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Home My WebLink About2004-P07353 (add/remodel/repair) � PERMIT CITY OF ORONO Permit Number: �'750 Kelley Parkway - PO Box 66 P07353 Crystal Bay, Minnesota 55323 P2fCTllt Typ@: Addition/Remodel/Repair (952) 249-4600 Date Issued: a�2�2o04 SITE ADDRESS: 1525 Bay Ridge Rd Wayzata,MN 55391 P I D: 10-117-23-34-0009 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Construction Type VN Census Code 434 Pernut Class: Building Permit Type: Addirion/Remodel/Repair Permit Sub-rype(s): Building Undefined DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: T_"""___." _"_ T__�C�"]_ FEE SUMMARY: Permit Fee: $ 69.25 Valuation: $ 2,000.00 State Surcharge Fee: $ 1.50 TOTAL FEE: $ 70.75 APPLICANT: Mark Peterson OWNER: Bob Mack 2341 Shadywood 314 Buchanan NE Wayzata,MN 55391 Minneapolis,MN 55413 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. , �' ,... �r� �, p , -� ° � ' .C�o�t' �7a.�. ,��-�. c� C�_ � � - 1- 1- APPLICANT P iRMITEE SIGNATURE ISSUED BY SIGNATURE Copies: 1-File(SiQnitures Repuired). 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 ! �-�7��s�a-�✓ Total Fee: $ �(7. `]� Date Received: � Entered By: ,,��2 Permit#: � �� 7 '�� j CITY OF ORONO - BUILDING PER�fIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) -------------------------------------------------------------�---�------ ---------------------------------- --- THE APPLICANT IS: (circle one) WNER�R CO�iTRACTOR �- JOB SITE ADDRESS: � .� �; s:" t'> �=a',✓ 1�. � �J C� �: ZIP: �" � `=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 approval 60 days prior to the event. Non permitted events will not be allowed. NAME OF OWNER: �t U��C:. � \. 1� b4 E:.,L� PHONE: (home)��i-'�7 r��' ��' �"`'�'=�` (work) _� 1�,� ��-3" 9�$v MAILING ADDRESS: � i �l �L/ t;,�-{ !�1\S�4.tt N L� CITY: ��S� �'. ZIP: S�_S�A lo CONTRACTOR: `,;� .?�_ �L ti �:.��; � t� PHONE: , � >1 �+ -� � �� ,. `�' CONTACT PERSON: _1�� f� � ,� � c <<�c�:S�� MOBILE/PAGER: ;��.,_z�� -7�; �;_- MAILING ADDRESS: �?.��; � �t l ��t�3`t ��j;�:>,.,, CITY: �,�,/�' ZIP: �S� s�� STATE LICENSE: # ARCHITECT/ENGINEER: '- PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Accessory Structure Addition 11�1o�-e RemodeUAlteration k Land Alteration PROPOSED WORK(describe in detai�: � r� ;�� - �� r �- .� Z" `� ; � � STORIES: = SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: �_ GARAGE STALLS: ATT. �.� DET. C'JV'" " ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 2 ;�� 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 pernut and work is not to start without a permit;and that the work will be in accordance v��ith the approved plan. APPLICANT'S SIGNATURE: DATE: Sec.13.04 RIGHTS OF SUBJECTS OF DATA � Subd.1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agencr�,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 supplyio;or refusing to supply private or conf 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[o supply investigative data,pursuant to section 13.82,subdi�ision 5,to a law enforcement o�cer. The commissioner of revenue mav olace the notice reauired under this subdicision in the individual income tar or oropertv tax refund instructions�nstead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authority,an indi��idual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private orconfdential. lipon his turther request,an individual�ho is the subject of stored private or public data on individuals shall be shown the data without any charge to him and,ii he desires,shall be informed of the content and meaning of that data. A[ter 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 oo the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,itpossible,with any request made pursuant to this subdivision,or H ithin 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 comph 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 authorin describing the nature o[the disagreemenL The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or iornmplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act relating to contested cases. DATA PRIVACY ADVISORY In accordance with 11�I.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data,but refusal may require that the City deny the permit or license. 3. The information may be shared with other local,state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under M.S. 13.04(available upon request)to re�zew private data on yourself. 6. Your full name is required to process this application or permit. First Middle Last Address City State Zip Phone I understand my rights as stated above. . Signature CHECK OFF LIST FOR ISSUANCE OF PERMITS , FOR OFFICE USE ONLY � ADDRESS OR LEGAL: I S Z S �3 A y i 2►,��C�� bo9-Q PID: DESCRIPTION OF WORK: �},(�p�-r�n� o i= �J 0(?�t,r0,�,S ZO.vI�1i G REVIEW BY: DATE APPROVED: �- /- oy BUII.DING REVIEW BY: DATE APPROVED; �- � -a y FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes f No PLAN REVIEW Yes No 1/ SEWER CONNECTION STATE SURCHARGE Yes �� No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No STTEINSPECTION Number of SAC�Units OTHER (specify) ZONING CH�CK LIST Zoning District: W c� C <�� Fire Department: Post Office: School Districr. � Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Right Side: Rear(Street): Left Side: Adjacent Structures: W land: Building Height: Def. Hgt. eal:Hgt. L.ot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic; Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setback: L.ot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 BUILDING REV�W C�CK LIST �C� /` 3 CONSTRUCTION TYPE: �N _ Sq Footage $ Per Sq Ftg Basement x _ lst Floor z _ 2nd Floor z = Garage x _ x = TOTAL Fstimated Construction Value: $ Z,o0 0 °O Inspections Required: `Vork Requiring Separate Permits: S ite Plumbing Fire Hardcover Removal Mechanical Water Connection FO°��g Septic Sewer Connection _,�Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Boazd � (Mfg.) Well (Scate Permit) �` F�� Grading/Filling Electrical (State Permit) Other REMA.RKS(IN HOUSE): . ------- ------------------------------------------- REV�W BY OTHERS: DAT'E: Access: Ezisting New Access Approval: Date By: ------------------------------------------------- ---- REI�Zr�RKS (TO BE NOTED ON PERi�: 8 �� q,D E / TIME � CITY OF ORONO CALLED IN 7 ��`�—� INSPECTION NOTIC.E�j SCHEDULED � PERMIT NO. �� l,�� COMPLETED ADDRESS �`�J�� 2��"Y�� K.L�/ OWNER�,��_� CONTR. LEPHONE N0. � � � � � � �� '�• PTION � 01 FOOTING 11 MECHANICALRI 18 EXCAV/GRADING/FILLIN6.�ur y 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS�', {� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMUVAL � Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP O6 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:_ S_NO � COMMENTS: � `� � P O`?��1 � � �I �.� � p �- 0 � � � �� w� � � � Q z-- o ~c. � r�r— vt�l� �-- Wu l� G u� (�S`�"�� v� �� S� C'�Nti ��'E3� I 1 IVll�i � _ � a W ❑ RK SATISFACTORY:PROCEED C� PROJECT COMPLETE � . CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. C PHOTOTAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALI INSPECTOR ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor o site: Inspector. ~ White Copyllnspector's ile Canary CopylSite Notice �D /3�.� �""� �V�C� T �"� "' T�E • ! ; CITY OF ORONO A IN �� C LLE� INSPECTION NOTICE SCHEDULED ' � PERMIT NO. COMPLETED ADDR SS �5a5 NER �FR.��/�� TELEPHONE NO. �� C1 3 �l) d (P � DESCRIPTION (� � � r-(�`-� � 01 FOOTING 11 MECHA I AL RI 18 C V/GRADING/FILLING Q 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 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 � OWNEHICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: W � �� o� �e,� � ��,� � 0 � � �� ° � � wes � o ��i W +�� i Q �`+� � l � �� O \�i � � y l ` c C+ �l "1' � u (� � ` f w � � � �G 0. � a � K s r� ��C.S � Y�t' � ❑WORK SATISFACTORY:PROCEED [7 PROJECT COMPLETE W ❑CORRECT WORK&PROCEED �-; ISSUE CERTIFICATE OF OCCUPANCY O �CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for ihe next inspection 24 hours in advance. �95Z� Z49-460� OwnerlContra on ite: Inspector. ��- White Copyllnspector's File Canary CopylSite Notice