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Home My WebLink About2003-P06622 - addn/remodel/repair � � � PERMIT CITY rJF ORONO 2750;<elley Parkway- PO Box 66 Permit Number: Po6622 Crystal Bay, Minnesota 55323 PeCCTIIt Type: Addition/RemodeURepair (952) 249-4600 Date Issued: s��2o03 SITE ADDRESS: 1280 Bracketts Pt Rd Wayzata,MN 55391 PID: 11-117-23-32-0019 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Pernut Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate pernuts required: riumbing iviecnanicai Eiecmcai�siaiej NOTICES/REMARKS: FEE SUMMARY: PernutFee: $ 542.75 Valuation: $ 40,000.00 Plan Review Fee: $ 352.83 State Surcharge Fee: $ 20.50 TOTAL FEE: $ 916.08 APPLICANT: Tom Potter Consmzction Inc. (see notes) OWNER: 7ohn Pillsbury 6531 Devonshire Dr. 1280 Bracketts Pt Rd Chanhassen,MN 55317 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. „ � .�_ C��r��ti_.__ �� APPLICAN PERMITEE SIGNATURE ISSUED BY SIGNATURE Conies: 1-File(SiQnitures Required), 1-Apolicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1 Total Fee: $ '1 � � � Date Received: �-�/-p,� Entered By: �I�2f - Permit#: ,��(�a� , , , . CITY OF ORONO - BUILDING PERNIIT APPLICATION 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 30B SITE ADDRESS: � B�ACI�Tj.'S I"a�;(�T /�D- ZIP: C��L� � NAI�TE OF OWNER: c�i`i�.5 �y� PHONE: (home)�z "��" �z� . (work) EJ�,Z -�'Z - 7—� MAILING ADDRESS: 'S,t�/Vl.� �-5 l�,�4^� CITY: ZIP: CO��TRACTOR: ��I�\ ��"C-)z C��.'ST. �.�-'�G PHONE:_ �Iv�L- S��a '�� COti�'ACT PERSON:�o�_p�7-�'E�_ l�IOBILE/PAGER: �! Z- Z8 z -7�l3ro NLAII,ING ADDRESS: 3( -v �'� �- CITY: �i�,✓h��S��G-,r/ ZIP: S 3! ST�TE LICENSE: # D I. �3 ARCHTTECT/ENGTivEER: �j�U.GE- �C.l�i��zt'�-�S.SvC PHONE: l✓��- �71�-� �a� Z!Z- iVIAILTiV�G ADDRESS: ��-r /�'j .t�iTo QA c,'E. :5�. CITY: �Q' ZIP: �1( NA.ti1E: REGIST TION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration ti' Land Alteration PROPOSED WORK(describe in detai�: pl ��F,/ /1�j��r��L �`D�o�,ct � LS�I"� /��PfA F —,, STORIES: Z SQ. FEET OF EACH FLOOR: NO. OF BEDROONIS: �_ � GARAGE STALLS: ATT. � DET. ESTLI-IATED CONSTRUCTION VALUATION (excluding land): $ '�"� vt�p, a o I hereby apply for a building permit and I acknowledge that the information above is complete 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 wilI be in ac dance with the approved plan. � APPLICANT'S SIGNATURE. ,�,-�Y�� DATE: �f` �''�.3 NOTE! Parade o Homes events require ,separate permit approval by Police De�artment and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 ' t � Sec.13.04 RIGHTS OF SIIB,TECTS OF DATA Subd. 1. Type of data. The rights of individual on whom the data is stpred or to be stored shall be as set forth in this secaon. Subd.2. Information required to be given individual. An individual asked ro supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested data wi�tun the collecdng state agency,polidcal subdivision,or statewide rys[em;(b)whether he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing to supply private oc coc�fidenaal dara;and(d)the identiry of other persons or enaaes aurhorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investi;adve data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav olace the nocice teauired under this subdivision in the individual income taz or orooertv tax refund instrucrions!nstead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidenrial. Upon his further request,an individual who is the subject of stored private or public data on ir.dividuals shall be shown the data without any char�e to hun and, if he desires, shall be informed of the content and meaning of that data. Afrer an individua!has been shown the private data and informed of its meaning, the data need not be disclosed to him for six months thereafrer unless a dispute or action pursuant to this secoon is pending or addidonal data on the individual has been collzcted or created. The responsible authoriry shall provide copies of the private or pubfic data upon request by the individual subject of the data. The responsible authority may require the requesring person to pay the actual cosC�of making,certifying,and compiling the copies. The responsible authoriry shall comp(y immediately,if possible,with any request made pursuant to this subdivision,or wi[hin five days of the date of the request,excluding Saturdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within that time, he shall so inform the individual, and may have an addicionai five days within which to comply with the request, excluding San:rdays,Sundays and legal hoIidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public oc private dara concerning himself. To exercise this right,an individual shal]noti;y in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplere and attempt to nodfy past recipiencs of inaccunte or incomplete dara,including recipienu narnzd by the individual;or(b)noafy the individual that he believes the daca [o be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The deternvnadon of the responsible authoriry may be appealed pursuant to the provisions of the adminis�aUve procedure act relatin, 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 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: � 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 City deny the 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 reques[ed pemut 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. First Middle Last ?.ddress C�ry State Zip Phone I understand my rights as stated above. Signature , 6 , CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: (Z.`a0 BF1�4C�c�S 'Po i N� PID: DESCRIPTION OF WORK: �Z�,ww�n eZ Z0�1ING REVIEW BY: N I � DATE APPROVED: BUII�DING REVIEW BY: DATE APPROVED: 8 -b -0 3 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓� No PLAN REVIEW Yes ,/ No SEWER CONNECTION STATE SURCHARGE Yes �� No WATERCONNECITON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) --------------------------------------------------------------------------------------------------------------------- ZOr�ING CHECK LIST Zoning District: N d c�n�C,�- / Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Se[backs: Front (Lake): Right Side: Rear (Street): Left Side: Adjacent Structures: Wetl d: Building Height: Def. Hgt. Peak�gt. i Lot Coverage: �i i` Grading: Staff Approval Date: By: �I Council Approval Date: Septic: Staff Approval Date: By: � �— Zoning File: # Resolution: # �Resolution Date: . � Shoreland District: Av�. Setback: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes I�10 Date of Council Approval: RENIARKS (in house): �. 7 . . . , � BUILDING REVIEW CHECK LIST �c: R�3 CONSTRUCTION TYPE: Y,� Sq Footage $ Per Sq Ftg Basement x = ist Floor R = 2nd Floor R = Garage x = R = TOTAL Estimated Construction Value: $ �-(0,Oo 0 � Inspections Required: Work Requiring Separate Permits: Site �Plumbing Fire Hardcover Removal _�Mechanical Water Connection Footino Sep[ic Sewer Connection _�Framin� Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) Final Grading/Filling _�Electrical (State Permit) Other REMARKS (IN HOUSE): � �-----�- --------------------------------------------------------------------------------------------------------------------- REV�W BY OTHERS: DATE: Access: Existin� Nec✓ Access Approval: Date By; ---------------------------------------------------------------------------------------------------------------------_� REiI�IARKS (TO BE NOTED ON PERMII�: g , 1�� DATE TIME CITY OF ORONO CALLED IN -'- '� 1NSPECTION NOTI E SCHEDULED �-,S=V`/ ��I S PERMIT N0. ' � COMPLETED ADDRESS /a�.�CJ ��C��f 5 � ��{{' OWNER CONTR. �('��,; �T C�dhSr TELEPHONE N0. �G�� .��5�� %��(i � DESCRIPTION L�Y�S�-� �5 ly Ot FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION 05 FIN L 14 SEWER HOOK-UP O6 PROGRESS � MO-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 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YO�ES_NO � COMMENTS: � �� N� � � � � 0 � � 0 � W � Q � Z W � W � � � �ORKSATISFACTORY:PROCEED PROJECTCOMPLEfE W ❑COFiRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITH�N HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED O STOP ORDER POSTED.CAIL INSPECTOR �INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor o si� • Inspector. White Copyllnspector's File Canary Copy/Sfte Notice �� f DATE TIME CITY OF ORONO CALLED IN '�--�I"��`I INSPECTION NOTIC D�SCHEDULED `"-[�� 1,S�I PERMIT NO. COMPLETEO ADDRESS ��Ci�v'�l'yt C:�C..t,1�T � OWNER CONTR. ��-E�i��Q-�lci��b� TELEPHONE NO. �.(� I� - �� 2`��(0 C.vn1.1��9�t,rC��s�-� � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z0�4 W�BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 5'0�' 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT `� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL 10 PLUMBING FINAL � 36 FOUNDATION/REMOVAL � TO MEET YOU=YES_NO � COMMENTS: a �1 t�z,�ce C�� 0 � � 0 � W � Q � Z W � W � � d W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WtLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED O INSPECTION REQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. �952� Z49-4600 OwnerlContr o 'te: Inspector. � White Copy/lnspector's le Canary CopylSite Notice � DATE TIME CITY OF ORONO CALLED IN � G ��L � � INSPECTION NOTICE SCHEDULED G' � � .�1 S� t,j PERMIT NO. �L%�'�i •�� COMPLETED ADDRESS ��- �"�)r� ,.( ICc.,Tl ` ��; �2� - OWNER CONTR.� I�°��1� ��,��C-4'� CG��I, TELEPHONE NO. �( c� 1? -�.� [ r" ��-I I � ` � � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INS TION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION 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 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W 0. � J ;. O � � � O W � Q � 2 W � W � i% � O W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR FiEINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR D INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. � Call for the next i spection 24 hours in advance. (95Z� 249-46QQ OwnerlContra r o s e 1 Inspector. � White Copyllnspector's File Canary Copy/Site Notice V DATE TIME CITY OF ORONO CALLED IN lC-- 5 Q3 INSPECTION NOTICE SCHEDULED E,c� 7, �cr> �O�3c�� PERMIT N0. � - COMPLETED ADDRESS � �J(/1 �li - � �� OWNER CONTR. ��' ' �' G TELEPHONE NO. ��-" .� .=� �'��_��I I I � � DESCRIPTION � 0 OTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z • 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-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL v ��#�F��"� �/ 36 FOUNDATIOWREMOVAL � O NERICONTRACTOR T EET YOU:J,c'YES_NO � COMAI(�NTS: � W C � J O � � O � t � y �� -� <� , �� Q � � 2 W � W � �,m d � W��WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE ��❑CORRECT WORK 8 PROCEED W ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFECONDITION W�THIN HOURS. p pH0T0 TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hour�in advance. (952) 249-46�� p OwnerlContractor on site: Inspector. ��,� `;��'�`_�. White Copyllnspector's File Candry Copy/Site Notice