HomeMy WebLinkAbout2005-P08538 - addn/remodel/repair � ' PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P08538
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 4/20/2005
SITE ADDRESS: 850 Wayzata Blvd W
Wayzata,MN 55391
PID: 35-118-23-44-0004
DESCRIPTION: UBC Occupancy El
Construction Type VN
Proposed Use: Institutional-Schools
BuildingCensus Code 326
Permit Class:
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#: 3088
Separate permits required: Plumbing Mechanical irrigation Electrical(state) Other-(Fire Sprinkler SL Alarm
System/Septic Replace By 2010 Or If Use Is Expanded)
NOTICES/REMARKS:
Chuich
FEE SUMMARY: Permit Fee: $ 1,217.75 Valuation: $ 140,000.00
Plan Review Fee: $ 791,63
State Surcharge Fee: $ 70.50
TOTAL FEE: $ 2,079.88
APPLICANT: Cutting Edge Construction,Inc. OWNER: Michael Kuruvilla
P.O.Box 726 760 Hunt Farm Rd
Long Lake,MN 55356 Orono,MN 55356
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.
L9-AA-rt/11 0110
40
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE 6
Copies: 1-File(Si&nitures Required). 1-Anplicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
•
•
Total Fee: $ 9• A Date Received: i GAS
t Entered By: L.. pp Arno, y-20 Permit#: 1669.45
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 O CONTACTOR).
JOB SITE ADDRESS: KO �= z�It-� V �,� ZIP: C3Ct--,
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes js, 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: nCL, \ \\o, PHONE: (home)9C2--4L1 -ZQ4I
(work) bl7- 2c-tb (r3
MAILING ADDRESS:7tic cc_r,.,..V Q CITY: ZIP: 553
CONTRACTOR: a,v h`nc:3 [I_o PHONE:x(52 - -_3 5 �
CONTACT PERSON: 'l, A MOBILE/PAGER: (,t2 -
MAILING ADDRESS: ? -726 CITY: 1-0,Ne� L—. ZIP: fl1`i
STATE LICENSE: # LIS-06 S'S
ARCHITECT/ENGINEER: JAL cc) ,a(e LAd- PHONE: RS -4vy -166
MAILING ADDRESS: 301 1�'1��, ,,�o pve. �,;,� „ CITY: ' J�%-tz c L ZIP: 5.5 3g I
NAME: J. 1\,-c3.te, REGISTRATION# I`(e)l€'
TYPE OF WORK: New Accessory Structure
Addition Move
Remodel/Alteration K Land Alteration
PROPOSED WORK(describe in detail): I)
STORIES: 1 SQ. FEET OF EACH FLOOR: 4.65-0
NO. OF BEDROOMS: GARAGE STALLS: ATT. -- DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ k-r) `i U • Cu'
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: DATE: 3` Z \- (-2)
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 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.
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.
Signature
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 5s-0 W A,yz-66.-rr° L-`t'�
PID:
DESCRIPTION OF WORK: (2Ew\o OEc- c.%4 v RCN -kms A c ACL.E.
ZONING REVIEW BY: D.ATEAPPROVED: Y-1 g - os
BUILDING REVIEW BY: C Nw--- DATE APPROVED: Y - o S
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes t/-
PLAN
/PLAN REVIEW Yes ,/ No SEWER CONNECTION
STATE SURCHARGE Yes t/ No WATER CONNECTION
INVESTIGATION FEE Yes No r/ PARK FEE
SAC Yes No ✓ SITE INSPECTION
Number of SAC Units ��T<< Ate► OTHER (specify)
ZONING CHECK LIST Zoning District: RR-'
Fire Department: Post Office: School District: _..
Lot Area: Sq.ft. Acres C `i Width '10O Depth
Survey Submitted: Yes fC No Date of Survey: 1'2-Z"- r1
Proposed acks:
Front(Lake): Right Side:
Rear(Street): Left Side:
N� Wetland:a Adjacent Structures:
Building Height: Def. Hgt. Peak Hgt.
Lot Coverage:
rading: Staff Approval Date: By: Council Approval Date:
tecOu►ce- if 2.0/0 oR sr USE 1S
Septic: StaffApproval Date: D.k- Oki MAIT By: ExpAv./0 0 Sf SySTen1 FAIL S
C 6L1-E2Nv4N
Zoning File: 4 .5-306B Resolution: # Resolution Date: 2-2. -OS
Shoreland District: Al 0
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):
31
•
BUILDING REVIEW CHECK LIST
UBC: E • CONSTRUCTION TYPE: vN
Sq Footage S Per Sq Ftg
Basement c =
1st Floor .r =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: S 1140,000
as2
Inspections Required: Work Requiring Separate Permits:
Site x Plumbing • Fire
Hardcover Removal x Mechanical Water Connection
Footing Septic Sewer Connection
X Framing Fireplace .x Latin Irrigation
)e Insulation • (Masonry) x Other Fuze- SPRrrJta4-12- Acr4201 s1ST l
Wall Board (Mfg.) Well(State Permit)
X Final Grading/Filling X Electrical(State Permit)
Other
•
REMARKS(IN HO USE): •
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT):
32
PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P08538
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 4/20/2005
SITE ADDRESS: 850 Wayzata Blvd W
Wayzata,MN 55391
PID: 35-118-23-44-0004
DESCRIPTION: UBC Occupancy El
Construction Type VN
Proposed Use: Institutional-Schools
Permit Class: Building Census Code 437
Permit Sub-typ ) Addn/Remodel/Repair
Permit Type: Addition/Remodel/Repair
DETAILS:
Approved per resolution#: 3088
Separate permits required: Plumbing Mechanical irrigation Electrical (state) Other-(Fire Sprinkler&Alar
System/Septic Replace By 2010 Or If Use Is Expanded)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 1,217.75 Valuation: $ 140,000.00
Plan Review Fee: $ 791.63
State Surcharge Fee: $ 70.50
TOTAL FEE: $ 2,079.88
APPLICANT: Cutting Edge Construction,Inc. OWNER: Michael Kuruvilla
P.O. Box 726 760 Hunt Farm Rd
Long Lake,MN 55356 Orono,MN 55356
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 OBINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
WL-
APPLICANT
PERMITEE SIGNATURE ISSUED BY SIGNATURE
Conies: 1-File(S&nitures Required), 1-Annlicant, 1-Monthly Renorts, 1-Assessing, 1-Finance Page 1
,,*7) s DATE TIME I
CITY OF ORONO CALLED IN i /t'1
INSPECTION rpTI E Q� SCHEDULED (o% /t_�
`75 q ,e`
PERMIT NO. t' C� COMPLETED
ADDRESS g.5(..-, 0),` 0,_.,L3''? AOa • rjt vr) (,c) ,
OWNER CONTR. • u._ A-... t4111,
TELEPHONE NO. cs l c Cl tio ---7a-3
w/Ras.ci 1+,
a DESCRIPTION -:/ V1O I - 7-3 I c-19
LU 01 FOOTING 11 MECHANICAL RI 1 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 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
ct
IL 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
yo COMMENTS: 1�
Q.
W C Ze_ I,,,,,, << 0 K
CC
0
CC
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0
4.
W
CC
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W
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�2 WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W ClCORRECT WORK&PROCEED I i ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
cj BEFORE COVERING /_/Z7/�c
PERMANENT �C
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
illSTOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/ConSr site:
Inspector. I 'i
White Copy/Inspector's ''le Canary Copy/Site Notice
. ` el DAT �' TIME
CITY OF ORONO CALLED IN � �/ �
INSPECTION NOTIC SCHEDULED 7/61 )- _-� fit)
PERMIT NO. pel w p 61 COMPLETE/D' '
ADDRESS OS w d LU . 4exia
OWNER CONTR.if.e _ Ai i i drt
TELEPHONE NO. a (.e 7--7023 _ I
DESCRIPTION A.27 tl
IL 01 FOOTING 11 MECHANICAL RI 1: X AV/GRADING/FILLING
• 02 FRAMING 13 MECHANICAL FINAL LAKESHORE/WETLANDS
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 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
IQ 09 PLUMBING RI 23 SEPT C FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: ' YES_NO
o COMMENTS:
cc
W
CC
O
O
ti
CC
W
W
CC
2 WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED Cl ISSUE CERTIFICATE OF OCCUPANCY
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U 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 ne t inspection 24 hours in advance. (952) 249-4600
Owner/Contr. ow; le:
Inspector. c 61-A/
White Copy/Inspector's File Canary Copy/Site Notice