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Home My WebLink About2002-P04984 - addn/remodel/repair CITY OF ORONO PERMIT Permit Number: 2750 Kelley Parkway- PO Box 66 P04984 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 4/16/2002 SITE ADDRESS: 3670 Togo Rd Wayzata,MN 55391 PID: 17-117-23-31-0032 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Construction Type VN Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 83.25 Valuation: $ 2,200.00 Plan Review Fee: $ 54.08 State Surcharge Fee: $ 1.10 TOTAL FEE: $ 138.43 APPLICANT: owner OWNER: Tom&Nancy Kirk MN 3670 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. -46�—I 1�449 APPLICANT ITE SIGNATURE ISSUED SIGNATURE Copies: 1-File(Siknitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 Total Fee: $ 43 Date Received: - + Entered By: . -4= Permit#: '�. 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 R CONTRACTOR JOB SITE ADDRESS: ZIP: NAME OF OWNER: aAf\O I-' 1 fV PHONE: (home) v] (work) GI S, -'fI 1 -y C) MAILING ADDRESS: G)0 CITY: LJ,,,-7-,,t& ZIP: CONTRACTOR: 2 1�� PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP. STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PRO OSED WRK(describe in �detail): L h-+y w 0.V1T Doov 4 a C4 Cvv\� *01W" 1,: AG( v w STORIES: 3 SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. 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: 4ry DATE: zto -j T NOTE! Parade of Homes events require dparate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 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 concerning himself shall 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 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 shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property 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 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 arty 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 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 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. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. f' 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 Middle Last Address City State Zip Phone I understand my rights as stated above. ale- Signature 6 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESSOR LEGAL: _36-10 - o e o 20 An PID: DESCRIPTION OF WORK: o ZONING REVIEW BY: DATE APPROVED: BUILDING REVIEW BY: DATE APPROVED; FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes G,--' No SEWER CONNECTION STATE SURCHARGE Yes No WATERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No STTEINSPECTION Number of SAC-Units OTHER (specify) ZONING CHECK LIST Zoning District: Fire Department: Post Office: School District: Lot Area: Sq.ft. W-50 Acres • t g� Width SO Depth 1 VS Survey Submitted: Yes x No Date of Survey: 4-15- 'd 3 Proposed Setbacks: Front(Lake): Ag Cl Right Side: i2 Rear(Street): SS Left Side: Z5 Adjacent Structures: r47-rA c td. d Wetland: /J(A Building Height: Def. Hgt. 0.1< Peak Hgt. Lot Coverage: 1 Z•�1 Grading: Staff Approval Date: N I A By: Council Approval Date: Septic: Staff Approval Date: ti VA By: Zoning File: # — Resolution: # Resolution Date: Shoreland District: /,J V Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 BUILDING REVIEW CHECK LIST UBC: Z `3 CONSTRUCTION TYPE: y Sq Footage $Per Sq Ftg Basement x = 1st Floor x _ 2nd Floor x — Garage x = ect� iii x TOTAL Estimated Construction Value: $ Z,2.00 Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection b< Footing Septic Sewer Connection D,,Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) d`Final Grading/Filling Electrical(State Permit) Other RENIARKS ON HOUSE): ---------------------------- - __ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: --------------------------- - RE VL4RKS (TO BE NOTED ON PERM M: 8 Certificate of'Survey for Richard L. Haas in Lot 43 Block 10, Townsite of Langdon Park ' Hennepin County, Minnesota .50.00• - �1r edge of r _/ahs 9MUM I he by ertify that this is a t an correct representation of a su�wey of the boundarie s of t 9 E�t 50 feet of the west 158 �`E. ; +. eet f the South 175 feet of Lot , Block 10, Townsite of o Langdon Park, and the location of ` a;1 existing buildings thereon. ........... ......s8 ._...._... .. . . ._ I, does not purport to show other Lf �jImprovements or encroachments. N N • f GORDON R. COFFIN CO.,, INC. E�sfiy Q �` h. �o T- /VP 9 3 a ` s 6.� s;_ Gordon R. Coffin Reg. No. ZS' Mark S. 0ronberg Reg. No-12755 Land Surveyors and Planners 54L4¢h ��"`Of g : Long Lake, Minnesota 4"— —�, -�_ o Courtly re_fakku; °3-9-59 . So.oO 4 �iqo .Paoa� . Scale: Ip • 301 COPY Date : 4-15-83 ORONO o s Iron marks r CITY OF ORONO, ,r*, SITE PLAN GRADING PLAN APPROVED - b ec.tL G APPROVED WiTN REVISIONS 2-DISAP ' V - er"" rt-oot= a BY ti DATE CITYNO CALLEDDATE TIME INSPECTION NOTIC scHEDULED PERMIT NO. D COMPLETED ADDRESSln�� G3 OWNER�_ x l'rk- CONTR. TELEPHONE NO. Ob^'— (P DESCRIPTION _ 01 FOOTING 11 MECHANICAL RI 18 EXCAWGRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/AREPLACE 34 TREE REMOVAL Z04 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL36 FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU: PESO COMMENTS: a94 LA. z CC ie <;�7r0 S IS Gy/ c. ALL2 &0.21 cc WCC ❑WORK SATISFACTO :PR'04 7- ❑ ROJECTCOMPLETE LU 2tORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECTWORKCALLFOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNWF CONDITION WITHIN-- -HOURS.- ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED-- ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor onsite: - Inspe —. White CopylInspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED s'-/ �L /%cc A-" PERMIT NO. 100 SCI COMPI.ETED 'z ADDRESS 1 OWNER CONTR. 7-0,-h TELEPHONE NO91 �/7/-Q(a is DESCRIPTION t 4 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAD NG/FILLING ,.;tING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h 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 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 FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W a J O cc O 2 W QC Q 2 W Z W O W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Co ntracto sit Inspector. White copynnspector's File Canary Copy/Site Notice ' / DATE TIME CITY OF ORONO vvv CALLED INS INSPECTION44CUAQTI d SCHEDULED PERMIT NO. O COMPLETED �Z %Con ADDRESS 3(`9 OWNER CONTR. TELEPHONE NO. `f7 DESCRIPTION Uj 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS ti 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION J�05 FINAL 14 SEWER HOOK-UP 06 PROGRESS EMO-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 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO COMMENTS: CC W a cc 0 0 cc 0 W cc Q 2 W Z W CC UjORK SATISFACTORY:PROCEED �ROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Con r on s' Inspector. White Copyllnspectoes File Canary Copy/Site Notice i A o ro HIM I i - Aj I y � e tai vt" � C _ N ' M � r rb I 9- l rr Ii. %Na A A C fI (41 CeJtA oil E -M