HomeMy WebLinkAbout2008-P12164 (add./remod./repair) � � ' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p12164
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
6/24/2008
SITE ADDRESS: 3277 Casco Cir Unit#
Wayzata,MN 55391
PID: 20-117-23-43-0042
DESCRIPTION: UBC Occupancy R3
Construcrion Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Other-(If deck repair requires structural work,furtrher review will be required.)
NOTICES/REMARKS:
Repairs to house,garage&tool shed. Repair soffit&shingles,repair deck/rail
FEE SUMMARY: Permit Fee: $ 41.25 valuation: $ 1,000.00
State Surcharge Fee: $ 0.50
TOTAL FEE: $ 41.75
APPLICANT: Owner/Self OWNER: Daniel Cox
MN 3277 Casco Cir
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 PERMITEE SI NATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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Total Fee: $ '�"/, �� DateReceived: �°-�3���
Entered By: Permit#: /-�(a/lo
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(pleuse print a!!information)
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THE APPLICANT IS: (circle one) OWNER R CONTRACTOR
JOB SITE ADDRESS: ;'����a�:o C'ircle Orono.Mn ZiP: SS391
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes Q NO !f ve:s,a speeiul c:vent pernrit is rey:�ired x�ith Poliee Departmefri ancl Ciry Corrnerl approi�nl
60 davs prior to dre erent. Slnittle bus sen�ice will be re y:�ired tuJless applicanl denlor�strates
srt�ererN on-site parkirtg is avuilable. ;Vo�i pernrittecl everits wi11 not be allowed.
NAMEOFOWNER: �a"'��H.��°x PHONE: (home) �9s�ia�t-a6�a
(w�p�) 1763)47A-6757
MAILING ADDRESS: ;'����"'°°c"°�` CITY: °rono ZIP: SS;yI
CONTRACTOR: ►i<,mz o�i„�� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: C[TY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCH[TECT/ENGINEER: �""� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessorv Structure
Move Home Remodel/Alteration(ie: Siding,Windows) ✓
Any earth movement may require MCwD review and permits!
PROPOSED W ORK(describe in detain: Mi�;rcpairs to die house garage and tool shed Repair x�tlit attd
shingl�s,r��air dcck&railings,�iaint extenor.
STORIES: -' SQ.FEET OF EACH FLOOR: 5cx�
NO. OF BEDROOMS: ; CARAGE STALLS: ATTACHED DETACHED ✓
ESTIMATED CONSTRUCTION VALUATION(excluding land): S �•�������
I hereby apply for a building pennit and I acknowledge tl�at the infonnation above is complete and accurate:
that the work will be in confonnance with the ordinances and codes of the City and with the State Building
Code:that I understand tlus is not a pennit and work is not[o start«�ithout a pennit:and tliat the work will be
in accordance���ith the approved plan.
APPLICANT'S SIGNATURE: fN��u[ �� • DATE: osi3oa�x
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Sec.13.04 RIGIi7'S OF SUB,IE;("1'S ON'DA7'A
Subd.l. "Pype of data. 'I'he righlx of individual on whcxn the data ia stored or to be stored shall be as sel forth in this section.
Subd.2. [ntirrmation roc{uired to l�e givcn inJiviJual. :1n individual aaked to supply private or confidential data conceming him.gelfshall be
informed ot`. (a)the purpose anJ intenJed uae��f tlie reyuesteJ Jata widiin the collecting atate agency,political subdivision,or statewide system:(b)
whether he may refuse or is legally reyuire-d to supply thc rcyucsted data;(c)am I:nown conseyuence arising tTom his su�lying or refiuing to suppl}
private or conf idential data:and(d)the identily of other per!ronx or entities authorized by state or federal law to receive the data.This reyuirement shall
not apply when an individual ie asked to wuppl,y inveatigative data,purxuant to section 13.82,subdivision 5.to a law enfbrcement ofticer.
The commixsioner of revenue may_place tlte notice required under this subdiviYion in the individual income fas or propertv L�x refund
instructicros instead of on those tbrtns.
Subd.?. Access to daW by individuaL [?pon reyuest to a respon�ible authority.an individual shall be infbrmed whether he'v5 the subject of
stored data on individuaLs,and whether it is classif ied ax public,private or confidentiaL Lfp��n his fuRher reyuest an indi�idual who is the��bject of
stored private or public clata on individual�shall be xhown the clata without an}'charge to him and.if he desires.shall be informed of the content and
meaning of that data. After an indiviJual has been ahown the private clata and infortned of i[s meaning.the data need not be disclosed to him for s is
months thereaRer unless a dispute or action pur�suant to thiw section is prnding or additional data on the individual has been collected or createcl. The
r�ponsible authority shall provide copiea of die private or public Jata upon reyuest by the individual subjed of the data. The responsible authority
may reyuire the reyue!zting person to pap the actual costs of making,certifying,and compiling the copies.
The responYible autharity shall eomply immediat�ly,ifnossible,with any request made pursuant to this subclivision.or within five clays of
the date of the reyu�st,escluding Saturdays,Sundays and legal holidays,if immed iate compliance is not poasible.If he cannot wmply with the reyuest
within[hat time,he shall so inlircm Ihe individual,and mav hav�an additional tive days within which to complV'with the request excluding SaturclaVK.
Sunda,ys and legal holidays.
Subd.4.ProceJure when data is not accurale or complcke. r1n individual may contest the ac:curacy or completeness of public or privatc;da[a
concerning himself'. T'o exercise this right.an individual shall notify in wriling the resperosible audiority Jescribine the nature of the disagreement.The
responsible aulhority shall within?0 drys eilhcr: (•r)co�rcx;l thc data liwnJ to be inaa:urate or incomplete and attempt to notify past rcx:ipients of
inaccurate or incomplete data.including recipicnts namcd by lhe inJiviJual;or(b)notify the indi��idual that he believes the data to be co�rect Data in
diYpute shall be diselosed only if the inJiviJual'x statemcrot o1'disaerecKnent is ineludecl�vith the diselosed data.
7'he Jetennin•rtion of the renponsible audiority may be appealed pursuant to t6e provisions of the administrative procedure act relatinst to
cont�ted cases.
DATA PRIVACY ADVISORY
In accordance with M.S. l 3.04,Subd.2,"Rights of yubjects of data",a e w�ould like to inforni you that your reyuest
for a perniit or licen�from thc City of Orono or atty of its departments may require you to ti►mish certain private or
co�iti�lential uiforniation.
You are notitied tliat:
l. The inforniation you furnish will be uxd to deterniine vour qualitication for the perniit or license
requested.
2. You may refus�to sup�ly data,but refusal may require that the Citv deny the perniit or license.
3. The uifonnation may be share�l with other local, state or federal agencies to the eartent necessarv to
process the pennit or license.
4. If vour requested pennit or license recluires Coimcil action to approve,some nifonnation mav become
public.
5. You have certani rights un�ler MS. 13.U4(available upon request)to revie���private ciata on yourself.
6. Your full name is required to process this application or penuit.
Uaniel Halloran Cox
Fi rst MidJ le Last
3277 Casc:o Circle
Addre!ss
Orono Mn 55;91 (9521471-0664
City State Zip Phone
I understand m��ri�hts as stated above.
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Signature
Reset Form 32
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CHECK OFF LIST FOR ISS UANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 327? GAS c�n c,2 L�.,�
PID: �
DESCRIPTIONOFWORK: �-�„v6u,�, �c �L fZ,,�-�R,,2 � (�,A,���,,, S
ZONING REVIEW BY.• /v/A DATEAPPROVED:+��
B UILDING RET�IEW BY.• � DATEAPPROVED: 6-i 6 -a�
FEES TO BE CHARGED: Misc. Fees Calculated By: � ��
PERMIT Yes .� No
PLAN REVIEW Yes No ✓ SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (spec�)
ZONING CHECIf LIST ZoningDistrict: � G��,/ ���Y
��
Fire Department: Post Off ce: School District•
Lot Area: Sq.ft. Acres GVidth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
• Adjacent Structures: etland:
Building Height: Def. Hgt. eak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Appr-oval Date:
Septic: StaffApproval Date: y.
Zoning File: # Resolution: # Resolution Date:
Shoreland District: MCWD Permit:
Avg. Setback: Bluff Setbac Lot Cover•age:
Fxisting Proposed
Hardcover: D-75'
75-250'
250-500'
500-1000'
Ha�•dcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
3
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B UILDING REVIEW CHEC%LIST
UBC: �2'3 CONSTRUCTION TYPE: Y n1
Sg Footage $Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Alechanical I�Y'ater Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
�all Board (Mfg.) Well(State Permit)
Final Grading/Filling Electrical(State Permit)
Other
REMARKS(INHOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ONPERMIT): SF U-ec� 2e Ph�2 �,�;q�,2�S 3;��„c,��
e,vcut.K j u.t�l-� �u r�c,.� �„�( (�e /LerT���
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