HomeMy WebLinkAbout2005-P08405 - addn/remodel/repair ' PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P08405
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 2/16/2005
SITE ADDRESS: 280 Wakefield Rd
Wayzata,MN 55391
PID: 36-118-23-31-0013
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: Plumbing iviechanicai Firepiace irrigation Eiectricai(stale)
NOTICES/REMARKS:
A ]].i__._ O_T._a__..
FEE SUMMARY: Permit Fee: $ 4,255.00 Valuation: $ 714,200.00
Plan Review Fee: $ 2,781.17
State Surcharge Fee: $ 360.50
TOTAL FEE: $ 7,396.67
APPLICANT: Aulik&Associates OWNER: Thomas&Katherine Batina
6401 Wayzata Blvd Blvd 280 Wakefield Rd
St.Louis Pk.,MN 55426 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.
! . APPL T PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(Si2nitures Required). 1-Applicant. 1-Monthly Reports. 1-Assessin2. 1-Finance Page 1
Total Fee: $ Date Received: D 5
Entered By: Permit#: --A
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: (((tuIrtle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: C � 'L\ � ZIP:
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. Non permitted events will not
be allowed.
NAME OF OWNER: ;0q:i" a PHONE: (home)
(work)
MAILING ADDRESS: I&' C W Nv r_rr-,� V—'t> CITY: ZIP:
CONTRACTOR: PHONE:''N tiz -`��► I ,(,a-� iv i
CONTACT PERSON: MOBILE/PAGER: (-,('2 Z40 - l-,
MAILING ADDRESS: (,44::3 ( ZIP: j,_4 4--ie .5
STATE LICENSE: # '-I b <4
ARCHITECT/ENGINEER: LL lcf�' Grp a PHONE: I S c►�
MAILING ADDRESS: 6401 w �a _ �;/ CITY: is « t~ZIP: � Zv
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure
Addition _ Move
Remodel/Alteration Land Alteration
P POSED WORK(describe in detail): fL a 1,-a C,� y- �v
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ `, 1 `4- , Z c ,
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; tb
understand this is not a permit and work is not to start without a rmit; and that the work will be in accord
the approved plan.
APPLICANT'S SIGNATURE: - / DATE: Z 6
U _
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 any request made pursuant to this subdivision,or within rive 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.
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 7
quired to process this application or permit.
First Middle Last
Address
City State Zip Phone
I understand my rights as state above
jI r
Signature
CHECK OFF LIST FOR ISSUANCE OF PERJ HTS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z$a WAIU---F'1f--L-v0 (�
PID:
DESCRIPTION OF WORK: c roe,
--------------------------------------7f------ - -------------------------------------------
ZONING REVIEW B I DATEAPPROVED: 2-9 -ateBUILDI[VG REVIEW B DATEAPPROVED: •of-6 s
--------------------------------- --
FEES TO BE CHARGED: Misc. Fees Calctilated By:
PERMIT Yes i-,� No
PLAN REVIEW Yes ✓' tVo SEWER CONtVECTION
STATE SURCHARGE Yes �� tVo WATER COXIYECTI0IV
IiVVESTIG,4TION FEE Yes tVo t/' PARK FEE
SAC .Yes No' «' SITEIVSPECTIOcV
Nwnber 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_y No Date of Survey:
Proposed Setbacks: ,
Front(Lake): 32Z ' Right Side: $S
Rear(Street): 2131 Left Side: psi
Adjacent Structures: 3) 'te 're-3-105 tp+eWetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage: /V 18-
Grading:
AGrading: StaffAppr•oval Date: By Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District: p')-Z,
Avg.Setback: Bluf)`'Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes NoDate of Council Approval:
R WARKS(int hoicse):
31
{I(t
BUILDING REVIEW CHECKLIST
UBC: J?• 3 CONSTRUCTION TYPE: VN
Sq Footage S Per Sq Ftg
Basement x =
I st Floor x _
2nd Floor i =
Garage x =
TOTAL
Estimated Construction Value: S 71`{, 2Ao cia'
Inspections Required: Work Requiring Separate Permits:
Site K Plumbing Fire
Hardcover Removal o�,Mechanical Water Connection
_ K Footing Septic Sewer Connection
X Framing oo, Fireplace _ !�,Lavvn Irrigation
Insulation (Masonr}) Other
Wall Board t (Affg.) Well(State Permit)
Final Grading/Filling _�Electrical(State Permit)
Other
IM11"ARICS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
.Access Approval: Date kv:
REMARKS (TO BE NOTED ONPEM1111T):
3?
�-`)2 CY� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NQTJCE CHEDULED a
PERMIT NO. COMPLETED I ,J
ADDRESS C_j0_k:k- 1 .=P
OWNER CONTR.
TELEPHONE NO. AOJ(U �.12 7,3(O (o 0
DESCRIPTION '' V�� / N!3
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
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
-4 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL " 36 FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU: YES NO
o COMMENTS:
CC
LU 0 P.BC, or
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CC
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W
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CC
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WCC WORK SATISFACTORY:PROCEED 1-1PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
11STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. (952) 249-4600
OwnerlContr o s te:
Inspector.
White Copyllnspector's F e Canary Copy/Site Notice
tAT tdd TIME
CITY OF ORONOV_ CALLED IN
INSPECTION NOT E�( SCHEDULED
PERMIT NO. COMPLETED
ADDRESS
u -
OWNER CONTR. -k-
� C'
TELEPHONENO.
DESCRIPTION `
W 01 FOOTING 11 M CHANICAL RI 18 EXCAV/GRADING/FILLING
W 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti
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
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:
cc
W
C
cc
J
O
O
W
W
W
Q
f2
Z
W
W
CC
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
LU ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
11STOP ORDER POSTED.CALL INSPECTOR EJ CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ne inspection 24 hours in advance. (952) 249-4600
Owner/Co te:
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
DATA TIME V
CITY OF ORONO CALLED IN `* /
INSPECTION NOTICESCHEDULED
PERMIT NO. JPO ��-b15_COMPLETED,� /
ADDRESS o9.-U (�t1Gt_k g� / j -� / d le
OWNER / CONTR. L�
TELEPHONE NO.
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
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
iE 07 DEMO-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
v 10 PLUMBING FINAL p� 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:
\ YES_NO
COMMENTS:
CC J�
W
C
J
O
cc
O
U_
W
c
Q
Z
W
W
CC
Z
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Wrc /WORK SATISFACTORY:PROCEED 1-1PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 El CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
Cj 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 ext inspection 24 hours in advance. (952) 249-4600
Owner/Contrac o ite:
Inspector.
White Copy/inspector's File Canary Copy/Site Notice
� ,y�" ���� C aD T TIME V/
/// CITY OF OI 6NO CALLED IN
INSPECTION NAOTIVSCHEDULED
PERMIT NO. COMPLETED - „
ADDRESS
OWNER CONTR.
TELEPHONE NO.__ a2=9
DESCRIPTION
41
01 FOOTING 11 MECHANICAL RI 18 XCAV/GRADING/FILLING
L 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WE LANDS
h
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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
W
C
11C
cc
0
W
cc
Q
2
W
W
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Uj ❑WORK SATISFACTORY:PROCEED ROIECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ UE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C1 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ 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. (952) 249-4600
Owner/Contractor on Ite:
Inspector. 4
White Copyllnspector's File Canary Copy/Site Notice
ogaouo
M BEEN
UE
Certificate cf Survey for PAS
Im
' H-AS, BEEN
Donald C . Wildman 'G
of Lot 4 , Block 1 , WAKEFIELD FARMS SECOND ADDITION
"I
Hennepin County , Minnesota L o
.350.00'
IV
3,
Z.7-
47.7,
xy-
F
XV
-1z
P
Concrcfc
elate �1160jp 1�
West -31Z.00,
I hereby certifythat this is a true and correct represent-
ation of a survey of the boundaries of Lot 4 , Block 1 , WAKEFIELD 6)o4v" my cAAjs1"c"t)A) r,at c
FARMS SECOND ADDITION , and of the location of an existing house , tennis
court , concrete slab , dog run , and. the partial location of a blacktop AV NL
V-%
M IL
encroachments .
driveway . It does not purport to 'show any other improvements or & a
s� -r�+� �► 8� Pit �Pr-�
COFFIN & GRONBERG , INC . OF
Scale : I inch = 50 feet
Mark S . Gronberg Mn ." Lic . No . 12755 Date November 11 1985 6Cow?*,(
Gordon R. Coffin Mn . Lic . No . 6064 0 Iron marker 0 rA$m Voj A
FW—I%w
Engineers , Land Surveyors , Planners