HomeMy WebLinkAbout2002-P05730 - foundation only .
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PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P05730
Crystal Bay, Minnesota 55323 P@I'C111t Typ@: Addition/RemodeURepair
(952) 249-4600 Date Issued: ioiia�2oo2
SITE ADDRESS: 2080 Spates Ave
WAYZATA,MN 55391
P I D: 10-117-23-31-0095
DESCRIPTION: trBc occup��y x3
Construcrion Type VN
Proposed Use: Residenrial
Permit Class: Building Census Code 434
Pemut Type: Addirion/RemodeURepair Pemut Sub-type(s): Foundarion Only
DETAILS:
Approved per resolurion#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 209.25 Valuation• $ 12,000.00
State Surcharge Fee: $ 6.50
TOTAL FEE: $ 215.75
APPLICANT: Gardner Construcrion OWNER' T&C MORSE
16619 Imperial Way � 2080 SPATES AVE
Lakeville,MN 55044 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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APPLICANT PERMITEE IGN -" ISSUED BY SIGNATURE
Conies: 1-File(SiQnitures ReQuired), 1-Aunlicant 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1
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Total Fee: $ ��S 7 S Date Received: %[)-/��-��-
Entered By: ;?`�'y�-- Permit#:
CITY OF ORONO - BUILDING PERNIIT APPLICATIOleT
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 O CONTRACTOR
JOB SITE ADDRESS: � O � L � p,/� �J;= s ZIP:
NAME OF OWNER: �=2 lZ t/ S�� �/� S PHONE: (home) �l��- `�7.�- �D�D
(work)
MAILING ADDRESS: .�D�v ,S�� �i=S CITY: U j��tiI v ZIP: .�� � �
CONTRACTOR: �/3�C'�l�1 i.',� �d�l S� � . PHONE: �j'�� - `���- �`�7'O
CONTACT PERSON: ,` I / MOBILE/PAGER: (�/� - 76,� - �, 6„2/
MAILING ADDRESS: ��� (,/ �� i-2i`,� �✓/1 CITY: �J� G!`.'/��=' ZIP: SS�6 ��
STATE LICENSE: # :�r �
ARCHITECT/ENGINEER: �/� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure X
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�:�j,>rra v�= �o��o��- rz -�o�n��a t i o�r
✓',H�� /�I��a CT' �^,'//2 ;��� l�Loc� �° �tZr �'i I � �l�i=r �'a��= )
STORIES: � SQ. FEET OF EACH FLOOR: �
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
� C� ��
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �,,.� U d�� ,
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 a proved plan.
APPLICANT'S SIGNATURE:L�(,.��Z� � ,,C DATE: /� � % O
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
♦ �
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Sec.13.04 RIGH'TS OF SUBJECTS OF DATA
Subd. 1. Type of data. The righ[s of individual on whom che data is stored or to be stored shall be as set forth in this section.
Subd.2. Information reqtrired to be givea individual. An individual asked to supQly private or confidenaal data concerning himself shall
be informed of: (a)the purpose and intended use of the requesred data within the collecdng�tau agency,political subdivision,or stauwide sysum;
(b)whether he tnay refuse oY is legally required co supply tbe requested data;(c)any known consequence arising from his supplying or refusing to supply
privau or confidendal data;and(d)the identity of o[her persons or enudes authorized by state or federel law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgaave data,pursuant to ucdon 13.82,subdivision 5,to a law enforcement officer.
The commissioner of re�enue mav alace the nodce required under this subdivision in the individual income tax or�ropertv taz refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is ihe subject
of stored data on individuals,and whe[her it is class�ed as public,priva[e or confidenaai. Upon his further request,an individual who is the subject
of stored private or public data on individuais shall be shown the dara wirhout any charge to him and;if he desires,shall be informed of the content
and meaning of chat 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 acdon pursuanc to[his secdon is pending or addidonal data on the individual has been coilected or created.
The responsibie authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry
may require the requesdng person to pay the actual costs of making,cerdfying,and compiling the copies.
The responsible authoricy shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the request,exciuding Saturdays,Sundays and tegal holidays,if immediate compliance is not possible. If he cannot comply with the requesc
wirhin that tune,he shail so inform the individual,and may have an addidonal 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 concerning himself. To exercise this right,an individual shall nodfy in wridng the rosponsible authoriry describing[he nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found m be inaccurate or incomplece and aaempt to nodfy past recipienu 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 shail be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinarion of the responsible authority may be appealed pursuant to the provisions of the adminisuarive procedure act relating co
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 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 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.
First Middie Last
Address �
C�ry State Zip Phone
I understand my rights as stated above.
Signature
, � �
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z O`�3 O SPA T�5
PID•
DESCRIPTION OF WORK: r� ,�,�/brg-rZvJ �Ac�r��`
ZO�tPi TG REVIEW BY: DATE APPROVED: _ft//�-
BUII.DING REVIEW BY: DATE APPROVED•, �o .r Y-o�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes_� No
PLAN REVIEW Yes No � SEWER COTfNECTTON
STATE SURCHARGE Yes �/ No WATERCONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC�Units OTHER (specify)
ZONING CHE.CS LIST zoning Districc: /Y� G�r,►�e�,e .
Fire Department: Post Office: School Districr. �
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: �
Front(Lake): Right Side:
Rear(Sueet): Left Side:
Adjacent Structures: W tland:
Building Height: Def. Hgt. P Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setba k: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes N Date of Council Approval:
REMARKS(in house):
f r
� r
BUII.,DING REVIEW CHECK LIST
�C� r`' � CONSTRUCTION TYPE: �//J
_ Sq Footage $Per Sq Ftg
Basement a _ - __. . .
lst Floor x _
2nd Floor x =
Garage x _
x =
TOTAL
Estunated Construction Value: $ 12, U r�v�
Inspections Required: �Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Remaval Mechanical Water Connection
. �F���S � Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board • (Mfg.) Well(State Permit)
—�F�� Grading/Filling Electrical(State Permit)
Other
REI�ZARI�S(IN HOUSE):
REV�W BY OTHERS: DA�: --------_____�_____�_____
Access: Existing New
Access Approval: Date gy;
------------------ ------_----_--______�__________
REMARI�.S (TO BE NOTED ON PERMI�:
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DATE TIME /
CITY OF ORONO CALLEO IN ''�
INSPECTION NOTICE SCHEDULED �
PERMIT NO._ �Q S �3d COMPLETED
ADDRESS ozC��O S�G�..3�"CS �1C �
OWNER CONTR.^�rG-►��r�e._r Ca�S�'
TELEPHONE N0.�p � c�- 7 �cl c��-�5
� DESCRIPTION�,���n 7'c��n���N��rk'(r'u �r�rc� vLp �—�
� 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
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Qj0 INAL 14 SEWER HOOK-UP O6 PROGRESS
�Zf7-�� -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
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
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OwnerlCon o�n site:
Inspector.
White Copyllnspect r's File Canary CopylSite Notice
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`�� � ; J DATE TIME
CITY OF ORONO v CALLED IN
INSPECTION TICE� SCHEDULED � -�
PERMIT NO. � � � COMPLETED
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ADDRESS�a�Ci J C� _>I"l-�'C.�_<i
OWNER CONTR.�c�✓f���-{ f:r°2�a'
TELEPHONE NO. l�%' ��� 7� � � �.S �
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� �OOT� DES�N
ING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 0 MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 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
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINA� 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL�NSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerlContractor si et
Inspector.
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White Copyllnspector's File Canary CopylSite Notice