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HomeMy WebLinkAbout2001-P04177 - addn/remodel/repair PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 P04177 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 8/20/2001 SITE ADDRESS: 845 Willow Dr S Wayata,MN 55391 PID: 10-117-23-22-0002 DESCRIPTION: UBC Occupancy R3 Proposed Use: ttesidentiai Construction Type VN Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Porch-Residential DETAILS: Approved per resolution#: Separate permits required: Eiectricai (state) NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 209.25 Valuation: $ 12,000.00 Plan Review Fee: $ 135.98 State Surcharge Fee: $ 6.00 TOTAL FEE: $ 351.23 APPLICANT: Owner/Self OWNER: Mr.&Mrs. Anderson MN 845 Willow Dr S 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. PEI A T E SIGNATURE I SU BY SIGNATURE Copies: 1-File(Signitures Required), I-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Pagel Total Fee: $ Date Received: Entered By: / / Permit#: ,�y 41/77 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 R CONTRACTOR JOB SITE ADDRESS: 2i�S f,()!/-po) De -`�AD (,'07)OZIP: SS3�l NAME OF OWNER: 6T PHONE: (home)4}�2 (work) -14,3 - 76S MAILING ADDRESS: g4<S��1w ,e Sv CITY: ZIP: SSS i CONTRACTOR: V fiM 642 PHONE: CONTACT PERSON: 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): Q k /Ccs U-Y) r � STORIES: SQ. FEET OF EACH FLOOR: /1, X /Z, 5 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 C 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: . ,4%4&&Laj DATE: Q 9-©9 •-Q/ 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. 5 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 art 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 compit;teness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the stature 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 6 BUILDING REVIEW CHECK LIST UBC: /Z•3 CONSTRUCTION TYPE: Vi'J Sq Footage $Per Sq Ftg Basement x = 1st Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ 12�00o Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) o`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 PERMM: 8 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESSOR LEGAL: $45 so PID: DESCRIPTION OF WORK: *,C..�i.r OA-C-43 ZONING REVIEW BY: DATE APPROVED: ff- 13-oi BUILDING REVIEW BY: DATE APPROVED: tr-t.7- vt FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes No SEWER CONNECTION STATE SURCHARGE Yes —� No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------------------------------- ZONING CHECK LIST Zoning District: R2-1-d Fire Department: (Add(.&Zo Post Office: GJA�� School District: 0"/VO Lot Area: Sq.ft. Acres 1) /K4w3 Width Depth Survey Submitted: Yes - No Date of Survey: 10-Zs -S It (o^j, 11, Proposed Setbacks: Front(fie): $ Right Side: -)3 Rear(Sareet): 900b ' + Left Side: yQ t t Adjacent Structures: A'i1'YMWetland: Z 6 f Building Height: Def. Hgt. 6� .(C Peak Hgt. Q (G Lot Coverage: Grading: Staff Approval Date: — By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # —AHA Resolution: # Resolution Date: Shoreland District: N HA 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): 7 ��rfiti�at §�urimtl $UfVOy For Ann S Gilbert Anderson Book Page File Sec.10.r.117,R.23 Willow Drive Orono, MN ORONO Cnny Oro M 87 3 -=NO Copy I 1n � M ck r\ O n� -33 I 2d0,0 77' I rr :X 4 ,Yo J 4 I North line Johnstons French Lake Sec CITY OF ORONO SITE PLAN GR%ING.PLAN W-APPROVED- 5�^,- (1jo"'` k+ ❑ APPROVED WITH REVISIONS ❑ DlSAPPR `EDBY Q Scale: 1" DATE • Denotes Iron Mon. Found Description: That part of Government Lot 7. Section 10, Township 117,Range 23, Hennepin County, Minnesota, lying North o Johnstons French Lake Second Addition and except the North 235 feet of the East 200 feet thereof and except road. according to Hennepin County survey. Containing 17 acres :. Registered This plan, specification or report was prepared by me or under my direct Supervision,�n9d99that I am a duly Land Surveyor in the State of Minnesota. Signed this day-of rank r a e a Sta a g. License No. 6 08 Page 6 of 6 '•-�' r, -C7 7 4'. 1 Cr OROS COPY �- 0A _...�_ ..-�---4•----:--- I it. �1 I � I �� � �i� -r. j a_ �_ __.1 �� l/W`.� CITY OF ORONO ILDING BU RMI PLAN REVIEW u;d P 7_ _1 I I I � •L, -' �. i � r � I ' IN PE�TOf� DATPERMIT NQ. Af°PR(�VEDASiSUB TjED t r:, F PROVED W1+H CORE ECT10fJS AS�iOTED 0 NPT APPROVED---'CORRECT&RESUBMIT 'ase comments air2 fo.; ourpnfor fion. All Work Shall be done in Wl comp!Ance With all sp licaue building and toning COCW. �, I Rg9uir�ents'inclugino i ms Nt ss�i!ically no;tad m this revievri ;KE P TI P SE SITE AT Ate.TIMES 1 1 7f I I ; 1 : I' . 1 I iKJ1 b" �Sck� �Q d LU �s � —SIC — ' 0 o a 11b, z -4- 0 � Ln {— �' 3 Z 3 t4a rib , I T c � Ob 0 d 1 � Z -- J a - -s � o � 6 In Gi o , [� N a T 4-� 3 t { ss I 4 �, as , CAI- ® -J Q_d NO z - o Q4 3 �, i v r N i J 7 N G cv d� c.10 O � o o j I Cb � d o d- -zy � 3 lee, i 404- 44, c � � h t t i i T c6 � Y •t � f Z j 4 ' "v- c-4. v-cb cb I e6 t � I f e -g s `.9 a t� � � j DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI¢� `� �� SCHEDULED PERMIT NO. tf�-Y O`Kl -/7 COMPLETED ADDRESS / (�� �l�U✓ 2,r S, OWNER CONTR. 57 TELEPHONE NO.-7 1 ���/ /z/7 0 DESCF,IPTION 01 FOOTING` 11 MECHANICAL RI 18 EXCAWGRADING/FILLING Q 62-FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES NO COMMENTS: ajr, �-�,✓ �J�7 i�r` Com; + w���\ cc J O a cc O U_ W cc Q Z W W CC Z) d WORK SATISFACTORY:PROCEED C PROJECT COMPLETE / '❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. El PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 Owner/Contractor on site: Inspector. I, r"IT, �c_I'_ White Copy/Inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE i -')SCHEDULED D PERMIT NO. ! (COMPLETED ADDRESS A ffir e`/t :3 �ICCU OWNER fAT 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 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL OWNER/CONTRACTOR TOMEETYOU:_YES,#ANO COMMENTS: cc W 77 cc O U_ W CC Q 2 W Z W CC d � ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE LU ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 '�j CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V 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 next inspection 24 hours in advance. (952) 249-4600 Owner/Contraptor on site: Inspector.' White CopylInspector's File Canary Copy/Site Notice CITY OF ORONO CALLED IN DATE TIME INSPECTION NOTIC SCHEDULED 5:--36vvl PERMIT NO. 177 COMPLETED ADDRESS Dfif . y, OWNER �j'icf�.��1'J CONTR. / I/72 UC-Ae✓` TELEPHONE NO. Q So2 1-/7& /S /O 3Z DESCRIPTION �'h--Gl—i 67 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS 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 10 PLUMBING FINAL � � 36 FOUNDATION/REMOV,9L OWNER/CONTRACTOR TO MEET YOU:JG YES_NO I1EQ ne LJ A S ff r,0 r� COMMENTS: cc Cc;. W a O O O W cc Q 2 W W CC O W �p�j/VORK SATISFACTORY:PROCEED ROJECT COMPLETE LU //❑''CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORECOVERING 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 next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. 10�C'��G /1 White CopylInspector's File Canary Copy/Site Notice