HomeMy WebLinkAbout2001-P04657 - addn/remodel/repair � .
PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P04657
Crystal Bay, Minnesota 55323 P2C'I?llt Typ@: Addition/Remodel/Repair
(952) 249-4600 Date Issued: i v2ai2ooi
SITE ADDRESS: 1220 Bracketts Pt Rd
Wayzata,NII�1 55391
PID: tl-li�-23-32-ooig
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Buildin Census Code 434
Permit Class: g
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: riumbing iviecnanicai c,iecnicai�sratej
NOTICES/REMARKS:
FEE SUMMARY: PermitFee: $ 1,553.75 Valuation: $ 200,000.00
Plan Review Fee: $ 1,010.03
State Surcharge Fee: $ 100.00
TOTAL FEE: $ 2,663.78
APPLICANT: Dovetail Renovations Inc. OWNER: Julie&Elizabeth Hannaford
3503 Hennepin Ave. S. 1220 Bracketts Pt Rd
Minneapolis, MN 55408 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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APPLICANT PERMITE�SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signitures Required). 1-Aovlicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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�Rp4ITS - �IJIIDIN�
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Base Fee
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Mai 1 in 1�� �.00 p.GO �
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1 P 1(�.(►U 1(►(J.40 �
;i� Charge '
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! Investigatiar� Fee �
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�� SUBTQTAL � ��,�63.79 ��,
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' C�heck Received ^c6b3.78 '
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Total Fee: $ tp�p 3, � Date Received: ,' I -11 ; -� l
Entered By: ;��,. - � Pernut#: ,�; ; c�(,� �=;�--7
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CITY OF ORONO - BUILDING PERNIIT APPLICATIOIeT
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER O CONTRACTOR
JOB SITE ADDRESS: /2 � D p,,���-,��-{�-s �'�' Qa0 ZIp:
NAME OF OWNER: ��/� f/�, ����o w� PHONE: (home)
(work)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR �o���r;� u���o���i�.� /•� � , PHONE: (/Z 3 7� - 34T/
CONTACT PERS N: .�o�s �„��^ MOBILE/PAGER: �/Z �j�0 - �3 0¢
MAILING ADDRESS D3 P� �� ' S. CITY: /s ZIP: �
STATE LICENSE: # 2�c�I�O¢ ���08
ARCHITECT/ENGINEER: ��'��� ,.�di���t�s o� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
PROPOSED WORK(describe in detain: /�, fP.� :o r �'��r�%� �loar` ��.��c�e/
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ -'��-- �� ` • �
.-- .
I hereby apply for a building permit and I acknowledge that the information above e e and
accurate; 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 work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'SSIGNATLTRE: � DATE: ///Z6/�/
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
Sea 13.04 RIGHTS OF SIIBJECTS OF DATA
Subd. i. Type of data. The righrs of individual on whom che data is stored or co be scored shall be as set forth in this secaon.
Subd.2. Information reqirired to be given individual. .�n individual asked to suppiy private or confidenaal data concerning himself shall
be informed of: (a) the purpose and intended use of the requesred data within the collecang"state agency,poliacal subdivisioo,or sntewide rysum;
(b)whe[her he may refuse oY is legally required to supply the requested data;(c)any Imown coasequence arising from his supplying oc refusing to supply
privace or confidendal dara;and(d)the idenriry of ocher persons or enddes au[horized by state or federal law to receive the data. 'Ihis requirement shall
noc apply when an individual is asked to suppiy invesdgaave da[a, pursuanc to secrion 13.82, subdivision 5, to a law enfoccement o�cer.
The commissioner of revenue mav place the norice reauired under this subdivision in [he individual income tax or propertv tax refund
instruccions instexd of on�hose forms.
Subd. 3. Access to data b�individual. Upon request to a responsible au[horiry,an individual shall be informed whether he is the subject
of stored data on individuals, and wherher it is classified as public, private or confidendal. Upon 6is further request, aa individual who is the subjec�
of stored private or public data on individuals shall be shown the data wichout any charge to him and, if he desires, shall be informed of the content
and meaning of chat data. Aftzr an individual has been shown the private data and informed of ics meaning,the data need not be disclosed to him for
six months thereafrer unless a dispute or acdon pursuan[to �his secaon is oending or addidona!data on the individual has been collected or created.
The responsible au[horiry shall provide copies of the private or public data upon requesc by the individual subject of the dara. The responsible authoriry
may require the requesting person to pay the ac[ual coscs of makine,cerrifying, and compiling the copies.
The responsib(e authoriry shall comply immediately, if possible, with any reques[made pursuant to this subdivision,or within five days of
the date of che request,excluding Saturdays,Sundays and legal holidays,if immedia�e compliance is not possible. If he cannot comply with the request
wichin that time,he shall so inform the individual,and may have an addiaonal five days within which to compiy with the request,excluding Sarurdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or compfeteness of public or pri�•ate
data concerning himself. To exercise this right,an individual shalf noafy in wriang che responsible authoriry describing[he nature of the disagreement.
The responsible aurhoriry shall within 30 days eirher. (a)correct che dara found ro be inaccurate or incomplere and attempt to nodfy past recipients of
inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual that he believes[he data to be correct. Data
in dispuce shall be disclosed orily if the individual's sta[ement of disagreemenc is included with the disclosed data.
The dererminanon of the responsible authoriry may be appealed pursuant to the provisions of the administrarive procedure act relaang to
contested cases.
DAT�, PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rig.hts of subjects of data", we would like to inform you that your reauest
for a permit or license from the Ciry of Orono or any of its departments may require you to fumish certain private or
confidential information.
You are notified that:
1. 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 Ciry deny the permit or license.
3. The information may be shared wich o[her local, state or federal a�encies to the extent necessary to process
the pernut or license.
4. If your requested permi[ 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 perm.it.
First Middle Last
Address
C��y State Zip Phone
I understand my ri�hts as stated above.
Signature
, .
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: � 2,2 0 ��c k,�-� �o r n�T
PID:
DESCRIPTION OF WORK: �vtn o�L,-Z -- t � {_-Lo��2
ZO.�i G REVIEW BY: r! i4 DATE APPROVED:
BUILDPIIG REVIE`V BY: DATE APPROVED; I r • z.�_o t
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes � No .
PLA��t REVIEW Yes ✓/ No SEWER CONNECITON
STATE SURCHARGE Yes �/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CI�CK LIST Zoning Districr. No Gl�f�1N[�e
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Reaz (Street): Left Side:
Adjacent Structures: Wetland
Building Height: Def. Hgt. Peal:Hg .
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
ZoninF File: # Resolution: # esolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
BUILDING REV�W CHECK LIST
�C� 2 � 3 CONSTRUCTION TYPE: �lN
Sq Footage $Per Sq Ftg
Basement x _
lst Floor x =
2nd Floor x _
Garage x _
R =
TOTAL
Estimated Construction Value: $
Inspections Required: `Vork Requiring Separate Permits:
Site _ (�Plumbing Fire
Hardcover Removai _ �C Mechanical Water Connection
Footing ' Septic Sewer Connection
_�Framing Fireplace Lawn Irrigation
_�Insulation (Masonry) Other
�Wall Board (Mfg.) Well (State Permit)
o� Final Grading/Filling yt Electrical (State Permit)
Other
REI�ZARKS(I�T HOUSE):
--------------------------------------------------------
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy:
-------------------------------------------------------
KEMARK.S (TO BE NOTED ON PERl�1IT�:
8
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DATE TIME
CITY OF OR O c�(�� CA�LED IN �
INSPECTI N TIC SCHEDULED �
PERMIT N0. COMPLETED `f ' ai -
ADDRESS d /e �
OWNER CONTR. �.D/��-�� � ��aU
TELEPHONE NO. �� /o? ��D I � v� c� �O
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� DESCRIPTION �
� 0� 11 MECHANICAL I 18 EXCAV/GRADING/FILLING
Q 02 F ING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING FI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
O CORRECTUNSAFECONDITIONWITHIN HOURS. p PHOTOTAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
� INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnedContractor on site:
Inspector.� �'�z�� ?O�
White Copyllnspector's Ffle Canary Copy/Sfte Notfce
�� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED ___��� ' ��
PERMIT NO. � �'�� COMPLETED << y
ADDRESS � ��C' ��"� cic,�z,� �'n,/
OWNER CONTR. ��?�� �7`�r f
TELEPHONE NO. _ __ �`� -�yL �' Sl����-�
� DESCRIPTION ���-��v�,�
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 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
� 07 DEMO-FINAI 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBiNG RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATIONlREMOVAL
� OWNERICONTRACTOR TO MEET YOU:�.YES_NO
� COMMENTS:
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�ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46�0
OwnerlContracto i .
Inspector.
White Copyllnspector's File Canary CopylSite Notice
\/ `'�;� DATE TIME
CITY OF ORONO � ��CALLED IN
INSPECTION NOTtC �j, SCHEDULED —r��-����
PERMIT N0. T��� COMPLETED ��-' �
ADDRESS I �� I� �-��-�rt� �
OWNER ��;�-�Ca IC�i'1f(���ONTR. C���U'�-�t �
TELEPHONE N0. ��� oc �" ��O ��-I'��U
� DESCRIPTION
� 01 FOOTING 11 M NICAL RI 18 EXCA�//GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLAND�u
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL �
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTI
Q OS 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
� OWNERICONTRACTOR OMEETYOU: S_NO
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERINCa PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnedContr �pr on site:
Inspector.,��l`��C��
While Copy/inspector's Fiie Canary Copy/Site Notice
� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE�e SCHEDULED v •� 3�P
PERMIT N0. P� yV'S� COMPLETED �' _
ADDRESS a1 o�d �� - � �-P
OWNER CONTR. (/e-.
TELEPHpNE NO. `O�� �D y��CJ�
� IPTION O r�
� 01 FOOTIN 11 MECH ICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRA NG 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATIGN 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
� 07 DEMO-FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER AEMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
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W� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p 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) 2Q9-�6QQ
OwnerlConUactor on site:
Inspector. ////Q-U�L�C��'
White Copyllnspeclor's Ffle Canary CopylSite Notice