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Home My WebLink About2005-P08464 - addn/remodel/repair CITY OF ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Po8464 Crystal Bay, Minnesota 55323 Permit Type: aad�c�o�xemoaevxepa�r (952)fZ49-4600 Date Issued: 3i3i2oos 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: Residential Pernut Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: i'iumoing iviecnanicai rirepiace �iecuicai�siaiej NOTICES/REMARKS: T'"___1' T___"___"_� FEE SUMMARY: PermitFee: $ 441.75 Valuation: $ 30,000.00 Plan Review Fee: $ 287.13 State Surcharge Fee: $ 15.50 TOTAL FEE: $ 744.38 APPLICANT: Lecy Construction OWNER: Kenneth&Laura Higgins 15012 Hwy. 7 110 Chevy Chase Dr Minnetonka,MN 55345 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. /� , , � `��--� Ct c�+'� /� - APPLICANT PERMITEE SIGNAT E ISSUGD BY SIGNATURE Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 �� I �,�;-� � i �,� Total Fee: ,$ �, Date Received: ;:�� Zv�� Enter.ed By: ;��r'�_ �i � �� Permit#: ;� �.`� ��(p� � �, , ' 1 CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all infornzatio�z) --------------------------------------------------------------------------- ---------- ---------------------------------- THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: ��iV � �'� � � ZIP: � Cj,�J� J Will this be a P r de of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Non permitted events will not be allowed. NAME OF OWNER: �� j�' C �'� PHONE: (home) Z ' � � ��j� (work) MAILING ADDRESS: ��(,�,�')'y� L� � ��-}� CITY: �►'��Y) O ZIP: CONTRACTOR: � I�S - Y�'� PHO E: ��jL �/��-f ��, CONTACT PERSON: Gt r 1 ��,-C� -C MOBILE/PAGER: �3�8 (�I Z 7U 3 Z-z-t/Z MAILING ADDRESS: __J�/a I�w y �7 CITY: /I��'nn��h^�k� ZIP: SS� S— STATE LICENSE: # � 7�_3 ARCHITECT/ENGINEER: ��--f�yt� PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Accessory Structure Addition Move RemodeUAlteration �� Land Alteration PROPOSED WORK(describe in detai�: �ArJ-� i?'1�'.-i'l,t �-j n 1�!� STORIES: I SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � ��, �%t'� 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 pernut and work is not to start without a permit; and that the work will be in accordance with the approved plan. � „ ' ) l � � APPLICANT'S SIGNATURE: " ' �t �'/ ��d�-' DATE: � �� ' � Sec.13.04 RIGHTS OF SUBJECTS OF DATA , Subd.1. Type of data. The rights ot 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 con�dential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collect(ng 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 sl�all 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 nlace the notice required under this subdivision in the individual income taz or orooertV 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 individuat 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 uuthority 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 ofthe 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 writing the responsible authority describing the nature of the 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,inclading reciptents 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 individual's statement 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: 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. First Middle Last Address City State Zip P6one I understanc�my righ�s stated a ove. � ! �� ` ��_�... Signature CHECK OFF LIST FOR ISSUAIVCE OF�'ERItiIITS � FOR OFFICE USE ONL Y ADDRESS OR LEGAL: I l� Gt�t.v v�5 c �2 -- PID: DESCRIPTIONOF Y�ORK: ��S�.wv..-�� N�si� ------------------------------------ ------------------------------------------------------- ZO�VING RE VIE YT�B Y: D.A TE APPR O VED: '� - S-o � B LiILDING RE VIE l�B Y: D,�TE APPR O 6'ED: � - �—�S --------------------------------- FEES TO BE CHARGED: hlisc. Fees Cnlccclated By: PERttitIT Yes f Na PLAN REVIEGV Yes � �vo SELVER GO�VNEGTIOtV STfLTE SURCH.4RGE Yes '� tVo tiT�ATER COtV�JECTIOtV INVESTIG,4 TIO�V FEE Yes �Vo � PftRK FEE S�l C Yes tVo � SITE tNSPECTIO�V 1Vumber' of SAC U�zits OTHER (specify) ------------------------------------------------------------------------------------------------ ZO�VIIYG CHECh'LIST Zor�irt,;Discricc: N o G[.F-�4�v�'�P Fir•e Departnaerrt: Post Ofj"�ce: Scltool Disd'ict: __.. Lot,�{ren: Sq.ft. Acres GYidth DepNi Scuvey Sc�brnitted: Yes N Date af Scuvey: Proposed Setbadcs: Frorit(Gal;e): Riglzt Side. Rear(Str•eet): Left Side: Adjacent Structures: GYetlan : Biiilding Keigltt: Def. Hgt. PeRk gt. Lot Coverage: � Grading: Staff.4pprovc�l Date: By: Cour2cil rLpp��oval Date: Septic: Staff,�lppral�a( Date: BY� Zo�iing Fife: # Resofutiai: # Resolutia:Dnte: Sl�oreland Dish•ict: Avg. Setback: uff Setback: Lot Coverage: E.�istin,; Pa'oposed Hardcovei•: 0-75' 75-250' 250-500' 500-1000' Harcicover Var•iarice Reqccirect: Yes o Date of Cocuaci!�lpproval: RE11�lARKS(i�t ltouse): 3 �. r�„ , ��.� . ��r � � . � '� BUILDI�VG REVXEI��CHEChrLIST UBC: �?• 3 COh''STRUCTIO!ti TYPE: �LI� _ Sq Faora�e .S Pe�•Sg FcJ Baseme��t x = !sr Floor x = ?,1d Floa• .c = Garrge � _ .� _ TOTAG Estir�tated Caiistructio�� Y'alue; ,S 3C��C�OO� Inspectiolts Required: lY"ork RequiriitJ Separate Perr�iits: Si�e �[Plurribing Fire Hardcove�•Ramoval _�t �Llechanical GYater Co�uaectioJi Fooh:r�g Septic Setiver Coiuiectioii X Frnmii�g �_Firepface Gatiwi!�•r•igatioi: _ C (nsulatioit ('i�lasonr}�) Other �_ GY'al!Board o- (A�ffg.) 6Ve11(State Per��tit) _�_ Firial Gracfi�ig/Filliitg o�Electrical(State Peririit) Other RE�tiIARIiS(IN HO USE): ------------------------------------------------------------------------------------------------------------------------ RE C�IE tV B Y O THERS: DATE: Access: Exisci�t,� rV"etiv ,•tccess�{pproval: Date B�•: ---------------------------------------------------------------------------------------------------------------------- RE�'�f�Rh'S (TO BE NOTED ONPE121titIT): 32 :� ��- ✓ DATE TIME CITY OF ORONO� CALLED IN INSPECTION NOTICE scHE��Eo ��. 1��(�t-� 1 G�.-�� PERMIT NO. �'C; � �-!Lc`� coMP�TEo ADDRESS � I C� C� l ti ��I �..��C_'�e�_�Q �IZ ; OWNER CONTR. t� TELEPHONE N0. �r� �� C'-� �'� � � � DESCRIPTION ��« ��'`� � ��y�"1� � 01 FOOTING 11 MECHANICAL RI '� 18 EXCAV/GRADING/FILLING Q 02 FR.4MING 13 MECHANICAL FINAL �\ 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLA E 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE 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 SEPTI FINAL 35 HARO COVER REMOVAL J 10 PLUMBING FINAL � �'�� 3.6 FOUNDATION/REMOVAL � OWNERICONTRACTORTOMEETYOU: YES_NO � �� T �� ,�� COMMENTS: �'�7� 5 �%L� P Ru�qq i �- �C=� +�l r �� , � C"t 1 � .l ��,1 l � J O � � � � o .�r, � �� W � Q � �� - � Q t� z w � W � � d W ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL{NSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca�l for the next inspection 2a hours in advance. (Q52� 249-4600 OwnerlContracto r��ite: Inspector. ' White Copyllnspector' File Canary CopylSite Notice �� `� DATE �TIME Y CITY OF ORONO CALLED IN �/(�/ '�� INSPECTION NOTIC ��j�,.,(,J SCHEDULED � �, /v PERMIT NO. U��`� � COMPLETED ADDRESS �"�"�'�"� OWNER CONTR. ` `-�`'`�� TELEPHONE N0�/,z!'' L��c� �U3 �c��3 � DESCRIPTION ' ' �� ! ��'�� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h O 03 INSULATION 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 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP � 09 PLUMBING RI 23 SEPTI FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: ,(o� /�� /J_i2.! 7�U � �—�rC�1� !� � ` O a � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE � ❑CORRECT WORK&PROCEED I l ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR � CITATION ISSUED ❑ INSPECT�ON REQUIRED.CALL TO ARRANGE ACCESS. Call for the n t inspection 24 hours in advance. (952� 249-4600 OwnerlContr ite: Inspector. White Copyllnspector's Fil Canary CopylSite Notice