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Home My WebLink About2001-P04289 - addn/remodel/repair ' ' PERMIT CITY OF ORONO Permit ►vumber: 2750 Kelley Parkway - PO Box 66 P04289 Crystal Bay, Minnesota 55323 P2fClllt Typ@: Addition/Remodel/Repair (952) 249-4600 Date Issued: 9i2si2oo� SITE ADDRESS: 139 Chevy Chase Drive Wayzata, 1VIIv 55391 P��: 36-118-23-4]-0025 DESCRIPTION: UBC Occupancy x3 Construction Type VN Proposed Use: Kesidentiai 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: r,iecuicai(staie j NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 522.55 Valuation: $ 37,540.00 Plan Review Fee: $ 339.69 State Surcharge Fee: $ 18.80 TOTAL FEE: $ 881.04 APPLICANT: Micheal Hayes Homes Inc. OWNER: Mr. &Mrs. Beltrand 6998 Kenmar 139 Chevy Chase Dr Bloomington, MN 55438 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. � _ /`�� l_.+`'li"��-- �� APP T ER TEE I NATURE ISSUF,D 13Y SIGNATURE Copies: 1-File(Signitures Reguired), 1-Applicant, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1 � `�.� �-.. Total Fee: $ '��? '�� / Date Received: t�-y -�'� Entered By: ��/�) Permit#: �C�`-/� ��y � : �; r;�— �;I /`�; , / 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 OR�ONTRACTOR JOB SITE ADDRESS: I 3�j C1��„ C I,v�s�;• �2 ZIP: SS 3 i i NAME OF OWNER: ,CS��,�, ��/�i��„/ PHONE: (home) (work) MAILING ADDRESS: �� e �.�ti CL�,,� D• CITY: w��z�.� ZIP:�-� CONTRACTOR: /�-��r1�,/".�.,�� /✓d;..K�: PHONE: `IjZ-�i7S— �i'�i �l CONTACT PERSON: �,j� MOBILE/PAGER: MAILING ADDRESS: G Ss� %��,,,,.�.,.,�, ��:�,� CITY: i�/��,�, ZIP: Ss��K STATE LICENSE: # Z�� ARCHTTECT/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�: �� yc� �Gy �� '� r,--.u� , �'' /�?�5/c� �S'c-z�..�.�-�--- ��S c�c /��-V--�`.: � STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �J .s Y� i 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: �`��2� DATE: �� / �� NOTE! Parade of Homes events require separate permit 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. The rights of individual on whom the data is stored or ro 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 wi[hin 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 identiry of other persons or entities 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 place the nocice reauired under this subdivision in the individual income tax or nrooerrv 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 infornted whether he is the subject of stored data on individuals, and whether it is dassified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public dara 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 da[a and informed of iu 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 authoriry 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 coscs 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 shall so inform the individual, and may have an additional five days within which to compiy 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 complcteness of public or private data conceming himseif. 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)correct the data found ro be inaccurate or incomplete and attempt to notify past recipienrs 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 induded with the disclosed data. The dererntinadon 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 Ciry State Zip Phone I understand my rights as stated above. Signature 4 6 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: t 3�t C 1-� c'c,v y C 4-t�A S� PID: DESCRIPTION OF WORK: �N T�Ly (,,4� � -f-1 b r�J ZOti"Pi tG REVIEW BY: DATE APPROVED: °r -�v-�vc BUII..D�1G REV�`V BY: DATE APPR4VED: � - r� - n� FEES TO BE CHARGED: Misc. Fees Calculated By: PER�VIIT Yes �/ No PLA�v REVIEW Yes �' No SEWER CONNECTION STATE SURCHARGE Yes _� No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ZO�tING CH�CK LIST Zoning District: (Z-1/� Fire Department: W�y-u..� Post Office: ��,pr�,,-�--�-r� School District: �„��ar..�-�.4��3 Lot Area: Sq.ft. /Uo c.1�Frwbe Acres �va C/�i4rv�e Width — Depth — Survey Submitted: Yes oc No Date of Survey: o,� �_��,�, -t-��.- b 1 Proposed Setbacks: Front (Lake): $S� �' Right Side: 40� } Rear (Street): I 8p' '�' Left Side: SS3� '� Adjacent Structures: N(Ih Wetland: N 1 v4 Building Height: Def. Hgt. U� � Peak Hgt. U�l� Lo[ Coverage: C9�1�- Grading: Staff Approval Date: N � 14 By: Council Approval Date: Septic: Staff Approval Date: N� l�4 By: Zoning File: # — Resolution: # Resolution Date: Shoreland District: 11�(� Avg. Setback: Bluff Setback: Lot Covera�e: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: RE1�IARKS (in house): 7 BUILDING REV�W CHECK LIST UBC: R' 3 CONSTRUCTION TYPE: V � Sq Footage $Per Sq Ftg Basement x _ lst Floor z = 2nd Floor x = Garage x = R = TOTAL Estimated Construction Value: $ 3`7,S`{C� sO Inspections Required: `Vork Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection _�Footing ` Septic Sewer Connection �Framing Fireplace Lawn Irrigation oC Insulation (Masonry) O[her a Wall Board (Mfg.) Well (State Permit) �Final Grading/Filling �_Electrical (State Permit) Other REMARKS(IN HOUSE): ---------------------------------------- REV�W BY OTHERS: DATE: Access: Ezisting New Access Approval: Date gy; - ----------------------------------- RENIARKS (TO BE NOTED ON PERivIIT�: 8 - t 39 �he�� C1ti�! � � _ � • - � F.LED vJ PE[w��-� � I - �) S Pnone: GReenwood 3-8352 .�RLEIGH C. SMITH Regisiered Professional Engineer and Land Surveyor 1S215 1h'ayzaia Boulevard Wayza2a, Minnesoia . (' , , �� , _. � ''� , � _ , PLAT OF SURVEY � �=y, � �=. �._ J ;._� : . . _. . _ � OF PROPERTY OF. �T_ - - '- - - - -"- � _ .:� :- -" -- - — - -- ' - - • _ . H �_ • . - � • described as fol;o•.�•s:___ __. _ - ' , ---- --— - --- - --- -- -- - - -- ---� -- I� . • � ' � - • ,, . . , ,� , , .. . 1 � , . . ScaIe: i inctL__-�_ __feet. ---- -- - , � � _ •- - - ----- -- - --- -- -- _. ...._ . � - -• -. ; - - -- - - --� — 1 �'��. � ' -. _ - i i � , , , . i � ' i , iw . - ��. �. ` , . i_; � j �. �� V ' ' - _ � ONO ��P� � � . .:. �, � � � � .�.., n.t � . � , :.,_ . CITY OF t�� ,�� .� . � D� S1 i E P�A�V Gt�AD1NG P�AN �t` � . � '� C<APPP�4`Jc�► - �� '�'� � �, � �>- - ' �� , �,� fi!"��tillf�J ia,'�T�f t-!�".1�ISI��J •`.'� r n � 1r�.-��rr�' � . T � � i � . . � �15y�-, �.J , , . .,t, �.� a . �. BY � . �/ � �� DA'f� � - � ` '. � �` � � �� j , ' i i /; � , � � � � �'�. _ f / ``` �\\\`• ' , '�` �` 7 �� Y � i� �� r�� . • r . � �� _ ,' � �! .` • , \\I`; . ,� r '� f. � �� , �' j_'�, � // i CERTIFICATE OF LOCATION`OF BUILDING CERTIFICATE OF SURVEY � �' ' . / �'" �. '.1" 'r,; I hereby certii}- that on_..:_>:�� ' �, 19._��I I hereby certify that or. • • - •- - - , 19�.L I made a surve�• cf the propo�ed ]ocation oi tre buiidin�, surve�•ed the property described abo��e and that the on the abo��e describ2d property and that the location, above pla: is a cori•e�t representation of said survey. of said building is correctly shown on the abo�•e plat.�. � ..-_� , h 1` ;__'_---�---•- \ �+'1��i q�,�,��..!�{.l L �� ,;9 � f 1 �'''��' " _ . _ - ��_ � ;- � t �'�Q.� �-�+fY1 ti31�\��"�`-� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED o ��..�„ blynxr- PERMIT N0. QO�� COMPLETED �� ADDRESS OWNER � ., CONTR. TELEPHONE N0. 1�� C�St_VlA �--Kl�� D� ON �OT �!1 C1 CI-Q--��. l�� 01 FOOTING 11 MECHANI RI 18 EXCAV/GRADING/FILLING Q 0 MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 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 � 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: a ,� {'�e��1 j � � o ,Y /--2 (/1 c �c ' � �U a . � � � � �� .��-�_��c�nF o � � W � Q � z W � W � � O W� ❑WORKSATISFACTORY:PROC D ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIHED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 Owner/Contra tor on site: Inspector. .�C-�l`i��: t�t� White Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALIED IN INSPECTION NOTICE� SCHEDULED PERMIT NO. � �� l COMP ETED ��`'f —� ADDRESS �3�� G �'�Y `��'�`'�� OWN ER CONTR. TELEPHONE NO. � DESCRtPIlON � �FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP Q = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z D COMMENTS: � w a j ��/� 11� ,%C-��,,t�v O -z- , a � O � W � Q � Z W � W � � d �qJORKSATISFACTORY:PROCEED � PROJECTCOMPLETE W � ❑ CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. �� PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance.473-7357 OwnerlContractor on site: /�� > Inspector. l Y�� White Copyllnspector's File Canary CopylSite Notice � n�� DATE TIME CITY OF ORONO � CALLED IN INSPECTION NOT E SCHEDULED � PERMIT NO. COMPLETE � �.;. ADDRESS ��'` c OWNER CONTR. � TELEPHONE NO. � r �� ' �� ,-- � DESCRIPTION �f�:�IrJQ1 l� 01 FOOTING 11 MECHANICAL 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y O 03 INSULATIGN 24/25 WOOD BURNEFUFIREPLACE 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 � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTORTOMEETYOU: YES_NO � COMMENTS: � W a o � � C�(/� j/ �. � 0 � W � Q � z W � W � � � d W� i�VVORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W �❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERINCa PERMANENT O CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL FETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector.�L-�i; � � �� White Copylinspector's File Canary Copy/Site Notice � � � G � � �ATE TIME CITY OF ORONO ° CALLED IN INSPECTION NOTI�j,� ^�� SCHEDULED � � PERMIT NO. ��L� C PLETED t� ''• ADDRESS � ��/ `-'�-�� CT � OWNER CONTR. �� "��-� TELEPHON E NO. �� '�7�� —�3`�T � DESCRIPTION J�l'��C-� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y O 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 PLUMB(NG RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a � J O � � O � W � Q � 2 W � W � � � d �.�'1NORKSATISFACTORY:PROCEED �iOJECTCOMPLETE W ❑CORRECT WORK 8 PROCEED �❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED �INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-460� OwnerlContractor on site: :•�'� � , ; ,,�..._ Inspector. ��t.� �--� .• White Copyllnspector's File Canary CopylSite Notice