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HomeMy WebLinkAbout2007 - P11114 - addn/remodel/repair PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: P11114 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 6/20/2007 SITE ADDRESS: 1250 Woodhill Ave Unit# Wayzata,MN 55391 PID: 02-117-23-24-0008 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit T e: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair YP DETAILS: Approved per resolution#: Separate permits required: Fireplace Electrical(state) NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 1,105.75 Valuation: $ 120,000.00 State Surcharge Fee: $ 60.00 TOTAL FEE: $ 1,165.75 APPLICANT: Patrick Hanily&Associates, Inc. OWNER: United Healthcare Ins Co P.O.Box 784 1250 Woodhill Ave Excelsior,MN 55331 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. c/ Ly On (rrf APPLICANT • RM EE SIGNATU ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 ‘P.12' Total Fee: $ Ili(0,) 15 Date Received: b - /3- D 7 Entered By: CJ' Permit#: Am// -I 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 ONTRACTOR JOB SITE ADDRESS: I zco et:NDLv`, JOt ZIP: SSS 39 Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? nYes rNo Ifyes, 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 parking is available. Non permitted events will not be allowed. NAME OF OWNER: atkilA AN►t3�jtD PHONE: (home) 9 5Z 413-i l l'4 (work) MAILING ADDRESS: I LSO �1.t.5 CITY: OZOIVID ZIP: SS ( JG CONTRACTOR: -.I. :,, PHONE: qsz -O CONTACT PERSON: ( t."-- MOBILE/PAGER:..(pt L. Vat-SS:1 p MAILING ADDRESS: 71 .O.TzeK, 7e`'E CITY: Eat c t ZIP: Ste( STATE LICENSE: # SCS'? EXPIRATION DATE: m L 7.0091 ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home -emo e el/A tera 10 i.: Siding, Windows) Any earth moveme -.. re MCWD review and permits! PROPOSED WORK(describe in detail): LC Co futtlisto rnititu tboat�'s I �oF IN.)10 a meds. \ L 4 LA.00o Pi Ce 't"c Co4k�. STORIES: ( SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: 3 GARAGE STALLS: ATTACHED DETACHED O ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 1 aot00 • 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 approve. : . . 011 APPLICANT'S SIGNATURE: N4 i;_ *_ etS DATE: ___(41(a_____ 31 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. Your full name is required to process this application or permit. Ccfr,.>.- l._ 41,4k), 1 First Middle Last Lls Address O u db. C — Z. .i,1g--Ofci/ City State Zip Phone I understand my rights as rated above. Signature Reset Form 32 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 12.50 W opo t-4t LC. PID: DESCRIPTION OF WORK: (ZE[zoo t .t- CoA -ttiter c-,5 ZONING REVIEW BY: N/A nn DATE APPROVED: BUILDING REVIEW BY: �/( [�C DATE APPROVED: to-19-a'� FEES TO BE CHARGED: QQ Misc. Fees Calculated By: PERMIT Yes t/ No PLAN REVIEW Yes No ✓ SEWER CONNECTION STATE SURCHARGE Yes ✓ No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No --- SITE INSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST Zoning District: 4JO C heAry Fire Department: Post Office: School District: Lot Area: Sgft. Acres Widt Depth Survey Submitted: Yes No Dai• of Survey: Proposed Setbacks: Front(Lake): Right Side: Rear(Street): Left Side: Adjacent Structures: Wetland: Building Height: Def. Hgt. Peak Hgt. Lot Coverage: Grading: StaffApproval Date: By: Council Approval Date: Septic: StaffApproval Date: By: Zoning File: # Resolution: # Resolu''on Date: Shoreland District: MMMCWD\Permit: Avg. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover 6 ariance Required. Yes No ate of Council Approval: REMARKS(in house): 33 BUILDING REVIEW CHECK LIST UBC: 12.3 CONSTRUCTION TYPE: Y✓Q Sq Footage $Per Sq Ftg Basement x = 1st Floor x 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ 12-0,000 " Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection A Framing K Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board �(Mfg.) Well(State Permit) pk Final Grading/Filling K Electrical(State Permit) Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS(TO BE NOTED ON PERMIT): • 34 Ge)/ DAT TIME CITY OF ORONO CALLED IN 0 INSPECTION NO,T1pE SCHEDULED a as oR /DJ &O PERMIT NO. COMPLETED ADDRESS /025P z ) l4 OWNER CONTR. iG - C-k-, 5c G24c., TELEPHONE NO. 6/422 Flo/ & 3 >:: DESCRIPTION `fin al —' �/ . LLJ LU ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS L ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. 0 FOLLOW-UP Li 0 PLUMBING RI ❑ SEPTIC FINAL 0 HARD COVER REMOVAL ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL <---- OWNER/CONTRACTOR TO MEET YOU:_YES NO o COMMENTS: cc W Q. o ii----7)tdu� A n c i=fle P,... 5 © K cc O W Ln W z W cc Lu ceiWORK SATISFACTORY:PROCEED PROJECT COMPLETE LU ❑ RRECT 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 ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on tte: j. Inspector. White Copy/Inspector's File Canary Copy/Site Notice