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Home My WebLink About2007-P11108 - addn/remodel/repair ` � PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P111o8 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 6/2U2oo� SITE ADDRESS: 1635 Concordia St Unit# Wayzata,MN 55391 PID: 17-117-23-22-0040 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Usc: Residential Census Code 434 Permit Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Plumbing Electrical(state) NOTICES/REMARKS: Remodel kitchen, new garage doors,replace 2 patio doors FEE SUMMARY: PermitFee: $ 748•75 Valuation: $ 65,000.00 State Surcharge Fee: $ 32.50 TOTAL FEE: $ 781.25 APPLICANT: Stonewood Design Build OWNER: Howard Alton III 7407 Wayzata Blvd 3905 North Share Dr Minneapolis,MN 55426 Mound MN 55364 THE UNDERSIGNED HE1REBY 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�OTA BUILDING CODE REQUIREMENTS. ( . ---.--� � �►'ll�a,� APPLI p PERMITEE SIGNATURE ISSUED BY SIGNAT E Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reparts, 1-Assessing,(If Septic, 1-Septic) Page 1 ` ' . -��--� �� ^5� � . . . -� Total Fee: $ � 7 � �,Z`�� Date Received: L—YI�j'�l�D�l L�� Entered By: �,�1�y1� Permit#: /-�-I 1 l0 8 CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all inf'ormation) THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �i�3� (',-,��t^`��e�_ �-1 - ZIP: �S.SSC Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ YCS � NO Ifyes, a special event permit is reqa�ired with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be requrred unless applicant demons/rates sirJJicient on-site parking is availahle. Non-permitted events will not be allox�ed. NAMEOFOWNER: ��(�;n ,�I�U�� PHONE: (home) — (work) — MAILINGADDRESS: %(�,:i$� ('�n«}rc�� s1 CITY: r1�'�•��- ZIP: CONTRACTOR: �-{c:��..�C�� 2c>no��i..�� PHONE: �'jsZ �ill-I��y CONTACT PERSON: �,-,;� t�r-tr�-�e�e f MOBILE/PAGER: �;�Z�Zz.l- Z3�`f MAILINGADDRESS: �� .i ��,yz��. �il��..� _ C1TY: rt�;.��e�`�<<• ZIP: Ss�+z� � STATE LICENSE: # .zo;-3y,S��f� EXPIRATION DATE: 3/.ri/z�_^; ARCHITECT/ENGINEER: ;}„��oc1�. PHONE: ;s z-��-os�-i MAILINGADDRESS: 7'-iul U=�vz��_ �1�.� . CITY: /Y�.nrn�•.�i�•, ZIP: "s'`I 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 ! PROPOSED WORK(describe in detai�: ��r,-��,�� 1.��ch��. / �•�e�, l`�r._.r�c r —� (\`.,lS �t��h� Z,. �t�:0 QoorS i�� STORIES: Z SQ.FEET OF EACH FLOOR: -- NO. OF BEDROOMS: — GARAGE STALLS: ATTACHED ✓ DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �,S� �OC' I hereby apply for a building permit and I acknowledge that the information above is complcte and accurate; that the work will be in conformance with th�ordinanccs 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: -.-: . �t, W ' DATE: �a////6 i 31 r -' M Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. Type of data. The rights of individual on whom[he data is stored or to 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 conceming himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide sysrem;(b) whe[her 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 to 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 may_place the notice required under this subdivision in the individual income tax or property 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 classitied as public,private or contidcntial. Upon his further request,an individual who is the subject of srored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be intbrmed of the content and meaning of that data. Atter 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 of the private or public data upon request by the individual subject of the data. The responsible authority may require the reques[ing 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 Icgal holidays,if immediate compliance is not possible. If hc cannot comply with the reques[ within that time,he shall 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. A�individual may eontest the accuracy or eompleteness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe 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,including recipients named by the individual;or(b)notify the individual that he believes the data ro be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination 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 requcst 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: l. 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 thc 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. ,J_.Yc� .�C�hry�r, First Middle Last 7�� .,�•_yz�a�.. bt,,.t Address .'/ 1tnY'�t�c}I� c f�l� �S`17�- "ifZ``l7l• �i��L� C�ty State Zip Phone I understand my rights as stated above. . � ( � . ` Signaturc Reset Form 32 �HECK OFF i,IST FOR ISSUANCE OF �ERi�1ITS FOR OFFICE USE ONLY ADDRESS OR LEirAL: I�� S l r��' �•��0�� ' - PID: DESCRLPTION OF WORK: K ��vH+�N (Z�:w��Oc.�zi/ Z- P�'n4 - Dao�s ZOYING REVIEtiV BY: �--- N (�_____.. DATE APPROVED: BUII�DING REVIE�V BY• �,..L ( a....�... . DATE APrROVED: F, •t�i•o� FEES TO BE C�IARGED: Misc. Fees Calculated By: PERMIT Yes ,/ No PLAN REVIE`V � Yes No �/ SEtiVE.R C0�INECTTON STATE SURCHARGE Yes v' No `VATERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) ZONIi�IG CTiE.CK LIST Zoning Districr. . Fire Department: Post.Office: School District: I.oc Area: Sq.ft. Acres �'Jidth Depth Survey Submitted: Yes No Date oE Survey: _ Proposed Setbacks: Froac(Lake): R.ight Side: Rear (Street}: Left Side: Adjaceat Structures; We 1and: Buil�lin� Height: Def, Hgt, Fe ' Hgt. Lot Covera�e: ._ Gradin�: Stafi Approval Date: By: Council Approval Date: ' i Sep�ic: Staff Appro��al Date: �Y: Zoain� File: : Resolutioa: � Resolution Date: Sho�eland District: Av�. Setback; Bluff Setback: Lot Covera�e: Etisti�o Preposed Hardcover: 0-75' , 7�-25�' 2�0-SGO' 500-1bC0' � �,�,` �;c ` Da�:e of Cc��cil App-ov�: Tr.� �Y?: �,rcri?LC� D.=`i'�..��' Va5 i - � l� � ' ti n I,LLSz�. ��il+�� !/r/t��` 'r �l�T Ci1-6 F.�_.L-a��_ �L_rl ,v� �}N,�O /} (� �oa4h i.v c.�2_��.�-1� � � � . � �� .--------___ _ BUILDING REVLEtiy CI3ECK LIST �c: 2• 3 CONSTRUCTTON TYPE: v� Sq Foocaoe $ Per Sq Ftg Basement X _ lst Floor z _ 2nd F1oor z = . Garaoe X = z — TOTAL I Estimated Construction value: $ b 5,p��oy i Inspections Required: �Vork Requiring Separate Permits: Site _�Piumbing Fire Hardcover Removal Mechanical Water Con.aection Footing � Septic Sewer Connectio❑ � Fr��° Fireplace Lawn Inigation Insulatioa (Masonry) Other 1�Va11 Boazd (Mfg.} Well (State Perm.it) �_F�� Grading/Fillin� _� Electrical (State Permit) Other � j ' � REMARKS (1N HOUSE): ' - -- ------------------------------------------------------------------------------------------------------- REVIEW BY OTHERS: DAT'E: Access: Existing New Access Approval: Date � gy; -- - -------------------------- REI�TARKS ('�'O �E NO'I']ED �DN PERM�'�: Q,��, ��.o �o -f- sn.�,orc� R�-�,,�,�5 8