��--f-�S ZIP: ��3 `7 j
h`A1biE OF Otiifi�R:�M��-�� �`�-'���r� PHONE: (home) � 7 G' 1 � 4,5�
(work) �
iVIAILING ADDF•ESS: �65�`--��� S CI'1'Y: ZIP:
CONTRACTOR:w�F.S r1'�,T� ��7�1�' PHONE: ��a' ` 6�`� cJ'
CONTACT PERSON: l,� �.D MOBILE/PAGER: �6� -31 �1�_
MAII.I�'G ADDRFSS:55�� L�vv��-o a glVb CITY: Y��h p ZIP: S__S�_G�--/
STATE LICENSE: # 53 o S �
ARCHITECTlEl\GINEER: PHO�TE:
iV1AILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF tiVORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
PROPOSED WORK(describe in detai�:
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GA.R.AGE STALLS: ATT. DET. �
. S S�o �
FSTII�i IATED CONSTRUCTION VALUATION (excluding land): $ �
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 wi[h the ordinances and codes of the Ciry and with
the State Buildin� Code; that I understand this is not a pemut and work is not to start without a
permit; and th�t the work will be in accorda w' the approved plan.
PLICAi�"T'S SIGNA DATE: v � ? �
AP
NOTE! �arade Qf Homes events require separate permit approval by Police Department and
� Citj► Council 60 days prior to tke event. Non permitted events will not be allowed.
� - �
Sec.13.04 RIGHTS OF SVBJECTS OF DATA '
Subd. i. Type o!data. The righcs of individual on whom rhe daa is swred or to be stoced shall be u sec focch in this secrion.
Subd.2. Intormation reqirired to be givea iadividual. An individual uked w supply private or coafidendal dam coacecning himself shall
be infocmed of: (a)the purpose aad iatended use of the requuud dam wichin the collecdng�tatt agenry.goliacal subdivisian,or sacewide sysum;
(b)whe�ec he taay retuse oti is.legally nquir_d to supply the rsquesced dsta:(c)aay imown coauqueace uising from his supplyicg or re[usiag to suppiy
privace or confidenda!data;and(d)�he ideaary af ocher peaaas or enddes auchorized by st+re or tedecai law to receive che dara. This requiremene shaI!
not apply when an individual is uked w supply iavesagadve daa,pursuaat to secaon 13.82,subdivisioa S,tn a Iaw enfac�emenc officer. .
'Che eecamissioner of revenaa mav ofacr che nodce r.auired under dlis subdivision in the individual income �c or provem taz refund
inscrucaons insuad of on rhose forms.
Subd.3. Aecess to data by iadividual. Upon�cquesc to a responsible authoriry,an individuaI shall be informed whether he it the subjecc
of swred daa on individuals.and whecher ic is classiFied u pubGc,private or confidenaal. Upon his furcher request,an individual who is che subjecc
of scoced private o�public dam on individuals shall be shown ehe dam wirhaut any charge to him and;if he desires,shali be informed af the coatznc
and meaning of rhat data. After an individua!has been showa the privat6 data and iaforaud ot iet meaning,the daa need not be d'uclosed oo hira for
six mondu thereafter unless a dispute or acrion pursuanc w this secdon is pending or addidonal dara on the individual has been eollecred or ereaced.
'Ihe cespoasible auehoriry shall'provide copies of the privam or public dara upon«quest by the individual subject of che dara. The responsible authoriry
may require the cequesdng pecson to pay che aceual eosu of making,eerdfying,and eompiling the eopia.
The cesponsible authoriry shall eomply immediacety,if possibie,wich any tequat made putsuant to this subdivision,or widun five days of
the date of�he nquest,excluding Saturdays,Sundays and legal hotidays,if irsuaediate compliance is not possible. If he cannot comply with the request
wichin rhat dme,he shall so inform the individual,and may have an addidanal five days within which to comply wich the request,excluding Saaudays,
Surtdays and legal holidays.
Subd.4. Proeedure when data ts not aecurate or eomplete. An individual may eontest the accuracy or completeness of public or private
dam concerning himself. To ezerciu chis right,an individual shall aodfy in wridng the respoasible aurhoriry describing die nature of the disagreemenc
The respoasible authoriry shall within 30 days either; (a)cocrect tha data found to be inaccuratt or incomplete and atumpc to norify past recipien�s of
inaceurate or incomp[ece data,including recipienrs named by the individual:or(b)naufy the individua!thac he believes the dara to be correc4 Data
in dispu�e shall be disclosed only if the individual's stacemenc of d'uagreemenc is included wi[h the d'uclosed data.
The decerminaaon of the responsible auchoriry may be appealed pursuant to the provisions of the administraave procedure act relating to
contesad cases. •
DATA PRIVACY ADYISORY
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 peraut or ticense from the City of Orono or any of its depaztments may require you to furnish certain private or
confidential information.
You aze 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 or license.
3. The information may be shazed with o[her local, sta[e or federal a�encies to the ectent 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 cectai.n 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.
1N tF-�a-�',' � �-�,,.. d-� �-
F'usc �tiddle I.asc
S�"1 � �-`��w�-r.� �L✓r�
�lddreu
Y�ti r�� V�^,�`'• �S3L� ���'��'3 .f
Ciry Sace Zip Phane
I understand my ri;hts stated bove.
� .
Sigrumce
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED � 7 G���.
PERMIT NO. f��-r`j 3 COMPLETED � �
ADDRESS D �
OWNER CONTR.
TELEPHONE NO. '7'�I�- �-��3 9
� DESCRIPTION /I�n ��./,./
� 01 FOOTING 11 MEC:HANICAL RI 18 EXCAV/GRADING/FILLING
Q FRAi�MIGti'� 13 MECHANICAL FINAL 19 LAKESHORE/WEfLANDS
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
J 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
� COMMENTS:
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d ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� CORRECT WORK R PROCEED O ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION W�THIN HOURS. p pHOTO TAKEN
INSPECTOR W�LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor
Inspector.
White CopyMspector's File Canary CopylSite Notice
PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P07133
Crystal Bay, Minnesota 55323 Permit Type: FiXcures
(952) 249-4600 Date Issued: 12�3oi2oo3
..
SITE AD,Tl�F',ESS: 2055 Spates Ave
�
Wayzata,MN 55391
P I D: 10-117-23-31-0008
DESCRI PTION:
Proposed Use: Kesicienrial
Permit Class: Plumbing
Permit Type: Fixtures Pernut Sub-type(s): Water Heater
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pemut Fee: $ 35.00 Valuation• $ 750.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 35.50
APPLICANT: City View Plumbing&Heating OWNER: Terry Morse
1880 B Wayzata Blvd W. 2055 Spates Ave
P.O.Box 150 Wayzata,MN 55391
Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENT'S 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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APPLICANT PERMITEE NATURE SSUED BY SIGNATURE
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Couies: 1-File(SiQnitures Required), 1-Avplicant 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1
CITY OF ORONO APPLICATION FOR PLUMBING PERMIT
Box 66 (2750 Kelley Parkway)
,Crystal Bay, MN 55323
,
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices.
2. Permit cazds will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL, THE PERMIT CARD IS
POSTED ON THE JOB SITE.
3. Plumbing pemuts may be issued ONLY to licensed plumbing contractors and to property owners residing
in the dwelling.
4. When any new construction or remodeling is involved, a separate buildin� permit must be obtained.
5. All work must be done in accordance with the State Code requirements.
6: All work must be inspected and air tested before it is covered. Call 249-4600. 24-hour notice required.
Instructions Complete all items on this application. Compute the permit fee. Sign and date
the certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have
questions, call 249-4600.
Please check one: New Addition Repair � Replace
Residential Commercial
JOB STTE: o2d j� .5 Ql�-�S �U �.., Zip: S j I
Owner's Name: ��,,�f� �'Y;�;���, Telephone Number:
Niailing Address: T City: Zip:
Contractor's Name: C,�-�-U���W �,.� � }-c, Telephone Number: � 3 3
Mailing Address: P('l,��x j S C) City: �i��•�,l�Zip: SS3 S"
PLUMBING FIXTURE SCHEDULE
FIXTURE BSMT 1ST 2ND OTHER FIXTURE BS;�iT 1ST 2ND OTHER
TYPE FL FL TYPE FL FL
Water Closet Floor Drains
Lavatory Sewer Ejector
Bathtub Laundry Tray
Shower Washer
Kitchen Sink Water Heater ,�
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Misc (list)
PERMIT TEE CALCULATION
1. 1.25% of Contract Price* or Minimum Fee ($35.00)
i 7� d� x .0125 $
(contract price) •
2. State Surcharge. ** Add the State Building Code Division �
Surcharge to each permit. x .0005 $
(contract price)
or $.50, whichever is greater
3. Posta�e and Handling (Only mail-in applications) $ 1.50
4. TOTAL PERMIT FEE (Add lines 1-3 above) $
* CONTRACT PRICE or JOB COST means the actual or estimated dollar amount chazged for the permitted
work including materials, labor, profit, and other fixed costs. It is the amount to be chazged to the
customer for the work done. If any material, equipment, labor, or installation aze furnished by the owner,
tenant or any other party the reasonable market value of such items must be added to the estimated cost
or contract price for pemut fee purposes. In the event that there is a dispute on the amount of the job cost,
the Ci�y may request the submission of a signed copy of the actual contract.
�
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50 - whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the price.
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certi�es that all statements made on this application are complete, true and
conect.
Applicant's Signature: Date: � �� ��
.
_ � ✓
�rT DATE TIME
CIN OF ORONO CALLED IN � �?/�/� 3 2.'�
INSPECTION NOTI SCHEDULED � 0 3 f�`"`3f1
PERMITNO. _ COMPLEfED � '� '��
ADDRESS �� SS ��f �= a l�-i-�-
OWNER CONTR. �i�to %r� �c.,t..-v
TELEPHONE NO. �."r� �" � � � p � ���3
� DESCRIPTION �� �" �����
� 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 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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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
�INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnedContracto ' e•
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White Copyllnspector's File Canary Copy/Site Notice
PERMIT
CITY� OF ORONO
Permit Number:
2750 Kelley Parkway- PO Box 66 P1167o
Crystal Bay, Minnesota 55323 Permit Type:
Fixtures
(952) 249-4600 Date Issued: 11/8/2007
SITE ADDRESS: 2055 Spates Ave Unit#
Wayzata, MN 55391
PID: 10-117-23-31-0008
DESCRIPTION:
Proposed Use: Residential
Permit Class: Plumbing
Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: - Pernvt Fee: $ 35.00 valuation: $ 2,000.00
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 36.00
APPLICANT: Steinkraus Plumbing Inc. OWNER: Terry Morse
ll2 E. Sth St., Suite 101 2055 Spates Ave
Chaska,MN 55318 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.
�� L ��/� �� ' ' '"��`. �,�
APPLICANT PF.RMITEE SIG] ATURE (1 SUED BY SIGNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, ]-Septic) Page 1
` � ��� FOR CITY L'SE ONLY
,�p�, City of Orono
p P.O.Box 66 Date Received. Pennit#
' �,��s ��i 2750 Kelley Parkway
� ���j�b,� i Crystal Bay,MN 55323 Approved��By: ' Amount$:
�a'� ti�, �,u•c��� (952)249-4600 � �
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CITY OF ORONO—PLUMBING PERMIT
(All Commercial permits must be.approved by the Building Official or Inspector)
GENERAL INFORMATION
1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within two working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE
3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners
residing in the dwelling.
4. When any new construction or remodeling is involved,a separate building permit must be
obtained.
5. All work must be done in accordance with State Code reGuirements.
6. All work must be inspected and air tested before it is covered. Call(952)249-4600.
(24-48 hour notice required)
TYPE DF PERMIT
Check All That A lv
�Residential ❑Commercial(Approva]Required)
❑ New �'Additional ❑Repairs ❑Replace
❑ In Accessory Structure?
*You will need arior approval and may need CUP.(Per Orono City Code,Chapter 78,Article IV)
Job Site /Owner Information:
Site Address: r�(�::�� �����s �r�
Owner: �1�,J��S Qe.S.,���,��� Mailing Address:
City: ('�rv i'\�7 Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor: �j��n�r.»� >I�N.b,��� ContactPerson: ��S
Address: 11� L 5'"`' �} State Bond #: '��cj rj
City: � � Zip:�S 3i`� Expiration Date:
Phone: �5 d - 3(,,1 -�7 I ;��S Alternate Phone: � 5,� - ��j ;� - y�y�-(
❑ Insurance-Current:
1
"� -
FIXTURE BSMT 1 2 OTI�R FIXTURE BSMT 1 2 OTI�R
TYPE FL FL TYPE FL FL
Water Closet � Floor Drains
Lavatory Sewer Ejector
I
Bathroom Laundry Tray
Shower ' Washer
Kitchen Sink Water Heater
Disposal Water Softener
Dishwasher Wet Bar
Sillcocks Miscellaneous
❑ Yes,this section applies
The replacement of a Residential fixture or apnliance that meets all three of the following requirements:
1. Does not require modification to electrical or gas service.
2. Has a total cost of$500.00 or less;excludine the cost of the fixture or appliance: and
3. Is improved,installed or replaced by the homeowner or lictnsed contractor.
Skip next section,if this applies; Cost of Permit $ 15.00
State Surchazge $ .50
Mail-In Fee(If Applicable) $ 1.50
Total Permit Fee $
(Permit Fees Continued On Next Page)
2
�'��,����� � �a�P�RMIT FEE CALC.ULATION(�)—JOBS OVER$.
If above does not apply; follow guidelines below:
l. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00)
$ aOb� x.0125 $
(contract price) (minimum$3�.00)
2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of�.50)
� ���� x.0005 $
(contract price) (minimum$ .50)
3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $
■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, labor,profit, and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor or installations are furnished by
the owner, tenant or any other party, the reasonable market value of such items must be added to the
estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
amount of the job cost, the City may request the submission of a signed copy of the actual contract.
■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is
greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price.
��,_.: �1VIBINU PERMIT �������'���€`'�,�"'�r ��� � ;
a s
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance with the ordinances of the City and the regulations of the State of
Minnesota, and certifres that all statements made on this application are complete, true and
correct.
Applicant's Signature: L���=sn--�— ,��� Date: ..�%� � � ��'7
Reset Form
3
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CITY OF ORONO CALLED IN
INSPECTION N ICE SCHEDULED /.. Un
PERMIT NO. C� COMPLETED
ADDRESS ' ����� '�����S ���
OWNER CONTR. � � �h
TELEPHONE NO. "/ �� ��� "�� �'� �'�" '�'
� DESCRIPTION r � ��a- � �� �-'�� �'�
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Q � FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
J ❑ D O-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
i UMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REOUIRED.CALLTO ARRANGE ACCESS.
Call for the next spection 24 hours in advance. (J52� 249-460�
OwnerlContr i :
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White Copyllnspector's File Canary CopylSite Notice
r ' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p11598
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952)249-4600 Date Issued:
10/23/2007
SITE ADDRESS: 2055 Spates Ave Unit#
Wayzata,MN 55391
P I D: l 0-117-23-31-0008
DESCRIPTION: UBC Occupancy R3
Construcrion Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Pemut Type: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
Kitchen&Bathroom
FEE SUMMARY: Permit Fee: $ 522.55 Valuation: $ 38,000.00
Plan Review Fee: $ 339.66
State Surcharge Fee: $ 19.00
TOTAL FEE: $ 881.21
APPLICANT: JI,M Design/Build OWNER: Terry Morse
7141 Amundson Ave 2055 Spates Ave
Edina,MN 55439 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 RE UIREMENTS.
/��� ��
APPLICAN ERMI EE SIGNATURE SLJED BY SIGNATURE
Y
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
� ��� �
Total Fee: $ ��j�a'� Date Received: �����D 7
Entered By: Permit#: i9//�'9�
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 ONTRACTOR
JOB SITE ADDRESS: ZoS� �j� �-y� 7,Ip;
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �No If yes, a special event permit is required with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
su�cient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER:�� � PHONE: (home)
(work)
MAILING ADDRESS: CITY: � ZIP:
� .
CONTRACTOR: � �� PHONE: Z " l� ��
CONTACT PERSON: o MOBILE/PA F,,R: !�/2-2�G
MAILING ADDRESS: CITY: /�li'! ZIP: �
STATE LICENSE: #�2��y EXPIRATION DATE:
a'
ARCHITECT/ENGINEER: 11CL; ~"�: � PHONE: - Z ! 3�
MAILING ADDI�ESS: (/ �/ -C. CITY: ZIP: �
NAME: ,� � REGISTRA ION: # �
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) �
Any earth movement may rec�uire �MCWD review and pe its!
PROPOSED WORK(describe in detai�:�f���.� /%��+j-r� /fi�
_�. � , �,a
STORIES: � SQ.FEET OF EACH FLOOR: � �
NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED DETACHED�
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �� �
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: �� D / 'O
ATE:
31
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 himselfshall be
informed of: (a)the purpose and iMended use ofthe 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 arising 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 shal I
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement o�cer.
The commissioner of revenue mav�lace the notice reauired under this subdivision in the individual income tax or prooerty 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 individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual 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 desires,shall be informed ofthe 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 requite the requesting person to pay the actual costs of making,certifying,and compiling the copies.
T'he responsible authority shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with ihe 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 authority describing the nahue of the disagreement. The
responsible authority shall within 30 days either. (a)correct 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 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.
'fhe determination of the responsible authority may be appealed pursuant to the provisions of the adminisVative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04,Subd.2,"Rights of subj ects 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 infotmation 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 or license.
' 3. T'he 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 reyuired to process this application or permit.
�,
First Middle Last
�� v C��d r� �✓..�
Address
�•��� ll/��c/ ��� ���v'�3��
C��Y State Zip Phone
I understa my rights as stated abov .
Sig at •e
32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE L'SE ONL Y
ADDRESS OR LEGAL: �bSS S�K�k�3 ,�ve
PID:
DESCRIPTION OF WORK: `ZZL't�-.��/Jc:.`Z
ZONING REVIEW BY.• DATEAPPROTfED: /?� �
BUILDING REi�IEW BY.• DATEAPPROVED: i o-Zz-c�7
FEES TO BE CHARGED: Misc. Fees Calculated By: � �w�� ��____
PERMIT Yes �/ No
PLAN REVIEW �es_� No SEWER CO.NNECTION
STATE SURCHARGE Yes !/ No , WATER CONNECTION
INVESTIGATIOIV FEE Yes No ✓ PARK FEE
SAC Yes No—� SITEINSPECTION
Number of SAC Units OTHER (spec�j
ZONING CHECK LIST Zoning District: � � � �w �"�__�_________
Fire Department: _ Post Office: School District:
Lot Area: Sg ft. Acres 'idth Depth
Survey Submitted: }'es 1�'o Date f Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
.4djacenl Structures: W'etland:
Ba�ilding Height: Def Hgt. __ Peak Hgt.
Lot Coverage:
Grading: StaffApprova!Date: By: Council Approval Date:
Septic: StafJ,4pproval Date: ��__ By:
Zoning File: # Resolution: # Resolut on Date:
Shoreland District: MCGd�D Permit:
.4vg. Setback: BluffSetback: ` LotCoverage:
Existing Proposed
Hardcover: Q-7.5' ;
'.i-_'.i 0' �'
250-.i 00' �
�00-1000' �
Hardcover G ariance Reguired: }'es No � Date ojCouncil.4pproval.
REMARIiS(in house):
33 �
�
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BUILDING RET�IEW CHECK LIST
UBC: �- 3 CONSTRUCTION TYPE: `�n�
Sq Footage $Per Sg Ftg
Basement x =
lst Floor z =
2nd Floor x =
Garage x =
x =
TOTAL
OQ
Estimated Construction Value: $ �����
lnspections Required: Work Requiring Separate Permits:
Site _�_Plumbing Fire
Hardcover Removal pC Mechanical Gi'ater Connection
Footing Septic Sewer•Connection
�Framing Fireplace Lawn Irrigation
_�Insulation (Nlasonry) Other
�W"all Boa��d (Mfg.) Y[�'ell(State Permit)
F'inal Grading'Filling � Electrical(State Permit)
Other_
REMARKS(IN HO USE):
REVIEW BY OTHERS: DATE:
Access: Existing 1�"ew
Access Approval: Dare Bti:
RE11L9RI�S (TO BE NOTED ON PERMIT):
34
6� �— DA TIME
CITY OF ORONO CALLED IN ��-��
INSPECTION N I��g� SCHEDULED //-� l�;DO
PERMIT NO. « COMPLETED
ADDRESS 0�55
OWNER CONTR. ��-/u �r���f�ri Q��
TELEPHONE N0. �D �� 3�a Ta`C" �
� DESCRIPTION rrd m 1 n -�'i � � �
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL O SEPTIC INSTALL. ❑ FOLLOW-UP
i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnedContractor on si
Inspector. �„_��� �
White CopyllnspectoPs File Canary CopylSite Notice
�� ������ G�- f
DA TIME
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED l-a -G / -��
PERMIT NO. ���59� COMPLETED
ADDRESS �55 ���J G��P
�WNER CONTR. ��-M
TELEPHONENO. �P�� 3(��p �a��
� DESCRIPTION l<<%lnS� � �rt!
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y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector. �/ ���
White Copyllnspector's File Canary Copy/Site Notice
`� — ,,��DA'�E TIME V
CITY OF ORONO CALLED IN �_
INSPECTION NO CE �. SCHEDULED d-�3-DB //.'D�
PERMIT NO. � �g COMPLETED
ADDRESS o?OSS SA�$ ��
OWNER CONTR. UL'� �/P��Y! � v�
TELEPHONENO. IP�Z 3�1p 7�Z-S�
� DESCRIPTION f"� h�( — ��-��
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❑ TREE REMOVAL
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Q FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
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❑CORRECT UNSAFE CONDITION WITHtN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CAlLTO ARRANGE ACCESS.
Cal1 for the nex inspection 24 hours in advance. (952� 249-4600
Owner/Contrac
Inspector.
White Copyllnspector's File Canary CopylSite Notice