HomeMy WebLinkAbout2008-P11943 - addn/remodel/repair � � R
-
PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: p11943
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
4/4/2008
SITE ADDRESS: 108 Chevy Chase Dr Unit#
Wayzata,MN 55391
PID: 36-118-23-41-0034
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residenrial Census Code 434
Permit Class: Building
Addition/Remodel/Re air Permit Sub-type(s): Addn/Remodel/Repair
Permit Type: P
DETAILS:
Approved per resolution#: Mark Schill
RFALTOR"
Separate permits required: Plumbing Mechanical Electrical(state) previews�°-Disiinccive Homes�ivision
� � 952-476-3622 Direc[
_ _ a 612-859-4507 Cell
952-473-3932 Fax
maschill@cbbUrnet.com
NOTICES/REMARKS: B�ET Www.t�tarks�h�il.com
Interior Remodel Kitchen&MB,reshin le&reside wayza�a ots�e
$ 201 East Lake Street
Wayzata,MN 55391
llwned And Ope�ated By NRT Incoryo�ated. ��
FEE SUMMARY: Permit Fee: $ 1,956.75 valuation: $ 250,000.00
Plan Review Fee: $ 1,271.89
State Surcharge Fee: $ 125.00
TOTAL FEE: $ 3,353.64
APPLICANT: Mark D. Williams Custom Homes OWNER: Mark D Williams
102 West Sth Street 108 Chevy Chase Dr
Chaska, MN 55318 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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�APPLtCANT PF,RM[TEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), I-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, ]-Septic) Page 1
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Total Fee: $ 3353.�o`f' DateReceived: 3�� �0�
Entered By: Permit#: �3
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 NT
JOB SITE ADDRESS: �� � v � $� ZIP: SS3�'1
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ �To If yes, a special event permit is reguired with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non-permitted events will not be allowed.
NAME OF OWNER:�C�� �. �:.�1 lq wl S PHONE: (home)
(work) (ol Z-2 S I- 9 7 S'o
MAILING ADDRESS: CITY:G�ask� ZIP: S 3
d oZ w. $L._. g�. �..
CONTRACTOR: fl. �� ` r G,S 4'�o�S PHONE:
CONTACT PERSON: � C�.r���,� MOBILE/PAGER: (�l2-�Z S (—q?SO
MAILING ADDRESS: (�2 �. `3'�' S _ S- CITY:�,tSk't ZIP: �-5-�!�'
STATE LICENSE: # ZO� 91?�,3 EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) �_
Any earth movement may require MCWD review nd permits!
PROPOSED W(�),TR�K(describ in detai�: ft' � ✓'•.•S► �t,. � � ,�- T
I 1 �iS�-c.�iZ,v. 1��
STORIES: `���� SQ.FEET OF EACH FLOOR: ZD y S� �)S� Z ,� �'3 �
NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED Z DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ZS���Q
I hereby apply for a building permit and I acknowledge that the information above is complete and aeeurate;
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.
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APPLICANT S SIGNATURE: � DATE:
�✓1�1�• t�,�l���„�s c��-. l�(,0�-3
31
_ �
Sec13.04 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 himselfshal I 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 iden[ity of other persons or entities authorized by state or federal law to receive the data. This requirement shal I
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 reauired under this subdivision in the individual income tax or pro�erty tax refund
instructions mstead 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 ofthe private or public data upon request by the individual subject ofthe 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 ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compl iance is not possible. If he cannot comply with the request
within that time,he shall so inform the individual,and may have an additiona]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 ofpublic or private data
conceming himself. To exercise this right,an individual shall notify in writing 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 bel ieves 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 appeated pursuant to the provisions ofthe administrative procedure act relating to
contested cases. •
DATA PRNACI'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 perrnit 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.
First D4iddlc
Last
Address
City State Zip Phone
I understand my ights as st ted above.
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ig ture
Reset Form 32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR QFFICE USE ONLY
ADDRESS OR LEGAL: _ 1��`� � �. Q� � � V1, (��;�;
PID:
DESCRIPTIONOF WORK G�Gv P� cr � • � reS�c�g
--_____________________—______y _______________________________________ �'oa��/�.
ZONING REVIEW BY.• DATEAPPROi�ED: / C�
BUILDING REVIEW BY.• DATEAPPROTfED: K - z- a�
FEES TO BE CHARGED: � Misc. Fees Calculated By: ��r��y ��
PERMIT Yes �% No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes_� No ufATER CONNECTION
INVESTIGATION FEE Yes No-� PARK FEE
SAC Yes No�� SITEINSPECTION
Number of SAC Units OTHER (spec�)
ZONING CHECK LIST � Zoning District: �—��_ �� �� � � ' �'_—"�_
Fire Department: Post Off ce: School District.�
Lot A��ea: Sq.ft. Acres •�� Width Depth
Survey Submitted: Yes�L No Date of Survey: �q9� �-�j�/��
��rcr, li C.e..)
Proposed Setbacks: ,
F�ront$a�: �� . � Right Side: �/j0 C.�C)yt�
Rear(Street): �O R� Left Side: Ij0 �
Adjacent Structures: h/� Wetland: ��
Building Height: Def. Hgt. Peak Hgt. � �C�/�'� � �C
Lot Coverage:_�
Grading: S1affApproval Date: _ By: Council Approval Date:
Septic: Staff Approval Da[e: ����� By. ��
Zoning File: # Resolution: # Resolution Date:
Shoreland District: MCu'D Permit:
Avg. Setback: BluffSetback: LotCoverage:
Fxisting Proposed
Hardcover: D-75'
75-250'
250-.i 00'
500-1000'
Hardcover i�ariance Regui�-ed: Yes No Date of Council App��oval:
REMARKS(in house):
33
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CITY OF ORONO CALLED IN � ��
INSPECTION NO,T�� SCHEDULED 8� /�
PERMIT NO. � COMPLETED "
ADDRESS C�������
OWNER CONTR.//'1/.��-� f G
TELEPHONE NO. �P�O�-°�J% �7�v
. � � _
� DESCRIPTION
��NG ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
RAMING ❑ MECHANICAL FINAL ❑ IAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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W� ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED '� ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP OROER POSTED.CALL INSPECTOR
O INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� 249-46QQ
OwnerlContractor on site:
Inspector. ��„_�I 1 �
White Copyllnspector's File Canary CopylSite Notice
� _� �_ ' TE TIME V
CITY OF ORONO ��1y�3 CALLED IN � S�
INSPECTION TIC SCHEDULED T'.' C�
PERMIT NO. COMPLETED '
ADDRESS lD f�
OWNER _ CONTR.
_�—
TELEPHONE N0.���Z'L� �a —�-5— ��� g�
� DESCRIPTION \�����c2�
� ❑ FOOTING � MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
O4�aAlSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
v WALL BD. ❑ WATER HOOK-UP
Z ❑ ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBtNG RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
� ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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W
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ��CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �952� 249-4600
OwnerlContract r on s,ite;,
Inspector. ��l�� �
White Copyllnspector's File Canary Copy/Site Notice
�� � �Q�``
`-�'� � ^DA7T TUvI�(
CITY OF ORONO CALLED IN �� I� �-��f/
INSPECTION TIC� � SCHEDULED � -D L3; �
PERMIT NO. �I I COMPL TED
ADDRESS �� (l �!�v� C�CISP �
OWNER��J`S�'fnh-� -��S CONTR.��.S�� �
TELEPHONE N0. LP� 2 ZS ( G�] �
� SCRIPTION ��
� �FOOTING ❑ MECHA RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
� WALL BD.
Z ❑ ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
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INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours irt advance. �952� 249-46QQ
OwnerlContractor on site:
Inspector. � . n
White Copyllnspector's File Canary CopylSite Notice
V� DATE TIME �
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CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED F� -ZZ� '- '(��
PERMIT NO. 1�l L C/T 3 COMPLETED
ADDRESS � � •
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TELEPHONE NO. l9 �� — ��� "—q�G
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� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
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❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� 249-4600
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White Copyllnspector's File Canary Copy/Site Notice
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1 heceby certify that this is a true and correct representation of a survey of F� �'
- �ARs - GABRIEL the bo�x�daries of the above deacribed land and of ths location ot aM buildings. ��z - ; PR E PA R E D FO R � , _
LAND SURVEY�ORS, INC. �� �r' �� a� aN visibb encroechments, if any, from or on said land. - �� - " - - _
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3 As survsyed by me this 7�h da�r of �CY'/� . 19 �� - , 3�_�e � C�s�or� Cof�a es _
3030 H�rbor LarN Noa /��� �
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a Phone: (a 12) 55�-0908 ���-30�
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