HomeMy WebLinkAbout2000-P02572 (add./remod./repair) � � PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po2s�2
Crystal Bay, Minnesota 55323 P@I'1711t Typ@: Addition/Remodel/Repair
(612) 249-4600 Date Issued: 6�2��00
SITE ADDRESS: 3277 Casco Cir
WAYZATA,MN 55391
P I D: 20-117-23-43-0042
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Single Family
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 23.50 Valuation: $ 300.00
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TOTAL FEE: $3�-�
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APPLICANT: LEE GEINERT OWNER: LEE GEINERT ETAL
3277 CASCO CIR 3277 CASCO CIR
WAYZATA,MN 55391 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 CI7Y OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
�/�% ` —
APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: City,Applicant,Assessor, Finance Page 1
Total Fee: $ .;�<�, �_ '' Date Received: ��jy�o��
Entered By: ,r,3 Perm.it#: (�.�-��7z-
CITY OF ORONO - BLTII�DING PERNIIT APPLICATION
All information must be submitted in full before pla.n reoiew will be started.
(please print all information)
TIiE APPLICANT IS: (circle one) OWNER OR CONTR.ACTOR
JOB SI'TE ADDRESS: �.�7 7 �'Q4�f� �-��-� ;
ZIP: v`S�i 9/
�
NANIE OF OWNER• ,��cL��cv��;; _ o>.L>���� PHONE: (home) �f 7/-��'7.�
� (work)
I1��IAII�IYG ADDRESS: s.�,�7�G��c.�-c,c� ���.c� CTTY: �J�z _ . �'.: _ZIP:S�s�Y�
C0�1TR�.CTOR -���� PH0�1E: -�%/- �/7"�
C01�1TACT PERSON: NiOBILE/PAGER: .
NL�,II.,ING ADDRESS: CITY: ZIP: � -
ST�TE LICENSE: #
A,��HITECT/ENGIPtEER: PHONE:
l�L-�ILI`i'G ADDRESS: CITY: ZIP:
N��;�: REGISTRATION�
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED�'ORK(describe in detai�: �..�-�a ��� � ' � ��`'�-' -
�=��:�'�--� z�- =c � ,�
STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDROOI�IS: --3 GARAGE STALLS: ATT. DET. L
ESTI1,i IAT'ED CONSTRUCTION VALUATION (excluding lanc�: $ �3��' �
I hereby aoply for a buildin�permit and I acknowled�e that the information above is complete and
accurate; �hat 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.
�
APPLICAN'T'S SIGNATURE;'j�'�-�P DATE: l�//y/o� -
1�'OTE! �rade Q Homes events require separate permit approval by Police Department and
City Couneil 60 days prior to the event. Non permixted events will not be allowed.
Sec.13.Q-i RIGHTS OF SL'BJECTS OF DaTa
Subd. 1. Tvpe of daca. The righ�s oi individual on whoa�e daa is s:o::d or m be scorrl shall be as set focth ia[his secrion.
Subd... Information reqirirrd to be�ven individual. An ir.dividual asYed to suFp[y privac:or confidendal daa cocceraing himself sfiall
be infocned of: (a)the purpose and inL:nded use of etre reGuat-d dari v+ithin ehe collecdag'sam agenry,polirical subdivisioo,or satewide rysum:
�b)whe:�:r he may rfuse or is le3ally requir.d co n:ppiy[he r_�uesced dars:(c)aay l�own cobs-:�ueace arisia3 from his supplyi;.g or refusing co supply
privam or conr.dendal data;and(d)che idanricy of o�er peaors or enades au[horiz�by sca[_er fadd�I3'.V(0 R�tive[he da�a. This requiremeac stiall
no�appfy when an individual is asked to supply incesrigaave daa, pursuaac ro sec�on 13.83, subdivision 5, to a law enfoRemeac officer.
"Ihe commissioner of r.�:e:�ae mav oli:_ the nocce re�uired under this subdivision in the ir.dividual income ttt oc vrooem mz reFur.d
insrrucdons ins.e�d of an chose forms.
Subd. 3. ?,ecess to data b�indiridual. lipon r..;_at to a r_sponsible auc.`:oriry,aa individual shall be informed�vhecher he is the subjec�
of scored daea on individuals,and whe:her i�is clsssifed as public, pr.vace or con.-:�eaaal. [;Foa his fur,her rer{uest,aa individual who is the subjecc
of scor_d privase or pubfic daei on individuals shall be show��e daa wi�hout aay caar3e m hi�and,�if he desires, shall be iniomed of che concer.c
ar:d meaning oi�ha�data. After an individual hu been shown che privarr,daca az:d icfor,ned o[its meanin3,che daca need noc be disclosed m hi.�n for
six mon�s cher_siuc unless a d'upute or acrion pursuanc co 4�is secdon is pendi:.g or addidoeai data on che individual has beea collected or cresced.
Tne responsible aurhoriry shall provide copies ot�he privac�or public dac�upon r:qu_sc by cEe i�dividual subjecc of che daci. 'I"a�responsible auchoriry
may require rhe requesring person to pay che acnul cosu of r..aking,cerrifying,sr.d.ompiling [he copies.
The responsib(t aurhoriry shail comply ir.ur:edia�ely, if possible, wirh�:.v�quest�dt pursuanc co this su6division,or wirhin five dsys oi
the dac�of cha requesc,e�ciuding Sanzr3ays,Sur,days and 1e3s1 holidays,if is.medu:e complia:ce is noc possible. If he esnnoc compty wich the roquesc
wi�`�in rhac dme,he shall so inform�he individual,and may have an addidonal five days wichin which to:omply wi�z the requ�st,exc!uding Saturdays,
5undays and legsl holidays.
Subd.4. Procedure whea data is not accurate or complete. An ir.diviZual may concest[he accuracy or completeaess of public or pri�•a�e '
data cor.ceming himselF. To exerise c,4is ri¢hc,an inCividual shall noa"ry in wriae;te resporsioIe auchor.ry describing rhe natt::e oi thz disagteemeac .
'Ihe responsiblz authoriry shall wichin 30 day5 eic.`.er. (a)c�.:�ce eh�dan four.d�`_=in3ec::��or ineonple[e and aaemp�to nodfy past reeipients of
inaccurs:e or incomplece dara, induding recipiena named by 4he u:dividual: or(b)�odfy et:= iadividual thac he believes che dac�to be corroce Dan
in dispuce shall be disc!osed oniy if[he individu�l's sacer..e^t of disagrr_meac u�.duded wi:tc che disclosed daca.
'I'he de�e:minadon oF the r:ronsibl:auchoriry r.:y be aopealed purn:�-c to the p;ovisions of the admuustr3rive pro.edure act relaciag ro
conces:ed cases.
D:�T�. PRIV:�CY :�D`'ISORY
In accordance wi�h�1.5. 13.04, Subd.2, "RiQhcs of subjeccs oi daca", ��e would like to inform you thac your reauesc
for a perm.it or license from che Ciry or Orono or any oi ics deaz.mencs nay require you to fumis� certain private or
confiden�ial information.
You are notified tha[:
1. The information you fi:raish will be used to de�emzir.�your qLzlification for the perm.it or license requested.
? You may refuse to suoolv daca, buc refusal may reeuire tha� the City deny the permit or license.
3, The informacion may be shared with other local, scac�or federal a�encies co the extenc necessary to process
the permit or license.
.�. If your request�d permit or lice:se requires Council action to approve, some informacion may become
public.
j. You have certain riQhts under �1.5. 13.04 (availabl� upon request) to review private data on yourself.
6. Your full name is required to process this applicac:on or pe:mic.
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Ciry ) Srtte Zip P�ona
I understa�d my ri�hts as stated above.
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Signacur
CHECK OFF LIST FOR ISSUANCE OF PERl�IITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 32—j � �s C.o G r(LC.C�I��
PID:
DESCR�TION OF WORK: �Z_e�o �' o v� CC,�C_
ZO�G REVIE`Y BY: DATE APPROVED: �- Z�- v�
BUILDPTG REVIE`V BY: DATE APPROVED: �- Z� -��
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes No �/ SE�VER CONNECI'ION
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZO�i� CH�CK LIST Zoning Disuict: /v� C l-Fs4r��
Fire Departmen[: Post Office: School Disuict:
Lo[Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Se[backs:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetland: .
Building Height: Def. H;t. Peal:Hgt.
Lot Covera�e:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: �# Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REi�1A.RKS (in house): � cG� �1--�c � � r ss-e.� `�- 0�
7
BUII.,DING REVIEW CHECK LIST
�C� 2 � 3 CONSTRUCTION TYPE: V�"
Sq Footage S Per Sq Ftg
Basement x _
lst Floor x =
2nd Floor x =
Garage x =
z =
TOTAL
c�c�
Estimated Construction Value: $ 3 Q('
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal hlechanical 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
REI�IARKS(I�i t HOUSE): .
REVIE`V BY OTHERS: DATE:
Access: Ezistin� New
Access Approval: Date By;
REtiIARKS (TO BE NOT'ED ON PERitiiIT):
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