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Home My WebLink About2008-P11783 - mechanical - � PERMIT CITY OF ORONO Permit ►vumber: 2750 Kelley Parkway- PO Box 66 P11783 Crystal Bay, Minnesota 55323 Permit Type: Mechanical Permits (952) 249-4600 Date Issued: 1/3/2008 SITE ADDRESS: 3450 Birch La Unit# Wayzata,MN 55391 P�� 08-117-23-43-0023 DESCRIPTION: Proposed Use: Residential Permit Class: General Permit Type: Mechanical Permits Permit Sub-type(s): Ventilation DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 15.00 valuation: $ 0.00 State Surcharge Fee: $ 0.50 TOTAL FEE: $ 15.50 APPLICANT: Practical Systems OWNER: Mr. &Mrs. Engler 4342B Shady Oak Rd 3450 Birch La Hopkins, MN 55343 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. � � API IC NERMITEE SIGNATUKE ISSUED BY SIGNATURE Copies: 1-File(Sig�ia[ures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � FQR CITY[JS�ONLY City of Orono _ O�O�O P.O.Box 66 Date Reccivcd: Pcrtnit# 2750 Kelley Pazkway �� Crystal Bay,MN 55323 APProved By: AmouDt$; � (952)249-4600 CITY OF ORONO—MECHANICAL PERMIT (All Commercial permits must bc approvcd by thc Building Officia]or Inspcctor and/or Firc Marshall) GENERAL INFORMATION � i 1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Mechanical Designs—Complete calculations,details and specifications are required for each heating,ventilation,humidification-dehumidification,and air conditioning installation including heat loss/heat gain calculation,design temperatures,equipment ratings and identification as to type,manufacturer and model. Data shall be presented on form provided. 4. When any new construction or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code requirements. 6. All work must be inspected(rough-in and final). Call(952)249-4600. (24-48 hour notice required) 7. House Heating Test Record must be submitted before final. TYPE OF PERMIT ..:�' Check All That A 1 �Residential ❑Commercial(Approval Required) ❑ New �Additional ❑ Repairs ❑Replace Job Site/Owner Information: , �� Site Address: ��/��' ,�J�� 1"�� Owner: Mailing Address: �" Cit � ��_�1`�� Zip: �' � �'�r� Y� � Home Phone: Alternate Phone: Contractor Information: ,:.., ..: . ' � � e/" Contractor: �� 'L�= - 7� Contact Person: �fS1�Jr'�+ � �,.� � Address: � 7t ' � .�.1 „� �� State Bond#: � ""��r'� �� ,� C�j City: �k�l�'�� Zip'�� Expiration Date: � �~� �h � Phone: �5�)3,3 l .�j�� Alternate Phone: � � a � � Insurance—Current: � �� K � Yt • % PERMIT FEE CALCULATI�N(S) - BASED OFF -2002 STATE STATUE. Ycs, this section applies The replacement of a Residential fixture or appliance that meets all three of the Yollowing requirements: 1. Does not require moditication to electrical ur g�s serviee. 2. Has a total cost of$500.00 or less;excludin��the cost of the fixture or appliance:and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section, if this applies; Cost of Permit � I5.00 State Surcharge � 50 Mail-ln Fee (If Applicable) $ �,Sp Tutal Permit Fee � PERMIT FEE CALCULATION(S)"�JOBS QVER$500 00 '^1 If ubuve does nut�ipply: lollow guidelines below: 1. CONTRACT PRICE * is I.��'io of a>ntract price with a(Nlinimum Fee of$35.00) x .01?5 S (cunh�acl�xicc) hninmium$35.00)- 2. STATE SURCHARGE ** .Add the State Bldg Codc Div. Surcharge(Minimum Fec of�.50) — __ . —.. _-- x .0005 � —_ ___ —_-- (contraet pricc) (minimum$ .i0) 3. POSTAGE& HANDLING (Only on Mail-In npplications) � I.SO 4. TOTAL PERMIT FEE(Add Lincs I-3 Above) g ' * CONTRnCT PRICC or JOB COST mcans the actual or estimated dollar amount charged for the permitted work including materials, labor, pro�it, and other tixed costs. It is the amount to be eharged to the customer for the work done. If any material, eyuipment, labor or installations are fumished by the owner, tenam or any other party, ihc rcasonable market value ol'such items must be udded to thc estimated cost ur contract pricc for permit fee pur��u,cs. In �he cvent that there is a dispute on the amount ol�the jub cost, ihe City may reyuest the submis�ion o��a sibned copy of the tictual contract. ■ ** The STnTF SURCHARGE is .0!)OS ol the Building Department at(952)249-4600 for the price. MECHANICAL PERMIT APPLICATION AGREEMENT The undersigned hereby applies to thc City tor issuance of a Mechai�ical Perinit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certitics that all statements made on this �pplication are complete, true and corrcct. � ! � � , i npplicant's Signature: %�� Date: � t Reset Form 3 . , � HEATING SYSTEMS , Quantity: _ Make: Model: Fuel: Flue Size: � Input BTUs: _ Output BTUs: CFM: COOLING SYSTEMS Quantity: _ � Make: Model: Tons: H.Power FIREPLACES ❑ Gas Factory Fireplace � ❑ Wood Burning Fireplace , ❑ Wood Stove ❑ Wood Stove With Flue ,� Brand Name: Model No.: VENTILATION Na � Kitchen Exhaust duct • recirculating cfm �' No. Bath Exhaust(must have duct outside) cfm ❑ No. Other Fans: Locations __ cfm FUEL STORAGE(MUST BE APPROVED BY FIRE MARSHALL) ❑ Installation ❑ Removal Fuel Oil: gallons , ❑ Underground ❑ Inside ❑Outside LP Gas: gallons Other: • GAS LINE ONLY ❑ Outdoor Grill ❑ Other/List What&Where: 2 � —� � —" TE / TIME CITY OF ORONO CALLED IN �/ �J� INSPECTION OTICE SCHEDULED C�� =D� PERMIT NO� � COMPLETED ADDRESS��5D G OWNER CONTR L� TELEPHONE NO. �`4/ �� DESCRIPTION �/�� (� -�r� � ❑ FOOTING �HANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ 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 J ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVA� J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � W � Q � Z W � W � � d W��INORKSATISFACTORY:PROCEED C� PROJECTCOMPLETE � ❑�RRECT WORK&PROCEED ': ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN �CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIOtJ REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-4600 Owner/Contractor on site: Inspector. �f l (/�� ____ White Copyllnspector's File Canary CopylSite Notice j� �� 1.�-� �-o , / ATE TIME �� CITY OF ORONO CALLED IN INSPECTION TICE SCHEDULED �� %� �� PERMIT NO. COMPFETED ADDRESS �� OWNER CONTR.� TELEPHONE NO. � l� �� l �� DESCRIPTION ��l �� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING �NIECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ 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 � � DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBiNG RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � W a � � O a � O � ti � Q � Z w � W � � d W WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK&PROCEED r' ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CA�L FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next ins tion 24 hours in advance. (J52� 249-46�� OwnerlContractor Inspector. White Copyllnspector's File Canary Copy/Site Notice " PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p11753 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 1/2/2008 SITE ADDRESS: 3450 Birch La Unit# Wayzata, MN 5539] PID: 08-117-23-43-0023 DESCRIPTION: UBC Occupancy R3 Construcrion Type VN Proposed Use: Residenrial Census Code 434 Permit Class: Building Addition/Remodel/Re air Pcrmit Sub-type(s): Addn/RemodeURepair Permit Type: P DETAILS: Approved perresolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 748�75 valuation: $ 65,000.00 Plan Review Fee: $ 486.69 State Surcharge Fee: $ 32.50 TOTAL FEE: $ 1,267.94 APPLICANT: Friedell Architects&Builders OWNER: Mr. &Mrs. Engler 2238 Edgewood Ave. S 3450 Birch La St. Louis Park,MN 55426 Wayzata MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGR S TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNE T�A BUILDING CODE REQUIREMENTS. � D APPI,ICA �PGRM17'1:1?SIGNA'I"URG ISSUED BY SIGNA7'URE Copies: l-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 � �� ,��i��o Total Fee: $ � � Date Received:�" �' �` Entered By: Permit#: / 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 OR ONTRACTOR JOB SITE ADDRESS: ��SC� �1�G1� ��. ZIp; 553°t � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a special event permit is required with Police Department and City Council approva/ 60 days prior to the event. Shuttle bus service will be reyuired unless applicant demonstrales su�cient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: �� 'E��N�� E rJ vLL-' ?Z. PHONE: (home) 95Z- y-1 1• 0 9 '�-3 (work) (012• ��o • -�1b$ MAILING ADDRESS:3'��0 �3��.GFI LH�J� CITY: W�l'f ZAi,!} ZIP: 5539 � CONTRACTOR: F2iEDg�� '�N�rt��TS y- �v�c,D��s PHONE: 9SZ 'S$g'7U�b CONTACT PERSON: D AN ►�!u� l�l MOBILE/PAGER (o I 2- g(o�-. $�g ) MAILING ADDRESS:zZ3�s �D b��,.,00a �►v��•s- ciTY: 5�'• Lov�s ►�A�t�ZIP: 55�2� STATE LICENSE: # 17 7 Z EXPIRATION DATE: ARCffiTECT/ENGINEER: W�/k2 � (�(/�UST�� PHONE: �oJ � � �D`}'S-'�z�� MAILING ADDRESS: Z�5�010 ELu S �V� . CITY: S�'- ��""- ZIP: SS�I �— NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) x Any earth movement may require MCWD review and permits ! PROPOSED WORK(describe in detui�: I��w.Di��L. IC lTGrl'�,1� , Q�h'�oi7�{:. �1�-n-�12-b�1� -r STORIES: � SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ��J O� 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 wit e ordinances nd codes of the City and with the State Building Code;that I understand this is not a per� t nd work' n to start without a permit;and that the wark will be in accordance with the approved plan. APPLICANT'S SIGNATURE: DATE: I z I 3 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 orconfidential data conceming himselfshall be informed of: (a)the purpose and intended use ofthe 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 identiry of other persons or entities authorized by state or federal law to receive the data. This requirement shal I not apply when an individua]is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax o�ropertv 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 dassified as public,private or confidential. Upon his fuRher 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 ofthe 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 disdosed 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 col]ected or created. The responsible authority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authoriry shal l comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe 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 comp]eteness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement. The responsible authority shall within 30 days eithec (a)correct the data found to be inaccurate or incomplete and attempt[o 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 ofthe responsible authority may be appealed pursuant[o the provisions ofthe administrative procedure act relating[o contested cases. DATA PRIVACY ADVISORY ln accordance with M.S. ]3.04,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. Db� ►.-e�� g - t�v�� First Middie Last Ib�Z��- ��--+�,,r" L,v J'� Address I��rlJ�v�,12 �/Y{DV- ��'] (pI 7i �G`� (�� City State Zip Phonc I unders a above. Signature Reset Forn� 32 CHECK OFF LIST FOR ISSUANCE OF PERMITS .�O j�QFFICE USE ONLY ADDRESS OR LEGAL: _ � S O Q�.�� -� L��l� PID: DESCRIPTION OF WORK: i�;� /�,ljl � F �� ZONING REVIEW BY.• /yJCp�/17�a� (rh C�J DATEAPPROVED: BUILDING REi�IEW BY.• DATEAPPROi�ED: FEES TO BE CHARGED: Misc. Fees Calculated By: � PERMIT Yes ✓ No PLAN REVIEW Yes_J� No SEWER CONNECTION STATE SURCHARGE Yes ,/ No WATER CONNECTION INVESTIGATION FEE Yes No � PARK FEE SAC Yes No �/ SITEWSPECTION Number of SAC Units OTHER (spec�) ZONING CHECK LIST Zoning DisU�ict: 0 c:� i� ~w�� Fire Department: Post Office: School District: Lot Area: Sg.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Right Side: Rear(Street): Left Side: Adjacent Structures: Wetla Building Height: Def. Hgt. Peak H . Lot Coverage: Grading: StaffApproval Date: By: Council Approval Date: Septic: StaffApproval Date: _��'� gy.�� Zoning File: # Resolution: # Resolution Date: Shoreland District: MCWD Permit: Avg. Setback: Bluff Setb . Lot Coverage: F.xisting Proposed Hardcover: 0-75' 75-250' - 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council App�•oval: REMARKS(in house): 33 BUILDING REVIEW CHEC%LIST UBC: �?� 3 CONSTRUCTION TYPE: \!�V Sg Footage $Per Sq Ftg Basement z = Ist Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Canstruction Value: $ �j,Sc"�`'i 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) _�C Final Grading/Filling �Electrical(State Permit) Other REMARKS(INHOIISE): REVIEW BY OTHERS: DATE: Access: Existing New Access flpproval: Date By: REMARKS(TO BE NOTED ON PERMIT): 34 � � ATE TIME V CITY OF ORONO I�75,3 CALLED IN � INSPECTION N C P SCHEDULED o� /:� PERMIT NO. con��ETE� ADDRESS J �S� � OWNER CONT��G� �-t� TELEPHONE NO. — ` � 6 —D ( � DESCRIPTION l� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING �ING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP ? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ��` ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:✓YES_NO � COMMENTS: � W � � � O a � O � W � Q � Z W � w � � a W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ RECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-46�� OwnerlContractor on site: Inspector. �� ._ `� White Copy/lnspector's File Canary CopylSite Notice �� T l�/�' TIME V CITY OF ORONO CALLED IN � �� INSPECTION NOT � � �-2 SCHEDULED __�%�\ A ) PERMIT NO. �J COMPLETED ADDRESS � � l�C%� L- OWNER CONTR. �Y� �� TELEPHONE NO. ( .� �� —-1 ��"I� O � � � DESCRIPTION 1 �'�-�� l 1 Z�C.aI � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILIING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ 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 � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a o �� S �. - i��,„ 4 L,i� G.��, '' � �� fia�S � 0 � W � Q � Z W � W � � � GW�WORKSATISFACTORY:PROCEED PROJECT COMPLET � ❑CORRECT WORK&PROCEED C I SUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECT UNSAFE CONDITION WITHfN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ IHSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-460� OwnerlContractor on site• Inspector. �/ ,�i � White Copyllnspector's File Canary Copy/Site Notice PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p11779 Crystal Bay, Minnesota 55323 Permit Type: Fixtures (952) 249-4600 Date Issued: 12/28/2007 SITE ADDRESS: 3450 Birch La Unit# Wayzata,MN 55391 PID: 08-117-23-43-0023 DESCRIPTION: Proposed Usr. Residential Permit Class: Plumbing Pcrmit Type: Fixtures Permit Sub-type(s): Multiple Fixtures DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 66.19 valuation: $ 5,295.00 State Surcharge Fee: $ 2.65 Misc.Fee: $ 1.31 TOTAL FEE: $ '70.15 APPLICANT: Berg Plumbing&Heating Inc. OWNER: Mr. &Mrs. Engler 648 Second Ave 3450 Birch La Mendota Heights,MN SSll8 Wayzata MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK [N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. < `�'1,�c,c ��r� ��-y�,,� APPLICANT AERMITEE SIGNATURE SL'ED BY SIGNATURE Copies: I-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 FOR CITY USE ONLY �;��, CityofOrono P.O.Box 66 Date Received: Permit# '� Q`` 2750 Kelley Parkway �+ �� *� Crystal Bay,MN 55323 Approved By: Amount$: �'��^ '�,�_;��.�`��` (952)249-4600 .•,t,�x .�8�,�s CITY OF ORONO—PLUMBING PERMIT (All Commercial permits must be approved by the Building Official or Inspector) GENERAL INFORMATION 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cards will be sent by retum mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved,a separate building pennit must be obtained. 5. All work must be done in accordance with State Code requirements. 6. All work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) TYPE OF PERMIT (Check All That A 1 ) �Residential ❑Commercial(Approval Required) ❑ New ❑Additional ❑Repairs ❑Replace ❑ [n Accessory Structure? *You will oeed arior apnroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: �;�N�U��._ ('Giti i(k-t�C,'+(,1'L— — ��-► �o�EL�L f��t-t-� r'[�fifis �'{ Site Address: �L�C� t"J 1 �� L ��L% ��'p�� ' Owner:�C�f�� Mailing Address: �1 �L� I�l �L�C�� -� Ciry: l.� ��-��J� zip: Home Phone: Alternate Phone: Contractor Information: Contractor:��"�� rn�� ContactPerson: ��.� Address: �� L% ��lV �� State Bond#: �5—` ��-��f�" ��i�G� . � ��RC,�1�.� � City: �� Zip:"✓ )�(��xpiration Date: �L wC)�" ��' (►'� �t�0� Phone: �� —�� "�� C� Alternate Phone: �� z�� _�� ] Insurance—Current: C�� '��i 1 PLUMBING FIXTURES BEING INSTALLED �� FIXTURE BSMT 1 T 2"u OTHER FIXTURE BSMT i � 2�`D OTHER TYPE FL FL TYPE FL FL Water Closet i Floor Drains Lavatory � Sewer Ejector Bathroom Laundry Tray Shower I Washer Kitchen Sink � Water Heater Disposal � Water Softener Dishwasher � Wet Bar Sillcocks Miscellaneous � � PERMIT FEE CALCULATION(S) �� BASED OFF - 2002 STATE STATUE ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludin�the cost of the fixture or appliance:and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section,if this applies; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 1.50 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 PERM�T FEE CALCULATIQN(S -JOBS OVER$500.00 � If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) �l��p� x.0125 $ �V1 + ��L� ��') (contract price) (minimum$35.00) � 2. STATE SURCHARGE **Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) ° ( �'�� Z � � x.0005 $ � � (� � (contract price) (minimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. 7fOTAL PERMIT FEE(Add Lines 1-3 Above) $ �� " �� • * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are furnished by the owner, tenant or any other party, the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. ■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. PLUMBING AERMIT�'PLICATION AGREEMENT � The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all wark in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and correct. n ' ��-. `��. �2 z�� Applicant's Signature: Date: Reset Form 3 �� CL^�� DA E^ Q TIME � CITY OF ORONO CALLED IN �� v INSPECTION NOTI � SCHEDULED � ` PERMIT NO. � C MPLETED ADDRESS � � ) r i�-- OWN ER CONTR. �-mY, TELEPHONE NO. � �� DESCRIPTION ��'�'�'�� (G� � ❑ FOOTING ❑ MECHA ICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ 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 � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W � � � O a � O � W � Q � Z W � W � j GW�\WORK SATISFACTORY:PROCEED Ci PROJECT COMPLETE � ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: � � � � Inspector. - White Copyllnspector's File Canary CopylSite Notice J ' �� n D TE TIME V CITY OF ORONO CALLED IN d�_��I INSPECTION NOTICE �-7 (� SCHEDULED �2��'�-�rp ,-�l.t PERMIT NO. �� /� / COMPLETED ADDRESS � � �N OWNER CONTR. �, TELEPHONE NO. � �� - a � ' a Q �- DESCRIPTION � � 1 � � � ��i� � � � ❑ FOOTING ❑ M CHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ 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 � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � � O � � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED ROJECT COMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN �NSPECTOR W4LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTIOtV REQUIRED.CALL TO ARRANGE ACCESS. Call for the nex inspection 24 hours in advance. (952� 249-46�� OwnerlContra si - Inspector. White Copy/lnspector's File Canary CoRylSite Notice PERMIT CITY OF ORONO 2750*K�iley Parkway- PO Box 66 Permit Number: p11772 Crys�al Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 12/27/2007 SITE ADDRESS: 3450 Birch La Unit# Wayzata, MN 55391 PID: 08-117-23-43-0023 DESCRIPTION: Proposcd Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Pcrmit Sub-type(s): Windows DETAILS: Approved perresolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 167.25 valuation: $ 8,869.00 State Surcharge Fee: $ 4.45 TOTAL FEE: $ 171.70 APPLICANT: Renewal By Anderson OWNER: Mr. &Mrs. Engler 1920 County Rd C. West 3450 Birch La Roseville,MN 55113 Wayzata NIN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISS[ON TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CfTY OF ORONO OR�INANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. �h��. j y��-%� � �, APPLICAN"I'PERMITEE SIGNATURE ��y' ISSUED BY SIGNATURE V Copies: 1-File(Sig�iatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, l-Septic) Page 1 PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p11772 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 12/27/2007 SITE ADDRESS: 3450 Birch La Unit# Wayzata,MN 55391 P�� 08-117-23-43-0023 DESCRIPTION: Proposed Use: Residenrial Census Code 434 Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 16725 Valuation: $ 8,869.00 State Surcharge Fee: $ 4.45 TOTAL FEE: $ 171.70 APPLICANT: Renewal By Anderson OWNER: Mr. &Mrs. Engler 1920 County Rd C. West 3450 Birch La Roseville,MN 55113 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. \J��Y��j �/ APPI.ICANT PERMITEE SIGNATURG ISSUED I3Y SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, l-Assessing,(If Septic, 1-Septic) Page 1 �� r-�:, „� ��,,,Tzxr � '��_ �'"'^�''�""��7� . . ..W .."'��,::•""wic.i;,r;;�' W S � D Permit Service 9533 — 367`h Street: North Branch. MN 55056 Phone 65 I-674-I 766 — Fax: 65 I-674-6 I 90 To Whom It May Concern: I am a.n authorized agent by Renewal bv Andersen to pull, pay for, and obt ' Permits. I have enclosed a self addressed stamped envelope for you convenien Pennit back to me. If there is a problem with this please fee] free t a1n their building 651-674-1766. ce to mail the o give me a call at Thank you for you assistance, Kara Benson WS&D Permit Service 651-674-1766 — Phone 651-674-6190 - Fa� � � � ��-1 ,�b + Total Fee: $ Date Received: Entered By: Permit#: 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 CONTRACTOR JOB SITE ADDRESS: 3y�� (C� �.Y�.� � (� q ZIP: ?j9 � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ NO Ifyes, a special event permit is required with Police Department and Ciry Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates suffrcient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: �6��t-� L�� I�� PHONE: (hom��' ��I��73 (work) MAILING ADDRESS: �I CITY: ZIP: Renewal By Andersen CONTRACTOR: 1920 County Road "C" West PHONE: CONTACT PERSON: Roseville, MN 55113 AGER: MAILING ADDRESS: _ Lieense #20130983 ZIP: STATE LICENSE: # 651-264-4777 DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) Any earth movement may require MCWD review and permits ! PROPOSED WORK(des ibe in detain: Q,T(�C 1> _p ��U� , ,� �C C,`J7,i�Q c STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ g � I hereby apply for a building permit and 1 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 nd work is not to start without a permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE• ATE: 31 Scc.13.04 RIGHTS OF SUBJECTS OF DATA Subd. I. Type of data. The rights of individual on wfiom 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 ro supply private orconfidential data conceming himselfshall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,politicai subdivision,or statewide system;(b) whether he may refuse or is leeally 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 identiry of other persons or entities authorized by state or Yederal law to receive ffie data. This requirement shall not apply when an individual is asked ro supply investigative data,pursuant ro section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or provertv 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 classitied 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 sho�vn the data without any charge to him and,if he desires,shall be informed ofthe 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 ro pay the actual costs of making,certifying,and compiling the copies. The responsible authority shal I comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe 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 himsel£ To exercise this right,an individual shall notify in writing the responsibie authoriry describing the nature ofthe disagreement. The responsible authority shall within 30 days eithec (a)correct the data found to be inaccurate or incomplete and attempt to notify past reeipients of inaccurate or incomplete data,induding 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 individuaPs 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: l. The information you fumish 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. � ��Y1 Firs/t'� ,J Mid le Last / �� `� _ �l/��`� 1 Address (`�r�(�,.QCC��I� �(�f11p,�� l-(��/-��(v(o C�4' State Zip Phone 1 understand my rights as stated ove. Signature Reset Form 32 � D TIME " ��TY OF ORONO CALL� P �� INSPECTION NO E SCHEDULED � PERMIT NO. � ��' COMPLETED ADDRESS � ��C> � ► 1�C"'I��.I�,j I�I� OWNER CONTR. ' L � I �-1 TELEPHONE NO. � � � � �� 'i `�C `"I_� � - f � � DESCRIPTION _�.�� u% 1�� I � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE Q ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE r ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTI FINAL ❑ HARO COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � � W C � � O � � O � W � Q � 2 W � W � � d � WORKSATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTO TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�0 OwnerlContr on�Site; Inspector. — � '�� White Copyllnspector's File Canary Copy/Site Notice PERMIT C.ITY�OF ORONO 2750 Keliey Parkway- PO Box 66 Permit Number: pi 1037 Crystai Bay, Minnesota 55323 Permit Type: Fixtures (952) 249-4600 Date Issued: 5/23/2007 SITE ADDRESS: 3450 Birch La Unit# Wayzata,MN 55391 P�� 08-117-23-43-0023 DESCRIPTION: Proposed Use: Residential Pernvt Class: Plumbing Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Water Softner&Filter FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 2,400.00 State Surcharge Fee: $ 1.20 TOTAL FEE: $ 36.20 APPLICANT: Clear Water Systems Inc. OWNER: Mr. &Mrs. Engler 1519 148th Ave NW 3450 Birch La Andover,MN 55304 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 MINNESOT�BUILDING CODE REQUIREMENTS. � � � � v--- �C-�� Y�= C'��'1 �2,/� PL ANT PERMITEE SIGNATURE ISSUED B SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, l-Assessing,(If Septic, 1-Septic) Page 1 � ' FOR CITY USE OtiLY �A� City of Orono �O`r P.O.Box 66 Date Received: Permit# �ti„,,,� � 27j0 Kelle}�Parkway �`�s� "' Approved By: Amount$: a �j -,-.�,-_ �* Crystal IIay,MN 5�323 `�i �'�:�."�,o` (952)249-4600 ly�,��$6 CITY OF ORONO -PLUMBING PERMIT (All Commercial pemiits must be approved by the Building Official or Inspector) GENERAL INFORMATION 1. You may apply for plumbing pernuts by mail or in person at the City offices. Applications will be reviewed and a pennit will be issued within two warking days. 2. Pernut cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing pernuts may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved,a separate building permit must be obtained. 5. All work must be done in accordance with State Code requirements. 6. All work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) TYPE OF PERMIT (Check All That A ply) ❑ Residential ❑ Commercial(Approval Required) ❑ New ❑Additional ❑ Repairs .-�Replace ❑ In Accessory Structure? *You will need prior approval and may need CUP. (Per Orono City Code,Chapter 78,Article IV) Job Site/Owner Information: Site Address: � / S� ��=/y�- �� Owner: s Mailing Address: ��-��.�-L� City: Zip: Home Phone: Alternate Phone: Contractor Information: Contractor�� Contact Person: C oti, �Sw�- Address: ��/�'/��'�✓�v. �� State Bond#: �e 3`� � City: f-/Y'NQ�c� /jir�Zip:�3Gt/Expiration Date: l��d�7 Phone: �7��-��y-�� Altenlate Phone: ❑ Insurance- Current: 1 � PLUMBING FIXTURES BEING INSTALLED FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2' OTHER TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory Sewer Ejector Bathtub Laundry Tray Shower W asher Kitchen Sinlc Water Heater Disposal Water Softener � Dishwasher Wet Bar Sillcocks Miscellane�o[s � PE�'��I'I'FEE C�I,CULATION�S) BASED OFF>- 2402 STATE STATUE ❑ Yes, this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas seivice. 2. Has a total cost of$500.00 or less; excludin�the cost of the fixture or appliance: and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section, if this applies; Cost of Permit $ 15.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 1.50 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 ` ♦ PERMIT FEE CALCULATION S —JOBS OVER$500.00 If above does not apply; follow guidelines below: 1. CONTRACT PRICE *is 1.25%of conh�act price with a(Minimum Fee of$35.00) p��9d� x.0125 $ --�'"—' � (contract price) (minimum$35.00) 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee of$.50) ' x .0005 $ f c �� (contract price) (minimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ 1.50 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the pernutted work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are furnished by the owner, tenant or any other party, the reasonable market value of such items must be added to the estimated cost or contract price for pernut fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. • ** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50—whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. PLUMBING PERMIT APPLICATION AGREEMENT The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all st��ements made on this application are complete, true and correct. � � �,! �� -�� o � Applicant's Signature• ;'' ' � Date: 3 �� DATE TIME � � n CITY OF ORONO CALLED IN �� ' "LTOD INSPECTION OT CEy SCHEDULED �1'Z3'(� l L:OD PERMIT NO. � � �OJ� COMPLETED ADDRESS �''�� <&1 � I-�1�'' __ __ _ OWNER CONTR. � ' � TELEPHONE NO. �DI2—"' �3 � 3� L"! � DESCRIPTION ��t�X.— WG(,71,� S 1CiSlu' ` lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FIL�ING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAI. 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q ti Z W � W � j GW ORK SATISFACTORY:PROCEED PROJECT COMPLETE►/ � �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �; pHOTO TAKEN INSPECTOR WILL RETURN ��CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for th next inspection 24 hours in advance. (J52� 249-4600 OwnerlCon t " n site: Inspector. - White Copyllnspector's File Canary CopylSite Notice PERMIT CITY OF ORONO 27`�0 Kelley Parkway- PO Box 66 Permit Number: P11027 Crystal Bay, Minnesota 55323 Permit Type: Fixtures (952) 249-4600 Date Issued: 5/22/2007 SITE ADDRESS: 3450 Birch La Unit# Wayzata,MN 55391 PID: 08-117-23-43-0023 DESCRIPTION: Proposed Use: Residential Permit Class: Plumbing Permit Type: Fixtures Permit Sub-type(s): Multiple Fixtures DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Pernut Fee: $ 48•75 Valuation: $ 3,900.00 State Surcharge Fee: $ 1.95 TOTAL FEE: $ 50.70 APPLICANT: Thompson Plumbing OWNER: Mr. &Mrs. Engler 15001 Minnetonka Ind. Rd. 3450 Birch La Minnetonka,MN 55345 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. �� ,�.� �� t_ � 'L � G' ! � ` /'J��- L— , APPLICANT PERM[TEE SIGNATURE ISSUED BY SI NATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, l-Assessing,(If Septic, 1-Septic) Page 1 r FOR CITY USE ONLY �` City of Orono '' ` � pate Received: Permit�# '¢' `r p.0.Box 66 �".. �' 2750 Kelley Parkway ��z Crystal Bay,MN 55323 Approved By: Amount$: � �952)249-4600 ��d►� CITY OF ORONO-PLUMBING PERMIT (All Commercial permits must be approved by the Building O�cial or Inspector) � � � � � � »�$.a�a�,��'��E''�' �� r a� �,€� �� 1. You may apply for plumbing permits by mail or in person at the City offices. Applications will be reviewed and a permit will be issued within two working days. 2. Permit cazds will be sent by return mail after a review is completed. PERMITS ARE NOT VALID UNTIL YOU RECEIVE A PERNIIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners residing in the dwelling. 4. When any new construction or remodeling is involved,a separate building permit must be ou�ained. S. All work must be done in accordance with State Code requirements. 6. All work must be inspected and air tested before it is covered. Call(952)249-4600. (24-48 hour notice required) TYPE OF PERMIT. " Check All That A 1 �Residential ❑Commercial(Approval Required) �New ❑Additional ❑Repairs �,Replace ❑ In Accessory Structure? *You will need prior aaaroval and may need CUP.(Per Orono City Code,Chapter 78,Article IV) � �� Site Address: ��J '1�.�. w''�-' � Owner�Q o�- Mailing Address: �'�--�Y�-� City: �� _ Zip: Home Phone: Alternate Phone: � :� f;or Information: -� Contractor�� `�� Contact Person: `��-�^ ��- Address: 15a��t��"�,�-`-`-��`'`�tate Bond#: �- J1�- �4�0- ( � City: rn��c�c�-�,'��-:�- - Zip:� `-t�Expiration Date: /a_ �� I--��rl Phone: `��a.��- �� " Alternate Phone: �!a- "�lbl- `��[�i� [� Insurance-Current: ' 1 _ .: . . ,, � . ; , _ ., �as, ,.r � �, f�;, .�,' � FIXTURE BSMT 1 2 OTHER FIXTURE BSMT 1 2 OTF�R TYPE FL FL TYPE FL FL Water Closet Floor Drains Lavatory I Sewer Ejector Bathroom Laundry Tray -F"11�b � Shower W asher Kitchen Sink Water Heater Disposal Water Softener Dishwasher Wet Bar Sillcocks Miscellaneous -�_PE�IVI[T PEE CALCU�A.TI�N(S} ,:° ' � 3 < , . '.SAS�D OFF -2002 STA"1"�STATCJ�,B` ; ❑ Yes,this section applies The replacement of a Residential fixture or appliance that meets all three of the following requirements: 1. Does not require modification to electrical or gas service. 2. Has a total cost of$500.00 or less;excludin¢the cost of the fixture or appliance:and 3. Is improved, installed or replaced by the homeowner or licensed contractor. Skip next section, if this applies; Cost of Permit $ I5.00 State Surcharge $ .50 Mail-In Fee(If Applicable) $ 1.50 Total Permit Fee $ (Permit Fees Continued On Next Page) 2 . �r�'� If above does not apply;follow guidelines below: 1. CONTRACT PRICE * is 1.25%of contract price with a(Minimum Fee of$35.00) �`�� x.0125$ �-t� �� (contract price) � (minimum$35.00) 2. STATE SURCHARGE ** Add the State Bldg Code Div. Surcharge(Minimum Fee ofS.50) 3`too� X.000s $ j, 9� (contract price) (minimum$ .50) 3. POSTAGE&HANDLING(Only on Mail-In Applications) $ �8 4. TOTAL PERMIT FEE(Add Lines 1-3 Above) $ "J�� (7 ■ * CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the permitted work including materials, labor,profit,and other fixed costs. It is the amount to be charged to the customer for the work done. If any material, equipment, labor or installations are furnished by the owner, tenant or any other party,the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the amount of the job cost, the City may request the submission of a signed copy of the actual contract. ■ ** The STATE SURCHARGE is .0005 of the contract price under$1,000,000 or$.50-whichever is greater. For valuations over$1,000,000 call the Building Department at(952)249-4600 for the price. The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all work in strict accordance with the ordinances of the City and the regulations of the State of Minnesota, and certifies that all statements made on this application are complete, true and conect. Applicant's Signature: u ��Gc..�.� Date: � ' / 7 -(�� ; �Reset Fotm ��A...,s.�� , . .�. ..,_.._. <. . ._ .�,. .- 3 � D E TI � � CITY OF ORONO CALLED W �47 � INSPECTION T ,. SCHEDULED ��3�7 c� ""' PERMIT NO. �� COMPLETED ADDRESS ��J� �XC� � OWNER CONTR.��d°Sv-^ �Yn�o TELEPHONE NO. � C�� 77 I� � DESCRIPTION ( �4�� ` �``� � �� , _( l� 01 OOTING 1 MECHANICAL RI 18 EXCAV/GRADING/FILLING Qi'02 MWG��/�� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS OIN LATION `� 1V 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z ALL BD. � 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMQ__,E1NAL__` 15 SEPTIC INSTALL. 22 FOLLOW-UP Q �. = d�9�11MBING RI _� 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a j �� O >. � O � W � Q � Z W � W � j d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALLINSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next nspection 24 hours in advance. �95Z� Z49-4600 Owner/Cont r s • Inspector. White Copyllnspector's File Canary CopylSite Noti� �� /� � DATE TIME CITY OF ORONO CALLED W 7' �'�� `7•� INSPECTION NOTICE /''7 SCHEDULED '-t•ZS' �1 �I�O-0 PERMIT NO. PI I�L/ COMPLETED ADDRESS �� i�, �l�-- OWNER CONTR. I �M TELEPHONE N0. V1I Z'�D3—� iq � DESCRIPTION � � � � � 01 FOOTING ti MECHANICALRI 18 EXCAV/GRADING/FILLING Q 02 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a j �� O � � O , � W � Q � Z W � W � � d W� WORK SATISFACTORY:PROCEED PROJECT COMPLETE W 1 CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. �:; PHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR r1 CITATION ISSUED � INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContr site: Inspector. White Copyllnspector's File Canary CopylSite Notice PERMIT GITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p10961 Crystal Bay, Minnesota 55323 P2rmlt Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 5/10/2007 SITE ADDRESS: 3450 Birch La Unit# Wayzata,MN 55391 PID: 08-117-23-43-0023 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residenrial Census Code 434 Permit Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved perresolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: Reface existing bath-fixtures,tile and paint FEE SUMMARY: Pernut Fee: $ 265.25 valuation: $ 15,200.00 State Surcharge Fee: $ 7.60 TOTAL FEE: $ 2�2,gg APPLICANT: Erotas Building Corp. OWNER: Mr. &Mrs. Engler 21930 Minnetonka Blvd. 3450 Birch La Excelsior,MN 55331 Wayzata MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED GREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNE TA BUILDING CODE REQUIREMENTS. �� ._--- APPLICANT PERMITEE SIGNATURE S ED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, l-Assessing,(If Septic, 1-Septic) Page 1 Total Fee: � Date Received: � r3 U� Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all informatioiz) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: 3�� `� �,t�� Wp�/Z�i�i ZIP: � � 3 � � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �NO !f yes, a specznl evenl permit is r•eqa�zr•ed tinith Police Departrnent and City Cozrr�cil appr•oval 60 days prior to the event. Shuttle bus service wil!be required z�nless applicant de�r:azstrates su�cient on-srte parking rs avnilable. Non per•nn�tted events will tvot be allowed. NAME OF OWNER:�tpw'�A�'�J lj,�uvhl�v� ��`�� PHONE: (home) l �Z �7/—b% �3 (work) MAILING ADDRESS: 3`�Sv �[IZ�N �^� CITY: G.l,Dy'Z,o i� ZIP: 5�39 ( CONTRACTOR: �I AS � �!��^l �l�• PHONE: �7 � Z��U( �3Uv CONTACT PERSON: U i�� p MOBILE/PAGER: F,l z-363-3��?O MAILINGADDRESS: ��5'3� irl-��° i�U1n_ CITY: �c-�C�-LSjo�-�. ZIP: �33� STATE LICENSE: #�� EXPIRATION DATE:�3 v B ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) �_ Any earth movement may require MCwD review and permits ! PROPOSED WORK(describe in detain: (�— �A� ��,d S�)�w� Q R i}�_ l �) U'��') %� /�� t'�� STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED � DETACHED � ESTIMATED CONSTRUCTION VALUATION(excluding land): � �SZ- v� � I hereby apply foc a building permit and I acknowledge that the information above is complete and accurate; that tile�vork��ill be in conformance tvit��.t�e ordinances and codes of the City and with the State Building Code; that[ understand this i fiot a ermit an vork is not to start without a pennit;and that the work will be in accordance ��ith the app o�ed �all, , ___ �____._____------_- _ � � (�� APPLICANT'S SIGNAT DATE: � 3t . Scc.13.04 RIGHTS OF SUBJECTS OF DATA Subd. L 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 contidential dataconceming himselfshall be infonned of: (a)the purpose and intended use of die requested data witliin 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 reflising to supply private or confidential data;and(d)d�e identity ofother 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 la��enforcement officer. The commissioner of revenue maXplace the notice required under this subdivision in the individual income tax or�ro�ertv tax refund instructions instead of on those fonns. Subd.3. Access to data by individual. Upon requestto a responsible authority,an individuai shall be informed whether he is the subject of stored data on individuals,and whether it is ciassitied as public,private or contidential. Upon his further request,an individual�vlio 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 ofthe content and meaning of that da[a. After an individual has been shown the private data and informed of its meaning,the data need not be disdosed to him for six months thereafter iniless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible audiority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible audiority 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,orwidiin tive days of the date ofthe request,excluding Sa[urdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request within that time,he shall so inform the individual,and may have an additional tive days within which to comply with the request,escluding Saturdays, Sundays and legal holidays. S ubd.4. Procedure�vhen 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 notiiy in writing the responsible authority describing the na[ure of[he disagreement The responsible authority shall within 30 days either. (a)correct the data tbund to be inaccurate or incomplete and attemp�to notif'y 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. Daca in dispute shall be disclosed only ifthe individual's statement ot disagreeinent 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 contes[ed 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 deterniine 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. Tlle 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 pubiic. 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. �Av� � C��,�.rA� ��i p S First N[iddlc Last a �� 3 � �;.��,�� r��,� . Address f� C��.�/�►� ��l � �3?/ �� Z — ��—�' 3v o Citv Sh�tc 7ip Phone I under�tand y rights as s ted above. ,___ ' � � � Si�naturc Reset Form �� CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 3`{� �t�H (�-�-P PID: DESCRIPTION OF WORK: Q,A►�-t�vw o w� +��'��<— ------------------------------------------------------------------------------------------------------------------------ ZONING REVIEW BY: (/+ DATEAPPROVED: BUILDING REVIEW BY: DATEAPPROTrED: s'-9-v7 FEES TO BE CHARGED: Nlisc. Fees Calczclated 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 SITE INSPECTION Nirnzber�of SAC UniCs OTHER (specify) ------------------------------------------------------------------------------------------------------------------------ ZONING CHECK LIST 7_o�7i�ag Disrrict: _fd,1v Fire Depnrtinent: Post Offrce: Sclrool Distr•ict: Lot:lrea: Sq.ft. Acr•es YY'idth Depth Scrrvey Sarbmitted: 3'es No Date of 5arfvey: Pi�oposed Setbncks: Frorit (Lake): Ri 1t Side: Rear(Sh•eet): Left 'de: Adjacenl Sd•uctzn•es: l�etland: 13uildi�7g Herght: Def. Hgt. Pe k Hg�. Lo1 Coverage: Grnding: Staff.dpproval Date: B: Council,4pproti�al Date: Septic: Stnff.=lpproval Unte: �: 7_oningFile: � Resolution: r Resolt�tionDale: Sdaor•eland District: r1-ICGVD Per•mit: �t rg. Setbacic: Bl uff S'etb ck: Lot Coverage: Esrs�ifig Proposect Hn�•dcover: 0-'�' 7 i_7 i�' ---- ?.$�-?�� son-�ono� flardcover I��riniice Reqtrired )''es �A`o D�ite of Coiu�cil.4pprol�al: RE,L14RIiS(i�t lrouse): 3� BUILDING REIfIEW CHECKLIST UBC: Iz �� CONSTRUCTIONTYPE: �� Sq Footage �'Per Sq Ftg Basement r — 1 st Flaor c — ?nd Floor L = Garage Y = x = TOTAL Ov Estimated Coxstruction Vnlue: $ �S.�� Inspectia:s Required: 63'ork Requirirtg Separate Permits: Site D� Plunibing Fir•e Hardcover Renzova! iC rllechnniccrl Water Caznection Footing Seplic Sztiver Conrzection �C Frarrting Fireplace Lcnvn L�rlgation Insulatio�a (��lasoniy) Other Ytfctll Board (d'lfg.) GY'ell(State Per�»rit) Finnl Grading/f illi�7g e Electr�icn!(State Pern�it) Othej• REMARXS(INHOLISE): ---------------------------------------------------------------------------------------------------------------------- RE vIEW B Y OTHERS: DATE: Access: Existing New Access Appr•oval: Date By ------------------------------------------------------------------------------------------------------------------------ RENIARKS (TO BE NOTED ON PE.RMIT): 3=t � ` �/ DATE TIME CITY OF ORONO ALLED IN �'�q� Q� INSPECTION NOTICE,^ SCHEDULED �T•.Z$•01 t l�OO PERMIT NO. P ��lil I COMPLETED ADDRESS �C� �� L.�.�� OWNER CONTR. TI l�Y� TELEPHONE NO. Ul�Z� �PJ� � �J�� DESCRIPTION ��— ��d/ � 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 � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 05 INAL O� 14 SEWER HOOK-UP 06 PROGRESS � DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � d � WORKSATISFACTORY:PROCEED PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 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) 249-46�� OwnedContractor site: Inspector. White Copyllnspector's File Canary CopylSite Notice � PERMIT CITY OF ORONO 2t50 Kelley Parkway- PO Box 66 Permit Number: P1o471 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 10/20/2006 SITE ADDRESS: 3450 Birch La Unit# Wayzata, MN 55391 PID: 08-117-23-43-0023 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Doors DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: Replacement doors FEE SUMMARY: Permit Fee: $ g3.25 valuation: $ 2,370.00 State Surcharge Fee: $ 1.20 TOTAL FEE: $ 84.45 APPLICANT: Renewal By Anderson OWNER: Mr. &Mrs. Engler 1920 County Rd C.West 3450 Birch La Roseville,MN 55113 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. � ��_� �/� �L�" / APPLICANT PERMITEE SIGNATURG ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 From:ELDER JONES INC 952 854 4909 10I18I2006 18:06 �207 P.00�I002 . . �� '°1��.� To#a.l Fee: S �4• �5 DateReceaved: �v ' ✓ - �� Entered By: Permit#�: l��7 / �ITY OF ORONO`-BU�DING PERMIT APPLICATION All i�iaformatiom m�st bc aubmitted in full before plan r�view will be started. . (p[easeprintallir,}formiation) THE APPLICANT IS: (circle one) OWNER O NTRACT ' JOB SITE ADDRESS: a ys� �� -�"�� ZIP: . 5.��J W' is be a P of Homes,Remodelers 3howcase Hdme or other Display Home? ❑� �O .�}'yes,a special event permit is reguired with.Police,Uepartmenl and City Council q�p,ptoval 60 d�s prior to the event Shunle bus service wP!!be reguf�ed unless qp,plicarit de�►ton4dC�ed . su,�Iclent on-,rtte parking is available. Non permitted even�s wtll not 8e allowed NAME�b'O'Vi/N�i'12: '�D OJ 1.1 l� � G L.�Q PT�ON�: (home) G� �1 /-�/��3 1171�1NG AbDRE5S: �J o (�) �r�'� �a�^ �� bg � S L't� CT�i'X: C�'I�o�J O ZYP: rs3� I CONTRACTOR: ��'SY ANDE�RSEl� �orrE: 94.�- i92o coviv�xn. c wEST s,�,�t�m yo CON'z'ACTPERSON: _ ROSEVILY.�,NIN 55113 P`4��' �� ""��--' MAYLnvG AnnxEss: , z�TP: — •� -- - STATE T.ICENSE: # 651-26�-4777 � 1T DATE: LICENST#20130983 ARCHITECT/ENG7�VEEXt: P�IONE: M�ING ADDRESS: CI'TY: ZIP: NAIVIE: , . � . � REGISTRATION: # TYPE OF WORK: New Home Addition . Accessory Structure � Move�Touae Rezz�odeU,Altezation(ie; Siding,Windows) �- Any earth movement may require MCWD seview and permiteJ PROP05�D WOR�C(describe in dezai�. 1r / �� . STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDRUOMS: GARAGE STALLS: ATTACH�D DE'ZACHED E�TIMATED CONSTRUCTTON VALUATION(ezcluding land): $ �� .J� I horeb�a��ly for a bui.ldit�.g�azx�ait and T ackx�.o�uvledga�that thc information abovo is com�lcto and accuratc; tb�at the wvrk will be in conformance with the ordinances and codes vf the City and with the State Bualdiug Codc;that I undcrstand this is not a permit an,d work is not to start wi out a pormit;and that thc work will bo in accordaznca with the approved plan. � AP�T.�CAN'r'S SIGNATURE: TE: ro ` ��p� 31 � From:ELDER JONES INC 952 854 4909 1011812006 18:06 #207 P.001I002 . 1120 Ea9t 80�'Streat,6te-#211;Bloomington,MN 55d20 � .. � - _ � . 952�45-soa7—Dlwct 852�\54-4908-Fax 'To� O�ono,City af Attn: Bldg. Dept. Fro�� s��i"� Fsx: 95z-249-4816 Pasos: Phonea 852-2d9�600 ��' �� I I g I 0 � Rs: Building P�rmit(s) CC: ❑Urgent ❑ Fvr Reviaw ❑P��se Comment X Plsaso Reply ❑ PlsSse ReGyCle • Commsn+s: Please call when tne permit fee(s)have eeen fi�ures. So I can cut a check and come to the city te picK up the permit(s). Thank You, 952-345�'(p 0�O � � pAT TIME CITY OF ORONO �D IN �/�� INSPECTION NO ICE SCHEDULED /a�� ' (JZ' PERMIT NO. y � COMPLETED ADDRESS�SD �('� �C/ OWNER CONTR. TELEPHONE NO. J � /� � DESCRIPTION �D� ��' lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FR,4MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION 05 AL 14 SEWER HOOK-UP 06 PROGRESS � 7 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/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O � � O � W � Q � Z W � W � j a W WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next nspection 2a hours in advance. (952� 249-4600, OwnerlContra or i : Inspector. White Copyllnspecior's File Canary CopylSite Notice PERMIT CITIr' OF ORONO 275U Kelley Parkway - PO Box 66 Permit Number: P09635 Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 3/21/2006 SITE ADDRESS: 3450 Birch La Unit# Wayzata,MN 55391 PID: 08-117-23-43-0023 DESCRIPTION: Proposed Use: Residential Census Code O/S -Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 139.25 Valuation: $ 6,900.00 State Surcharge Fee: $ 3.45 TOTAL FEE: $ 142.70 APPLICANT: Renewal By Anderson OWNER: Mr. &Mrs. Engler 1920 County Rd C. West 3450 Birch La Roseville,MN 55113 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. � A I ANT PE MITEE SIGNATURE UED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 Mar. 2. 2006��12: 12PM"' Elder Jones Permitting "a`Y' � �` ", °"'' No, 3082�°�P. 2/3 , � � �a�t�e�q e��s�p� s�ra��a�i9��ua� �;��aa aa�t��o�r�Og 11��r�� . . p��p�� g g��a��v�e�a��:��a�r�b�s�ta'� 6�O�C � �� /�� . ��'�fp,L�lii�IS s��k'�aYai�' � �. � � •u�gd��o1dd�� aq��b ��eq� P� =ara�ad , . � '� ��11D��A0 3aS3� 0;�OU�� SOhA �8�YliY1�[8� � f�#PBg7�PIIR Y�� '�P�3 ��P.��i��S �R , � ��E� ��30�P��P�o��,��3u�� A [t!�� e . �{�a�ajdmo�s sr aeoqe avp�u�o,}�i��e�a��na�g P�g��_�nn[p�B�o��R��q� . / O � ��paaa f�ulpn(ax�)AZ��Yf�'II�A i��f��IJ.SAI�� t�e7� , � . l �'J.3� �".Lb� �5'�''Y��'� � �3�Ai��d� 'OAd� � , . � ��4/�l��/�•� ' . �r�` �4�� ' � ��(� S . ::Vt��'Q��S�� v - � - �qO��IY P�'� uo��s�lYll�� Ro� , . , ��'�� '_'�"�?�'PP� �oAi ��m �YO ��L . . . . . , , .. � . . �l�IOLL1�'��I� � � ��liYAi �______.._ . 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CITY OF ORONO CALLED IN � U�l WSPECTION NOTICE SCHEDULED '�'I '7'O� c�?•' � PERMIT NO. �G'QLd,,.S COMPLETED /� 'y ADDRESS �`�� - �-�2-�- OWNER CONTR.��/./IEe.��:.� (�v �gr1dC,��<.;� TELEPHONE N0. �o �l 3(p y y�� J � DESCRIPTION l�,r�� k%� � 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 � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 5 FINAI. 14 SEWER HOOK-UP 06 PROGRESS � 07 O-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � � O � � O � W � Q � Z W � W � � d RK SATISFACTORY:PROCEED Cl PROJECT COMPLETE W CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY O ❑ Ct�RRECT WORK,CALL FOR REINSPECTION TEMPOFARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN 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� 249-46QQ OwnerlContracto i Inspector. '��"�---� White Copyllnspector's File Canary CopylSite Notice PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: p08776 Crysta!Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 2��-4600 Date Issued: 5/26/2005 SITE ADDRESS: 3450 Birch La Unit# WAYZATA,MN 55391 P�� 08-117-23-43-0023 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Minor Alterations Permit Sub-type(s): Windows DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: replace 3 wondows& 1 patio door within existing openings FEE SUMMARY: Pernut Fee: $ 195.25 Valuation: $ 10,430.00 State Surcharge Fee: $ 5.25 TOTAL FEE: $ 200.50 APPLICANT: Renewal By Anderson OWNER: E R ENGLER&B ENGLER 1920 County Rd C. West 3450 BIRCH LA Roseville,MN 55113 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 BUILDIN 6�ODE REQUIREMENTS. / �i� �.� `�.��'V�� -Q f c�i� C�Y� /�� AP L CA T PER TEE SIGNATURB IS UED BY SIGNATURE Copies: 1-File(Signatures Reguired), l-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page 1 � May. 24. 2005" 9:46AM'" � Elder Jo�es Permitti �g '�a�!' � P� `�a ""'�No, ]032'°atp, 6/] . � � ��s��ore�� s�a��pWu��tro� ��ras�as��i��I��tt�� . p� d��°�r�Aard��a�e��as upn6��a� 1��'� . � •��,�t�i�IS �e�L�i'V��'�d� ; � � . � . , . , , . .�d}��osddB� �� :��a . . . � 8��a�s ��ou s� �o�o p��u�d �� p� s�rap�c�g��3 :aPv� l�1PP.��»S� .� ��E� P� ��3� ��E� s�u�p.��a�4�[�.�3u��F��.Ifl��a�+ ' �p�� •�ffims� . p�s�a�d�aa��g 9eoc��Vo��utQo��tr a��eq;��pai�o��g Pu��ts.¢�.�atpl!nq��a� ,61�d� Rq��I . . O/ � �(p�l�A�I��ld0��l��A A�1Y�Ll��l�i��BI��'B�L�.� . ' , ,�O , ��r'b<6 �_��iw1�r �►�i�0l81C1 ��4/ . � °�M�1��{'$�� . . . ' ' `�4/4/WI' ��v�.lfl�fi�� ' ��lklrW r� , " . � ::(��a��n'4. ��P)� �lA, , � `� V . ' �� . _ cropei�e�� r�g��J�l�li�� 9e�y� , � . , �x�g�� o�ep� �aRi :�Ot��O�L� � � . , . . , . , . � - . . � �. � �11�0�,�� . �� ' , �dl� �� 5'�IQ�Jl�� t)��..._. -...�—, . •��I�l��' ' , , .. , � o��!!�I'��1,9, , : �C�� •� ��,LY� + �� c' ��1 �� . . 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M[a�rirldwl ast�ed to euPPfy QA�ace or oan�idaedal da�eaneernin�hltnadPahyl . be it��ed of; (aJ du�u�poie atu!iiftaadtd(lae o!the tequeaad d��wlth�a the�ollacsln�lvie�epey�PoLlel�l aubdivtdan,e�sdtaarids syetnm: (bI abethar ho m�r mfl�ie ot is Isgtlly r�qulKd m supPW 4►a Isques�dnttt(a)�ry known eon�eques�e ariting from hls mPPly In;or iePltalqg ro aupply ' pti�be oaelldantla!darsp and(d)�h�fdendry o[odtiar psesons oe eadcas aud�oel�d by au�r ar lederal law m rtcelve�e da�a. Thf�reqults�fope ahall ' aot eppty whan on iediridurl Is asked ea sopply tave�dgadve daa,punvant m s�edon'l�;$2,mbdlrision S.to a te�eefoe�rnenc o(6rer.� , . .� � �( � v e ' subdiv' f 1 or o rid '�•"� � i�utevcdon:ie�a�c!_u(o�� ao fgm+�. . , � ' - � " ,� ' . . 8nbd.3; Aeeesa to dafm by Indl�idual. Upon�equese b a�amibte authori,ry.in la�lvtdual�II M Infor�aed whmther 6e L�e suDJ+ee ut�coted dw,oa IDdl�iduals,ead whodter ic i�d�lfied aq publ'u.p'tirue er conOde»rial. Vpon his flsnber re�ues�,�n is�ridual e�ri�o ta d�e�,bjeat ' or�end Pri.wa ue putiila dw an iodtri�u�ts s6a11 be�,o�a�da,��rltl�ou�a�ehu�e w h�ea�:if bo deai�aa.9half be latbemid of�e mn�enc �d�olmila�of d��.da�. Att�r on tadividual h�s baen showa rhe pd�ua d.m nnd informsd ot la aennia;.me�aa eeid out ba dl�ebsed to.blm Par ei�e ameat�e aher.�il�e►rt,lai�dl�pute e��edan pucsvart�m fil:ieedoe Is petfdla�or addidornl don on U1a individud has beea oolleceed Qr er��. . , '4�tapv�tbl�au�pdqr c6�11 pto�ido�opiec of d►e pclv�ae or public da�upoe requesc hy rha individua!gubjaet of rhe d�n� 'ihe taper�autAo�iqr �- �nY ieqvite rho ee4W��i P�Q�A'Y dro seaal rossr nP�ieing.ear�lyieo.aed ea�pflla��e eopJes� 'Llre tsspeneiWe suthodb.shall comp�y lenmedi�taly,if��bk.ghl��'et9ueac nuda pu�latu w Wis�ubdlvldon.or alfila fiva days oE iha dste of�he mquec��fcef�din��uuNatYs.Svnd�Ys end 1e�1 holld��iP cn�edlare aompl�ncn b nocpa9s'bk. 1f'h,aema�comply�rlih r�e cequue , ' witqin tbex d�.lu e�ll oa.{Nbnn tlro lediridu�l,aad nay hsv.an eddldon�l Bue dryx wld�3n whiah co qo�ply,d(�a r5e mquen,eRa�ulfe�Sow�days. _: .Svadwrs"�d ltsai holld�yd. . . ' . Bubd.4, peeeedtu�whi�de��mt occur.ka or eomp�:ee, An IDdi�lun!nw�!eo�u me u�ue�Y or eomplerenas�oE�Mk or pm�aos d�o ie�srttia;lilmrelG Yo acereise rhis bg6t.�n�sdlvlduel`shall np�il�r la rritlri6�hc rnspoaslbk wd�,y deu�lrt�dss�ot�a dls�ereea�cn� . , ' ?he teapaa�lEle i�nllodcy 6haJl wid�i�30 d�ya ei:her. f�aortee�dt�dam found i�6e miaur�ta or inaoatpisae and�mempe an nodl�►puc[eafpk�s oE� i�aa ot lrqeompte►e dea.fe�ludln`�ipie,ati�a�ed b��U�dWbduel�oc(�)anAly daa�diYhlual fi�c he bclteves the dem co ba eorsee�. Dara . . ia�Wpu�e�all be di�olatrd ody U�he icdivfdu�l's sn�smeas of dlA�tr.�meiu is ittsluded wi�h d�e disclosed daes. , • �'he de�rminotion o�the tsepartiiblo awLorfry may 6o appaded p�t�uwt to 9po p�lslo�u of t!u adtnlnis�indva prarrdupe tct neles�na fa wn�md waes. ' , � , . . ; , DA°LA��i��r�� ' f � 'h • . • . . la avcocaance wich I1R.�:13.Os,Subd.2, 'Righcs af sutiJoccs ot daca°, we would�9ka to�aform you chac yo�r requesc . -. ..for a petmit oc tle��se fr�m the Cny► of Omno or ar►y ef its�epaccmenta:may�equi�you eo f�rnish certni�pr{Yau ar . confidantial frifocinatton. • � . � �ou are ncdfiad d�at� � � . � � 1. Th�a infoeflaa�ion yov t�tptsh w�11 be�sed�bo dcmrmine your qnalifica�ion for the permit orlieeaae cequaa+ced. - 2. You mqy refasa �o suPP�Y daa�, bn�ret4ual may r�qulre cha� cbe Clcy deqy iha F'tnnit or fi�tse. � � � •, 3. Z7ie'inFormasian mey be�a�ared wich ot�ec loeal,sta�s or fedecal agmcies io the wcreui nec�asaiy.�a pcocess �. che permic or license. � , . . 4. . If youT roquesc� petmit ar 1lceoaa tequ�rea Ca�cil u�oa �o appmve, some intorraulon �r become . . ' � publk. ' . . . ,' ' , . . � 5. . Xou�hava cer�in righcs under M.�. a3,Q� (av�a6le vpae reqe�es�) ro�roaf�► priv�te data an yo�u�self. , Your full name is�+equi�ed procc�s,_ flcatfoa or permit. . � . F a . . • . � . • , ' L:�J , S� . , , ��p. . ',- g�p . ' ' pLo�� ,��y . , . • • f / ,L� . � � ' I�w�de�staad y dgtitr's�sc�d abo - . - . . . . . . aigno . . .. � , _ L/C 'd- l�OL 'oN � ' �ui �� iu�aad sauo� aaPl3 � WdC� �6 SOOZ 'tiZ '�pW � � . � �ld�r��s � . � , _ . , Huilding�ermit Servics,Inc. �� T� � � � � . � p� �� - � � �1'�� J!�i�� LEAS� D�LIV�� I��A'�'EI.Y �'�: �. NAl� = - . . . � � C�M�AN� � . FAX NO: � � �-�l�C� �y I � +� �1'� Kara �� ' . . �,�, �e�t ServYce ex�.147 Nc�. o� ��s �o �o�L�� _� - �:, � � . . � " ��cT �o: . '� ��.1.� �� c��s . . . . � .� . � , . � NOZ'�S: , . , � r � � � � ' . �. ' 11'QV� , � � �f y�u ha�re tro��r��s#�as �a�, please c,a�l me as soo� as poss�lble.� ' . El'der�lones �uilding Permi� Service, Inc. � �1120 East�th Street • Bbomingron, Minnesota 55A�20-1�98 612-8542E64 FAX: 612-854��08 - L/l 'd Z�OL 'oN �ui �� iu�aad sauor aePl3 WH��6 �OOZ 'til '��W � DATE TIME (/ CITY OF ORONO CALLED IN =� � INSPECTION N IC SCHEDULED �4 '- �? � 3D PERMIT NO. 7 � COMPLETED ADDRESS �U S O ��!'L.G� L1-L.(1 P_ OWNER�;,�(�..�P �.t.�C.�l�_� CONTR. �"le-l.�ct-f� ��f •�c��-f-� TELEPHONE NO. �5�� ( 7 I L�`'ry� � DESCRIPTION � i>tiU �JS � �CIL dt` �G�(/�. lV 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q FINAL - 14 SEWER HOOK-UP 06 PROGRESS � 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 J 10 PLUMBING FINAL � 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � (�S�ZGfifi�fl CC�r� � � �f�'�� 6C�' � � � O � � O � W � Q � Z W � W � � � GW WORK SATISFACTORY:PROCEED PROJECT COMPLETE V � CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cal{for the ne inspection 24 hours in advance. �952� 249-46QQ Owner/Contr r n e: Inspector. � � White Copyllnspector's File Canary CopylSite Notice