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Home My WebLink About2004-P07939 (additiona/remodel/repair) PERMIT �ITY OF ORONO Permit Number: 2750 Kelley Parkway - PO Box 66 Po�939 Crystal Bay, Minnesota 55323 Permit Type: Addition/KemodeURepair (952) 249-4600 Date Issued: lo�ti2oo4 SITE ADDRESS: 1485 Bay Ridge Rd Wayzata,MN 55391 P I D: 10-117-23-34-0006 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Permit Type: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 195.25 Valuation: $ 11,000.00 Plan Review Fee: $ 126.88 State Surcharge Fee: $ 6.00 TOTAL FEE: $ 328.13 APPLICANT: Vangen-Anderson, Inc. OWNER: 7ohn C Holm 5127 West 98th. St. 1485 Bay Ridge Rd Bloomington,MN 55437 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. � APPLICA T P RMITE SIGNATURE ISSUED BY SIGNATURE Conies: 1-File(Si�nitures Required), 1-Aonlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 , ta Fee: $ �7�� 'I� Date Received: � �- nt red By: r � � Permit#: �v �;�jC� �ti��j �t � CITY OF ORON - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please pri�it all i�zfOYlllQllO)1� ---------------------------------------------------------- --�:.�---------- - - ---------------------------------------------- THE APPLICAl\'T IS: (circle one OWNER R CONTR.ACTOR JOB SITE ADDRESS: f `� �`� �.'�Y ✓�C�� 7IP: �-� ��I Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a special event pernzit is required witl� Police DepaYtnzent and Ciry Council appr-oval 60 days prior to the event. Non perinitted events will not be allowed. NAME OF OWNER: .J�I,t,v` ( ) �y 7� - S�'S 3 �'vt� PHONE: home (work) G, I�2- 3�� 0 32G� MAILING ADDRESS: %yuS /�,�y n�r.��c� CITY: ��.v ZIP: �S 3�I � CONTRACTOIZ (.�«� �1,-; ��1 - .�I��' ��^s c�i�� _ �iv�" PHONE: �j�'� �'��' - l:� �yG CONTACT PERSON� '�,41.�" �-� �, , MOBILE/PAGER: MAILING ADDRESS: �� 7 /�} �z'�=��i �"�:{''�� CITY: I��<�„>,�..c:J�i7 ZIP: � �� ;7 STATE LICENSE: # .,2 � ,c 3 �{ 1� .,Z ARCHITECT/ENGINEER: ��.zt�;�;•f�� -,¢,,,�.fc-;�sc;�,, �,c:� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: J��t.�';�- F', � , REGISTRATION # TYPE OF WORK: New Accessory Structure Addition Move od Alteration 1� Land Alteration PROPOSED WORK(describe in detai�: _1� r. �J� , �ek �� ,r,��f. „� �)� � K_ ��1 �--� /-�ry%�- L.�`�C it.T;:�� . � ��7�-'t' �i �'�. � � �.� � f-� r:,,.,� STORIES: � SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ `�� , v c c I hereby apply for a building pernut and I aclrnowledge that the information above is complete and accurate;that the work will be in conformance with the ordinances and codes of the City and with the State Building Code; that I understand this is not a permit and work is not to start without a permit; and that the work will be in accordance with the approved plan. "' ' _.l APPLICANT'S SIGNATURE: � �` �� '�— DATE: �� / 5��`� ! Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth(n this section. Subd.2. Information required to be given individual. An individual asked to supply private or conCdential data concerning himself shall be inCormed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legaliy required to supply the requested data;(c)any Mown consequence arising trom his supplying or refusing to supply private or con�dential data;and(d)the identity, of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav n�ace the notice required under this subdivision in the individual income tax or nropertv tax refund instructions instead of on those forms. Subd.3. Access to data by indi��idual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject ot stored private or pubtic data on individuals shall be shown the data N�ithout any charge to him and,if he desires,shall be intormed of the content and meaning ot that data. After an individual has been sho��-n the private data and informed o[its mcaning,the data need not be disclosed to him for six months thereatter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pa��the actual costs ot making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any requcst made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.If he cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness otpublic or private data concerning himself. To exercise this right,an individual shall�otify in writing the responsible authority describing the nature of the disagreemenL The responsible authority shall within 30 days either. (a)correct the data tound to be inacwrate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shalf be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. '. DATA PRIVACY ADVISORY In accordance with M.S.13.04,Subd.2, "Rights of subjects of data",we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. 3. The information may be shared with other local,state or federal agencies to the eztent necessary to process the pernut 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. �06�.vt � ._ �c.�t�f First Middle Last ��S ��y �t G�� ,�r�.� Address �� v ��' �S�3� � �s z�� s'�s 3 City State Zip Phone I understand my ri ts as st above. � ��. Signature CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: I�jS3S QA�t R�K�C,I': �A� PID: DESCRIPTION OF WORK: dccJ� ZO�IG REVIE`V BY: DATE APPROVED: 9 • �a-oY BUII.,DI'i�1G REV�`Y BY: DATE APPROVED; � - u�- �`f FEES TO BE CHARGED: / Misc. Fees Calculated By: PERiV1IT Yes �/ No PLAi'V REVIEW Yes �/ No SEWER CONIVECTION STATE SURCHARGE Yes �� No WATERCONNECTTON TNVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) -------------------------------------------- ZONI�tG CHE.CK LIST Zoning District: �-� ' �� Fire Department: Post Office: School District: � Lot Area: Sq.ft. 33,$�� Acres ,�6 Widch I/'L '�'"��`� � Dep[h Survey Submitted: Yes No Date of Survey: Proposed Setbacks: F'•�e�t(Lake): /3`1•Z- Right Side: ,3f3' � F�e�ar (Street): 2�S� ' Left Side: 35� t Adjacent Structures: f�'�� Vetland: ' Building Hei;ht: Def. Hgt. -- Pea�:Hgt. "— Lot Coverage: O.k— Grading: Staff Approval Date: � By: Council Approval Date: Septic: Staff Approval Date: � BY� Zoning File: # D�-/-3a y3 Resolution: /# Resolutioa Date: Shoreland Dis[rict: y�s Avg. Setback uq.ru�� Bluff Setback: �//�- L.ot Coverage: �•�< Ezistino Proposed Hardcover: 0-75' 75-250' Z�� '�•��o 250-SQO' 500-1000' Hazdcover Variance Required: Yes o� No Da[e of Council Approval: REMARKS (in house): � BUII.,DING REV�W CHECK LIST trsc: R '3 CONSTRUCTION TYPE: JN _ Sq Foocaje $Per Sq Ftg Basement x _ lst Floor x _ 2nd Floor x = Garage x _ z = TOTAL Estimated Construction Value: $ 1 1, Ooo � Inspections Required: `Vork Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection D� Footing ` Septic Sewer Connection _�Framing Fireplace Lawn Irrigation Lnsulation (Masonry) O[her `Vall Boazd (Mfg.) Well (State Permit) �_Final Grading/Filling Electrical (State Permit) Other RENIARKS(Pi 1 HOUSE): . --------------------------------------------------------------------- REV�W BY OTSERS: DATE: Access: Existing New . Access Approval: Date By; ��------------------------------------------------------------------------------------------------------ RENLARKS (TO BE NOTED ON PERiI�IIT�: � . �iY.'.., .. 8 . , _ ^�'� -- � . � ��.��. � �� ` �. y r 'r il /�, /, / / � � � s� �25°�o , , o� ��,��. � �,q 0 8. � -�5 - �'S ; . .., � �.�.�,�.,�.�L � / , ;� ��`�` �� j�� , {h�-,, ;.k � � „ �o, �. �,� u,��4 . � ..�!'S _ . . ,.. , _._C�C� � � ,�` ��i � .� i .. ' 'J�/� .Gi . ` -..�._-__._.. "� .... r . . . . .. . . � 6S'!; k !� �V �' � �,�t�_— � rp».rr..,.w""". . ��''8Z' / ' � I Z`��V , � ��'t � .,.....�,� ti w � � � � � - - '- ��- �, `� z � "` . _ � �, � __.._ , �- - -- � � �,o� ` ,/ a � ,.,�,' � � vO� ;-�: ., � >_.,:;.� � � S .,,� #;, , � � o V, . _ I-�4. 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TELEPHONE NO. f�Z' �7�0 �O �,1� � DESCRIPTION � � ��C� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 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 Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 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 ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. i-� pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALLINSPECTOR C INSPECTION REQUIRED.CALlTO ARRANGE ACCESS. Call for the ext inspection 24 hours in advance. (J52) 249-4600 OwnerlContr site: Inspector. - White Copyllnspector's Fi Canary CopylSite Notice ''� D TE TIME CITY OF ORONO � � � INSPECTION NO CE DULED �� PERMIT NO. � COMPLETED ADDRESS c OWNER <��tllll � ��CONTR. TELEPHONE NO. � �� " 3�� 3 �'�O � DESCRIPTION �� :�� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 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 COMPII>INT v 07 DEMO-FINAL 15 SEPTiC INSTALL. 22 FOLLOW-UP Q = 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 � � O � � O � W � Q � 2 W � W � � d W WORKSATISFACTORY:PROCEED � PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETIJRN ❑STOP ORDER POSTED.CAIL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlCont�rctUr 1site: Inspector. �� White Copyllnspector's ile Canary CopylSite Notice DATE TIME CITY OF ORONO / CALLED IN �/_ � ,s �(� INSPECTION NOTICE n ,� � SCHEDULED �� ' ' " '�D PERMIT NO. �� COMPLETED ADDRESS �LI �� . /`�O�� i'�"i�".� OWNER �Ks� ��fl�3z� CONTR. TELEPHONENO. �7� —��II � DESCRIPTION F�►e-�L. l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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-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: a i �P� � 5 G- � � � C��G�� G� � � 0 � w � Q � z w � W � j d W .Cl WORK SATISFACTORY:PROCEED C PROJECT COMPLETE � C_1 CORRECT WORK&PROCEED = ISSUE CERTIFICATE OF OCCUPANCY W � C7 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT Cl CORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN INSPECTOR WILL RETURN Cl STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 OwnerlContractor n ' Inspector. Whiie Copyllnspector's File Canary CopylSite Notice