HomeMy WebLinkAbout2000-P02626 - land alteration � �
� � PERMIT
C I TY O F O RO N O Permit ►vumber:
2750 Kelley Parkway - PO Box 66 Po2626
Crystal Bay, Minnesota 55323 Permit Type: User Defined
(612) 249-4600 Date Issued: �is�oo
SITE ADDRESS: 1635 Concordia St
WAYZATA,MN 55391
P ID: 17-1 17-23-22-0040
DESCRIPTION:
Proposed Use:
Permit Class: General
Permit Type: User Defined Permit Sub-type(s): Land Alteration(0-500 cu y
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: HOWARD ALTON OWNER: HOWARD R ALTON III
1635 CONCORDIA STREET 3905 NORTH SHORE DR
WAYZATA, MN 55391 MOUND MI�T 55364
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 ORllINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
_._____
� _ _ �-�`��-----= _ �
APPL[CANT PERMITEE�SIGNATUR� ISSUGD BY SIGNATURE
Copies: City,Applicant,Assessor, Finance Page 1
f �
� Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BITII�DING PERNII'I' APPLICATION
All information must be submitted in full before plan review will be started.
(please print all inforncation)
THE APPLICANT IS: (circle one)�� OWNER O� CONTR.ACTOR
�- ---
JOB SITE ADDRESS: I� 3 � C G,'�G ol���a S�� ZIP: /n�� � �, ��
NA1�IE OF OWNER: �o,�1�/-�( 2 ��-�on � _ PH��� �ome) y� � - 80�o
(work) � yC� -- y� 5�
l�IAII.ING ADDRESS: / � 3 5 G U.'�L v r�,�, CITY:_� 2 h�ZIP: 5 5 3°►I
CONTR.�CTOR: ����(��, � S o,� 5 PHONE:
CONTACTPERSON: J;��,-� N10BILE/PAGER: .
NL�,II_,ING ADDRESS: CITY: ZIP: � -
STAT'E LICENSE: #
ARCHIT'ECT/ENGINEER: P����
l�L4IL�'G ADDRESS: CITY: ZIP:
N��,�: REGISTRATIOr'#
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration �/
��yr
PROPOSED WORK(describe in detai�: G-r��'� /�vc� l Y�►ev9� S�c�r o� ��� �C
l U �'ls.n� -SGc� 5} �ree5 PU+ �7�OIn 5v�I o.a W�S� Sid� �J�� o�t�'�`
�Cf _S�>�� � fi�C'l'S .
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOI�IS: GARAGE STALLS: ATT. DET.
ESTI�i LATED CONSTRUCTION VALUATION (excludina land): $ Z[�C�c� "�� _
I hereby apply for a buildin'permit and I acknowled�e that the information above is complete and
accurate; chat the work will be in conformance with the ordinances and codes of the City and with
the Scate 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.
-� J��' � s - G�Ci
APPLICANT'S SIGNA'I�URE: � �/7`�DATE: � -
,�
NOTE! Parade of Homes events require separate permit approval by Police Department and
Ciiy Couneil 60 days prior to the event. Non permitted events will not be allowed.
r �
Sec.13.0-t RIGHTS OF SL'BJECTS OF DaTa
Subd. 1. Tvpe of daca. The righcs oi i�dividual on whom che dara is s;or.d or m be srDred shall be u set forch ia�his secrion.
Subd."_'. Information reqirired to be�vm individual. ?.n individual asYed co suFply privatt or confidendai dam concerning himself s�all
be inforaed of: (a)the purpose and iar_nded use of rhe requestai dam wi�hia�e collecdn3 iur_agency,poliacal subdivision, or sacewide rystm;
�b)whe:�er he may rfuse or is le3a[ly required m n:pply rhe rtques�d daci:(c)any I�own eoas�queace arising from lus supplyi,^,;or refusing ro suQply
privace or conr'.der.cal data;and(d)[he id:edty of or�erpecsoas or enriaes au�hor's�by suce or federai law to rec�ive che dacs. Tais�equir.meac shall
noc app[y when an ir:dividual is asl:ed to ssppty in�•esri¢a¢ve daci, pursuanc co sec:on 13.82, subdivision 5, rn a law enforzec.eac officer.
The comr,ussior.er of rve:�ue nav ola:: the nocce rauired under chis subdi�ision in the individual income at o: orooem raz �efur.d
insrrucdons inscesd of on �hose forms.
Subd. 3. ?,ccess to data br•individual. liQon requesc co a responsiblz auc.`:oriry,an individual shall be informed whe�her he is t�e subjecc
of scnr=d daci on individuals, and whe�er ic is cl�ssifed as publ;c, privace or cor':Ze^C3I. L�.`OQ I11S C1.ltCt1GC RQIIGSt.3II lIId1VIL�l13I who is the subjecc
of stored privace or pubtic daa on u;dividuals shal!be s�own ch:dara wichauc aay caar3e tD �and;if he desires,shall be iatormed of[he conrr.:
u:d meuuag oi ci:ac daca. After an individua!his be_n shown che privace daca ar.d ia:or.ncd oc ics meanin3,�he daca need noc be disclosed ro hun for
six monc,hs cher_ai�r unless a d'upute o�acrion pu:suanc[n �his secrion is pendi:.g o;addidoa�t daca on che individual has bzea collec�ed or ereaced.
The responsibfa au�horiry shall provid�copies ot che privam or public daea upon r��u:sc by the i�dividusl subjecc of c��daca. T"ne responsible au�horiry
m�y r.quire che requesring person to pay che acn�l cosc�of making,certifying,s:.d.ompiling the copies.
The r_sponsible auchoriry shall comp[y ir.ui:edia�ety,if possible, wich�;+r.quest s3d�Pursuan�co this subdivision,or wichin five dzys of
the dace of ehe requesc,excluding Sacurdays,Sur,days and legal holidays,if irnmed�:_compliatce is noc possible. If he cannoc comply wich the requesc
wi4'�in[ha[tima,he shall so infocm�he individual,ar.d may have an addiaoaal five daps within which to comply wi�Z the request,excluding Saturdays.
Sundays and 1e3a1 holidays.
Subd.4. Procedure whea data is not accurata or complete. P.n ir.dividual may concest che accurdcy or compleceaess of public or pm•ace '
data cor.ceming himself. To ezer.ise�is righ�,an individual shal!noa"ry in wri¢�g�•e rtsForsiole auchoriry dascribing�he nacu:e oi th�disagreemeac. .
'Ihe responsiblz auchoriry sh�ll wichin 30 days ci��er. (a)correct rhe data found ro`=inaccn�m or incomplece and ar..mpt to nodf}r past recipients of
inaccura:e or incomplece dan, including re:ipienct named by [he individual; or(b)codfy d:: individuai tha�he believes che dara to be correct Dac1
in dispu:r,shall be disc!osed only if che ir.dividual's sucement of disagreemenc is ir.cluded wic.`�[he disclosed dara.
'Ihe due:minanon of cha raronsibla auc.horiry may be appealed pursu�-c ro the p;n�isions of tha ad¢unisQarive procedure act reladng co
contesed cases.
D?,T:� PRIVACY :�D`'ISOR�'
In accordance wi�h�1.5. 13.04, Subd.2, "Ri�nts of subjec�s oi data", �c•e wouid like[o inform you that your reauest
for a perm.it or license from the Ciry oi Orono or any of ics depz.ments may require you [o fumisa cercain private or
confidencial informacion.
You are nocified that:
1. The information you fi:rnisa will be used to determir.�your qualification for che permit or license requested.
? You may refuse to supplv daca, but refusai may require that the City deny the perm.ic or license.
3, The information may be sflared wich o�her local, stat�or federal agencies co the excenc necessary to process
the permit or license.
.}. If your requested permit or license requires Courcil action to approve, some informacion may become
public.
�, You have cenain riQhts under �1.S. 13.04 (availabl� upoa request) to review private data on yourself.
6. Your full name is required to process chis applicat:on or pe:mic.
Fin: �tiddlz Luc
�dd;`ss
Ciry Sac� Zip PFona
I underscand ny ri�hts as staced above.
Signacur_
` ' , CHECK OFF LIST FOR ISSUAI�TCE OF PERi1�iITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Ci,�,�Go n✓>,✓�
PID:
DESCRIPZ'ION OF WORK: (�(t/�� � rv b
' _---------------------------------_---__ __
ZO�i'G REVIE`V BY: DATE APPROVED: '7 - S - �J
BUII�DI�i tG REVIE`V BY: DATE APPROVED:
FEES TO BE CHARGED: �'`Oi`"�S igc ees Calculated By: ~ ~
PERNIIT Yes � No �,
pLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATER CONNEG"TION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZO�tL\G CH�CK LIST zoning Districc: /V� G�yti'�.Q _
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres W dth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Fron[ (Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetl d: .
Buildia; Height: Def. Hgt. Peal: gt.
Lot Covera�e:
Grading: Staff Approval Da[e: B : Council Approval Date:
Septic: Staff Approval Date: B :
Zoning File: # Resolution: # Resolution Date:
Shoreland Dis[rict:
Avg. Setback: Bluff Setback I.ot Covera?e:
Ezisting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1Q00'
Hardcover Variance Required: Yes No Date of Council Approval:
RE�IA,RKS (in house)•
7
. �
BUII.,DING REVIEW CHECK LIST
�C� ` CONSTRUCTION TYPE: -��
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd F1oor x =
Gara;e x = •
z — +
TOTAL
Estimated Construction Value: $ --
Inspections Required: 1�Vork Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Nlechanical Water Connection
Footing � Septic Sewer Connection -
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
_�F�� Grading/FIlling Electrical (State Permit)
Other
REI�IARKS (Pi 1 HOUSE):
REV�`V BY OTHERS: DATE:
Access: Ezistin; New
Access Approval: Date By;
REI�IARKS (TO BE NOTED ON PERltiII1�:
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I 1 I - �"--'t �7 �_,.i
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE �„ �, SCHEDULED —� �; 3
PERMIT NO. '��`b COMPLETED �� �
ADDRESS � �N�'� �
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
ty� O1 FOOTING 11 fv1ECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 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
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� CO ENT .
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W CJ WORK SATISFACTORY:PROCEED �= PROJECT COMPLETE
� [7 CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. . pHOTO TAKEN
INSPECTOR WILL RETURN
�TOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46�0
Own C ntr site: �'�-
Inspect ��J
White Copyllnspector's File Canary CopylSite Notice