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HomeMy WebLinkAbout2003-P06877 (enclosed block chimney) PERMIT , CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 Po6g�� Crystal Bay, Minnesota 55323 Permit Type: MinorAlterations (952) 249-4600 Date Issued: io�io�2oo3 SITE ADDRESS: 3249 Casco Cir Wayzata,MN 55391 P I D: 20-117-23-43-0008 DESCRI PTION: Proposed Use: Residential Permit Class: Building Census Code O/S-Building Pernut Type: Minor Alterations Pernut Sub-type(s): Chimney DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 69.25 valuation: $ 2,000.00 State Surcharge Fee: $ 1.50 TOTAL FEE: $ 70.75 APPLICANT: Judd Luesse OWNER: Robert Luesse 2144 Southview 3249 Casco Cir Mound,MN 55364 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. � ; ,�� ;� � �, / � � , . . _ . �] � � 1` �'' ,c t c�-���--- _ f, _� �_ ; ���1 ��__ �Y�—� APPLICANT PERNIITEE SIGNATURE ' ISSUED BY SIGNATURE Conies: 1-File(SiQraitures Required), 1-Applicant, 1-Monthlv Renorts.1-Assessin�_ 1-Finance ., , , � Total Fee: $ Date Received: ' Entered By: Permit#: CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) T'HE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �� ��� �'� 5 �� �/2 ��Cl� ZIP: ✓�S 3 �� N��iE OF OWNER: �G Bc,� / (�� �G��=SS� PHONE: (home) �.5��-` `f�� - �1 z/s . (work) l��iAILINGADDRESS: �2yq �ifSGa �l� G�/=CITY: C�/2cNo ZIP: 5 5 ' CO\'�'RACTOR: S t.�a� ��e��� PHONE: �5���`��2-�/3 2— CO��ACT PERSON: NIOBILE/PAGER: ��Z -- s`�/ - 3�S.� 1�'L4ILI�i 1G ADDRESS: 7ij� �r/-F-viF� CITY: L��/U� ZIP: 5S3�Sl ST�iTE LICENSE: # 2 0�Z7�7� ARCHITECT/ENGINEER: PH0�1E: �LAII.I�i tG ADDRESS: CITY: ZIP: \T 4.`iE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: ��11G'Los�'� � �C�L C t-�l/i-C/U�' �J � STORIES: SQ. FEET OF EACH FLOOR: 1\O. OF BEDROOv1S: � GARAGE STALLS: ATT. DET. EST�IATED CONSTRUCTION VALUATION (excluding land): $ 2 r �� � 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 wi� be in ccor ance with the approved plan. � PLICANT'S SIGNATURE: ���-s� DAT'E: �� '��� ^ �-� �'�'OTE! Parade of Homes events require separate permit approval by Police Department and City Counci160 days prior to the event. Non permitted events will not be allowed. 5 � '. Sec.13.04 RIGHTS OF SLJB,TECTS OF DATA Subd. 1. Type of data. The righu of individual on whom the data is stored or to be stored s':all be as set fozth in this secrion. Subd.2. Information required to be given individual. ,�n individual asked to supply private or confidenrial data concerning himself shall be informed of: (a)the purpose and intended use of the requesred data within the collecdng state age�cy,politcal subdivision,or stacewide rystem;(b)whether he may refuse or is legally required to supp(y the requested data;(c)any(mown conu;,uence arising from his supplying or refiuing to supply private or confidennal dara;and(d)the idenrity of ed�er persons or entiries auchorized by��or fr+eral law to receive the data. This requirement shall not apply when an individual is asked to suppiy investigative data, pursuant to secrion 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav vlace the notice reauir^d under this subdivision in the indivi�•sl incor^e taz or vrooerrv taa refund instrucrions mstead of on those forms. Subd. 3. Access to data by individual. Upon request m a responsible authoriry,an individ�::!shall lx mformed whether he is the subject of stored data on individuals,and whe[her it is classified as public,private or co�denrial. Upon 3is further request,an individual who is the subject of stored private or public data on individuals shall be shown the data without any char�e to hua and, if h�desires, shall be informed of the content and meaning of that data. Aher an individual has been shown the private data and inforn:w'of its^'r�ninv� che data need not be disdosed w him for six months thereafter uniess a dispute or action p�rsuant to this sec6on is pending or addi�onal dam on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public dara upon requer by the individual subject of the data. The responsible au[horiry may require the requesring person to pay the actual cosu of making,certifyino,ar.d comp�7ing the copies. 'Ihe responsible authority shall comply immediately,if poss;ble,with any request made pursuant�chis subdivision, or wirhin five days of the date of the request,excluding Saturdays,Sundays and lega!holidays,if immediate compliance is rst possible. If he cannot comply with the request within that time,he shafl so inform the individual, and may have an addidonal five days wic:a 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 z=;,uracy or completeness of public or private data concerning himself. To exercise this right,an individuai shall nodfy in writing the responsible authority describing the nature of the disagreement. The responsible authoriry shall within 30 days eithec: (a)correct the data found to be inaccur�or ince�plere and attempt to noofy past recipiena of inaccurate or incomplete dara,including recipients named by the individual;or(b)nodfy�e indiviL'ual tbat he believes the data ro be correct. Data in dispute shall be disdosed only if the individual's statement of disagreement is incl���:d wirh L:e disclosed dara. The determination of the responsible authoriry may be ap�aled pursuant to the provisions of th�adminis�rive procedure act relating to contested cases. DATA PRIV�CY ADVISORY In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we wou?d like to inform you that your request for a permit or license from the �ity of Orono or any of its departments may require }-ou to furnish cer[ain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualificason for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deay the permit or license. 3. The information may be shared with other 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, seme information may become public. 5. You have certain rights under M.S. 13.04(available upon request) to re��iew pri�-ate data on yourself. 6. Your full name is required to process this application or permit. First Middle Last Address C��' State Zip Phone I understand my rights as stated above. Signature 6 � CHECK OFF LIST FOR ISSUANCE OF PEItNIITS ' � FOR OFFICE USE ONLY ADDRESS OR LEGAL: _�y �j C�4� � �o�.�i ��-� PID: DESCRIPTION OF WORK: ��rC�S� l�c � ZO�iING REV�W BY: �I G� DATE�iPPROVED: BUII.DING REV�W BY: DATE APPROVED: �U —��-� FEES TO BE CHARGED: �1isc. Fees Calculated By: PERIVIIT Yes � No pLpN REVIEW Yes No (/ SEWER CONNECTION STATE SURCHARGE Yes ✓ No WAT'ERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No STTEI�i iSPECTION Number of SAC Units OTHER (specify) ZOti�VG CHECK LIST Zoning Disuict: �� _ (�F� Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Da[e of Survey: Proposed Setbacks: Front (Lake): Right Side: Rear (Street): Left Side: —j� Adjacent Structures: Wetla�d: Building Hei�ht: Def. Hgt. Peak gt• Lo[Covera�e: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: # Resolution Date: . Shoreland District: Av�. Setback: Bluff Setback: L.ot Coverage: ExistinQ Proposed 0 Hardcover: 0-75' 75-250' 250-500' � 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 . '� BUILDING REVIEW CHECK LIST �C: �" � CONSTRUCTION TYPE: (Q� Sq Footage $ Per Sq Ftg Basemen[ R = lst Floor x = 2nd Floor x = Garage x _ z = TOTAL o� Estimated Construction Value: $ Z 0 U O Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection ) Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (1�Ifg.) Well (State Permit) �F�� Gradin�/Filling Electrical (State Perm.it) Other REI�IARKS(IN HOUSE): --------------------------------------------------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Existin� New Access Approval: Date gY: --------------------------------------------------- RENIARKS (TO BE NOTED ON PERi'�IIT): 8 ' ' .1` .. —� � _ � O�Iv� �V( --_. s c.-P,t, A'r F C-u L 1 ; G4LVANrL�t� i M�T�kL sT�a �2�,K£. f�l�7A�L --- `' L�P � � � �� � . � Z1C Z. c���� �R�1 n� r n�v ! 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' i ! � - � � j i , n '/ / C�;�" , �TE /O� TIME � CITY OF ORONO CALLED IN INSPECTION N TIC� SCHEDULED Z�? O3� PERMIT N0. �� 7� COMPLETED ADDRESS 3��/ � �a- S �� ( I� OWNER CONTR. � ,�.,tdd L.c.t_r� � TELEPHONE NO. ���' � �� - �('2 r.� � DESCRIPTION �dl_) .Y�C� � 01 FOOTING 11 MECHANICAL RI 8 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 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 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU�YES_NO � COMMENTS: � W � � � v� `� U� 0 � � 0 � W � Q � Z W � W � � � d W� ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe n�xt inspection 24 hours in advance. (952) 249-46�� OwnerlContract ite: Inspector. - White Copyllnspector's File Canary Copy/Site Notice