HomeMy WebLinkAbout2006-P08733 (add./remod./repair) � PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p08733
Crystal Bay, Minnesota 55323 P2fTllit Typ2: Addition/RemodeURepair
(952) 249-4600 Date Issued:
6/20/2006
SITE ADDRESS: 2428 Casco Pt Rd Unit#
Wayzata,MN 55391
PID: 20-117-23-12-0022
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Religious
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: Electrical(state) Other-Q
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 9�•25 valuation: $ 4,000.00
Plan Review Fee: $ 63.21
TOTAL FEE: $ 160.46
APPLICANT: Owner/Self OWNER: Stephen&7ean Skoro
MN 2428 Casco Point Rd
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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A P P L[C A N T P E R M I T E E S I G N A T U R E I S S U E D B Y S I G NA T URE
Copies: 1-File(Signatures Required), 1-Applicant, 1-MonthlyReports, 1-Assessing,(If Septic, 1-Septic) Page 1
`�'�^��D� Date Received:� -/C�
Total Fee: $ •`�� _��,,��� �
Entered By: (;'�1'T- Permit#:
CITY OF ORONO - BL'ILDING PERMIT APPLIC:�TION
All info�•mation must be subinitted in full before p[an review will be started.
(please print all informatiorT)
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THE APPLICANT IS: (circle o�ze) WNE OR CONTRACTOR
JOB SITE ADDRESS: �-s���a �" �v ZIP: _ �� 1
`'�'i11 this be a Parade of Hoznes, Rem,odelers Showcase Home or other Display Home?
❑ Yes [� No Xf yes, a special event permit is requiretl with Po!ice Depc�Ytment and City
Council approva160 days prior to the event. 1�'on permitted events �vill not
be allotived.
NAME OF OWNER: �n�'�� ��' �� PHONE: (home)Q�'2�`fa/-?`)��
(work} ��z.- �f��- �O r a
MAILING ADDRESS: �L���C> E�- 7= �D CITY: _f����_ZIP: �3�!
COIV'TRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP: � ____
STATE LICENSE: #
ARCHITECT/ENGIIV'EER: PHONE:
MAILING ADDRESS: CITY: ZTP:
NAME: REGISTRATIOPI #
TYPE OF WORK: New Accessory Structure
Additio�n � Move
RemodeUAlteration Land Alteration
PROPOSED WORK(describe i�: detail}: !��l� ��� ,��r�c�L� _
STORIES: / SQ. FEET OF EACH FLOOR: �2'�L—
NO. OF BEDROOMS: �� GARAGE STALLS: ATT. �"""� DET. �'`"""
ESTIMATED CONSTRUCTION VALUATION {excluding land): $ ��� • �� �
I hereby apply for a b�ailding permit and I aclmowledge that the information ahove is cucnplete anc�accurate;that the
work will be in conformance with the ordinances and codes of the City and with th+. State Building Code; that I
understand this is not a pexmit and work is not to start without a permit; and that the wark will be in accordance with
the appraved plan.
APPLICA�'T'S SIGNATURE: DA�CE: � �� p �
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.1. Type of data. The rights Of individual on whom the data is stored or to be�tored shall be as set forth in this sectlon.
Sabd.2. Information required to be given iodividual. An ind[eidual asked to supply prtvate or confide ztlel data concerning 6imselt shall be
informed of: (a}the purpose a�d tntended use of the requested dsta rvithin the eollecting state agency,pol[tical �ubdlvision,or state»�i�e eystem;jb}
whether he may retuse or Is fegalfy required to supply tBe requested data;(c)any known wnsequence arising(roin his supptying or retusing to supply
private or conf[dential data;and(d)the tdenttty of other persons or entitics authorized hy state or federal law to re�;efve ttse datu. This requirement shall
not appfy when ao individual is asked to supply im•estigatfve dsta,pursuant to section 13.82,subdivision S,to a Iaw enforcement officer.
The commissioner of revenue mnv nlace the notice reauired under thia subdivlsion in the ln�divid���ncome tux or urooerlv t�x refund
fnstructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsibie autfiority,an individual shall be inforined whether he is che subject of
stored data on individuais,and whether it is classified as public,private or confidential. tipon his further request,an 1n8ividuai who is the subject af
stored private or publtc datn on indivfduals shaA be ahown the duta without any charge to him and,if he desires,shall be informed of the content and
meaning ot that data. After an indivEdusl has been sho�vn thc private data and informed of its mean(ag,the dAts.aeed not be disclosed to him!or six
months thereafter urtless a dtspute or actton pursuant to this section is pending or add[tional data on the individu;it has been collected or created. The
responsible anthorlty ahail provlde copEes of the private or publlc data upon request by the individual subject of the data. The responsible autHority muy
requtre the requesting person to pay the actual costs of making,certifying,snd compSling the copies.
The responsible authorlty shall comply immediatefy,if possible,with any request made pursuant to this:�ubdivision,or withtn Cve days of the
date of the requcst,excluding Saturdays,Sunduys and legal hol[days,if tmmediate compliance is not possible.If he i:annot comply with the request within
that Nme,he sha11 so inform the indiv'rdual,and may heve an additional[ive days within which to comply with the rcquest,excluding Saturdays,Sundays
snd legal holidays.
' Subd.4. Procedure when data is not accurate or complete. An indiv,iduat may contest the accuracy or cnmpleteness of pablic or private datu
concerning himself. To ezerclse this right,an fndividuul shail nohfy in wrlting the responsible autdority descrlbing the natu re ot the disagreement. The
responsible aathority sbai!within 30 days either: (a)correct the data found to be Inaccurate vr incomplece and uftempt to noti[y past reciptents of
inaccurate or incomplete d�ta,incl.udir�g recfpients named by the individual;or(b)notify the individual that he be.ieves the data to be correct. Dsta En
dlspute shall be disclosed only if the indivtdual's statement of disagreement is�lncluded w[th the disclosed dsta.
The determinution of the responsible authority muy bc appealed pursuant to the provisions o[the adrrinistrative procedurc act relating to
contested cuses.
DATA PRIVACY A.DVISORY
In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we would like to infarm you that your requesE
for a permit or ticense from the City of Orono or any of its departments may require you to furnish certain private or
confidential informatian.
You are notified that:
1. The information you furnish will be used to determine your qualification for tt�e permit or license requested.
2. You may refuse to supply data,bnt refusal may requ'rre that the City deny ttie permit or license.
3. The information may be shared with other local,state or federat agencies to tt e 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(avaiiable upon request) ta review private data on yourself.
6. Your tull name is required to process this app!'rcation or permit.
'�1'rL-�'�� --� � ��v
First Middlc Last
�'��$' �.1}�c r> ""r�—. ��- _
Address
l��i'�1'�,s�T�}-- �2� • �'�71 �7�5��"'�7!"Gd! f�
City Stste Z[p Phone
I understa ' hts as stated above.
Signature
CHECK OFF i.IST FOR ISSUANCE OF PERi1�fITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z`i 8 C►q Sc-� P�in�t- iZoA/�
PID:
DESCRIPTION OF WORK: Scrz.EE...� ��cl-4
ZO.vl�ti G REVIEtiV BY: DAT'E APPROVED: -15 •��
SUILDING RE'VIEtiV BY: DATE APPROVED: �-i �- o�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIE`V Yes ,/ No SE�VER CONNECTION
STATE SURCHARGE Yes —� No WATERCONNECTTON
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No ✓ SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZONSi1tG CH�CK LIST Zoning Districr. LIZ-1 G
Fire Department: Post Office: School District:
Lot Area: Sq.ft. 1�ppo Acres . 32 Width l0 a Dep[h ��/�
Survey Submitted: Yes�� No Date of Survey:
Proposed Setbacks: �
Front (Lake): ';5� ± Righ[Side: 7?
�
Rear (Street): $Z � Left Side: I�•°�
Adjacent Structures: I}T7i4Gl�v'� Wetland: N 1✓}
Builcling Heigh[: Def. Hgt. 0.�- Peal:Hgt. —
Lot Covera�e: 1`�-3
Grading: Staff Approval Date: ,y� �i../.q,v�_ By: — Council Approval Date: — �
Szptic: Scaff Approval Da[e: ^! ( R BY: �
Zoning File: # c�5-3�3� Resolutioo: # Resolution Date: a-� -��S`9
Shoreland District: y�PS
Av�. Setback: /v 1.4 Bluff Setback: /J I A L.ot Covera�e: �`{•3
EListing Proposed
Hardcover: 0-75' N/(� �'�'
75-250' N� A /`�/�
2�0-500' � y0•'�- 3Q.� S,�-/3Ss-�. �t.
500-1000' 2a -,�-•z-c=—
Hardcover Variance Required: Yes pc No Date of Council Approval: "d'�'�S
RE`�L4RKS (in house):
BUII�DING REVIEtiV CHECK LIST
UBC: R' 3 CONSTRUCTION TYPE: �(I�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x _
2nd Floor x _
Garage x _
z =
TOTAL
Estimated Construction Value; $ y��pp �
Inspections Required: �Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Coanection
_i�Footing ' Septic Sewer Connection
�c Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wa11 Board (Mfg.) Well (State Permit)
—�F�� Grading/Filling _�Electrical (State Permit)
O[her
REMARKS (IN HOUSE): M
--------------------------------------------------------
RE'VIEtiV BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date By;
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REVIARKS (TO BE NOTED ON PERiI�II�:
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CITY OF ORONO CALLED IN �i
INSPECTION N IC 2 SCHEDULED
PERMIT NO. O ��v COMPLETED
ADDRESS �TaB �� � �
OWNER_9.X�!/�'eS CONTR.
TELEPHONE NO. 95Z �7/ Od�D
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVA�
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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p ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑ CITATION ISSUED
G INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next i spection 24 hours in advance. (952� 249-46��
OwnerlContractor
Inspector.
White Copy/lnspector's File Canary CopylSite Notice
� I T DATE TIME �
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CITY OF ORO CALLED IN �' �
WSPECTION C�E� SCHEDULED -1 �.0 )rrn�
PERMIT NO. O � COMP D
ADDRESS ��-L ��
OWNER �"� CONTR.�(��dUV1�L�
TELEPHONE NO. � _�- � ��� I ��/ �-J
� DESCRIPTION � I c.
l� 01 FOOTING 11 MECHANI AL I 18 EXCAV/GRADING/FILLING
��l2�FRAMING 13 MECH CAL FINAL 19 LAKESHORE/WETLANDS
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Q 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 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 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r� pH0T0 TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the n x 'nspection 24 hours in advance. (952� 249-4600
Owner/Contra o s te
Inspector.
White Copyllnspector's File Canary CopylSite Notice
r �D ATE TIME V
l/' �CITY OF ORONO CALLED IN �l���
INSPECTION N SCHEDULED
PERMIT NO. ?33 COMPLETED
ADDRESS a�� � C��D � �""�--
OWNER g���P �L�r� CONTR.
TELEPHONE NO. �-�Z- �7� �D l D
� DESCRIPTION �� — ���J
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
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 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 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WlLL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next'nspection 24 hours in advance. �95Z� Z49-4600
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