HomeMy WebLinkAbout2008-P11784 (add/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: P11784
Crystal gay, Minnesota 55323 Pel'I711t Typ2: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
1/15/2008
SITE ADDRESS: 1513 Bay Ridge Rd Unit#
Wayzata,MN 55391
P��� 10-117-23-34-0008
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Addition/Remodel/Re air Permit Sub-type(s): Addn/Remodel/Repair
Permit Type: P
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
Basement&Bathroom Remodel '
FEE SUMMARY: PermitFee: $ 324.50 Valuation: $ 18,500.00
Plan Review Fee: $ 210.93
State Surcharge Fee: $ 9.25
TOTAL FEE: $ 544.68
APPLICANT: GustafsonRemodellnc. OWNER: RobertSnyder
13816 54th Avenue 1513 Bay Ridge Rd
Plymouth, MN 55446 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.
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APPLICANT P� ITEE SIGNATURE ISSUE BY S[GNA'fUR[i
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-SepTic) Page 1
1 ����
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- Total Fee: $ 5`�� �op Date Received: r^`3�bB
Entered By: Permit#: i9 /!7��{
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 C�ONTRACTOR �
_
JOB SITE ADDRESS: / �r � �� �� � ziP:
Will this be a Paratfie of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �'�10 If yes, a special event permit is reguired with Police Department and Ciry Council approval
60 days prior to the event. Shuttle bus service will be��equired unless applicant demonstrates
sufficient on-site parking is available. Non-permitted events will not be allowed.
NAME OF OWNER: ��e�`T" ��~�� ����-
� �`p}'�r�. PHONE: (home)��'S�:z'—,�a�-
(work)`
MAILING ADDRESS: ✓�J 3 �-�j -,�--���.�ITY: ��,��.osc� ZIP:
:-, `
CONTRACTOR: 1-�-�s�.� �`��c+�-a� PHONE: ��.- ��� �2..E,dF'
__.
CONTACT PERSON: �r�� -. �=�-srrn-�.,��OBILE/PAGER: �� �i ?v,���-,3
MAILING ADDRESS: s' �'/� �5�`"� �:__ _ CITY: ��G:;,-�ZIP: �g�'"�y�
STATE LICENSE: # ���v ,�'�= EXPIRATION 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(describe in detai�: ��.�,�,,. �- ��-�-�,,�� ������
STORIES: j SQ.FEET OF EACH FLOOR: ��'�
NO. OF BEDROOMS: �, - GARAGE STALLS: ATTACHED� DETACHED_
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �� s�• �
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City and with the State Building
Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be
in accordance with the approved plan. �
s,=, �_� � �r_;��y;��� �.
APPLICANT'S SIGNATURE: �� `r � T�`J DATE:
31
Sec.13.04 RIGHTS OF SLIBJECTS 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 confidential data concerning himselfshall be
informed of` (a)the purpose and intended use of the requested data within the collecting state agency,pol itical subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or property tax refund
instructions mstead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of
stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of
stored private or public data on individuals shall be shown the data without any charge[o him and,if he desires,shall be informed of the content and
meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to this secticn 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 ofthe data. The responsible authoriry
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date ofthe 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 wi[hin which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describingthe nature ofthe disagreement. The
responsible authority shall within 30 days either (a)correct the data found to be inaccurate or incomplete and a[tempt 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 shail be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the resoonsible 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 ofdata",we would like to inform you that your request
for a pern�it or license from the City of Orono ar any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
First Middle LHst
Address
City State Zip Phone
I understand my rights as stated above.
Sihnature
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CHECK OFF LIST FOR ISS UANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I � I� �A�l � u �
PID:
DESCRIPTIDN OF WORK: �/ q- �.h �„�(,�,�,�r„� �,
ZONING REVIEW BY.• �� ,�,� y� DATEAPPROVED: /7 A / 7/O�J
BUILDING REVIEW BY.• _ DATEAPPROT�ED: t-�o -o�
FEES TO BE CHARGED: Misc. Fees Calculated By: � ����'� �r
PERMIT Yes � No
PLAN REVIEW Yes t� No SEWER CONNECTION
STATE SURCHARGE Yes f No WATER CONIVECTION
INVESTIGATION FEE Yes No� PARK FEE
SAC Yes No_� SIT�INSPECTION
Number of SAC Units OTHER (spec�)
ZONING CHECIC LIST Zoning District: /V O ���� ��� � � '-'��____
,
Fire Department: Post�ce: _ ool District:
Lot A��ea: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
F�ront(Lake): Right Side:
Rear(Streel): Left Side:
Adjacent Structures: Wet and:
Building Neight: Def. Hgt. Pea Hgt.
Lot Coverage:
Grading: StaffApproval Date: By.• Council Approval Date:
Septic: StaffApproval Date: By.�,�f, l��
Zoning File: # Resolution: # Resolution Date:
Shoreland District: MCWD Permit:
Avg. Setback: BluffSetback. LotCoverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcove�• Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
33
BUILDING REVIEW CHECK LIST
UBC: 12• 3 CONSTRUCTION TYPE: �N
Sq Footage $Per Sg Ftg
Basement x =
Ist Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 1 Sa.S pc�°—`�
—r
Inspections Required: Work Requiring Separate Permits:
Site _ !�Plumbing Fire
Hardcover Removal _ c 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(INHOUSE):
RET�IEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARXS (TO BE NOTED ONPERMIT):
34
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� TELEPHONE N0. �O�a D,� 3
� DESCRIPTION r��� �c// /"'�"�r �P ����5
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
� ❑ 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
Q ❑ 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
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W ORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CQRRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor on site:
Inspector. 1�� �� � �
White Copyllnspector's Fite Canary CopylSite Notice
DATE TIME �/
CITY OF ORONO CALLED IN
INSPECTION NO IC J�' SCHEDULED �� �'�
PERMIT NO. l��" COMPLETED '
�_
ADDRESS �� �
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
lL �01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
�COZ�FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
Q43 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
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cal{for the next'nspection 24 hours in advance. �952� 249-460�
OwnerlContrac_� t :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
�� � DA E TIME �
CITY OF ORONO CALLED IN ����
INSPECTION T CE SCHEDULED �-- �� �D'��
PERMIT NO. COMPLETED
ADDRESS �,'���_� �� �(,�.� �
OWNER CONTR. ��5�� ���
TELEPHONE NO. �P �� �D� ��C�,3
� DESCRIPTION �
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O ❑ 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 ❑ SEPTfC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FiNAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the ne inspection 24 hours in advance. (g52) 249-46��
OwnerlContr r �s e:
Inspector. -
White Copyllnspector's File Canary Copy/Site Notice