HomeMy WebLinkAbout2003-P06817 - attached deck ITY F R N PERMIT
C O O O O
2750 Ke;ley Parkway - PO Box 66 Permit Number: Po6ai�
Crystal Bay, M�innesota 55323 Per'mit Type: Addition/RemodevRepair
(952) 249-4600 Date Issued: 9�2a�2oo3
SITE ADDRESS: 1223 Brown Rd S
Wayzata,MN 55391
PID: 10-117-23-31-0065
DESCRIPTION:
Proposed Use: Residential
Buildin Census Code 434
Pernut Class: g
Permit Type: Addition/RemodeURepair Pernut Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
�--�- �---� �—�---�- -_, :- ---- --�----�-------�
FEE SUMMARY: PernutFee: $ 111.25 Valuation: $ 4,300.00
Plan Review Fee: $ 72.28
State Surcharge Fee: $ 2.65
TOTAL FEE: $ 186.18
APPLICANT: Midwest Turf OWNER: Curtis Quady
1251 Brown Rd S 1223 Brown Rd S
Wayzata,MN 55391 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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A LICANT PERMITEE SIG ATURE SSUED BY SIGNATURE
Cooies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
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Total Fee: $ Date Received:
Entered By: Pernut#:
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information) �
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THE A.PPLICANT IS: (circle one) OWNER OR CONTRACTOR
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JbB SITE ADDRESS: l.�� T� c✓�� ZIP: .s� 3��
/��`� ✓JCUL✓ / )i� J'
NAI�iE OF OWNER: PHOiVE: (home)
. (work)
MAILING ADDRESS: CITY: ZIP:
�s � - y��- 7�/�
CO�'TRACTOR: ��'1,��.,� �- �„�' Pxo�:. �ia - 3� 7- y.�y�
CO`�TACT PERSON: r�, NIOBILE/PAGER:
NLAII.ING ADDRESS: /� �'/ ,�s'.�,�,.r �7�/ I CITY: �-,J, - � ZIP: �s�/
ST�T'E LICENSE: #
•.ARCHITECT/ENGINEER: PHO�TE:
MAII.,I�i TG ADDRESS: CITY: ZIP:
NA�I�IE; REGISTR.ATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration� Land Alteration
PROPOSED WORK(describe in detai�: /�P,y,�t.� �.�.� �z-��<<P r�'S�s �'—���
STORIES: SQ. FEET OF EACH FLOOR:
1�'O. OF BEDROOMS: � � GARAGE STALLS: ATT. DET.
c�J
EST�IATED CONSTRUCTION VALUATION (excluding land): $ ��U�� �
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
perm.it; and that the work wiR be in ac rdance with th roved plan.
APPLICANT'S SIGNATURE: �,.J L DATE: �7 �y ��
NOTE! Parade of Homes events require separate permit approval by Police Department and
Cily Counci160 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 given indiridual. An individual asked to supply private or co�dencial data concerning himself
shall be informed of: (a)the purpose and inrended use of the requesred data within the collecting state agency,poliacal subdivision,or stacewide
system;(b)whether he may refuse or is legally required to supp(y che requested data;(c)any Imown consequence arising from his supplying or
retusing to supply private or confidendal data;and(d)the idendry of other persons or entiaes authorized by srate or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigaave data, pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
'Ihe commissioner of revenue mav lace the notice re uired under this subdivision in the individual income taz or ro ertv tax refund
instrucrions instead of on those forms.
Subd. 3. Access to data by indiridual. Upon request to a responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuais,and whether it is classified as pubiic,private or co�dendal. 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 to him and, if he desires,shall be informed
of rhe content and meanin�of that data. Afrer an individual has been shown the private data and informed of its meaning, the data need not bz
disclosed to him for six months thereafter unless a dispute or acaon pursuant to this section is pending or addicional data on the individual has been
collected or created. The responsible authoriry shall provide copies of the private or public data upon requesc by the individual subject of the data.
The responsible auchority may require the requesring person to pay the actual costs of making,cerdfying,and compiling the copies.
The responsible authoriry shall comply immediate(y,if possible,with any request made pursuan[to this subdivision,or within five days
of the date of the request,exciuding Saturdays, Sundays and legal hofidays,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 addirional 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 dara conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing the�ature of the
disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to bz inaccurate or incomplete and attempt to notify
past recipients of inaccurate or incomplete data,inctuding recipients named by the individual;or(b)noafy the individual that he believes the data
to be correct. Data in dispute shal]be disclosed only if the individual's statement of disagreement is inctuded with the disclosed data.
The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the administradve 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 ocher local, state or federal agencies to the extent necessary to
process the pemut 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
Last
Address
C�n' State Zip Phone
I understand my rights as stated above.
Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
AnDRESS OR LEGAL: / �Z� �3/��,,,� /�,,y,� S
PID:
DESCRIPTION OF WORK: (��LK ,Z.�,�Pt�lcc nn�-�
ZOtiTi 1G RE'V�W BY: DAT'E APPROVED: 9-Z y- 03
BUII.DI�i TG REV�`V BY: DA'TE APPROVED; S-Z�- aS
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning District: (7•�C p�C N.C,,
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres idth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Righ[Side:
Rear (Street): Left Side:
Adjacent Structures: Wetl d:
Building Height: Def. Hgt. Peal: gt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland Disuict:
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). jo f ll�-D t..= L���- �J c:G(� [,� ��� 24�� i.S
/� ivo.r c�=N c2oa� i-t w��/T
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BUII,DING REVIEW CHECK LIST �
�C' �`�J' CONSTRUCTION TYPE: V�
_ Sq Footage $Per Sq Ftg
Basement x _
lst�loor x _
2nd F1oor x _
Garage x _
x =
TOTAL
Estimated Construction Value: $ �/�S Up �
Inspections Required: �Vork Requiring Separate Permits:
S ite Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing ` Septic Sewer Connection
_�Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
—�-F�� Grading/Filling Electrical (State Permit)
Other
REMARI�S(IN HOUSE):
------- ----------------------------------- ---
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date BY:
-----------------------------------------------------------
RE11'1ARKS (TO BE NOTED ON PERivIIT�:
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KEEP THiS PLAN SET ON 81TE AT ALL TIP7rES` _ ' --- •-�--��-- ----- �
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Op�1
" DATE TIME
CITY OF ORONO CALLED IN g�Z�
INSPECTION TIC SCHEDULED -�3 �
PERMIT NO. COMPLETED
ADDRESS �aa 3 /� S �
OWNER CONTR.
TELEPHONE NO. �O�Z .3�7 �3�7
� DESCRIPTION F�l/V`�� � ��Gl�
� 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
Z0 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 5 INAL 14 SEWER HOOK-UP 06 PROGRESS
� EMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
`� 7 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL ,- 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL ��� 36 FOUNDATION/REMOVAL
� OWNERlCONTRACTOR TO MEET YOU:_YES"NO
� COMMENTS: �
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALI INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46��
OwnerlConUacto�n it :
r '
Inspector.
White Copylinspector's File Canary Copy/Site Notice