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Home My WebLink About2005-P08559 - addn/remodel/repair PERMIT CITY OF ORONO Permit Number: 2750 Ke��y Parkway - PO Box 66 P08559 Crysta! Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: a�s�2oos SITE ADDRESS: 2967 Casco Point Rd Wayzata,MN 55391 P I D: 20-117-23-31-0064 DESCRIPTION: UBC Occupancy R3 Consriuction Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permiYs required: Eiecuicai�statej NOTICES/REMARKS: (�"�""__. �S1""_]___"_ T_"__1""__ O 11.f__1__ C'�_"'__ (�a"___�_"__ /'�1__"____ .i.v..b� .•.....v..-� -....v..:b ..��:�vv vv...v��.v�.�u.:. v...a:bv.i FEE SUMMARY: Pernut Fee: $ 391.25 Valuation: $ 25,000.00 Plan Review Fee: $ 254.28 State Surcharge Fee: $ 13.00 TOTAL FEE: $ 658.53 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 STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. � ;'j C l �'�''Y'1C�v'i �� NTPERMITEE A"CURE ISSUEDBYSIGNATURE Covies: 1-File(SiQnitures Required), 1-Apolicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 i �a.c�-� �--�--Ub �I ?�� i c-;� • Total Fee: $ (0.5�8 S,3 Date Received: � r� Entered By: Permit#: �� -�� c-, . CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) -------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR Jos siTE avn�ss: ��j C� � ��-�- zir: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YCS ❑ NO If yes, a special event permii is required with Police Department and Cily Council approval 60 days prior to the event. Shuttle bus service will be required unless applicanf demonstrates sufficient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: �� Z� ��'�'�- PHONE: (home) , (work) MAILING ADDRESS: Z��O 7 GL�-��CITY: ��'� � ZIP: CONTRACTOR: �`� �� `��'�"`�^ " �—Cr PHONE: LI�� G`�� Z- CONTACT PERSON: � MOBILE/PAGER: MAILING ADDRESS: l G e/i 1�-�- f�.� CITY: Q��z-r� ZIP: STATE LICENSE: # /�"Gc EXPIRATION DATE: ARCHITECT/ENGINEER: �n--�- PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration �- , ��,�� P1�OPOS D WORK(describe in detai�: ^: w C�tT �`t-�� cz �G \\ 1/l-E��" ,�,._ � �� r-c-�L � }�/J�" � -�i�ec� STORIES: _� SQ.FEET OF EACH FLOOR: �� NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED , tX' ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �� ,�� o 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: 3 / � 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 conceming himself shall be informed o£ (a)the purpose and intended use of the requested data within the collecting state age�cy,political subdivision,or statewide system;(b) whether he may refuse or is]egally 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 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 may place the notice required under this subdivision in the individual income tax or�rooerty 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 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 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 of the data. The responsible authority may require the requesting person to pay the actual costs of making,ceRifying,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 wnceming himsel£ To exercise this right,an individual shall notify in writing the responsible authoriry 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 in dispute shall be disclosed only if the individuaPs statement of disagreement is induded with the disclosed data. The determinatio�of the responsible authoriry 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: 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 name is required to process this application or permit. � �� F \ �l 1 �:�r` � First Middle Last ! y�G' �li(j-�-E'�-G..�_ �.r� Address s� - ��-� � C�ty State Zip Phone I understan y rights as stated ove Signatur 32 CHECK OFF LIST FOR ISSUA1vCE OF PER1tiIITS + FOR OFFICE USE ONL Y ADDRESS OR LEGAL: 2 Sb1 �►�sw �o�� PID: DESCRIPTIONOFY�O.RK: 5��lJtrv� W iNooWs A�v� P�elhrc �� o�� ---------------------------------------------------------------- . ZONItVGREVIEt1�BY: -- D.ATEAPPROVED: BUILDING REVI.EW BY. Df1TEAPPR06`ED: y• Y-a�_ ----------------------------------- - FEES TO BE CHARGED: �Llisc. Fees Calcc�fated By: PERttitIT Yes �/' No PLAN REVIE 6V Yes �/ No SEYVER GONNECTIO�V STf1TE SURCH.4RGE Yes /� No tiVATER COtVtVECTIOiV ItVVESTIG,4TIO�V FEE Yes tVo �_ PARK FE.E Sf1G Yes ��Io v SITENSPECTION 1Viunber of SAC Uitits OTHER (specify) --------------------------------------------------------------- ---- 2'O�VIIYG CHECh'LIST Z011LIiJ Disd•icc: N o Fire Depar•trrierrt: Post Offcce: School Dist�•ict: __. Lot,�rea: S t. Acres 6(�iddi Depth 4•� Si«vey Su6rriitted: Yes No Date af Suivey: Proposed Setbnch.s: Fror�c(Lake): Right Side: Renr(Sh•eet): Left 5ide: Adjncent St�•ucnu•es: YU lland: Building H�iglat: Def. Flgt. eak Kgt. Got Coverage: � Grnding: Staff.4pproval Date: By: Council�Lpproval Date: Sepric: Scaff,�lpproval Date: BY� Zoning Fife: � Resolutio�t: # Resoli�tiaz Dnte: Shoreland Dish•ict: Avg. Setback: Bluff Setbnck: Lot Coverage: Existin� Proposed Hctrdcovet•: 0-7�' 75-250` Z50-500' � 500-1000' Hardcover Vm•tafice Reqc�ired: Yes No Date of Cot«tci!Approval: .RE1I�IARKS(iIt 1tOuse): , 31 .. !+ ` � � B UILDI�VG.RE VXE F�v CHECK LIST UBC: _ 12 •3 ca�vSTRUCTIOeV TYPE: �N Sq Footaue S PerSg Ft,; Base�neit� r = !st Floor x = 3nd Floor t = Garc�e x = � _ TOTAL Estirriated Constructio�c L`afue: S 2$�000 °� Lupections Required: Yf'ork Requirin,;Separate Perncits: Site Pl�uribir�g Fir•e Hardcover R�moval Ntedtarii.ca( YVntei•Co�inection Footdrtg Septic Sewer•Cauiectiat _�Franii��,; Fireplc�ce Latiwt lrrtgatio�i _�l�istilation (��lasolir}�) Olher• �_ GY'al(Boai•d (h�Ifg.) GVefl(Stnte Permit) o( Fiiia( Gradi,tg/Fi(lin�; �_Electrical(Sta�e Permit) Other RElYIARICS(IN HO USE): ----------------------------------------------------------------------------------------------------------------------- RE 1'✓ZE Y�B Y OTHERS: DATE: .'�CCCSS: EXIS�11iJ IVC'6V :�ccess�{pprovcif: Date By: ----------------------------------------------------------------------------------------------------------------------- ItEt'�I�R£iS (TO BE�VOTED ONPEIZNIIT): 32 �� ` _ � � /DAT�C TIME CITY OF ORONO CALLED IN �� INSPECTION TICE SCHEDULED - PERMIT NO. COMPLETED � ADDRESS OWNER CONTR. � TELEPHONE NO. �SZ 7�l �� Z- � DESCRIPTION I �� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q RAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 I SULATION�� 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL 4 WALL BD. � 12 WATER HOOK-UP 17 SITE INSPECTION 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 i09 PLUMBING RI 23 SEPTIC FINA� 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � a W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK 8 PROCEED J ISSUE CERTIFICATE OF OCCUPANCY W O ❑CI�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call forthe next'nspection 24 hours in advance. �952� 249-46QQ OwnerlContra n it : Inspector. � White Copyllnspector's File Canary CopylSite Notice � I� D TIME � CITY OF ORONO CALLED IN �� INSPECTION C SCHEDULED _�� S� �L � PERMIT NO. COMPLETED ADDRESS � OWNER CONTR. TELEPHONE NO. %SZ �7� �S�J � � DESCRIPTION � � 01 FOOTING 1 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL ZG4 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP ? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINA� 36 FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � � -� ��r � s � e � J O � � O � ti � Q � Z W � W � � d W WORKSATISFACTORY:PROCEED C PROJECTCOMPLETE � p CORRECT WORK&PROCEED L ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING 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 for the ext inspection 24 hours in advance. (952� 24J-460� OwnerlContr site: Inspector. White Copyllnspeclor's File Canary CopylSite Notice � AT TIME � CITY OF ORONO CALLEo iN � INSPECTION TI SCHEDULED — � PERMIT NO. d COMPLETED ADDRESS ��Z � � � OWNER CONTR. TELEPHONE NO. � DESCRIPTION �a� l� 01 FOOTING 11 MECHANIC R 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICA FINAL 19 LAKESHORE/WETLANOS ti 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 O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 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 a o �I Du.f' � � o � �' �, W � Q � Z W � W � � d W WORKSATISFACTORY:PROCEED f� PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED !-' ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR 7 CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContra site: Inspector. .. White Copyllnspector's File Canary CopylSite Notice ✓ DATE TIME CITY OF ORONO CALLED IN �r��/ INSPECTION�O �S� SCHEDULED -� D G� PERMIT NO. COMPLETED ADDRESS�� 7 �� D�� /� OWNER CONTR. G2��1� TELEPHONE NO. 9s2� �7�- D53 Z- � � DESCRIPTION � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 1QSITE INSPECTION Z Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 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 � COMMENTS: � � a — — �VL S c9 j � � o O t O �.� a � � - �' E�i E� � �� Q � z W � W � � a � .❑WOR SATISFACTORY:PROCEED C; PROJECTCOMPLETE W ❑ RECT WORK&PROCEED '; ISSUE CERTIFICATE OF OCCUPANCY � CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ,�� pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '-7 CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-4600 OwnerlContra ite: Inspector. White Copyllnspector's Fil Canary Copy/Site Notice R D TIME � CITY OF ORONO CALLED IN `�' � INSPECTION N TI SCHEDULED � - a%�� PERMIT NO. O SS COMPLETED ADDRESS �� OWNER CONTR. TELEPHONENO. �CJ Z- �7� ��J� y' � DESCRIPTION �� lL 01 OOTING Q� 11 MECHANICAL R 18 EXCAV/GRADING/FILLING � 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 FO�LOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOH TO MEET YOU:_YES_NO � COMMENTS: � W a � � `� �h � �JK �5 �� . � O � W � Q � Z W � W � � a � WORKSATiSFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED !-� ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR W{LL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALIINSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� 249-46QQ OwnerlContract ite: Inspector. White Copyllnspector's File Canary Copy/Site Notice