HomeMy WebLinkAbout2004-P07379 - outdoor in ground pool � PERMIT
CITY O.F ORONO
2750 ��Iley Parkway - PO Box 66 Permit Number: Po�3�9
Crystal Bay, Minnesota 55323 Permit Type: a��esso�-y sm►��ures
(952) 249-4600 Date Issued: s�6�2o04
SITE ADDRESS: 162s Bohns Pt Rd
Wayzata,MN 55391
PID: 17-117-23-11-0003
DESCRIPTION:
Proposed Use: Residential
Pernut Class: Building Census Code 329
Pernut Type: Accessory Structures Permit Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate permits required: Eieciricai�staiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 139.25 Valuation: $ 6,200.00
Plan Review Fee: $ 90.48
State Surcharge Fee: $ 3.60
TOTAL FEE: $ 233.33
APPLICANT: Site Works Design OWNER: Roger&Carol Rovick
1225 Hwy. 169 N. 1625 Bohns Pt Rd
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
MINNE TA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUE BY SIGNATURE
Copies: 1-File�Si�nitures Required), 1-Apolicant, 1-Monthlv Reports. 1-Assessine, 1-Finance Page 1
Apr-OA-10D4 OA:13an fro�-CITY OF ORONO +9511d94616 T-035 P.002/003 F-735
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Date Received• ,
, Tbtal Fee: $ Permit#• `,� � �,�
Entered By: �
CITY OF ORONO -BUILDING PE�tMIT APPY.ICA'�`ION
All information must be submitted in full before plen review will be started.
(please print a11 informaiion)
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Ti��APPLICANT ISt (circle one) OWNER UR CONTI2ACTOlt
. � ,r, ..:_ 'k�c_{ ;< � � ZIP:
JOB SIT�ADDRESS: � ;`�`�- •�== t ` .'-
WiU t6is be a Parade oi�omes,Remodelers Showcase Home or other Di9play Home?
� Y e S �] N o I f y e s, a s pecial event permit u required with Police Department and Ciry
Council apprvval 60 days prior to the event. Non p e r m i t t e d e v e n t s w i l l n o t
be atlowed. `�
� ' !C_ /i � � PHONE`v(h ome) .���=^•_�_�i_��-l5�
L.�+�= �'��_�� i�
NAME aF OWNEYt: �+'� (vvork) ;� _'�:3 - � ; �,
_ , ;�::� CYTY: ,s, -c t �, ZIP:
MAYLING ADbRES5: •, �`� , L`
PHONE: i � j
CONTRACTOR: -��`�
. �_�_. . –' MOBII.E/PAGEIt:
COIVTACT PERSOIV: � �. - CITY: _ _,f �: �, .�=. _ZIP: ':�;
MAILING ADDRESS: ,� ;_; ;: -
STA'I'E Y-ICENSE: #
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�� ._ .-- � ,u ,, i�. :.- �_PHONE:y�_ _,_ . �. �,_� ��:�
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ARCHYTECT/ENGYNEEYt: � ��- ��� \��\ i �� � � ,.y k� ,..�c t 1$IP' 1" >,�'-�-�,
� '3L=�` '�� ' � 't��-�:� CITY': �
MAYLING ADDTtESS: � � `�ECISTRATION#
NAM�: ��>>\� ,,_ i;•ti,.�;�-
Accessory Structnre _ —
TYPE O�'WORK: New Move
Addition ,�� Y,,and Altcr�tion
Re�aodeUAlteratiog
.,��; ,��� ��,��,� �-�C;�����_
pROPOSED WO�(�s�e in detai�: `
s.I.Q�s.�� SQ.FEET OF EACH F'1-��� DET.
NO.OF BEDROOMS: _ , GARAGE STALLS: ATT•
ESTIMATED CONSTRUCTION VALU�►TION(exciuding land): S, `'�(�i��G 1
1 hereby appiy for a building permic and I aCimowledge that�e infoimation above is complete and aCCurate;tllat the
�nrorg will be in confom�ance with the ordinattces and codes of the Ci��������t be'�'�o`���th
�nderstand this is not a pt�mit and work is not to statt without a percmt;
the approved plan.
APPLICANT'S SIGNATURE: ,
,� .`�_ �. –'_.._. DATE:
Apr-OA-1004 OA:13an From-CITY OP ORONO +A5124A4616 T-035 P 003/003 F-T35
. Scc.13.0� RICHTS OF SU9.1EC7S OF DA1'A
Subd.l. Type of daca. The rlghu ot{ndivldud oe wlam the drta�S uored or to pe s�orcd�hs{i be u at tortb In tl�is teetioa.
Sabd.2. laWrm�t�oa required m be glvon Sndlvideal. Aa Individoal aaked to wpply pri•ate o�coaGdtatlal data ooncereia=h�mseif cbap be
�to„p�p et: (�)�e perpose ana Inceoded we ot tb¢requeuad daa within�e ooliac�ing stxa agency,poUticnl subdivl�Mn,or�[atowide iystem;(b)
,rbsther be msY reiusa or b kC�11Y rcqa{red to mpp�Y��requesccd dus;(c)anr iwown cunxqeoace arlsin=trom bt�►upplying or nMsiaC m sapply
prirau or cooAd.utlaf dam;and(�thc Wendty°��°f pn'�`or�p°�ia°p��by��or(c��11•w�o nceivc cAe dst■.T6b requfrement UwN
iwt appiy w6en sn indlvldud b�skcd w'°vP�Y�°v�g'�"'e dsu.panu■ne to rcesion 1�.82.subdiruion 5,w a I�w entorcemen�oMcer.
Tbs eo s n�r o[ evenut mav ol ee sh� ntlee nn{r�yl�.�dcr h{�ssbdW{den tn tAe la�viAaal lnco tax or ntm+e*tv �x refra9
���uet�000�ppesd ef en t xe fornLt
' Subd.3. At��s to G�ta by Indlvidusl. Upoo reQue.t to a responffbu euthoriry,na iadrvidoal fh*11 be i�torm�d whrth��hc b the anbJa[af
itored daw on IadiriJuals,and wfiatYer h!s clas�ifud as pabUt,private or eo�lldemiuL Upon l�it tarsher request,an Individuul w6o is thc�ubjece of
R�td privqte or pqbllc dtls on iwd{vlAusb shaU be fhowq tM daca without atry char6e w blm and,tf 1u dt�a'c�.thsll bo in[ormtd of tbe oosteat and
maoioe of�at dan. Afa*s�in4irWw1 bas been�bown i6e prfvsto dacs•ad IMars�ed ef its rneaeln�.tut dats aca!not be diubfed to rim(or sis
moniAs therattrr unlnss u dlspu�e or secion pnnnant to rLM seccion b p�nding or rddh(on•!dots o�ihe Indtvidoal Aa�b�an colketod or erested. Tbe
rnpo.�le�uthority�6ai1 p.ovlde eopia o(she pHvate or publlc d+�n�lwn�equat by�he Indfvldnal aubJen o[tAeds�a The responc,'ble wiborlry m.Y
�equ{re tbt rtqaesting porsou to pay tde aetual sostt ot makleg,crri{I�foz�asd compll{�tht eopks.
Tbe respotuible suthoAty rbfl eowply imroediatelY.Yposs�le,whY any requc�t made pursuant w tbis subdWmion,erxithis flve dayseftbc
date o(tho requtst�e�cclud(sg Ssturday�,Sunday��nd legal heltAaya,It Immcdi�te comp�na 1.no[posyibl�i(he cannoc eomp{y witb ehe roquat wicbin
[hst tim0.fie►Ysl1 io Inlorm tAc iadlvidurl.aad may Aavn ao sddulonal tive dsy►witbin w41cb to comply wkq c6o requat,escluAingS■mrdays.Sundays
aal leg�l6olida�a. .
Sabd.4.Procedu�e wYta d�ta ie oot�c�roPate or tomp���.A�iadivldu�l o►vy tontat the accnruey or comp(ttrnas of puDllc orprivste dsla
coaterning himsel(.To axerel90 this r(ght,�n Indlvidoa!aM�U notlEy io w�ldng tbe►espoalible�uthority doscribiag tAe nature of tho Ji�4gret�acot TAo
rpyppflbtc wtberiq tha�l witpin 30 day!cicber: (a)��N the dat�tonnd to De Inaccurou or Intoroplete�ud a�ie�npt to aotlfy p�sti tedpient�of
lasccurpte or intompktt dsty IodudinS teclPirata nsmcd by tbe ip01�1dua1;or(b)notity tdc lndlvidaal tbY�he believet i�e data to be rnrree�. Dsta io
dk�►pta shaB bo direlosul only If�be IndiriUu�P�svueme.�of d�isz.am;��u��ua�to�b�ro 1 0�t tLe admioiur�tl•o proudura sc�relating to
'Y'he detcrminstion of the reaponsible swthorhy maY be aPpen A D
coaustM cues.
DATA PRIVACY VYSORY
In accordance wich MS.13.04,Subd.Z,"Righu ot subjects of data",we would like to inform you that your request
for A permit or license from t6e City ot Oronu or say o[its depArtments msty require yoo to furaisb certain prirate or
confidentiAl information.
You sre notifled that:
1, T6e information you furnish will be used to determine your qualification for the permit or license rtquested.
2. You may refuse to suppty data,but refusal msy require that t6e City deny the permit or license.
3. 1'he informatlon m'y be st�red with other local,sWte or federal agencies to tbe ertent necessary to process
che permit or license.
4. If yonr requated permtt or licease requires Council 9etion to approve,eome intormation awy become
public.
g, Yoa 6ave cercain rights ander M.S.13.04(available upoa request)to review private data on yourself.
6. 'Yoar tull ntimc is required to process this applic�tion or permit.
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Addrut
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Cirr Suco Zlp , Phone
I underst�nd my rights ss stated sbove.
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Sip.crre �_._.
CHECK OFF LIST FOR ISSUANCE OF PERMITS
' FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �(.,Z S Q o NNS �b i�r T IZ",a✓J
PID:
DESCRIPTION OF WORK: o ol
ZO�t1NG REVIEW BY: DATE APPROVED: 5-g- o y
BUII�DING REVIEW BY: DATE APPROVED: ��^�_o�L_
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes _� No
PLAN REVIEW Yes _�� No SEWER CONNECTION
STATE SURCHARGE Yes _� No WATE,R CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SIT'EINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning District: .
Fire Department: Post O�ce: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes_f� No Date of Survey: oa 1=i t�.r'
Proposed Setbacks: �
Front(Lake): � `�� �= Right Side: C "1 '
Reaz(Street): 356' + Left Side: ���
Adjacent Structures: �p` Wetland: /� �Pr
Building Height: Def. Hgt. — Peak Hgt. �
Lot Coveraoe: '—
Grading: Staff Approval Date: 5-S • o�-( By: � Council Approval Date:
Septic: Staff Approval Date: —' By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: v�S
Avg. Setback: � ,�c Bluff Setback: �� (t Lot Coverage: —
Ezisting Proposed
Hardcover: 0-75' �
75-250' Z Y• g 6
250-500' �b-�
500-1000°
Hardcover Variance Required: Yes No Date of Council Approval:
REMARI�S (in house):
7
BUII.,DING REVIEW CHECK LIST
�C� — CONSTRUCTION TYPE: '
_ Sq Footage $ Per Sq Ftg
Basement x _
lst Floor x _
2nd Floor z =
Garage x _
x =
TOTAL
Estimated Construction Value: $ �6,-z�o °u–
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
—L FO°��g ` Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (1�Iasonry,) Other
Wall Board (Mfg.) Well (State Permit)
—�F�� Grading/Filling � Electrical (State Permit)
Other
REl�ZARKS(IN HOUSE): .
_--_---_----------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gY;
--------------------------------------------------------
REMARKS (TO BE NOTED ON PERNIIT�:
8
� �OZ�J ��-� �011J P/LLiIR /�OMES tar 9,�tid.Ja No. s9Y —'�
� IIr�,�D GOV� ALCULATION WORKSt��ET ,� `�'�q '��
.�� ✓ � ' f �-7rJ�- 75—�.,d� �.��5��� �'�� ��;,e
� SETBACI.LO\�: (CIRCL� �i�t�) � ���;
� EXISTI�G H aitllCOV�R I�t ZONE � , �' �= '
A. House X
Lcngth Width '
= S.F.
X = S.F.
'� = S.F.
x .
- = S.F.
B. Garagc X .
C. Driveway x ' = S.F.
X = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x . = S.F.
.. X = S.F.
F. Landscape x ' _ ' S.F.
Underlain x = S.F.
By Plascic x = S.F.
Or FaUric
G. Other __ x: = S.F.
"I'OTAL HAI2DCOVER IN ZONE - D S.F. A
TOTAL PROYERTY�REA IN ZONE - `� 9 SS S.F. B
p � B x100 = . d %
PROPOSED HA]ZDCOV�R II�T ZONE
A. Ho��se x = S.�.
Ltnp�h Width
X = S.F.
X = S.F.
x = S.F.
B. Gnrage x = S.F.
C. Driveway x = S.F.
x = S.F.
D. Sidet�•alk = x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F. �
F. Landscape _ x-. = S.F.
Underlain � x = S.F.
By Plastic x = S.F.
Or Fabric �
G. Odier x = S.F.
"fOTAL HARDCOVER IN ZONE - 0 S.F. A
TOT?.L PROPERTY AtZEA IN ZONE - 9 9 SS S.F. B
A = - B x100 = o %
��� ; tZ�(S�•p C�L.GU l_,�(1
� � `�'�2� �� �,� � �s�.
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1�vC� ��`� ��rvT' �__-__' `�"
Pi�u R r��,�,�s •�- 4.q.o
1IATt�GOV�R CALCULAT�9�I WOF�{S#�-�T
' �SETB:�CI:'GO\�.: (CIRCI..�ON�) 0-75' 75-2�0' 25�-�00' S00-1000'
•� E?CIST[\`G T�a1tT)COY'LR T�I ZONE _ S F
A. House X
L�ngth Width •
x
= S.F.
= S.F.
X = S.F.
- = S.F.
B. Glrasc x ,
C. Dri�•e��°ay x = S.F.
X = S.F.
D. Sidewalk x = S.F.
X = S.F.
E. Patio/Deck x . = S.F.
- X = S.F.
F. Landscape x = ' S.F.
Underlain x = S.F.
By Plas[ic x = S.F.
Oi Fabric
G. Other -- �x= = S.F.
"i'UTAL I-IA1tDCOVER IN ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE - S.F. B
p = B x 140 = . %
PROPOSED H:�l2DCOV�R TN ZO1�tE _ �
A. House x — � S.F.
L�ngth Width
X = S.F.
X = S.F.
X = S.F.
B. I'aarer�e SCR f E�✓ oa2 C/,l x = . 2'T� • _S.F.
c. ��► .�o ac x = �'S�3 s.F.
x = S.F.
D. Side�r•alk x = ��,_S.F.
x = S.F.
E. Patio/Deck DCCK ! x = �2'o S.F.
Q Ec K 2 ._.— x = �D S.F.
OCc�c. 3 � '�
F. Landscapc _ x-. = S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Odier /Q�Ec Gri.teCS x , _ � �� S.F.
T01'AL HARDCOVER IN ZONE - �—`�� S.F. A
TOTAL PROPEItTY Al2.EA IN ZONE - ' !L. 't S.F. B
A -= B x 100 = 2 $ %
/�/L C.t R f�/Grn ES
. � IIAR(�GOVER CALCULA750N�WORKS 6��T 500-1000'
• � IC ZO�2.: CIRCLE f.►���,) 0-75' ��
SET13aC (
�- EXIS"�'I�G I-1�IZDCOV�R TN ZONE _ S.F.
A. House x
�r„�cn w�a�h � S.F.
X S.F.
'� S.F.
x — �
- S.F.
I3. GarAgc X
= S.F.
�C. Drive�ray X
= S.F.
x
= S.F.
D. Side�ralb: Y
-- = S.F.
x
= S.F.
E. Patio/Deck X ' �
X = _ S.F.
F. Landscape x = ' � S.F.
Uuderlain x = S.F.
By Plastic .. . x = S.F.
Or Pabric
G. Other _ x: = S.F.
TdTAL I-iARDCOVER IN ZONE - S.F. A
TO I'AL PROPER"fY AREA IN ZONE - S.F. B
A = B x100 = . %
PROPOSEll H:1]2DCOVrR IN ZOI�tE
A. I-ioi�se x = S.F.
Lrngih Width
X = S.F.
X = S.F.
X = S.F.
B. Garage x = �SO S.F.
C. Driveway x ' _ �'T��7 S.F.
X = S.F.
D. Sidervalk x = �,�� S.F.
X = S.F.
E. Patio/Deck s = S.F.
X = S.F.
F. Landscapc _ x.. = S.F.
Unde:rlaiii x = S.F.
By Plastic x = S.F.
Or Fabric
G. Odier �V\/Ar{�1� t x = �_l.._ - S.F.
't0'i'�L HARDCOVER IN ZONE - ��l—i(/ S.F. A
TOT.�L PROPERTY A1tEA IN ZONE - 2 a S.F. B
p = B x 100 = %
�y���E TIME �
CITY OF ORONO CALLED IN , �—G� 'f�
INSPECTION N,OTICE SCHEDULED ' l���_��s-`,
PERMIT N0. �C`� ��� COMPLETED
ADDRESS I �/ZS T�c:_,=G��'i`� �`t �
OWNER CONTR. S�� ��,��5
TELEPHONE NO. 4� � � -'�4� - ����
� DESCRIPTION ��;� � ��I 1�►��
L� 01 FOOTING 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 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
Z OWNERICONTRACTOR TO MEET YOU:_YES O
� COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � 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. �952� 249-46QQ
OwnerlContractor i •
Inspector.
White Copyllnspector's File Canary CopylSite Notice