HomeMy WebLinkAbout2005-P08897 (building- kitchen remod.) � �
PERMIT
CITY OF ORONO Permit Number:
2750 i�elley Parkway- PO Box 66 P08897
Crystal Bay, Minnesota 55323 Permit Type:
Addition/Remodel/Repair
(952) 249-4600 Date Issued: 7/27/2005
SITE ADDRESS: 3703 Casco Ave Unit#
Wayzata,MN 55391
PID: 20-117-23-31-0004
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit T e: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
YP
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Electrical(state) Other-(Deck NOT INCLUDED on this permit)
NOTICES/REMARKS:
Kitchen Remodel-Replace Pemut P06990 never used
FEE SUMMARY: Pernut Fee: $ 23.50 valuation: $ 0.00
Plan Review Fee:
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 24.00
APPLICANT: Owner/Self OWNER: John&Cynthia Klick
� 3703 Casco Ave
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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ATrLICANT P-E I'�EE SI ATURE ISSUED BY SIGNA'IURE
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Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
� � ���e 6�r-a� �D 6 99a -N�u� ��,
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Total Fee: $ � � �� � � �"�7 Date Received: b-�'�-�
Entered By: � �j,� ` Permit#: �{'d,��t
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CITY OF ORONO - BUILDING PERMIT APPLICATIQN
All information must be submitted in full before plan review will be started.
(please pri�zt all infor'i1ZQf1031�
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THE APPLICANT IS: (circle one) OtiYN�R OR CO�TRACTOR
JOB SITE ADDRESS: 3 ��'3 ����'� �� z�r: �s -�� (
Will this be a Parade of Homes, RemodQlers Showcase Fiome or other Display Home?
❑ YeS ❑ No If yes, a special eve�zt permit is required witli Police Depai•tmerlt and Cr.ty Council approval
60 days prior to the event. Shzrttle birs se�vice will be reqtrired z�nless applicanl demonstrates
sz�cient on-site par�-ing is available. Nor�Permitted events will not be allowed.
NAME OF OWl\TER: ���,�..� ���� C:� PHONE: (home)�S "L '�7 I —O`_���
(work) �S Z�1�1 i — �Z 5 z—
N1AI�..,ING ADDRESS: 3��o� �o:�,�c� �<-,Q._ CITY: �,-����� ZIP: �i
CONTRACTOR: _ �o� PHOi�"E: (�� Z�'3Z� � �3�`�
CONTACT PERSON: -�-� MOBILE/PAGER: S p�v.� �S �.
MAILINGADDRESS: ���(,; ��rr,(2 �.,re_ t CITY: �����t�� ZIP: "(/41 �J f
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: ��� 1�=��� ,r�-- PHO\TE:
MA�LING AD�IZESS: CI'i Y: ZIP:
NA�i�: �2EGISTRATION: #
i.
TI'PE OF WORK: New Addition `' ' Accessory Structure
Move Home Remodel/Alteration �_
PROPOSE���OJ[�(describe in detail�: 1�-�" �-��.-e_ ��^c�c�C��
S�'�RIES: Z- SQ.��-��'O��,:�CI�I��OOR: �r-�UO
I�O. OF �EDItOOi�IS: 3 �A��E S'TA�,L,S: A'T'TAC�I�'�3� DET'�C�-IEI�_
ES'I'IyI4'TEi� COIVS'i'�2UCTIOl�VALIJ�1'I'ION(excluding lancl): $ ��� �
I hereby apply for a bui?dina permit and I acknowled�e that the information above is complete and accurate;
that the work�vi11 be in conformance with the ordinances and codes of the Ciry and with the State BuildinQ
Code;that I understand this is not a permit and work is not to star without a permit;and that the work wi11 be
in accordance with the approved pian.
APPLICA:�T'S SIGNATURE: DATE: � Z `
�1
. ,
, , +
Sec.13.04 RIGHTS OF SIIBJECTS OF DATA
Subd. 1. Type of data. The righ[s of individual on whom the data is stored or to be stored shall be as set fortlt in this section.
Subd.2. Information required to be given indi��idual.An individual asked to supply private or confidential data conceming hin�self shall be
informed of: (a)the purpose and intended use of[he requesced data within the collecting state agency,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 supplying or refusing to supply
private or confidential daca;and(d)the identity of other persons or entities authorized by state or federal law to receive the daia.This requiremen[shall
r,ot apply when an individual is asked to supply investigative da[a,pursuanc to section 13.32,subdivision 5,to a law enforcemen[officer.
The commissioner of revenue mav pllce the notice required under this subdivision in the irdividual income ca�or nropertv tax_refund
instructions inseead of on those ferms
Subd.3. Access to data by individual. Upon request to a responsible authority,an individuzl shall be informed«�hether he is the subject of
stored data on individuals,.and whether it is classified as pubtic,private or confidential. Upon his fur[her requzst,an individual who is the suojece oi
srored private or public data on individuals shall be shown the data widlou[any charge to him and,if he desires,shall be informed of�he content aad
meaning of that data. After an individual has been shown the pnvate data and informed of its meaning,the data need not be discloszd[o him for s��
months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individua!has been collected or created. The
responsible authority shall provide copies of the pnvate or pubGc data upon reques[by the individual subject of the d2fa. The responsible authority
may require the requesting person to pay the actual costs of makin;,certirying,and compiling the copies.
The responsible authority shail comply immediately,ifpossible,wi.h any requzst made pursuant to this subdivision,or�vi:hin fi�;e-days oF
the date of the reques[,escluding 5aturdays,Sundays and leeal holidays,if immediate compliance is not possibie. ff he cannot comply with the requesc
wi[hin that time,he shall so iniorm�he individual,and may have an additional five days widiin tvhich to cocnply with the request,excluding Sacurdays,
Sundays and legal holidays.
Subd.4. Procedure�vhen data is not accurate or comp!zte. An individual may contest the accuracy or comple[zness of public or piivate da[a
concemine himsel£ To exercise this right,an individual shatl notify in wtiting the responsiblz authority descnbino[he nature of the disagreemenc.The
responsible authority shall wi:hin 30 days ei[hec (a)con�ect the data found to be inaccurate o:incemple�e and attempt to notify pas[recipients o`
inaccurate or incomplete data,including recipients named by[he individua(;or(b)notify the individual!hat he believes the datz to be correct. Data in
dispute shalt be disclosed on(y if che individual's seatement of disa�reemen[is included wich[he disclosed data.
'The determination of the responsible authority may be appealed pursuxnc[o[hz provisions of the administrative procedure act rela!ing to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04,Subd.2;"Rights of subjects oi data",we would like to infoml you that your request
for a permit or license from the City of Orono or any oi its departrnents may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to determ.ine your qualifcation for the pern�it or licease
requested.
2. You may refuse to supply data,but refusal may require that the City deny the pe:mit or license.
�. The information may be sha:ed with otner local, state or federal agencies to the extent necessary to
process the perniit or Iicense.
4. If your�equested permit o:license requires Council action to approve, some infomlation may become
pub lic.
5. You have certain rights under M.S. 13.04(available upon request) to revie�v private data on yoursel_`.
6. Y our full name is required to process this applicatien or pzrmit.
First t�Iiddle Last
��a�,. � ��` � � —
Address
3����� c� �s�� � � ,���� �u w1 � Sss� r
C�h, State Zip Phone
�52 ,,(7 l -os��
i unders � 'b tated above.
Signature
32
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CHECK OFF LIST FOR ISSUANCE OF PERI�IITS
FOR OFFICE USE ONLY
ADDRESSORLEGAL: 37 03 CAsW i4v�a
PID:
DESCRIP'TION OF WORK: �,pDi n�n� ��o,rc.
ZOVT�i tG REVIE`V BY: DATE APPROVED: �-Z y•o s
BUII..DING REV�`V BY: DATE APPROVED: �-21•05
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ,,/ No
PLAN REVIEtiV Yes ✓ Na SEWER COiVNECTION
STATE SURCHARGE Yes _yG No WATER CONNECTION
INVESTIGATTON FEE Yes No PARK FEE
SAC " '' ' ` �� ""' Yes No " ' SITEINSPECTION
Number of SAC Uruts��' OTHER (specify)
------------------------------�---------------------------------------------------------------------------------------
ZO�tI�IG CH�CK LIST Zoni.ng District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes �_ No Date of Survey: zo 03
Proposed Setbacks:
Front (Lake): S� � Right Side: Zv �
Rear (Street): �oo � f Left Side: Z�,�
Ad;acent Structures: �//v4 Wetland: � /✓�
Building Height: Def. Hgt. — Peak Hgt. —
Lot Coverage: U� k
Grading: Staff Approval Date: — By: Council Approval Date:
Sep[ic: Staff Approval Date: — By:
Zoaing F:ie: {t ' Resolution: # Resolution Date:
Shoreland District: /�)'J
Avg. Setback: Bluff Setback: I.ot Coverage:
E�istin� Proposed
b
Hardcover: 0-75'
7�-250'
2�a-500'
500-1600'
Hardcover Variance Required: Yes No Date of Council Approval:
RE�IA_RI�S (in house):
�
- . �
BUILDING REVIEtiV CHECK LIST
�C� R'3 CONSTRUCTION TYPE: �J/�
Sq Footage $ Per Sq Ftg
Basement x _
lst Floor z
zna r�oo� R _ N_--°r�'`-----
Gazage z = ��P�rh� r �`yfd w�s �ss�e�
x = v N I�-Z�f• 0 3 i¢,vO .�r�.t D�J'e�-7'
W q S No T p o Nt r}'+" `f�-r �-�a.�A
TOTAL
7!� ��'• Gun�ST. ��t(u-� w�5��t0.oaa
Estimated Construction Value: $���00 ��
Inspections Required: Work Requiring Separate Permits: n . ,.:. .�.- --_o
Site _�Piumbing Fire
Hardcover Removal Mechanical Water Connection
Footing ` Septic Sewer Connection
_�Framing Fireplace Lawn Irrigation
X Insula[ion (Masonry) Other
_�!Wall Board (Mfg.) Well (State Perm.it)
—�F�� Grading/Filling �Electrical (State Permit)
Other
REI�IARKS (I'�i 1 HOUSE): � �
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REVIE�V BY OT�IERS: DATE:
Access: Existing New
Access Approval: Date gy;
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REI�IARKS (TO BE NOTED ON PERII�IIT): 1�i;u� --I�r a; r•v c w✓���o t�N /�c:-7�'wt r i
8
� r,q� / <
C� � A TIME �
CITY OF ORONO CALLED W ��
INSPECTION N ICE SCHEDULED �
PERMIT N0. �� g � COMPLETED
ADDRESS L3 7 D3 �/�-� ��� �
OWNER CONTR. L.-
TELEPHONE NO. �'�2��-7 ��— �J���'
� DESCRIPTION 7'r /��-� '�� ��� � /C�'/��
�
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WEfLANDS
�
O 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING RI 23 SEP IC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED fl PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
W
O ��RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V � BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46�0
OwnerlContractor o 'te:
Inspector.
White Copyllnspector's le Canary Copy/Site Notice