HomeMy WebLinkAbout2006-P10301 (add./remod./repair) PERMIT
CITY OF ORONO Permit ►vumber:
2750 K��fey �a'rkway- PO Box 66 P10301
Crystal Bay, Minnesota 55323 Permit Type:
(952) 249-4600 Addition/Remodel/Repair
Date Issued: 9/19/2006
SITE ADDRESS: 3135 Casco Cir Unit#
Wayzata,MN 55391
PID: 20-117-23-43-0029
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: Electrical(state)
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NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 657.75 Valuation: $ 51,450.00
Plan Review Fee: $ 427.54
State Surcharge Fee: $ 25.75
TOTAL FEE: $ 1,111.04
APPLICANT: Doug Dzurik Construction OWNER: Milo&Audrey Thompson
12855 Hwy 55 3135 Casco Cir
Plymouth,MN 55441 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 PERMITE GNATURE ISSUED BY SIGNATURE
Copies: 1-File(SignaturesReguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page l
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Total Fee: $ e � Date Received: g-�'-�vU (p
Entered By: �'`�� Permit#: A /D3 C� (
��� CITY OF ORONO - BUILDING PERMIT APPLICATION
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' All information must be submitted in full before plan review will be started.
�� (please print all information)
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THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR �
JOB SITE ADDRESS: .3(3� � -,CI ��i ` �'✓�C l P ZIP: J��.3�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �NO !f yes, a special event permit is required with Police Department and City Counci!approva!
60 days prior to the event. Shuttle bus service wi![be required unless applicant demonstrates
su�cient on-site parking is available. Non permitted events well not be allowed.
NAME OF OWNER: '�'✓1,'�� �,p�m PHONE: (home)
�+� (work)
MAILING ADDRESS: ���jS �LSCU C;f��_ CITY: ��r��tC ZIP: S�� �� �
CONTRACTOR: �� �.0✓'� PHONE: (p��-�7� / -���/
CONTACT PERSON: 1 MOBILE/PAGER: fol�Z-��l -��=l��' l
MAILING ADDRESS: ' � CITY: �,� ZIP: ��J'7
STATE LICENSE: # �Z - EXPIRATION DA E: �3f 3/�C%7
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel, lteration ie: Siding, Windows)
PROPOSED�VORK(describe in detai : �1'1 LQ.✓ -� � • � p d" � ' ry���
�v'��n�O�Do r° ��� �� rc?�+1 � �2 f�' ' � Ct �' ' �vC M'J 6�iSl�s
� 7�z �Zx�S i��� fd��;��- �e�-z� c�, I.�`r'�
STORI�: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
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ESTIMATED CONSTRUCTION VALUATION(egcluding land): $ .�/ '�5�
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.
APPLICANT'S SIGNATURE: � � . � � ATE: � ��
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31
J Sec.13.04 RIGH'fS 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 conceming himself shall be
informed of. (a)the purpose and intended use of the requested data within the collecting state agency,political subdivisioq or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known wnsequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities authonzed by state or federal law to receive the data. This requirement shall
not apply when an individuat is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue may_place the notice required under this subdivision in the individual income tax or proper[v tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infortned 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 to him and,if he desires,shall be informed of the content and
meaning of that data. After an individual has been s4own 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 on the individual has been wllected or created. The
responsible authoriry 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,if possible,with any request made putsuant 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 accwate or complete.An individual may contest the aocuiacy or completeness of publ ic or private data
conceming himsel£ To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe disagreement. The
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individua►that he believes the data to be wrrect. 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 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 fumish certain private or
confidential information.
You are notified that:
l. 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 rmit.
J �C� / �(J{ �,�
First Middle Last
17��J /l�i+a.�C�2�'l� /l� .
Address
��,��� �l� -�-5 y�/ � �l� ��� ��-3/
City State Zip Phone
I understand my rights as stated above.
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Reset Form 32
CHEC� OFF i,IST FOR ISSUAI�tCE ��F PERiI�IITS
� � FOR OFFICE USE ONLY
ADD�tESS OR LEuAL: 313 S G�sc� c. � ,z c-� _
PID:
JDES CRIP1'ION OF W ORK: ►Z�. ►tiw rJ t�z / �L.��P�A�2
ZO�G RE�tiV BY: ----^�'(� AATE APPROVED:
SUII�DING REV]EtiY BY: DAT'E APPROVED: 9- � 3•c� ca.
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓� No
PLAN REVIEti�I � Yes r� No SEtiVER CONNECTION
STATE SURCHARGE Yes � No �VA'I'ERCONNECTION
INVESTIGATION FEE Yes No �- PARK FEE
SAC Yes No �- STTEINSPECTION
Number of SAC�Uruts OTHER (sgecify)
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ZONi.�IG CT-iE.CK. LTST Zoning Districr. /ll o r (+�rYv� e ,
Fire Department: Post Office: School Discrict: �
I,ot Area; Sq.fc. Acres Width Depch �
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: .
Froat{Lake): Ri�t Side:
Rear(�treet}: Laft Side:
Adjacent Strucn!res: �Vetland:
Buil�ling Hei�it: Dei. Hgt, Peak Hg .
Lot Covera�e:
Grading: Scaff F�pproval Date: y: Council Approval Date: '
Szptic: Staft Approval Date: B, �
Zoaing File: � Resolutioa: � esolution Da:e:
Shoreland District:
Av�. Se[back: Bluff Setback: Lo[Covecage:
E�iscino Proposed
Hardcover: 0-75'
75-250'
2�0-560'
500-l OG'�J'
�-i�dcove_ Vzia.nce Required: Yes �'.o D �.� e` �o�!�cil App�ovz:
F.E��L=�RKS (in house):
. •
BULLDING REVLEtiV CKECK LIST
��� �- 3 corrs�rxcrc�orr�E: ��/U
Sq Faotage $ Per Sq Ftg
Basement � x = .
lst Floor x � _
2nd Floor x _
GaraQe X _
z —
TOTAL
F.stimated Construction VaIue: $ �� y ti0 0=°
Inspections Required: �Vork Requiring Separate Permits:
S ite Plumbing Fire
� Hardcover Removal Mechanical Water Coaaection
Footing ' Septic Sewer Connection
� �Framing Fireplace Lawn Ircigation
Insulatioa (Masonry) Ot�er
E _g Wall Board (Mfg.) Well (Scate Perm.ic)
�'F�� Grading/Filling ec Electrical (State Permit)
Ocher
REMARKS (INHOUSE): _ -- �-
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REVU�tiV BY �THERS: DAT�E:
Access: Etusting New .
Access Approval: Date gy;
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REI�IARKS ('�'O BE NQ'�E� �v PER .. :
8
�\\ � v\� DATE TIME •
,/CITY OF ORONO � CALLED IN �^����0� �
INSPECTION N E SCHEDULED ' �0� ��
PERMIT NO. t �� COMPLETED
ADDRESS �`3 J� C,��.� �f �—��
OWNER CONTR. ����/� C�C.s��'t �en..R�,
TELEPHONE NO. 11�I a �a ) � �``f 3 1
� DESCRIPTION
LL 01 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 3 INS 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 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
0 �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. u PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
� INSPECTION RE�UiRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (J52� 249-4600
OwnerlContract site:
Inspector.
White Copyllnspecto s File Canary CopylSite Notice