HomeMy WebLinkAbout2002-P05529 (Remodel) • ` PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P05529
Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: si2si2oo2
SITE ADDRESS: 123o Arbor st
Wayzata,NIN 55391
PID: 10-117-23-31-0069
DESCRIPTION: UBc occupancy R3
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: �i�u-icai(siaie�
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 542.75 valuation: $ 40,000.00
Plan Review Fee: $ 352.83
State Surcharge Fee: $ 20.50
TOTAL FEE: $ 916.08
APPLICANT• Owner/Self OWNER: �'�'•&Mrs.Martin
. MN 1230 Arbor St
Wayzata MN 55391
TI�UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SfRICf COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MIl�INESOTA BUILDING CODE REQUIREIVIIIVTS.
� , � �
APPLICANTPE SIGNA ISSUEDBYSI NATURE
Conies: 1-File(Si.�nitures ReAuired),1-At�plicant, 1-Monthlv Reports,1-A�essinQ, 1-Finance Page 1
�
� ' Total Fee: $ (�� ' �� Date Received: �f� .SSZ%
Entered By: ,� Permit#: 8'�z�/��'
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CITY OF ORONO - BUII.,DING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all infot�nation) �
THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: . / 2 3� � R 1� O (l S T ZIP:
NAME OF OWNER: f�t� r�.L.►� G' �Co r�N���A.,�r r nf PHONE: (hom�y� �3"2.- '�75-�v8 1�"./
(work) ?l0 3 - S�I(, -- �o5'c.
MAILING ADDRESS: I�2.3� A-R (30� S r- CITY: pl�D nl O ZII': 5S'�q J
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: � CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: K F Y I 1d �0 8�R G PHONE: 7!0 3 -2'��J-o�`!5'
MAILING ADDRESS: 1200 -K i�►G.�V��cJ c,N, M CITY: f��y r+�a�rl+- ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition ,C Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �1 D D G�l�AG�, r� V D ('�OO v►'I , Aa�A
��O��T" A�vO Pot�c,� -r� ��t.�TrNG ��st ,�_r-�?�� ,.������
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STORIES: � SQ.FEET OF EACH FLOOR: �L�b � ���� �` (c�O '�'�q���
NO. OF BEDROOMS: � GARAGE STALLS: ATT. 2. DET.
ESTIlVIATED CONSTRUCTION VALUATION(excluding land): $ ��s �� �
I hereby apply for a building pemut and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the Ciry 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:�L(� �. �u��� DATE: �� 24f�'2
��
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF SIJBJECTS 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 gtven indfvidual. 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,polidcal subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or
refusing to supply private or wnfidertial data;and(d)the idenary of other persons or entiries authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigadve data,pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revemie mav nlace the notice reauired under this subdivision in the individual income taz or nrooertv tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,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. Ugon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown d�e data without any charge to him and,if he desires,shall be informed
of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be
disclosed to him for six months thereafter unless a dispute or acdon pursuant w this section is pending or addidonal data on the individual has been
collected or created. T1te responsible audiority shall proride copies of the private or pub6c data ugon request by the individual subject of the data.
The responsible authoriry may require the requesting person[o pay the actual costs of maldng,certifying,and compiling the copies.
The responsible audiority shall comply immediately,if possible,with any request made pursuant ro 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 wtrich to comply with the request.
excluding Sanudays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or comploteness of public or
private data concerning himself. To exercise this right,an individual shall notify in wriring the responsible authority describing the nature of the
disdgreemenc The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incamplete and attempt to norify
past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)noafy the individual that he believes the data
to be conect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible authoriry may be appealed pursuant to the pmvisions 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 �ity of Orono or any of its departments may require you to fumish 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.
{'�► � �� � P G�o r�G� M � ��- ►�r
First Middle Last
l z3 0 �}Y��60 (Z 5T'
Address
� �nl� M /� �.s3 � � �52.� �f75'-�8 i�
City State Zip Phone
I understand my rights as stated above.
C�^��-�/`'��
Signature
4
6
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' a CI�ECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: _ I 2"3 d q 26 ayC.
PID:
DESCRIPTION OF WORK: GA�t�� R�o, n o•J
ZONING REVIEW BY: DATE APPROVED: � � 2.�--csz,
BUILDING REVIEW BY: DATE APPROVED: � - L?•o e.
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT . Yes c.i' No
PLAN REVIEW Yes �' No SEWER CONNECTION
STATE SURCHARGE Yes �,� No T WATERCONNECTION
INVE9TIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: (�2•�3
Fire Department: Post Office: School District:
Lot Area: Sq.ft. 2 d,�t��{ Acres .�t 7 Width Depth
Survey Submitted: Yes No Date of Survey: �-ZS•�3 ft.c..av�s.�.�9 (�-10-C Z
Proposed Setbacks:
Front(I�± Z�` -� Right Side: �S� '�
Rear(St�eet): 125 `-'.: Left Side: (,2' t
Adjacent Structures: prr�ac� Wetland: ��•a
Building Height: Def. Hgt. d. 6c. Peak Hgt. n .j�,
Lot Coverage: /v//�
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: —' By:
Zoning File: # � Resolution: # Resolution Date:
Shoreland District: �Iv
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:
REMARBS(in house):
7
� „ „
BUII.DING REVIEW CHECB LIST �
UBG �' 3 CONSTRUCTION TYPE: \//'�
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x = .-
R =
TOTAL
Estimated Construction Value: $ y c�,y�p(�QD
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Fire
Hazdcover Removal � Water Connection
�Footing Septic Sewer Connection
�Framing Fireplace Lawn Irrigation
_�Insulation (Masonry) Other
_�Wall Board (Mfg.) Well (State Permit) .
o� Final Grading/Filling c� Electrical (State Permit)
Other
REMARKS(IN HOUSE):
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By: ,
REMARBS (TO BE NOTED ON PERNIII�:
8
FRANK R. CARDARELLE Land surveyor, Inc. Land Surve
{61�2j 94�-3031 � 6 � � Flying Cloud Drive o�� yo,
0 rjOp den Pra�ne MN
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- � ��rti�i�a�� �� ��tri�� .
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Survey For P h i 11 i p M a r t i n ' Book��p2g e�_F�e��
1230 Arbor St. . . � .
Orono MN - �
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- �,' • � rank R. Cardareite
. c+�tr. P�� 1��� Frnr
DATE T
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED a-o Z ti3O
PERMITNO. o��- COMPLETED
ADDRESS o�� /7"��D�c�T`
OWNER r `fi;`n CONTR. �r1�1 ° O�n
TELEPHONE N0. ��a ��� ���7
� DESCRIPTION
lV 01 FQOTING 11 MECHANICAL RI 18 IXCAV/GRADING/FILLING
Q0 RAMING 13 MECHANICAL FINAL 19 LAKESHORFJWEfLANDS
y INSULA ON 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� . 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPUUNT
� 07 DEMO—FINAL 15 SEPT'IC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
MBING FlNAL 36 FOUNDATIOWREMOVAL
OWN ONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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� ORKSATISFACTORY:PROCEED ❑PRWECTCOMPLEfE
W ❑CORRECT WORK 8�PROCEED ❑ISSUE CERTIFICATE OF OCGUPANCY
0 ❑CORRECT WOHfC,GALL FOR REINSPECTION TEMPORARY
V BEFORECOYERING PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR ❑CRATION ISSUED
❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne t inspection 24 hours in advance. (952) 249-4600
OwnerlCon o ite•
Inspector.
White Copy/lnspector's Flle Canary Copy/Site Notice
DATE TI
CITY OF ORONO CALLED IN
INSPECTION NOT CE SCHEDULED /�i -l7-(�2 �:
PERMIT NO. COMPLETED
ADDRESS CS �
OWNER „��tr f�./1 CONTR._ � �/
TELEPHONE N0. �P `o� " ��2, -- U '��/'v�
� DE ION
� 01 FOO� 11 MECHANICAL RI 18 IXCAV/GRADINC3/FIWNG
Q 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FlREPLACE 34 TREE REMOVAL
g 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 COMPWNT
J 07 DEMO-FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FlNAL � 36 FOUNDATION/REMOVAL
� OWNER►CONTRACTOR TO MEET YOU:_YES�NO
° COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE
W FO CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRE(;T WORK,CALL FOH REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL RERIRN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne inspection 24 hours in advance. (g52) 249-46�0
ObrnerlCon o ite:
Inspectoc
WhNe CopyMspecto�a flle Canary Copy/Site NoUce
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DAT TIME
CITY OF ORONO CALLED IN �'�
INSPECTION N ICE SCHEDULED - � __��'�
PERMIT N0. COMPLETED
ADDRESS_ �a�� �l3�K.
OWNER CONTR.'�r�.-
TELEPHONE NO. �� ��J ��/
� DESCRIPTION � ./jji��
� Ot FOOTINO 11 MECHANICAL 18 IXCAV/GRADING/FIWNG
Q 02 FRAMING 13 MECHAWICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULAT10N 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD• 12 WATER HOOK-UP 17 SITf INSPECTION
Q OS FlNAL 14 SEWER HOOK-UP 06 PHOGRESS
� O-SITE 27 SEP'TIC MAINT. 21 COMPLAINT
Q 07 DEMO-FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTI� 35 WARD COVER REMOVAL
BING FINAL 36 FOUNDATIOWREMOVAL
2 OWN CONTRACTOR TO MEET YOU:_YES_NO
��., COMMENTS:
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W� WORKSATISFACTORY:PROCEED PRWECTCOMPLETE
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� ❑CORRECT WORK,CALI FOR REINSPECTIDN TEMPORAHY
V BEFORECOVERINR PERMANENT
❑CORRECTUNSAFECANDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CRATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTIOtJ REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next in pection 24 hours in advance. (952) 249-46��
OwnerlContract
Inspector. -i
White CopyMapector's Flte Canary Copy/Site Notice