HomeMy WebLinkAbout2006-P10565 - deck attached R�I
PERMIT
CITY OF ORONO
2750 Kell�y Parkway- PO Box 66 Permit Number: P1o565
Crystai Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair
(952) 249-4600 Date Issued:
11/21/2006
SITE ADDRE�S: 2389 Blaine Ave Unit#
Wayzata,MN 55391
PID: 17-117-23-34-0012
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Commercial-Business �����
Census Code 4�%I' �
Permit Class: Building �
Permit T e: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached
YP
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
�`�'`M'�!
FEE SUMMARY: Permit Fee: $ 9�•ZS valuation: $ 4,000.00
Plan Review Fee: $ 63.21
State Surcharge Fee: $ 2.00
TOTAL FEE: $ 162.46
APPLICANT: Bridgewater Construction OWNER: Mr. &Mrs. Robert Harding
4001 Monterey Ave 2389 Blaine Ave
Edina,MN 55416 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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APPLICAN PE [TEE SIGNATURE ISSUED Y SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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Total Fee: ' -�, ..• `���� DateReceived: //-�`�� �t--�� '
Entered By: .__� �_ � Permit#: �U5 Lp �`)
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all r�nformatio�z)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
`����'"`7
�.�; �� ,,; -,
JOB SITE ADDRESS: '��9' � ts 1,��►v� C�v� zlr: s5 3�C 1
Will this be a Parade of Homes, Remodelers Sho�vcase Home or other Display Home?
❑ Yes �No If yes, a specral event permit is r•eqarirecll�vith Police Departnrent and Crty Coz�ncil approval
60 clays prior to the event. Shutt(e bz�s service will be reqzrireci iinless app/icant denrorrstrates
sufficient o»-site par/cif�g is availab/e. R�on-per��ritted events rvrll not be allorvecl.
NAME OI'OWN�R: �O j��� `'-��5��1 N� �o PHONE: (home)
(worl<)5 S Z-�-1 7 I - �i � �j
MAILING ADDRESS: �L?'� � �31�,( N� ��ITY: o��c� zIP: 5 S�`�' 1
CONTRAC'TOR: ��`�Z\j7(��(�c�'\ �=-1� G��� (`,, PHONE: C��Z-�\`�—��jZ�
CONTACT P�RSON: �2,� �i1Z S��`��IJMOBILE/PAGER: C-� t Z--�\�— ����j
MAILING ADDRESS: �-(0� � (i.J����� CITY: ��Q\ZJ� ZIP: �� z-( � (o
STATE LICENSE: #Z�� 8 �� �'j EXPIRATION DATE: 3 =�/— �7
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure _
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may require MCWD review and permits !
P�Z�P�SFT��I���(fl�sce�ibe dea cdetceal�: ��.�k-�,�C7V i,� G l�� l� �G(�. �
C��l ��7 ���v�-1 ���
STORIES: SQ.FF,ET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED llETACH�ll
o�
ESTIMATED CONSTRUCTION VALUATION(e�cluding land): $ � , � c�c� _
I hereby apply for a buildin�permit and I acknowledge that the information above is complete and acc�u�ate;
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�vork is not to start without a pennit;and that The�vork will be
in accordance with the approved plan. ,
APPLICANT'S SIGNATURE: DATE: � �—I ���
i
31
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Sec13.Od RIGEITS OF SUBJECTS OF DATr�
Subd. l. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this sectioii.
Subd.2. Infonnation required to be given individual. An individual asked to supply private or contidential data concerning himselfshall be
infonned of: (a)the purpose and intended use of the requested data�vithin the collecting state agency,political subdivision,or statewide system;(b)
�vhether he may retLse 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 13.52,subdivision 5,to a law enforcement ofFicer.
The commissioner of revenue ma�lace the no[ice required under this subdivision in the individual income tax or propertv fax refund
instructions instead of on those fonns.
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 classitied as public,private or contidential. 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 infonned of the content and
meanin�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 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 ofd�e privace or public data upon request by the individual subject ofthe data The responsible authoriry
may require the requesting person to pay the actual coscs of making,certifyine,and compilin�the copies.
The responsible authoriry shall comply immediately,it possible,�vith any rcquest made pursuant to this subdivision,or within tive days oP
the da[e of the request,escluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request
within that tiine,he shall so inform the individual,and may have an additional tive days within which to comply�aith the request,excluding Saturdays,
Swtdays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest die accuracy or completeness ofpublic or private data
concerning himself. To exercise this right,an individual shall notity in wTitin�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,induding recipients named by the individual;or(b)notiCy the individual that he believes thc data to be correct. Data in
dispute shall be disclosed only if the individual's stalemenl of disaereement is included�vith the disclosed data.
The determination of the responsible au[hority may be appelled pursuant to the provisions of the administrative procedure act relating to
con[ested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would lihe 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. Tl�e informaTion you furnis!� �vi11. be !ised to deterntine your qualificati�n for the permit or license
requested.
_. YGU IllBy"iciu52 io supply data,but refiiSdi ii�aj�icCjUiic iilni iiiC Cli'y'�i^c;�y the pe�n�it C��IC�C�;e.
3. The information may be shared with other local, state or federal agencies to the extent necessary to
process the pern�it or(icense.
4. If your requested pennit or license requires Council action to approve, some information may become
public. _
�. 1`ou have certain rights under M.S. 13.04 (available upon request)to review private data on yourself.
6. Yow'full name is required to process this application or permit.
First Nliddlc Last
Address
Cit� Statc Zip Phonc
I understand m�� rights . tated above.
Signat e
Reset Form 3�
��� �r
� CHE�:.K OFF i�IST FOR ISSUA.NCE OF �ERi.�IT5
FOR OFFTCE USE ONLY
AbDRESS ORLEGAL: Z3gi (�LAIr�� A��= -
PID: • - i., �«N� R-i:�cA-c_csvt�KJ r
J�ESCRIPZ�IO�T OF WORI�: CLI� i2.���r►nL�v� r
ZO`�i G RE�`V BY: ------ f} ------ DATE APPROVED:
I3UTI�DLNG REVIE�`V BY: . . DATE APPROVED: �� - 2� -o c:
-------- ------------- -
�F'EES TO BE C�IA_RGED: Misc, Fees Calculated By:
PERMIT Yes �/ No
PLAI�T REVIEti� � Yes f No SE�VE.R CO�INECTION -
STATE SURCHARGE Yes _�� No �GVATERCONI�'ECTIOi�7
INVESTIGATION FEE Yes No �/ PARK FEE
SAC Yes No i/ SITEINSPEC'TION
Number of SAC�Uruts OTHER (speci�y)
-----------------------
----------------------------------
ZONI�IG CH�CK LIST Zoning Discrict: �/Uc) Cl-�-✓4/J�� �.
Fi.re Dep3rtmenr. Post Office: School Distric[: �
Lot Area: Sq.ft.
Acres Width Depch
Survey Submitted: Yes No Date oE Survey:
Proposed Setbacks:
Front(Lake): RiQht S' e:
kear(Streecj: Left�ide:
Adjacent Scn:ch!res: Wetlane�:
Buil�linQ Heipht: Dei, Hgt, Pealc Hgc.
LOt COvera�e:
^ "' ��?;OV3�. n�C_' ,
Grading: S,aff App:oval Date: B;: �,�'�;ncLL •
Sepcic: S�af� Appro•�al Dace; E;�:
Zoain� Fuz� R Resotution: n Resolution Da:e:
Shoretz�^d Distr�cc:
�v�. SetbacK: Bluff Setba k: LotCovera�e:
Eusti�g Proposed
Hzdcover; 0-75'
75-2�0'
,;�„�,I 2�0-50Q'.
�oo-lc�c1��
�^��CC' _ �;'. ..�:C� `',' .s!i�C: :e5 . 1.�.'_:_ �: CC'��C'I A,�n^OVZ: --
_ ��� ..y' r
F.i��L��.'�s �!I!�?OLL2�.
EULLDING REVIEti� CH.ECg LIST •
��: lZ' 3 ' CONSTRUCTIONTYPE: �/N '
Sq Faotaoe $ Per Sq Ftg
Basement • . X = .
ls[ Floor x � _ � �
2nd Floor x _ .
Garaoe z � .
x —
TOTAL
Estimated Coostructioa Value: $_y�(���°-
Inspections Required: VVork Requiring Separate Pec-rnits:
S ite Plumbing Fire
Hardcover Removal Mechaaical Water Coaaection
�Footing � Sepcic Sewer Cannection �
Fra.ming Fireplace Lawn Irciga[ion
Insutatioa (Masonry) Other
�Vall Board (Mfg.} Well (State Permit)
F�� Grading/Fillin� Elec�rical (State Permit)
O che r
REMARK� (IN HOUSE): _ -- --
----------------------------------------
REVLE�V SY OTHERS: DATE:
Access: Existing New .
Access Approval: Date gy;
- ---------------------------------
REtiIARb'S f,'�'Q SE NC�'I'En n�?PEF.�� �� :
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BRIDGEWATER CONST.,INC. �����
4Q01 MON7EREY AVENUE
EDINA,!M�lINESOTA'.iS�16 '
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�K'E�?TiilS`'�+N SET ON.91TE AT ALL TIAA�S
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DATE TIME V
CITY OF ORONO CALLED IN l� ��
INSPECTION N ICE SCHEDULED �� � �
PERMIT NO. ���� COMPLETED
ADDRESS a 3�� � ���'e �
OWNER CONTR.
TELEPHONE N0. �o� �� ���a"f�
� DESCRIPTION ��� ��� `�-��
lL 01 FOOTING 11 Iv1ECHANIC RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
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 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
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED CI PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED '-, ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
G INSPECTION REQUIRED.CA�I TO ARRANGE ACCESS.
Call for the r1 xt inspection 24 hours in advance. (952� 249-46��
OwnerlCo a site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice