HomeMy WebLinkAbout2006-P10332 - attached deck PERMIT
CITY OF ORONO Permit Number:
2750 Kelley,Parkway- PO Box 66 P10332
Crystal Bay, Minnesota 55323 Permit Type:
Addition/Remodel/Repair
(952) 249-4fQ0 Date Issued: 10/11/2006
SITE ADDRESS: 3640 Togo Rd Unit#
Wayzata,MN 55391
PID: 17-117-23-31-0047
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 69.25 Valuation: $ 2,000.00
Plan Review Fee: $ 45.01
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 115.26
APPLICANT: Owner/Self OWNER: Micheal Novak
MN 3640 Togo Rd
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.
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, I-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
09/15/2006 13:51 763-559-0148 ENPATH MEDICAL PAGE 03/06
Total Fee: $ f 2-49 Date Received:
Entered BY: Permit#: /y_
CI'T'Y OF ORONO -BUILDING PERMIT APPLICATION
All information must be submitted in full before plain review will be started.
(please print all information)
----- _ ____----------------------__-- ----__--�---
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: 3640 Togo Road ZIP: 55391
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑Yes 0 No if yes,a special event permit is required with Police Department and Ciry Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
sufeient on-.cite parking is available, .Non permitted events will not be allowed.
NAME OF OWNER: Michael Novok PHONE: (home) (952)906-0870
(Work) (763)577.2250
MAILING ADDRESS: 3640 Togo Road CITY: Orono ZIn; 55391
CONTRACTOR: NIA. PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: NIA 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 review and permits!
PROPOSED WORD(describe in detail): Deck
STORIES: 1 SQ.FEET OF EACH FLOOR: 350
NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ z ooa,00
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work will be its conformance with the ordinances and codes of the City and with the State Building
Code;that I understand this is not a pennit and work is not to start without a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNAI'IJRE:`�^"�` '' DATE: 09/15/06
31.
09/15/2006 13:51 763-559-0148 ENPATH MEDICAL PAGE 04/06
SM13M 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 lbrdr in this section.
Subd,2.trdbmration required to be given individual.An individual asked to supply privW or conFdgmiml data concoming him clfshall be
infnrrried of(a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,m statewide system:(b)
whether he may refuse or is legally Tdquired to supply the tr quosscd dole;(c)ally/slower conacquence arising ttoro his supplying or refusing to supply
private or contidendal dote:and(d)the identity of other persona or entitles audrarized by watt or federal law to receive she data This requirtnncrtt shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision S.to a law enforcement officer,
ng commissio r of revenue M place thcLnodfil reguired Alec this s+r+ bi9lon in the Individual iagOrae tax or Willi U taxaml
instructions instead of on dtmae IbrrnS.
Subd,3.Access to data by individual,Upon request toarcaponsibleauthority,anindividualshallbeinfomiedwhetherheisthesubjector
stored dam on individuals.and whether It is classified os public,private or confidential. Upon his f ether regacst,an individual who is the subjectef
stored private or public data on individuals shall be shown the data without any cheeps to him and,if be desires,shall be informed of the content and
meaning of that data. A fter an individual bas been shown the privets data and informed of its intoning.the data need not be disclosed whim ibr six
months thereafter unrest a dispute or action pumuatU to this section is pending or additional data on the Individual has been collected or created.The
resptmsible authority shall provide copies of the private or public data upon request by the individual subject ofthe data, The responsible authority
rMy require the requesting person to pay the actual costs of mating,certifying.and compiling the copies.
The rwponsible authorlty shall comply immediately,if possible,with any req»est made purn iam 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 tinie,he shall so inform the individual.and may have an additional five days within which to comply with the request,excluding Sanudays,
Sundays and legal holidays.
Subd.4.Procedurawho data isnot accurateofcomplete.AnhWividualmayeontmdwaccwugorcomplctareesofpubliearprivandata
concerning himself,To exercise this right,an individual shall notify in writing the responsible authority describing the nature 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 rccipients of
inaccurate or Incomplete dam including recipients named by tM individuaL.or(b)raify the individual that he believes the date*be correct Detain
dispute shall be disclosed only if the individual's staaanent of disagmcirient is included with the disclosed data
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to
comested cases,
DATA PRIVACY ADVISORY
In accordance with M.S.13.04,Subd.2,"Rights of subjects of data".we would llketo 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 tet 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 HOOPS .
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.
Michael Daniel Novak
First Middle [.est
3640 Togo Road
Address
Orono MN 55391 (952)906-0870
-ally state Zip Phone
I oaderstand my rights as stated abuve,
%A t5 r CKO
Signature
32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 3(o C'O -ro q ft e cI
PID:
DESCRIPTION OF WORK: �� l0� k 1 A' eft C k 64c&L PAX S' deet t
Owrs
ZONING REVIEW BY.• 412'J-
DATEAPPROVED: ltd + std M�
BUILDINGREVIE WBY.• DATEAPPROVED: io -g -a(o
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes v`� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No v` SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECKLIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted. Yes No Date of Survey: IO
Proposed Setbacks: eps►- /-
Front(Lake): PIA 44&Side: 6 t d e deck)
i
Rear(Street): Left Side: nA
Adjacent Structures: ltif4 Wetland.-
Building
etland:Building Height: Def. Hgt. Ad 1A Peak Hgt. N t A
Lot Coverage: Alo.,xd s y zoo sqvpee,kAa-\ •propos.Lcl =i7 6 06
Grading: Staff Approval Date: Af j,A By: Council Approval Date:
Septic: Staff Approval Date: iv 1,4 By:
Zoning File: # -- Resolution: # — Resolution Date:
Shoreland District. MCWD Permit:
Avg. Setback: /V(l.�i Bh ff Setback: n(1 A Lot Coverage: _
Existing Proposed
Hardcover: 0-75' r-- --
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house): Gr k e%exs g ncA �n!iqa e `�,.
33
BUILDING REVIEW CHECKLIST
UBC: 3 CONSTRUCTION TYPE. U/y
Sq Footage $Per Sq Fig
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ zocb0',
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
_ Footing Septic Sewer Connection
p_Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
( Final Grading/Filling Electrical(State Permit)
Other
REMARKS(INHOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
34
110/0'x'/2006 08:08 763-559-0148 ENPATH MEDICAL PAGE 03105
SEP 27,2006 02:59P 000-000-00000 page 1
'1•`n
41.
lier..
D I r+� i A lob,
,* .Tt�► oma, 3 .14
U,
1 ""0 �n
,�
f
C �77LP
�, I
i
L9 Q �
CP
r"— OD
I D
to
r
W
k Jf- o
CP
Z �Oi li?
r, C
2 _ r
;C L
Q1 �j
.110/06x/2006 08: 08 763-559-0148 ENPATH MEDICAL PAGE 02105
C� N
N
r � Wx
� � N
a O
CITY OF %CRVIHO dRUND
SITE.PILAN �_ (imAl' N0 PLAN Certificate of Survey
i ;for Take Shelter Inc. THIS
;4AIRPI 0VED -��S of !t 1, Block 1, Halcyon Hollow
U4PPROVED AITH' REV18lt�NS H nnepin County, Minnesota ITEM #As' #DISAPPROVED
]"' EEN
.i
a E . + L.o . NICROMNEDDr'1�I E
N e9"a 3o"E 175,00
-
• -_ X959'— �'•-- — 78.00'
Drainagefu�iGlY
v \� easernen+s
A. �s' ►�
eose�eh N� I I �.
e-��cr``�`"
Soil 6or n
t s5.00' �, ��se
Z 97.9 •x7 ?
soil boi n DI. Q( I 1
-
qE9"48'3o"E 175.00'
u 'N Togo I�aoc! N
—Top kIJran loo.00 assulmecl
I hereby certify that this is a true and correct representation of a
survey of the boundaries of Lot 1, Block 1, Halcyon Hollow, the loca-
tion of all existing buildings, if any, thereon, and the proposed
location of a proposed building. It does not purport to 'show other
improvements or encroachments.
GORDON R. COFFIN CO., INC .
Scal
Date®: 1.0-28-33 GordonCoffin Regi
o : Iron marker Yark S. Gronberg Reg, No.12755
ioa,o Spot elevation band Surveyors and Planers
Datum: Mean sea level.... 1,ong :eke, Kinnesata p
3(oLio T030
2�®pp iaF
t
�®ha,rdco'e v ally d
ti L4
I C7,Ep-/Gb
V
Uy OF ORONO '�_)CA*LLeD IN TIME
INSPECTION NOTI(P5 SCHEDULED
PERMIT NO. COMPLETED
ADDRESS �`►V
OWNER ,'lWL V ON
TELEPHONE NO. C7C a -C?
DESCRIPTION T� I v�S
W 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING
W 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
tu 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU. YES—NO
COMMENTS:
W
a
J
O
CC
O
W
W
CC
Q
ti
Z
W
W
CC
O
W WORK SATISFACTORY:PROCEED [I PROJECTCOMPLETE
cc ❑
W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
OO L3CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
11STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for th n�xt inspection 24 hours in advance. (952) 249-4600
Owner/Con n site:
Inspector. 01A
White Copylinspector's Fil Canary Copy/Site Notice