HomeMy WebLinkAbout2005-P08635 - addn/remodel/repair � � PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P08635
Crystal Bay, Minnesota 55323 P@1"CTllt Typ2: Addition/Remodel/Repair
(952) 249-4600 Date Issued: s�a�2oos
SITE ADDRESS: 2967 Casco Point Rd
Wayzata,MN 55391
P I D: 20-117-23-31-0064
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Permit Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Pernut Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate pernuts required: Eiecuicai�siaiej
NOTICES/REMARKS:
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FEE SUMMARY: Pernut Fee: $ 125.25 Valuation: $ 6,000.00
Plan Review Fee: $ 81.38
State Surcharge Fee: $ 3.50
Misc. Fee: $ 125.25
TOTAL FEE: $ 335.38
APPLICANT: Danberry Company OWNER: Mr. &Mrs.Rozeboom
4410 Shoreline Dr 2967 Casco Pt Rd
Spring Park,MN 55384 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.
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AP [CANT P R IT E SIGNATURE ISSUED B GNATURE
Copies: 1-File(Sienitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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Total Fee: $ �5� � `" Date Received: 7'-
Entered By: Permit#: �Q�(p.35
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all infor�riation)
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THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: Z�CQ � (_l�c S Gs V�� ZIP: 5��
Will this be a P ade of Homes, Remodelers Showcase Home or other Display Home?
❑ Y0S �0 If yes, a special eve��t per�nit is reqi�ired with Police Department and City Cozrncil approval
60 days prior to the event. Shzrttle bars se�vice will be reqtrired unless applicant demonstrates
sz�fficient on-site pnrking is available. Non permitted events will not be allowed.
NAME OF OWNER: �'-� (l�j 0 Z� G�o o �^-�- PHONE: (home)
(work)
MAILING ADDRESS: �/CQ � C�C 5� ��CITY: �✓'�� ZIP: �3� /
CONTRACTOR; �Cc �Q�^r CO � PHONE: ��/ �� S`� Z-
CONTACT PERS N: MOBILE/PAGER: Z 7 0 � '7
MAILING ADDRESS: �U �e. ,'K.,�.�,�CITY: ��a✓' C ZIP:
STATE LICENSE: # ���" EXPIRATION DATE: �a(Q
ARCHITECT/ENGINEER: --� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTR.ATION: #
TYPE OF WORK: New Addition Accessory Structure
Move Home Remodel/Alteration �
PROPOSED WORK(describe in detain: FO k�u�'r'P� ���v" -- i.�-�e
�x�`s����� ar�� ��,-w�- �' -�
STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDR OMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �i �p�o J
I hereby apply for a building permit and I acknowledge that the information 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 permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: Z �S�
31
�
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 stored shall be as set forth in this section.
Subd.2. Information required to be given individuaL An individual asked to supply private or confidential data concerning himselfshall 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 refusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requiremcnt shall
not apply when an individual is asked to supply investigative data,pursuant to section]3.82,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 Qrooerty tax refimd
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 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 pending or addi[ional 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 of the 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
the date 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 individual,and may have an additional five days within which to comply with the request,excluding 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 himself. To exercise this right,an individual shall notify in wiiting the responsible authority descnbing the nature ofthe disagreement.The
responsible authority shall within 30 days either: (a)con-ect 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 in
dispute shall be disclosed only if the individuaPs statemen[of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of 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:
l. The information you furnish wi(1 be used to determine your qualification for the pernlit 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 name is required to rocess this application or p rmit.
� ��- �� �a����
First Middle Last
Address
City State Zip Phone
I understand my rights as ate above.
Sign e
32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: z.'�t� � L A s��v ��„-„T (Z..�;,.a-�
PID:
DESCRIPTIONOFWORK: �`c�,c+� i2�.��4+2 /'��r �,��•t^A-.^�, ��-e..c_-r�-� ����� +G�eE
------- ---__-------------------------
- -�----
ZO.�I�1i G REVIE`Y BY: .� .� ------------DATE APPROVED: `-1 Z� ' c`�
BUII.DING REV�W BY: ° ,,. DATE APPROVED: y - -Z-� - �S
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ;/ No
PLAN REVIEW Yes �/ No SEWER CO�tNECTION
STATE SURCHARGE Yes �,/ No WATERCONNECTION
�INVESTIGATION FEE Yes ✓ No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONIVG CH�CK LIST Zoning District: `�-I c_
Fire Department: Post O�ce: School District:
Lot Area: Sq.ft. �,c+� ��4: Acres .�l� Width ���'�``�rv,�.c�,�� Depth
.,i�, :°' )} �.�x.7�/a¢C/L
Survey Submitted: Yes�_ No Date of Survey: Z-z 1 -�i
Proposed Setbacks:
Front (Lake): Right Side: ru6 GE+/'�^k'�-
Rear (Street): Left Side:
Ad;acent Structures: ;' Wetland: ,s��v�
BuildinJ Height: Def. Hgt. ^ra �;.�,a„r.,c, Peak Hgt. —
Lot Covera�e: �,� c�c,�
Gradino: Staff Approval Date: N r a By: Council Approval Date:
Septic: Staff Approval Date: f✓ �/� By: –
Zoning File: # �>"- 3�>�,5 Resolution: # Resolution Date: `�'� S `�`�
Shoreland Distric[: v ps
Avg. Setback �//},r�,;,�.,�,u Bluff Setback: NO�� L.otCoverage: �,�Jc�
Ezisting Proposed
Hardcover: 0-75' ;�Cj'� �i�7�
75-250' ;�z 2S%
2�0-500' �_ � ` �
500-1000'
Hardcover Variance Required: Yes_� No Date of Council Approval: y �2 S.65
RENIARKS (in house): � (,vo�t K s� w�o �c7u+� �� _
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BUILDING REV�`V CHECK LIST
UBC: �' �3 CONSTRUCTTON'TYPE: J6"
Sq Footage $Per Sq Ftg
Basement z _
lst Floor x _
2nd Floor z =
Gara;e z =
z —
TOTAL
Estimated Construction Value: $ i�.Oc:U '`
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechaaical Water Connection
�C Footing ' Septic Sewer Coanection
_�Framing Fireplace Lawn Irrigation
_�Insula[ion (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
�F�� Grading/Filling c.� Electrical (State Permit)
Other
RENIARK�S (IN HOUSE):
-------------------------------------------------------
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
------------------------------------------------------------
REI�IARKS (TO BE NOTED ON PER�I�II'1�:
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Rozeboom Miller Architects,Inc. • 244 First Avenue North •�Minneapolis,MI�� 55401 • Tel: (612)332-2110 Fax: (612)664-8152
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ysisYr�bnr«le lY��� �U� p`�'� 5,9 \` ' \ .�O, O ond Stairs 660 Sq.Ff.
(_) ��6�/�����yD�/� '4"� 9 � . � +9 B`` ; � O�_ a Totol Hardcovei 660 Sq.Ft. � QnciQ
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n' e���x��i� � 6 a�a ess.s 5� /� casace'� - � �cnC° � �
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i �\ � IF--_-1� x 952.2 �y5l.2 ' HOUS � /",��Fj(� + v � House 1350 Sq.Ft.
��� \. ' ,IQt F7�.=9 �.e o :� j j�6. ,�k Goroge 505 Sq.Ft.
fa��5h���}7u�L. �1�i,�nn9 f ave.�.h4.17�6� 9s� \ (�k 4 .. .n �� a�� Drive. Potio, Wofk
�,-�. �� z 950.2 .r_n�.T �` `•'. A� °^�4' fA � G�`� � ond Walls 2289 Sq.Ft.
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ryYdd�necLatzad' \ R \ � - -� \ 57,5 .,-�� � 951.0� Tolal Hordcover 4144Sq.Ft.
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i �..:�'���-�,�� --�� ��� \ 9fe 6g � � � �� � Total Hordcover 1600 Sq.Ft. u0 1Ah E
LAKL' � \' h6' S� ' H�u���d�- �I�D hF� �ot A�ea 24B5 Sq.Ft.
� ��'� \� r'`'1_ , 59�3� JCfaGo A1o�1�Rol�tub to - 9fiVafio �101� (3b0 SF�
MINNFTONKA � \ �, �-�r� � Pe���� % of Hardcover = 64.4 9
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�\ � a ��, � ,, vt LEGAL DESCRIPTION:
� a' � g � uoc7 6wac�a t�'��a t mo s�
o Denotes l�on monument �' ^ ' p Aq
• Oenotes lountlmanument \\ �ac,\'��., " -r 3��9�� (n8� TRACT Q R.LS. N0. 1470 ����LUF 3��SP ' 2�:1.�0 �
a 000.0 Denofes existin Blev. G
(G00.0) Oenofes propa�d efev. �\\\2�'�� C J� SITE ADDRESS:
—�- Denofes su�/oce drornage �\\�\ J 2967 CASCO POINT ROAD
REVISED CONTOURS MARCH 14, 2005
1 hereby certi/y that this survey, plan or report was prepared by me File No. .
DE1��ARS—GAHf��1;L or under my direct supervision and thot� am o Auly Registered Land CERTIFICATE OF SURVEY FOR:
Surve under fhe Laws ol the Stafe o/M7nnesofo. 12761 B
I.AND SURVEYORS, INC. Book-Poqe
3o�a Horbor Lane No. • �-- 426�3� THE DANBERRY COMPANY— MR. JEFF DANBERRY
Plymauth, MN 55447 pa��d E. Crook
Phane:(763) 559-0908 � �
Foz :(763) 559-0479 ScGle �
Dofc Febivarv 21 2005 Minn. Req. No. 22414 1"=30' � .
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CITY OF ORONO CALLED IN ��� ` `��
INSPECTION NOTICE SCHEDULED � ���
PERMIT NO. ��R�(.o 3� COMPLETED
ADDRESS ��� 7 cC�J C O �T ��
OWNER CONTR. ��}Z�4—�-��
TELEPHONE NO._ � �`�— a�� ' 7O D �
� DESCRIPTION / �`" �L�� �/��'--m-
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAD /FILLING
Q 02 FR,4MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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