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HomeMy WebLinkAbout2005 - P09283 - addn/remodel/repair PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P09283 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 10/17/2005 SITE ADDRESS: 1101 Willowbrook Dr Unit# Wayzata,MN 55391 PID: 26-118-23-41-0003 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Addition/Remodel/Repair air Permit Sub-type(s): Addn/RemodellRepair Permit Type: P DETAILS: Approved per resolution#: Separate permits required: Plumbing Electrical(state) NOTICES/REMARKS: New kitchen cabinets,build up sunken floor,move plumbing FEE SUMMARY: Permit Fee: $ 251.25 Valuation: $ 15,000.00 Plan Review Fee: $ 163.31 State Surcharge Fee: $ 7.50 TOTAL FEE: $ 422.06 APPLICANT: Crystal Kitchen Center OWNER: Mark Wittig&Lucia Delaney 668 N.Highway 169 1101 Willowbrook Dr Golden Valley,MN 55427 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. atilatel APPLICANT PERMITEE SIGNATUREISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 a •w s Total Fee: $ Z .OCR Date Received: IC-/1-CS- Entered By: ]ZQ ,e,„,...- ,-c- 1°('"Z-- Permit#: /Qo 9028`3 CITY OF ORONO - BUILDING PERMIT APPLICATION All inforu(ation must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) OWNER O CONTRACTOR r W JOB SITE ADDRESS: I I0 I 1 I DL/10-(0b ZIP: S$ 39 I Will this be Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes 1,41No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parkin is available. Non-permitted,— events will not be allowed. NAME OF OWNER: Q )iI6flALI( L4( I PHONE: home 9 ca-(4'13- 3S ,� (work) MAILING ADDRESS: 11b1 �JiI I 4'4 0 . CITY: Of pt, ZIP: SS 391 CONTRACTOR: C(t1 0 l k C L act- PHONE:343 -S.(11-1-5-‘6.0 CONTACT PERSON: Kt v, N e is o)1 MOBILE/PAGER: 6 II-.)-->i -? 7 c1 g MAILING ADDRESS: (0f3$ til_ ill 1 Ll CITY: ‘a(ilia Vcx11el ZIP: 531.J J STATE LICENSE: # 7 ?,OO EXPIRATION DATE: 3/3 t/17(o ARCHITECT/ENGINEER: -----\.,, PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE_OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration • PROPOSE WORK(describe in detail): New 16(1 1L. (4,61 I heti I tivi_el 11 S t n ,t.4. c I / m ave etiA.4t„k„,3 STORIES: ' SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ IS, 006 T hereby apply for a building permit and I acknowledge that the information above is complete and accurate; :hat the work will be in conformance with the of mnnces and codes of the City and with the State Buildin: Code;that I understand this is not a permit an vot k is not to start without a permit: and that the o k will b in accordance with the approved plan. // I APPLICANT'S SIGNATURE: ` DATE: (0^ I—‘95 31 .. • Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. I. Type of data. The rights of mdivid'..,on whom the data is stored or to;,e stored shall be as set forth in this section. Subd.2. information required to be given in.'';,',w.,. 'r.individual asl. 1 )supply private or confidential data concerning himselfshal 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 niay 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 connect. 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. Fir-st Middle Last Address Ci-ty Sta e Zip Phone 1 unders a my ri v✓ ns •fated above. Signature 32 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 1101 W t1 kowbrz. okc PID: DESCRIPTION OF WORK: o ZONING REVIEW BY:r- _-I ---� DATE APPROVED: "ice BUILDING REVIEW B : / DATE APPROVED: /v-r x-0 5 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes r/* No PLAN REVIEW Yes r/ No SEWER CONNECTION STATE SURCHARGE Yes No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SACUnits OTHER (specify) ZONING CHECK LIST Zoning District: /lIO CHA'J6C Fire Department: Post Office: School District: Lot Area: Sc.ft. Acres Width Depth Survey Submitted: Yes No I ate 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: : : Council Approval Date: Septic: Staff Approval Date: :y: Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setb-ck: 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): 1 e BUILDING REVIEW CHECK LIST UBC: cz 3 CONSTRUCTION TYPE: \1N Sq Footage $ Per Sq Ftg Basement x = 1st Floor x = 2nd Floor x Garage x x = TOTAL Estimated Construction Value: $ Z-1600 °Q Inspections Required: Work Requiring Separate Permits: Site is Plumbing Fire Hardcover Removal Mechanical Water Connection Footing - Septic Sewer Connection X Framing Fireplace Lawn Irrigation K Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) pe:Final Grading/Filling of Electrical (State Permit) Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMIT): 8 /\ DATE TIME Y CITY OF ORONO CALLED IN /�`3 US INSPECTION NOT CE 2 SCHEDULED //`9.-0 i 9:3©444 PERMIT NO. ,'G G/�-F. 1 COMPLETED ADDRESS 110/ f1_9i I(uzvbroo rC /. OWNER CONTR. 0/76(5/7.3/l t- Ce-- ,- TELEPHONE NO. 7/ 3 5.-z-/(` `157_,.' DESCRIPTION / t C'/- rLA-il 6%. W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING FRAMING 13 MECHANICAL FINAL 19 LAKESHORENVETLANDS y O 0 TION 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 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO • COMMENTS: cca10<47) 4)egiirtz.. CC 0 CC 0 W CC Q I-- IQ Z w CC C2 ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CCW ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ElCORRECT 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 nex inspection 24 hours in advance. (952) 249-4600 OwnerlContrn si Inspector. — --- —� White Copy/Inspector's File Canary Copy/Site Notice J \ 2 6i 101- 3 D, E TIME CITY OF ORONO�r / ;", CALLED IN 1 r INSPECTION N•� SCHEDULED ,L,0 PERMIT NO. Offn./ 1— COMPLETED / ADDRESS l 1 o r! W �il6w t !tel/ OWNER CONTR. / 21-af TELEPHONE NO. C / T�3 i 5 DESCRIPTION Filial W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS cl) 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 LU 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: ccW CC O CC 0 LI- CC CC Q ti CC GW 13 WORK SATISFACTORY:PROCEED ROJECT COMPLETECC v/ W LI CORRECT WORK&PROCEED E ISSUE CERTIFICATE OF OCCUPANCY C ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY • BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. E PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on ite- Inspector. "" ce t s„7 White Copy/Inspector's File Canary Copy/Site Notice