HomeMy WebLinkAbout1998- 010160 - office space PERMIT
.� CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 EA i LO j NG
Crystal Bay, Minnesota 55323 Permit Number: "; ,t'; ":;
Date Issued: r
(612) 473-7357 V; :; _!;
SITE ADDRESS:
2160 WAYZATA BLVD
P. I .N. ; 34-118-23-21-0002
DESCRIPTION:
OFFICE SPACE
Building PermiT. Type COM-ACID RFMOOFL
Building Work Type COMMERCIAL
USC: Occupancy B
Co}n t.rui ti_in Type VN
Census Code 437 ALT . !WARES .
REMARKS:
FEE SUMMARY:
VALUATION $6C: z
Base t f,'ee $23 . 75
Plan Review $16. 44 1_5Q
Surcharge .2.s.a z!
Total Fee $39. 6ci
CONTRACTOR: OWNER: -. Applicant —
WEAR WILLIAM
ORONO MN L, 5 6
473-4030
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS
Sr'EC I F I ED AND AGREES: TO DO ALL WORK IN STRICT COMF LIANC E WITH ALL CITY OF
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ORONO ORDINANCES AND `-:;TATE OF MINNESOTA BUILDING CODE REQUIREMENTS .
•
41111*6
APPLICANT PERMITEE SIGNATURE w ISSUED BY:SIGNATURE _A',.61:
.
' Total Fee: $ 3g-(09 Date Received:
Entered By: 6Permit#: (o o
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 OWNE: . ' CONTRACTOR
JOB SITE ADDRESS: 2 I CoQ WJacd 'VQ ZIP: 5'335(0
NAME OF OWNER: Willi&nit W, W ear PHONE: (home) 4113- 4.030
W&t2LCt& J (work) 4.14.1-1 -1--(024r1MAILING ADDRESS: 2l(Q bt VQCITY: N ZIP: Gc-3-'-354..
CONTRACTOR: V\1\ �'la NI, 4 & LLr PHONE: f
CONTACT PERSON: irne or Waher K 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
PROPOSED WORK(describe in detail):
STORIES: I SQ.FEET OF EACH FLOOR: 450
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 oved plan.
APPLICANT'S SIGNATURE:, DATE: 1/ 3/97
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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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2 t(,o w yt� -4 GL_v
a
DESCRIPTION OF WORK: 0 ic't=t cx S P A c.-G
ZONING REVIEW BY: d DATE APPROVED: y-21-7
BUILDING REVIEW BY: O (!1 -- DATE APPROVED: Y- 2 -10
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ' No
PLAN REVIEW Yes t No SEWER CONNECTION
STATE SURCHARGE Yes V- No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Y:;s No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District:
— INTO G t-(-r4-illy_
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): _ Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak 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 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):
•
26
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BUILDING REVIEW CHECK LIST
UBC: G CONSTRUCTION TYPE: V N
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ (,04 00
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Oc Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
Final Grading/Filling Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
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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 undet_this subdivision in the individual income tax or orooertv 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.
S. 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 applicatio or permit.
1604 11`, ear-
First 160 1a zratc v d Last
Address
I-.MA $7.--- MA .35 L 413-70411
City - State Zip Phone
I understand y rights as stated above.
,7
z:deee..........._ s;po(.z.______
Signature
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ORONO COPY
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CITY OF ORONO --4
BUILDING P RMI PLAN REVIEW
INSPECTOR M
DATE `'%'2-Z IS PEPMIT NQ.
.,,arAPPR`OVED AS su5Mi-TED 1
❑ APPROVED WITH Cr3RREC i IONS AS NOTED ,
These comments arc for yoi.lti!ni'::rination.AU work Shalt be done i ;t �� •
in full ccmpl:anca with aot i.c cia Lui;ding and zoning code. l c t)i e-,,..,..-,-
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4 I Requirements in I 1 In ;toms not S ecihcaIIy noted in this!?:
'--- ��E`� `�` 'i KEEP THIS PLAN SET ON SITE AT AL.T;,E
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICESCHEDULED
PERMIT NO. /016° COMPLETED I Z" I° • C6 11. YO
ADDRESS Z-Io O W AKS"' ecu O
OWNER 0 I\1 W e CONTR.
TELEPHONE NO.
DESCRIPTION Ltci.ja- S-T
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
E.") 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
VNAL 14 SEWER HOOK-UP 06 PROGRESS
37 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
07 DEMO-FINAL J 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 49t{(o D 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL' 36 FOUNDATION/REMOVAL
WNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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WQ WORK SATISFACTORY:PROCEED ROJECT COMPLETE
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
OU BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
CI CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contra nof:
Inspector.
Whit opy/Inspector's File Canary Copy/Site Notice