HomeMy WebLinkAbout2003-P06365 - land alteration PERMIT
CI���Y OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P06365
Crystal Bay, Minnesota 55323 Permit Type: UserDefined
(952) 249-4600 Date Issued: 6�30�2003
SITE ADDRESS: 1725 Concordia St
Wayzata,MN 55391
P I D: 17-117-23-22-0044
DESCRIPTION:
Proposed Use: Residential
Pernut Class: General
Permit Type: User Defined Permit Sub-type(s): Land Alterarion(0-500 cu yc
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
B erm
FEE SUMMARY: PermitFee: $ 50.00
Valuation: $ 0.00
TOTAL FEE: $ 50.00
APPLICANT: Kyle Hunt&Partners Inc. OWNER: 7ames Nystrom
18324 Minnetonka Blvd 1701 Madison St NE
Deephaven,MN 55391 Minneapolis,MN 55413
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK 1N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNA URE ISSUED BY SIGNATURE ,
Copies: 1-File(SiQnitures Repuired), 1-Applicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1
- � �c�n� .� L-�G���fz ��� — l�if i � ��
, � �'�� Date Received: S�� �L�3
Total Fez: $ �l •
Entered By: �� (�`� Permit#: ,4�3�`3�-,� _
L�ti ti�--�i �� C;E%�-c�. -
CITY OF ORONO - PERNIIT APPLICATIOle1
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: �7�S���r�•�m-�%'�c _S� ZIP: ss �G �
NAME OF OWNER: � PHONE: (home)
(work)�'.� �l.L�o,�., �i��-7�'�-3�q/
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: �'/� ��n �t D-r���'�"S PHONE: TS�� �76` 5`�9�
CONTACT PERSON:��..r,lc L�r�� MOBILE/PAGER: 6�� � 3���6� 3�-
MAILING ADDRESS:��3�,�-�,�� �!�.Q CITY:,����,o�r,�e� ZIP: ��3 q l
STATE LICENSE: # l �'6 7
�'
ARCI-€ITECT/ENGINEER Ja ��t r�..�i,.-��.��5 PHONE: 6S/- � S-f� �`�6(
MAII,ING ADDRESS•g�� 5'. `�'`� s� CITY:S�,��/l�✓�'�c�r' ZIP:SSc�SS�
NAME: �r/fi�l,4�l�, �L,�,�-�i REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration_ x _
PROPOSED WORK(describe in detai�: /,�dJ� ��-r,yr � ��-✓ � e d
! I��'f�72f 7`� G�/ L�`-�/' T v,�G P C1 Gi h/f'/i '�-�"c�l.il G�(X i G!G-t'✓t "T �!S T
STORIES: � Q. FEET OF EACH FLOOR: ���C� D � �-g�-�
NO. OF BEDROOMS: � GARAGE STALLS: ATT. 3 DET.__
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $
I hereby apply for a building pernut 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 will be in accordance with the approved plan.
APPLICANT'S SIGNATURE� �wr �� �r`�n DATE: ��7�i��j �
NOTE! Parade of Homes events require separate permit approval by Police Deparlment and
City Council 60 days prior to the event. Non permitted events will not be allowed.
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Sec.13.04 RIGHTS OF S[JB.TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom[he data is s[ored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given individual. An individual asked to supply private or confidenrial dara concerning himself shall
be informed of: (a)the purpose and intended use of the requesced data within the collecting'state agency, polidcal subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or refusing to supply
private or confidendal data;and(d)the identity of o[her persons or enrides authorized by state or federal law to receive the data. This requiremenc shall
not apply when an individual is asked to suppiy investieadve dara, pursuant to section 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the nodce reauired under this subdivision in the individual income tax or oropertv taz 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 classified as public, private or confidenaal. Upon his further request, an individuat who is the subject
of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed 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 acaon pursuant to this seccion is pending or additional data on the individual 6as been collected or created.
The responsible authority shall provide copies of the private or public dara upon request by the individual subject of the data. The responsible authoriry
may require the requesring person ro pay the actual costs of making,cerdfying, and compiling the copies.
The responsible authoriry 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 legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shail so inform the individual,and may have an addirional 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. An individual may contest the accuracy or compieteness of public or pri��ate
data concerning himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing rhe nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attemp[to nodfy past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)noufy the individual that he believes the data to be correct. Data
in dispute shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data.
The decerminadon of the responsible authority may be appealed pursuant to the provisions of the administradve 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 reauest
for a permit or license from the City 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 deternune your qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the pemut 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.
(. Your full name is required to process this appiication or permit.
First Middle Last
Address
Ciry State Zip Phone
I understand my right st abov
� / /, ^ �� -- C>�
C._�
Signature
` � CHECK OFF LIST FOR ISSUANCE OF PERMITS
` FOR OFFICE USE ONLY
ADDRESS ORLEGAL: /72 S C�oivco�rJi,q si
PID:
DESCRIPTION OF WORK: LAiv/� /a�`r�i-z�4�-�0�
ZO.vI�1i G REVIEW BY: DATE APPROVED: b� s-��
BUII.D�1G REVIE`V BY: — DATE APPROVED;
W ,C 5-ao G✓'%3iL W v C:�i--- TrVI rr�2 G2��i�v
FEES TO BE CHARGED: Misc. Fees �alculate�By` �_
PER�I�iIT Yes ,/ No
PLA��1 REVIEW Yes No SEWER CONNEC'ITON
STATE SURCHARGE Yes No WATER CONNECTION
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC-Units OTHER (specify)
ZOi�TING CH�CK LIST Zoning District: N� GC .
Fire Department: Post Office: School District: �
L.ot Area: Sq.ft. Acres idth Dep[h
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: �Vetlan :
Building Hei;ht: Def. Hgt. Peal:H t.
L,ot Covera�e:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: L.ot Coverage:
EustinQ Proposed
a
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RENIARKS (in house):
7
. �
BUII,DING REVIEW CHECK LIST
�C' CONSTRUCTION TYPE: —
_ Sq Footage $Per Sq Ftg
Basement x
lst Floor x —
2nd F1oor x _
Garage x —
a
TOTAL
Estimated Construction Value: $ �
Inspections Required: `vork Requiring Separate Permits:
S ite Plumbing Fire
Hardcover Removal Mechanical
Footing ' Water Connection
. Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_ZG Final Grading/Filling Electrical (State Permit)
Other
RENLARKS(I�1 HOUSE):
- - ----------------------------------------------------------
REVIEW BY OTHERS: --- DAT`E:
Access: Ezisting New
—__
Access Approval: Date
By:
----------- ---------------------------------------------
--------------
MA.RKS (TO BE NOTED ON PERivIIT�:
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PROPOSEO ��
III I o O STIN k PROPO ELE 931.4 DRAMAGE
II N 32' �NDEN �6'oMA LE S 24�4.�" E 267.39 N �
��I� �� � � � - - - - - - — — - - -
25.58- —
� 26" SH � 93`
(If�I � � ' � _ �cEc _
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II � �5.00 \ ��i 1 i l � ' -� � PROPO D
IIII � � � PROPOSE�r � GARAGE Fl
0 0 °i � O �� PATIO FLOdR ELEV. 9
u
II O O o �o � EIEV. 936.�0 � `
II �� Fuc Po� � o � � ,J s.rt
I I o°�• � �� `�r.- � e4' �
OHN� 929.4 �� p O p�D / 17-117-23 22 0020 k• 26.
i31.5 9/14/51 II�I � � ' • 'n� I � ! ,��
II � PARCEL AREA � N PRqPOSED �
I I„ o OR 0.4666ACRES ET _ ' R E S h p E N C E ��� $ \
II 5'• MAPLE 75.00 J �IJICDfN st`F9�TP-BIN�AREA a '
II�I o FWND 7'65 � 3,553, SQ. FT. �
p � 3/4` — � $ 1 275 8-q<
IRON PIP 1 � �0�
ROPOSED
DOCK .39 <v IN LEVEI. �'— �
II o "' ° z � oo �.-sabao- �rnY ��
f- 71" 25" OAK 7 O 6" R . 937.63 '
III I � SPRUCE �� ` , � 3� 1
a� 1
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IIII � `le� CLUBIRER �;� / � 1
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CEDAR � � � OPOSED CRAWL�
II � n�� �M ' !`' ACE SLAB 10.0� 6
,TION m o a �2 PID �/ 1 - 17-23 22 0019 (] . � � ELEV. 931.61 9.75
-21-00) III I p ,y� PARCEL A EA � � 10. 9.75 �„J
II ''�� OR�0.463Q ACRES ET � 9 L,�'� $�0.5U r 9
��II � 75.00 �� \ $ �
O EXISTiNG RESIDENCE \
II�� � (TO BE REMOVED) \ w (•��G
�� o E � _ S1
d
III� ° . a . d � N
N 13" MAPL o ° o ° AC 1I oMi'
`O W � ` \ n
��� N EXI3TING PATIO a n 7" CR
II ° (TO+BE RE�IOVED)a F F\ A�P�E`
II � �
4" SPRUCE ��5�-�pRUCE °
—� �a_ e
II�I 12.7 , WOOD FENCE - - � 7" ELM -� — 2 WROU T IRON�
II ' �PP ��
II�I� � RETAMING WALL � o�i N 9 .3Z�42M W Z7�..�
a o
� FOUND i/2' 0 260.0 (R)
IIII � �� �PE
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