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Home My WebLink About2004-P07840 - addn/remodel/repair CITY OF ORON PERMIT '' O Permit Number: 2750 Kelley Parkway - PO Box 66 Po�s4o Crys�al Bay, Minnesota 55323 P2C'1111t Typ@: Addition/Remodel/Repair (952) 249-4600 Date Issued: si3iizooa SITE ADDRESS: 2677 Casco Point Rd Wayzata,MN 55391 PI D: 20-117-23-23-0020 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Pernut Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: ,.,----- ---_-,.,-- --�----- =-�- �----�-------- ---_�,- --� - ----— b.. b ":.:C:: ...::,:::::.�::::::::.'..... _.... b., FEE SUMMARY: Pernut Fee: $ 293.25 Valuation: $ 17,450.00 Plan Review Fee: $ 190.58 State Surcharge Fee: $ 9.25 TOTAL FEE: $ 493.08 APPLICANT: Doug Dzurik Construction OWNER: Alan&Susan Kluis 16717 Gras Bay Blvd 2677 Casco Point Rd Wayzata,MN 55391 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. - � �� APPL ANT PERMITE AT ISSUED BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Renorts, 1-Assessin�. 1-Finance Page 1 �� Iti � Total Fee: $ �3. D8 Date Received: �`�� \ Entered By: �q� Permit#: �f /(�;f� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full befare plan review will be started. (please pri�at all iiifor�z�atio�i) --------------------------------------------------------------------------�----------------------------------------------------- THE APPLICANT IS: (circle o�:e) OWNER OR CONTRACTOR \ ' JOB SITE ADDRESS: �� 7 7 �Z.SCL% �f ��(� ZIP: Will this be a P rade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, a special event perNiit is required with Police Depar•tment antl City Cou�i�cil c�pp�roval 60 days prior to the event. Non permitted events will not be czllowed. NAME OF OWNER: �}l �?�0� �� (�/��;5 PHONE: (home) 'l _� (work) MAILING ADDRESS: ��7 7 CQ.SC,G -f�_ �"��'. CITY: �� ZIP: CONTRACTOR: / - i,�.f' � _ �L_ PHONE: �p f�,Z - 07 v�l-o��f3/ CONTACT PERSON: MOBILE/PAGER: _ C�� - a,�� -a ti � � MAILING ADDRESS: ��?�SS f/Wti S�5 CITY: ZIP: .S�y y/ STATE LICENSE: # �bO�c��7� ARCHITECT/ENGINEER: --"" PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Accessory Structure Addition Move Remodel/Alteration_� Land Alteration PROPOSED WORK(describe in detain: C o h � ✓J'1✓' � 0 ✓�c� (.� S � c � .5 Ct C� STORIES: SQ. FEET OF EACH FLO��R: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. � ESTIMATED CONSTRUCTION VALUATION (excluding land): $� �S� 4� I hereby apply for a building permit and I aclrnowledge that the ir�formation 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��ermit; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATU � < � � � DATE: Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.l. 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 conFdential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or retusing to supply private or contidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or pronertV 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 informed 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 bc shown thc data without any charge to him and,if he desires,shall be intormed of the content and meanin;o[that data. After an individual has been shown 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 collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject o(thc 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 pursuant to this subdivision,or within five days of thc datc 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 individunl,and may have an additional�ve days within which to comply with the rcquest,ezcluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himselL To esercise this right,an individual shall notity in writing the respo�sible uuthority describing the nature of the disagreement. The responsible authority shall within 30 days either: (a)con•ect the data found to be inaccurate or incomplete and attempt to notify pust recipients ot inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. 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 appcaled pursuant to the provisions o[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 furnish certain private or confidential information. You are notified that: 1. 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 n is required to process this application or permit. i First Middle Last /'/ ` �iC <'�L��._.__ Address �' �� City State Zip Phone I understand my rights as stated above. l l ��w� u re ` CHECK OFF LIST FOR ISSUA.�'�tCE OF PERMITS FOR OFFICE USE ONLY A.DDRESS OR LEGAL: 2 61� C A s c,o �o i ni� IZe�+�� PID: DESCRIPTION OF WORK: 17�.�o�Jt_L ZO�tI�i IG REV��V BY: �tJ /�9 DATE APPROVED: BUII.,D .I�i IG REV�ti� BY: DATE APPROVED; 8 �Z3-a Y FEES TO BE CHARGED: Misc. Fees Calculated By: PER1ti1IT Yes ✓ No PLAl�t REVIEW Yes ✓ No SEWER CONNECI'ION STATE SURCHARGE Yes _�/ No WATERC0�INECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) ZO�It�1G CHE.CK LIST Zoning District: �v CHA�/G� Fire Departmenr. Post Office: School District: Lot Area; Sq.ft. Acres Width Dep[h Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front (Lake): Right Side: Reaz (Street): Left Side: Adjacen[Structures: �V and: Building Hei�ht: Def. H;t. Pealc Hgt. Lo[ Coveraoe: Gradine: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: �` Resolution: � Resolution Date: Shoreland District: Avg. Setback: B1uff Setba k: L.otCovera;e: Ezisting Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes o Date of Council Approval: REMARKS (in house): 7 BUII.,DING REVIEW CHECK LIST �C� �� 3 CONSTRUCTION T'YPE: V� _ Sq Foota�e $ Per Sq Ftg Basement x = lsc Floor z _ 2nd Floor x _ Garage x _ x = TOTAL Fstimated Construction Value: $ I 7,4 S O Inspections Required: '�Vork Requiring Separate Permits: S ite Plumb ing pue Hardcover Removal Mechanical Water Connection Faoting ' Septic Sewer Connection � ____Q�Framing Fireplace Lawn Irriga[ion Insulation (�fasonry) Other Wall Board (Mfg.) Well (State Permit) 'C F�� Grading/Filling Electrical (State Permit) Other REI�IARK�S(Pi 1 HOUSE): . --------------------------------------------------------------------------------------------------- REV�W BY OTHERS: DAT`E: Access: Ezisting New Access Approval: Date gy: ��------------------------------------------------------------------------------------------------------ RENIAR.KS (TO BE NOTED ON PER1tiII'1�: 8 � 7� D TE TIME CITY OF ORONO �CALLED IN �� INSPECTION N T C SCHEDULED - - _s �c� PERMIT NO. � COMPLETED ADDRESS a�077 C�GO � � OWNER CON�R. D TELEPHONE NO. �rZ ZZ/ 2�.3 I _ � DESCRIPTION 1�! �� ( V1� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 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 � COMMENTS: � W � � J O >. � O � W � Q � Z W � W � � d W ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE �� W ❑CORRECT WORK&PROCEED _ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR n CITATION ISSUED ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call forthe next in ection 24 hours in advance. (952� 24J-4600 OwnerlContrac o sit Inspector. �- White Copyllnspector's Fiie Canary CopylSite Notice _ __ . 1 � � -:� � � � o � v ,� � c rn � � � � � � � d , � : � � � � � _ __ _ � . ___ _ _--- - � ti ; , , ,_ . _ _ -__ � -� . � � : � �, � � � � � c� ', � � � �. ; �J s __ ._ ___ Os .�t; � � .� � �j � � Y !� � � --��' m , V'► ; � ( ,� � a... _ - � � _ \ �� _.._..__.._/ � - I 1, � / � 1 � C �` � J ` _ L � �� ff _._._._ __.__ _______� �' � � ..1__. .. __ � �' � � _ _ . - --_- ---__ �_ ..___...._ � �, � ' �' �-__ __.__.� 9� �_ � �� 1 �� C� � � � �' �e�� '� � o � � � � �., `. a,, - � c� � � -�' -r';, � ° C' � � � ^., '� Cc� �'�-� +�' '� ,� Z � '.-� cn �;�-� .� -y L-� Tr � �L m� -�v �- � � ' o �� F � �� x c �-� "_�, -�,. ---� --� � � � � � , -� � � r_i "� -� �' � "'r � � �� 'P , \ � , _ , - ��.:.::.. .._...:,......_. � �� . M,. ___ . - , , _ � i � �—_._.._.n- I ��j I ' I ' �\ . , � � ! � I a � �-� I t ! 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