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Home My WebLink About2005-P08982 - addn/remodel/repair PERMIT CIT,.Y OF ORONO ?750 Kelley Parkway- PO Box 66 Permit Number: po8982 Crystal Bay, Minnesota 55323 Pel'mlt Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 7/27/2005 SITE ADDRESS: 128 Chevy Chase Dr Unit# Wayzata,MN 55391 P�� 36-118-23-41-0041 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Plumbing Mcchanical Electrical(state) NOTICES/REMARKS: Garage Addition/Interior Remodeling-Double Fee-Work Started without a pernut FEE SUMMARY: Permit Fee: $ 776��5 valuation: $ 68,900.00 Plan Review Fee: $ 504.89 State Surcharge Fee: $ 34.45 Misc. Fee: $ 776.75 TOTAL FEE: $ 2,092.84 APPLICANT: Charles Allen Homes,Inc. OWNER: Todd&Jana Nelson 2320 Quinwood Ln.N. 128 Chevy Chase Dr Plymouth,MN 55441 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. PER T IGNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 Total Fee: $ Date Received: 7—ZO "O-� Entered By: Permit#: OBq$Z... CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER O CONTRACTOR JOB SITE ADDRESS: �ZPj �N,�1U� C�25G �'. ZIP: 55� 1� Will this be� P�rade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes }�NO If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates suf�cient on-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: ��I'(� ]��.�f V PHONE: (home) �SZ-`{��O' ��i��o (work) MAILING ADDRESS: (Z� Gk�I Y�,�,a� fJR, cITY: c�on,o zIP: ��J CONTRACTOR: C HA�(,E� A(LE l� T�ES PHONE: �C� 3'S�- S`l�� CONTACTPERSON: �� Nrap�r7�. MOBILE/PAGER: _C�12- �,yS- 5 ZQ� MAILING ADDRESS: 23Zp �u�Nwa�d vu. �J. CITY: �(�rndv'M� ZIP: �� STATE LICENSE: # S�� 20 Z�f.p�(� EXPIRATION DATE: 3�3/�Z 00� ARCHITECT/ENGINEER: C/1QCC��ipORF� PHONE: CaI Z• ��5�•SZ� MAILINGADDRESS: 23Z0 QVlNwooO Cn1 N CITY: PcXrnocfiN ZIP: �� NAME: REGISTRATION: # �$�¢Z TYPE OF WORK: New Addition X Accessory Structure Move Home Remodel/Alteration � PROPOSED WORK(describe in detain: � ��( �rQq�? �1d(�,�� lrt� i �i� � STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �p�jy g(�Q. � 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 ardinances 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 withthe approved plan. APPLICANT'S SIGNATURE: ` DATE: 7�� O�_ i 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 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 enforcement officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or property 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 individua]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,shal I be informed of the content and meaning of that data. After an individual has bee�shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unfess 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 the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe 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 Samrdays, 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 concerning himself. To exercise[his 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 individual's statement of disagreement is included with the disclosed data. 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 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 suppiy 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 Phone I underst my rights as state above. Sig 32 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: I 2 4'� C N C v�/ C��-/�5 c: PID: DESCRIP'I'ION OF WORK: �q,p,p„-�v...�� /��=`yioDP c. -, ZOr1NG REVIE�V BY: DATE APPROVED: -T- Z�1 - 0 5 BUILDING REVIEW BY: DATE APPROVED: �• z�- a S FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes ✓ No SEWER CONNECTTON STATE SURCHARGE Yes � No WATER CONNECTTON �INVESTIGATION FEE��'��'es r/ No PARK FEE SAC Yes No ,/ SITEINSPECTION Number of SAC Units OTHER (specify) ---------------------------------------------------------------------------------------------------------------------- ZO��G CI�CK LIST Zoning District: Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes oC No Date of Survey: (0- I - `j'�( Proposed Setbacks: Fron[ �a�e): 3�' Right Side: )00� � Rear (St�cct): I 2 3 Left Side: �{b Adjacent Struccures: /t!//� Wetland: N �� Building Hei�ht: Def. Hgt. p.k Peak Hgt. Lot Covera�e: c9.k-- Grading: Staff Approval Date: ^/�/a By: Council Approval Date: Septic: Staff Approval Date: n/�/� By: Zonin� File: # — Resolution: # Resolution Date: Shoreland District: /V� Av�. Setback: Bluff Setback: L,ot Coverage: Existin� Proposed Hardcover: 0-75' 7�-2�0' 2�0-500' 500-100�' Hardcover Variance Required: Yes No Date of Council Approval: � REl�L4RKS (in house): c�J O tZ 1� �T,/�l�-�'L',� �,.� ��t�-�� ('� +'— BUILDING REVIEW CHECK LIST �C� 2 '3 CONSTRUCTION TYPE: �((� Sq Footage $ Per Sq Ftg Basement z = lst Floor x = 2nd Floor x = Garage z _ z = TOTAL Estimated Construction Value: $ 6 ��Q Q c� °` Inspections Required: `Vork Requiring Separate Permits: Site C/Plumbing Fire Hardcover Removal _�Mechanical Water Connection �Oa��g � Septic Sewer Connection ✓'Framing Fireplace Lawn Irrigation vinsulation (Masonry) Other NWall Board (Mfg.) Well (State Permit) —.�F�� Grading/Filling ✓Electrical (State Permit) Other REl�IARKS(ni i HOUSE): ` _ �-~--- --------------------------------------------------------------------------------------------------------------------- REV�W BY OTHERS: DATE: Access: Existing New Access Approval: Date By: -------------------------------------------------------------------------------------------------------------------- REI�IARKS (TO BE NOTED ON PER1viIT�: 8 FRAN.K R. CARDARELLE 4�� '� _ � � � � �. ��'; Land Surveyor �,F12) 941-3031 � Eden Prairie, MN 55344 ��r�i�i�a� �e �� tri�� Survey For connell smith Book 345 Page 37 File 128 Chevy Chase Drive Orono, p1N . — �� x °%��:: :;, •.�.�! 1 ,, �'?�'v•,� �a��F`��';�l' F�rQo�`i �,:, � �(�6l-: � CN'e�� r l�. ±.� 6��' �d �, .,,.,,�•--'��' � � I � ',r `'j � �,+� r'I ��e��,�•:^i'y,!;�A!yi � �� r ', ,�t r..� '� t, �,,.--' J � �_ �s,'i , �. � ^ - ` �. V �>"1 '''~' g�± —' _'— '(` �, ,� �� n �1 �� . ��-�d e_....�.��.��.� i i" l \.r. ��/'' / / �- � / � : 1��. ��--� �� 1�,�i.2-Q-� � %� � �3 � �2°-��-�`' �' l� � ' l f`'� °`,, p ,�, C t4v Tt o� . ` 3� Q�_ \ry �— � �� Qr��Np,� r-�,� �+��ss ,' -;,,� � ;� ;' ST�� i� �Sm- �'`f � � � � ' ( /� �i�,�,5 ��7p ' z °.z ;� ; ,�� `— _' �— -_ 1y� 1 . � X �� ^ �� -..__,._6 1r.�_^�_..#_ � A t?r'Ive �- 4. .� L.J � i _Y �Gt�'� V �-�, �V ' " l � ^_f �— � - a• �.z �. \ ,' M` .�G,� "i �' � �- � \J � s ( , f" � ��: r � y,f (\j _ �� ` i� � � �% O r�( ^' �`� �_ '� � � � �� a �� i _�,� I �� ^-�-, -i 277 �,, o ,,�, , � " �8� � , �N I� V ,t 7,� __ � �;.. _; � `�i, �<'--,: , I\ �P � Scale: 1"=40 ' • o Denotes Iron Mon. found I hereby eeNly thel thle le a We nnd correcl representetlon of e survey of Ihe boundrlae of ��t 7� B 1 OCk 2, „Hi 11 owa _nor Hennepin County,Minnesote end the locetion o dl bufldinpg'theraon,end�ell �slble en rc pachments,M eny on seld land. 1 � 19 . � ;%�' . i . J � Surv�y��y m��n thls uc't ��y�t Ct��CL� __9_4— . - � -- , " .�- . ,�.,..._" �Y `�y� � ``�� Frank R. Cardarelle State Reg. No. 6508 L� AT TIME V CITY OF ORONO C LLE� g� INSPECTION N IC SCHEDULED � � PERMIT NO. D �7� COMPLETED ADDRESS o? ��-e � OWNER ONTR. < TELEPHONE NO. �� 2 3�� 7�1� � DESCRIPTION d�� / ��1�� 01 FOOTING 11 MECHANICAL RI 18 EX /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 OS FINAL 14 SEWER HOOrC-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 � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � J O >. � O � W � Q � Z W � W � � d �y W .�9VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE �❑CORRECT WORK 8 PROCEED r' ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR W4LL RETI}RN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cal1 for the next ins ection 24 hours in advance. (952� 249-4600 Owner/Contr s e: Inspector. White Copyllnspector's File Canary CopylSite Notice �/�!/ �� AT � TI M E �� CITY OF ORONO CALLED IN 1� � INSPECTION N IC SCHEDULED �� dD PERMIT N0. aJ COMPLETED ADDRESS ! C�� / OWNER CONTR. « �� TELEPHONE NO. (O l � D `t.� �Z%g � DESCRIPTION — � � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TFEE 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 i09 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 � � O � W � Q � Z W � W � � d W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ^❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITNIN HOURS. � pH0T0 TAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next insp ction 24 hours in advance. (952� 249-46�0 OwnerlContractor Inspector. White Copyllnspector's File Canary CopylSite Notice ✓� AT TIME � CITY OF ORONO CALLED IN �� INSPECTION T C SCHEDULED !D� :O� PERMIT NO. �" COMPLETED ADDRESS a� L� OWNER CONTR. � TELEPHONENO. ��oZ [Y�.r �a�� DESCRIPTION L �-��Z-{(�lJY� � 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 Z04 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � C�'� e� 0 � � 0 � W � Q � Z W � W � j d W� WORKSATISFACTORY:PROCEED L; PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN 7 CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next'nspection 24 hours in advance. �95Z� Z49-4600 OwnerlCo ractor n it : Inspector. White Copyllnspector's File Canary CopylSite Notice