HomeMy WebLinkAbout2001-P04546 - addn/remodel/repair � � PERMIT
C I TY O F O RO N O permit Number:
2750 Kelley Parkway - PO Box 66 P04546
Crystal Bay, Minnesota 55323 P@fllllt Typ@: Addition/Remodel/Repair
(952) 249-4600
Date Issued: l lisi2ooi
SITE ADDRESS: 110 Chevy Chase Dr
Wayzata, MN 55391
P i D: 3 6-118-23-41-0046
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: xesidentiai
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: ►�iumoing iviec;nanicai Eiecaicai (siaiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 1,032.95 Valuation: $ 106,700.00
Plan Review Fee: $ 682.43
State Surcharge Fee: $ 55.00
TOTAL FEE: $ 1,770.38
APPLICANT: Hayes Michael Homes, Inc. OWNER: Kenneth& Laura Higgins
6998 Kenmare Drive l 10 Chevy Chase Dr
Bloomington,MN 55438 Wayzata MN 55391
THE UNDERSIGNED I�EREBY 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 BUII,DING CODE REQUIREMENTS.
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,/' PP ITEE SI NATURE j ISSUED BY SIGNATURE
Copies: 1-File(Signitures Required),1-Applicant, 1-Monthly Reports, 1-Assessing, 1-Finance Page 1
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Total Fee: $ .��,; Date Received: 0��'� ��� �'
Entered By: ; � r.(1� � �t � � Permit#: � '„ , �
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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 O CONTRACTO
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JOB SITE ADDRESS: j%C� C'�/�UY «/���:� ZIP• S�S����/
NAME OF OWNER: %��,�,�,�_/L , .�u,,.,;; PHONE: (home)
(work)
MAILING ADDRESS: f�c � �,�., �� G���- CITY: �:;�.�� �� ZIP: << 3:i
CONTRACTOR: /.�i�/l��%/l�.��_ //_--`. PHONE: �j��z -C;'75= � 3� �/
CONTACT PERSON: �;��.•' %�-�, MOBILE/PAGER: �—
:VIAILING ADDRESS: G�G'� K��,.�,�:,_ ��� CITY: ✓'�/���:v�-��- ZIP: SS�J�
STATE LICENSE: # ?i�.�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: ���-�,�� � %/:.:,�._,
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �C�l - �U=' . —
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: �v�2�/�r
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
5
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 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
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
e�forcement officer.
The commissioner of revenue mav place the notice reauired under this subdivision in the individual income tax or�ro�ertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry, an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as pubiic,private or confidential. Upon his further request,an individual who
is the subject of srored 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 infornted 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 authoriry 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[he 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[he 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 conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible authority shall within 30 days either: (a)correct the data found ro 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 disdosed only if the individual's statement of disagreement is included with the disclosed dara.
The determination 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 �ity 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 1/%C/��c � /��'u�:-`--�' c �-�/�-i
First Middle Last
l�`S� ���z<-/�9- ,C'-�� -
Address
�='j�:� �. . .`�- �-��c� �—�- Y3�
City State Zip Phone
I understand my rights as stated above.
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Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: r �0 G N l:.V� C FE-►45 C
PID:
DESCRIPTION OF WORK: A���n��
----------------------------------------- - -- --------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: io -2 S -v�
BUILDING REVIEW BY: r,�-- DATE APPROVED: �v-z4 -v�
-------------------------------------�------------------------------------------------------------------------------
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes c/' No
PLAN REVIEW Yes �/' No SEWER CONNECTION
STATE SURCHARGE Yes �� No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST zoning District: (�� ��
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Z.S,25 3 Acres . 5�1 Width //1,(k;GUch�� Depth
Survey Submitted: Yes� No Date of Survey: Z-Ib� SS �,v ��,L
Proposed Setbacks:
Front (Lake): b2� } Right Side: 3p' �
Rear (Street): ���'� Left Side: �b' ?'
Adjacent Structures: A-�;-»,ct+t� Wetland: �1' ��}
Building Height: Def. Hgt. Q �� Peal:Hgt. Qk
Lot Coverage: `�•��a
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # ` Resolution: # Resolution Date:
Shoreland District: ��
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
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BUILDING REVIEW CHECK LIST
UBC: �- 3 CONSTRUCTION TYPE: �/�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
oa
Estimated Construction Value: $ (O6, ���
Inspections Required: Work Requiring Separate Permits:
Site _d�Plumbing Fire
Hardcover Removal �Mechanical Water Connection
n Footing Septic Sewer Connection
� Framing Fireplace Lawn Irrigation
�Insulation (Masonry) Other
�Wall Board (Mfg.) Well (State Permit)
<Final Grading/Filling �Electrical (State Permit)
Other
REMARKS(IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMI�:
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,/ DATE TIME
CITY OF ORONO " CALLED IN
INSPECTION NOTIC�Ej SCHEDULED • vU ✓'�
PERMIT N0. �J "� � COMPLETED -� �
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y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 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
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�ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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� BEFOflE COVERING
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INSPECTOR W{LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Call for the next inspec ion 24 hours in advance. (g52) 249-4600
OwnerlContracto
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
�� ` �� �ATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI E SCHEDULED � /�'��
PERMIT N0. � � COMPIETED �► r�
ADDRESS � � �' �-�� �' �
OWNER CO T ���'
TELEPHONE NO. ja' `�� `— g �
� DESCRIPTION
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Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOREJWETLANDS
y 03 INSULATIGN 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
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INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (g52) 249-46��
Owner/Contracto n si
Inspector. -
White Copyllnspector's File Canary CopylSite Notice
�� � DATE TIME
CITY OF ORON ��`-" caLLED IN
INSPECTION N j SCHEDULED ---��
PERMIT N0. COMPLETED ' �• mQ
ADDRESS � ��
OWNER CO T � � --�
TELEPHONE NO. � � ' � � �
� DESCRIPTION ��
� 01 FOOTING MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 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
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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� BEFORE COVERING
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�CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CAIL INSPECTOR ❑CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cal1 for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContra o on site:
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Inspector. C,f,,�C. � �
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALIED IN
INSPECTION NOTICE '//- SCHEDULED �'�� � /��
PERMIT N0. `'�S'f(!� COMPLETED L'^__'_e`=1L� �--
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� DESCRIPTION �il�:t/72C2--+�-
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Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� WALI BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FIPt� 14 SEWER HOOK-UP O6 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
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INSPECTOR WILL AEfURN ❑CITATION ISSUED
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❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46��
OwnerlCon r on site:
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Inspector.�� ��- -�r—�
White Copyllnspector's File Canary Copy/Sfte Notice
OATE TIME
CITY OF O CA ED IN
INSPECTION N CE yL,� SCHEDULED �� -/3.-�.�/ �.`3 �
PERMIT NO. � `S / COMPLETED G��- ,��V
ADDRESS -� � C,�e(�� -�
OWNER � NTR. �`'�-��.-�-aclz.
TELEPHONE NO. ��� � :Y J ���
� DES ON
01 FOOTING 11 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
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 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
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❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952� 249-460�
OwnedContr r on site:
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Inspector.
White Copy/lnspector's File Canary Copy/Site Notice