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HomeMy WebLinkAbout2006-P10043 - addn/remodel/repair . �, PERMIT CITY �F ORONO 27�0 Kelley Parkway - PO Box 66 Permit Number: P10043 Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodevRepair (952) 249-4600 ' Date Issued: , 7/l0/2006 SITE ADDRESS: 2914 Casco Pt Rd Unit# Wayzata,MN 55391 PID: 20-117-23-31-0031 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Plumbing Mechanical Electrical(state) NOTICES/REMARKS: Interior Work Only FEE SUMMARY: Pernut Fee: $ 321.25 valuation: $ 20,000.00 Plan Review Fee: $ 208.81 State Surcharge Fee: $ 10.00 TOTAL FEE: $ 540.06 APPLICANT: Tom Campion Construction OWNER: Andrew&Marcia Freese 5390 Laice Sarah Hgts. 2914 Casco Point Rd Loretto,MN 55357 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. % �C � � '1M�,c-/� APPLICANT PERMITEE SIG R ISSUED BY SIGNATURE Copies: 1-File(SignaturesReguired), 1-Applicant, 1-MonthlyReports, 1-Assessing,(IfSeptic, l-Septic) Page 1 f Total�ee: $ � �, "'� DateReceived: v' `..� �'���� Lntered By: ` Y2.� Permit#: � ��;;C>�+' ,, CITY OF ORONO - BUILDING PERMIT APPLICATION r 4 All information must be submitted in full before plan review will be started. (�,���,� _; � - (please print all infor•mation) J ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle o�ze) OWNER OR CONTRACTOR JOB SITE ADDRESS: ����y ( ��5��,O�:n� �',o� ZIP: �5��/ Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �lvo If yes, a specia/event permit is required with Police Depnrt�nent and City Council approva/ 60 days prior to the event. Shi+ttle bus sei•vice will be reguired a�nless applicant ctenzonstrates szff cient on-site parking is available. Non-perrnilted events will not be allowed. NAME OF OWNER:A���//���ilr�� d'/'�PS r PHONE: (home) �r / (work)�a'/�-�s�=CJ%f� MAILING ADDRESS: �y/� C �s�o �f ��CITY:�,f'�!ii>� ZIP: 5�3 CONTRACTOR: /, ( .y �� ' ` PHONE: ?��-y�9-�iss� CONTACT PERSON: MOBILE/PAGER: ���3 ��<j�' " 3�7� MAILINGADDRESS:�, �d �- CITY: L����� ZIP: >5..��'7 STATE LICENSE: # �p;/�y'S EXPIRATION DATE: 3 '". ��` � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Ho►ne Remodel/Alteration (ie: Siding, Windows) � Any earth movement may require MC D review and permits ! PROPOSED WORK(rfescribe in detnin: �/1-S P��°'�t� ��/'S� ,�'��� -�'- STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAG� STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 2-�� cl�� I hereby apply for a building permit and I acknowledge that the information 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 this is not a permit and work is not to start wi out a permit;and that the work wi Il be in accordance with the approved plan. APPLICANT'S SIGNATURE: � DATE: ` �� 6` ; r 31 � Sec.13A4 R[GHTS OF SUBJECTS OF DAT� ' Subd. 1. Type of data. The rights of individual on H�hom the data is stored or to be stored shall be as set foRh in this section. � Subd.2. lnformation required to be given individ�al. An individual asked to supply private orconfidential data concerning himselfshall be informed of. (a)the purpose and intended use of die requested data within the collecting state agency,poliNcal 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 refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized b��state or federal Iaw to receive the data.This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision�,to a law enforcement of�cer. The commissioner of revenue may.place the notice re�c uired under this subdivision in the individual income tax or orooertv tax refund instructions instead of on those fonns. Subd.3. Access to data by individuaL Upon requestto a responsible authority,an individual shall be infonned 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 be shown the data without any charge to him and,if he desires,shall be informed of the content and meaning of 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 pendin�or additional data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subjec[of the data. The responsible authoriry may require the requesting person to pay[he actual costs of making,certifying,and cotnpiling the copies. The responsible authority shall comply immediately,if possible,�vith any request made pursuant to this subdivision,or within five days of the date ofthe request,excluding Saturdays,Sundays and legal holidays,ifimmediate compliance is not possible. [fhe cannot comply with the request within that time,he shall so inform the individual,and may have an additional five days within which to comply with the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Arocedure when data is not accurate or complete. An individual may contest the accuracy or completeness oCpublic ur private data conceming himself. To eaercise this right,an individual shall notify in�vriting the responsible authority describing the nature ofthe disagreement. The responsible authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data m dispute shall be disclosed only if the individual's statement of disagreement is included wi[h the disclosed data. The determination of the responsible authority may be appealed pursuant to the provisions of the administrative procedure ac[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 ceirtain private or confidential information. You are notified that: 1. The information you furnish wiil 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 ar 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 NLS. 13.O�1(available upon request)to review private data on yourself. 6. Your full name is required to process this application or pertnit. First ��liddle Last Address Citv State Zip Phone I understand my rights as stated a e. �1 �- � ignaturc Reset Form �� �HEC�K OFF i�IST FOR ISSUANCE �F PE�'VfITS ' FOR OFFICE USE ONLY ADDRESS OR LEGAI.,: Z�i�`-( C`�SC� �o�� T �� PID: � DESCRIPTION OF WORK: Lrv1(�T�T N�3!-� ZO�tNG REVIE`V BY: O�l I/� DATE APPFOVED: SUILDING REVIEtiV BY: DATE APPROVED: (� - Z7-o� FEES TO BE C�-IARGED: Misc. Fees Calculated By: PERMIT Yes ,,� No PLAN REVIE`V � Yes �/ No SE�VER CONNECTION STATE SURCHARGE Yes ✓ No WATERCONNECTION ' INVESTIGATION FEE Yes No �,� PARK FEE SAC Yes No _�� STTEINSPECTION Number of SAC�Units OTHER (specify) ZONi�IG CI-iE.CK. LIST Zaning District: �Jo_C,�1.�s� . Fire Departmen[: Post Office: School Distric[: � L.ot Area: Sq.ft. Acres Widch Depch Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Froat (Lake): Ri�t Si : Rear(Stree[): Left Side: Adjaceat Structures: � etland: Buil�lin� Hei�ht: Def, Hgt, eal:Hgt. Lot Covera?e: Gradino: Staff Approval Date: By: Council Approval Date: ' Sepcic: Staff Approval Date: y� Zoaing File: � Resolution: # Resolution Date: Shoreland District: Av�. Setback: Bluff Setback: L.ot Coverage: E�isting Proposed Hardcover: 0-75' 75-250' 2�0-500' 500-1000' �-Ia.rdco�'er Va:iance Required: Yes No Da�z ef Council Approval: RE�L4RKS (in house): BUIZDING RE'VIEti�V CHECK LIST " � �C� 12 � � CONSTRUCTION TYPE: �(i'�l Sq Footage $ Per Sq Ftg Basement x = . lsc Floor z � _ 2nd F1oor x = Garage x _ z — TOTAL Estimated Construction'Value: $�OOo °=J Inspections Required: �York Requiring Separate Permits: Site _�Plumbing Fire Hardcover Removal _�Mechanical Water Connection Footing ` Septic Sewer Coanectioa _�Framing Fireplace Lawn Irrigation _,�Insulation (Masonry) Other ��Yall Board (Mfg.) Well (State Permit) F�� Grading/Fillin� �_Eleccrical (State Permit) Other REMARKS (IN HOUSE): - -- -- -------------------------------------------------------- REVIEW BY OTHERS: DATE: Access: Ezisting New Access Approval: Date By: ------------------------------------------------------------------------------------------------- REI�IARKS (TO SE NOTED ON PERMTi�: -r rt^�2�2 w o�-i� 6 N c.� 8 .'I "'� :, i / � - � • � �'� � �j .: • • I • • - - v !3 s � �/ � • y;�, • � ` - a �■ / �� � l �� ..�i� - . ._ .. • :.,a�-� � � : � • - ;: --- / � /� � � � � / ' ! � _/.1��/ ir/!�� ��/I_/�11�1GG!��■� „ ' i . 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