HomeMy WebLinkAbout2006-P10319 - add/remodel/repair PERMIT
CITY OF ORONO Permit Number:
2750 Kelley F�rkway- PO Box 66 P1o319
Crystal Ba;�, Minnesota 55323 Pel'mlt Type: Addition/RemodeURepair
(952) 2d9-4600 Date Issued:
10/2/2006
SITE ADDRESS: 1200 Bracketts Pt Rd Unit#
Wayzata,MN 55391
PID: 11-117-23-32-0021
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved perresolution#:
Separate permits required: Plumbing Mechanical Electrical(state)
NOTICES/REMARKS:
Renovation of Master Bedroom Bath&Add Windows To Lake Side
FEE SUMMARY: Pernut Fee: $ 923.75 Valuation: $ 90,000.00
Plan Review Fee: $ 600.44
State Surcharge Fee: $ 45.00
TOTAL FEE: $ 1,569.19
APPLICANT: Boyer Building Coiporation OWNER: John Noble
3435 County Road 101 1200 Bracketts Point Rd
Minnetonka,MN 55345 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFTED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
'� .�,r �
APPLICAN E EE S N RE � S ED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
ti � '�
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Total Fee: $ C '� Date Received: —�� r�-/(.�
Entered By: , Permit#: �� -
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all info�•�nation)
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THE APPLICANT IS: (ch•cle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: < <�.�C� ��5�`�����i�� ZIP: ,.�
� _
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ No !f yes, a special event per�nit is r•eqcrir•ed 1vr�th Police Departrr�ent and City Coarncil cappr•ova!
60 ctays prra•to the event. Shzdtle bus service will be required trnless app(icaf�t demo�7strates
si.��cient on-site parking is available. Noiz-pe�:nzittecl events�vill not be allotived.
NAME OF OWNER: J��.(� � �i Vl�i �.t3���Z- PHONE: (home) �
(�vork)
MAILING ADllRESS: �.c;p� c��c� o,\ �CITY: �v ZIP: ����
�-
CONTR.ACTOR: e, 'Z PHONE:�,7�-2 c���
CONTACTPERSON: � ' -� MOBILE/PAGER:�(��Z•-f���.-o�c�,
MAILING ADDRESS: ��3; CG(Z'*�t c�� CITY: l�V(;tlz-;�- ZIP: S� 3�S
STATE LICENSE: #_� �,� EXPIRATION DATE: ' c_I.l ��`-j
���` � J
ARCHITECT/ENGINEER +�' S � NE. ` 5� - Qc��
MAILING ADDRESS: -' � ' O CITY: i,r o��•- ZIP: -S �—�iL(a
NAM�� c, � � REGISTRA ON: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alterat�� (ie: Siding, Windows) j��_
Any earth movement may require MCWD review and permits !
PROPOSED WORK(describe in detai�: p ;� � �j
C� .C.' . � �" � � .. - -��r C'��.
STORIES: SQ.FE�T OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACH�D DETACHED
ESTIMATED CONSTRUCTION VALUATION(exc(uding land): $ �
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work will be in confonnance with the ordinances and codes of the City and with the State Building
Code;that I understand this is not a pennit and�vork is not to start�vithout a permit;and that the work���ill be
in accordance with the approved plan.
APPLICANT'S SIGNATURE. DATE: C7
1
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Scc.13.04 R[GEITS OF SUBJECTS OF DATA �
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 section.
Subd.2. [nfonnation required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be
informed of: (a)the purpose and intended use ofthe requested data�vithin the collecting state agency,political subdivision,or statewide system;(b)
whether he may retLse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusin�to supply
private or confidential data;and(d)the identity of other persons or entities authorized by stare 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�,to a law enforcement officer.
The commissioner of revenue makplace the notice required under this subdivision in the individual income tax or properry tax 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 whedier it is classitied as public,private or contidentiaL Upon his further request,an individual who is tlle subject of
stored private or public data on individuals shall be shown the data���ithout any charge to him and,if he desires,shall be in£ormed of the content and
meaning 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 of the private or public data upon request by the individual subject of the data. The responsible aufhority
may require the requesting person to pay the actual costs of makine,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of
thedateoftherequest,ezdudingSaturdays,Sundaysandlegalholidays,ifimmediatecomplianceisnotpossible. [fhecannotcomplywiththerequest
within that time,he shall so infonn the individua(,and may have an additional tive days within which to comply with the request,excludine Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
conceming himself. To exercise this ri�ht,an individual shall notify in writing the responsible authority describing the nature ofthe disagreemenC The
responsible authority shall�vithin 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to noti'ty past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bei ieves the data ro be correcc Data in
dispute shall be disclosed only if the individuaPs 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 inforn�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:
l. The information you furnish wilt be used to detennine your qualification for the permit or (icense
requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. The infonnation 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 1�LS. 13.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
�b���- � ��=.a��
First �liddlc Last
3�`�S �—� ��< UVl�--� S�
Address
'v1�-ju���rzt Ul�,l�-� S�S�'J�S� `1�Z - �.�7�2�`l�
Ci[y Siate "/_ip Phone
I understand mv ri hts as; tated above.
Signa urc
Reset Form 3�
CHECK O�`F i�IST FOR ISSU.ANCE OF �ERMITS
' FOR OFFICE USE ONLY
.A_DDRESS OR LEGAL: I Zc�c� QRACK �.TS Po,�v� \Zo�D
1'11�:
DESCRIPTIO�t OF WORK: Z,�, ��c� � ��n�
ZO:�I�ti G RE'��4V BY: ----N l(� � DAT'E APPROVED:
SUII.,DING REVI.EtiV BY: DATE APPROVED: 9 -rg-o�
�EES TO BE CHA_RGED: Misc. Fees Catculated By:
PERMIT Yes r� No
PLAN REVIE�V � Yes ,/ No SEtiVE.R CONNECTION
STATE SURCHARGE Yes � No WATFRCONNECTION
INVESTIGATION FEE Yes No ,/ PARK FEE
SAC Yes No �/ SITEINSPECTTON
Number of SAC�Units OTHER (sgecify)
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ZONi�tG CKE.CK LTST Zoning District: l'�/v Gf-fAN6 e ,
Fire Department: Post Office: School District: �
I,ot Area; Sq.ft. Acres Width Pep�
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks: .
Froat(Lake): Right Side:
Rear(S[reetj: Left Side:
Adjaceat St:uctures: Wetland
Builelin�Hei�it: Det. Hgt, Feal: gt.
Lot Covera�e:
Gradin�: S�aff�pproval Date: By: Council Approval Date:
Septic: Stafr Approval Dace: �Y:
Zoni.n� File: R Resolutioa: # Resolution Date:
Shoreland District:
Avg. Secback: Bluff Setback: Lot Covera�e;
E�iscing Proposed
H�rdcover: 0-75'
��-Zsa�
Z�o-sao�
soo-loco�
E1�i�C0'��� �a'2'1ZIICA R�.^lU!1'C�: `:e5 ti:Q �3`.= OFCQ�IIlC� A�r.OV2�:
F.E�L.=�RS�S (in house):
a
BUII�DING REVIEtiV CKECK LIST
�C� _ �' 3 � CONSTRUCTION TYPE: �(N
Sq Faotage $ Per Sq Ftg
Basement � x =
lst Floor z =
2nd Floor � _ .
Garaoe z _
x —
TOTAL
Estimated Construction Value: $ Rp���e�
Inspections Required: �York Requiring Separate Permits:
Site _,�Plumbing Fire
Hardcover Removal ,� Mechanical Water Coaaection
Footing � Septic Sewer Coaaectioa
�_Fr��o Fireptace Lawn Irriga[ion
C Insulatio❑ (Masonry) Other
!��Vall Board (Mfg.) Well (State Perm.it)
� F�� Grading/Filling p� Elec[rical (State Permit)
Other
REMA.RKS (IN HOUSE): - -- �-
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REVIE�V BY UTHERS: DATE:
Access: Existing New
Access Approval: Date gy:
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REI��.ARKS ('I'Q S� NQ'!'ETJ �N PERibfl'�:
8
� J �/'�TE TIME V
CITY OF ORONO CAL�ED IN l
INSPECTION N TIC SCHEDULED � '��
PERMIT NO. �� / COMPLETED
ADDRESS ���_��%���� �y��
OWNER CONTR. �J
TELEPHONE NO. �o l c� �oOS ���Z
� DESCRIPTION ^
ty� 01 FOOTING 11 MECHANICAL 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 tNSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W ORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the n xt inspection 24 hours irt advance. (952� 249-46��
Owner/Contr o ite:
Inspector.
White Copyllnspector's File ' Canary CopylSite Notice