HomeMy WebLinkAbout2002-P05003 - addn/remodel/repair ` PERMIT
V I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 Posoo3
Crystal Bay, Minnesota 55323 PefCTllt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: aii2i2oo2
SITE ADDRESS: 131 Chevy Chase Dr
Wayzata,MN 55391
PID: 36-118-23-41-0021
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: riumoing �iecfficai�siaiej
NOTICES/REMARKS:
FEE SUMMARY: PernutFee: $ 825.75 Valuation: $ 76,000.00
Plan Review Fee: $ 536.83
State Surcharge Fee: $ 38.00
TOTAL FEE: $ 1,400.58
APPLICANT: Anderson Buckeye Builders Inc. OWNER: Patrick Moyneur
6500 Elm St. 131 Chevy Chase Dr
Corcoran,MN 55340 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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t APPLICANT PERMITEE SIGNATURE ISSUED�Y SIGNATURE ��
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Copies: 1-File(SiQnitures Repuired), 1-Apolicant, 1-Monthlv Renorts, 1-Assessing, 1-Finance Page 1
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- Total Fee: $ ��/'� �; �� Date Received: �--��-(���
Entered By: 'K1 ' , ;
� ;'� � Permit#: �A-C�.��O��
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CITY OF OR�NO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER O ONTRACTO
JOB SITE ADDRESS: � �=-> �' � /-� � c/ i �-'_C�, �r: �>,_ZIP:
NAME OF OWNER: f��` T � `i�. ,�� c.,v� ,-_�, �-_ PHONE: (home) 7�; .� /�/73 s 3 3 '�
(work)
MAILING ADDRESS: %"3 I �� �= v y �Ge � ;� CITY: ;J r,v G ZIP:
CONTRACTOR: /-{ �; ;���-S y-�1 !3 :: �,�E�y� i3�: /�.� � PHONE: ��,3 H��:' �; cy�'2.
CONTACT PERSON: �.aHr y /��d�,_s ;; .J MOBILE/PAGER: �jz, �G � �,,S�
MAILING ADDRESS: G; s � <� �� � �., S T CITY: ,,_ ;; �.�, ��-,_. � ZIP: �>-S �, c
STATE LICENSE: # ���.: ,�Y ��s
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ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration ,K Land Alteration
PROPOSED WORK(describe in detai�: _ �., ;; � � /; ,'t�= /z � _.., -> � f :: � 7`
,`, } 1l. .i C_., - �',v i` C �. t.s;.--. ..� �. ,� �/
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTLVIATED 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 Ciry 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: .'� ;;�.t.�1 �:�(�i-�-�,�.�,--_ DATE: ��_ .:Z. -v Z---
,�;
NOTE! Parade of Homes events require separate pernzit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
. � •
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. T'he rights of individual on whom the data is stored or to be stored shail be as set forth in this secdon.
Subd.2. Information required to be given individual. An individual asked[o 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 ro supply the requested data;(c)any known consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identiry of other persons or endties authorized by state or federal law ro 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 nlace the notice reauired under this subdivision in the individual income tax or vro�ertv 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 thereafrer unless a dispute or action pursuant to this section is pec�ding 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 requesdng 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. If he cannot comply with
the request within that time, he sha11 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 hunself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreement. The responsible authoriry shall within 30 days either. (a)conect 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 determinaaon of the responsible authoriry may be appea(ed 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.
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First Middle Last
Address
C��y State Zip Phone
I understand�ny rights as stated above.
L-� ��t�4�/ ,i � � ----
Signature �
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6
• CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: (3� C i-�E v Y C K,as c� Q,2
PID:
DESCRIPTION OF WORK: �LE wl p p�.L
---------------------------------�------- ---------------------------------------------------:---y--------------
ZONING REVIEW BY: DATE APPROVED• i� o-z
BUILDING REVIEW BY: DATE APPROVED: �_�-o Z
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes .� No
PLAN REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District: N U G�-F►4�G iP
�1-
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres idth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetl .
Building Height: Def. Hgt. Peak gt.
Lot Coverage:
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:
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REMARKS (in house): �
;
7
BUILDING REVIEW CHECK LIST
UBC: IZ 3 CONSTRUCTION TYPE: �(/�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ -1(�,��� ou
Inspections Required: Work Requiring Separate Permits:
Site �c Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
x Framing Fireplace Lawn Inigation
yC Insulation (Masonry) Other
x Wall Board (Mfg.) Weil (State Permit)
oc, 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 �LLED IN �
INSPECTION NOTICE ��(� SCHEDULED � �
PERMIT NO. � '✓""� COMPLETED
ADDRESS � � v ✓K-
OWNER CONTR. C'- �
TELEPHONE NO. �Q���(�� —� ( I S ����
� DESCRIPTION �,tv�.��`'�
� Ot FOOTING 11 MECHANICA RI 18 EXCA�//GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WAIL 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
� 10 PLUM8ING FINA� 36 FOUNOATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:�YES_NO
� MENTS:
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W� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W�CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46�0
Owner/Con actor on s�t -
Inspector:��a y� �r�-1�
White Copyllnspecfor's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTIO�OTI� SCHEDULED L-�- � V�T
PERMIT N0. �'`� � �� COMPLETED
ADDRESS '�'� J � � �
OWNER ' c- I� CONTR._C�v�/��./J-t-►����,u.C�C�/}2
TELEPHONE N0. C�p �,� � � 7 � 1 �� O
� DESCRIPTION �����'Y�'Ck.f�.��
� 01 FO _ 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 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 OS FINAI 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 REM AL
J 10 PLUMBING FINAL 36 FOUNDATIONlREMOV
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO \
� CO MENTS: �
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W� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
��ORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
�CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTIONRE�UIRED.CALLTOARRANGEACCESS.
Call forthe next inspection 24 hours in advance. �9�2� 249-46QQ
Own�rl actor on site:
Inspe � �
hite Copyllnspector's Ffle Canary CopylSite Notice
�
` / ��� DATE TIME
CITY OF ORONO � CALLED IN
WSPECTION NOTICE SCHEDULED � t'��'Z •43�
PERMIT NO. ' O y b0� COMPL TE�
, 4
ADDRESS ` �L�
OWNER-� CONTR. '��� � �
TELEPHONE NO. �G I� — ,� � � — C' l� S
� DESCRIPTION
� Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
-_ 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
INSULATION j 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z • 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COM NTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
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❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspecti n 2q��� vance. (J52� 249-4600
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Inspector.
ite Copyllnspector's File nary Copy/Site Notice
DATE TIM
CITY OF ORONO CALLED IN
INSPECTION NOT�CE SCHEOULED fU--2T- UZ
PERMIT NO. S�� COMPLEfED
ADDRESS �
OWNER CONTR. i--
TELEPHONE NO. l� �o� �fG` ,��T/ S—
� DESCRIPTION G�=��2�- _ _
� 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
5 FINA 14 SEWER HOOK-UP O6 PROGRESS
� 7 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
� 10 PLUMBI 36 FOUNDATION/REMOVAL
� OW CONTRACT O MEET YOU: YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W O CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. (952) 249-4600
OwnerlContr�r o site:
Inspector. _
White Copy/lnspecto File Canary CopylSite Notice