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Home My WebLink About2003-P05965 - windows doors CITY �F ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Pos96s Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations (952) 249-4600 Date Issued: 1i16i2oo3 SITE ADDRESS: 1755 Concordia St WAYZATA,MN 55391 PID: i�-ii�-23-22-ooig DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential � �� Pernut Class: Building Census Code 4� �� Permit Sub-type(s): Windows Permit Type: Minor Alterations Doors DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUAIIMARY: Permit Fee: � 321.25 Valuation: $ 20,000.00 State Surcharge Fee: $ 10.50 TOTAL FEE: $ 331.75 APPLICANT: WAGENMAN JACOBSON REMODELIT OWNER: GERALD W KLECKNER 9483 JERGEN AVE S 1755 CONCORDIA ST COTTAGE GROVE, N1N 55016 WAYZATA MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI-IE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. , ^ � � �� ' ,�2� r,:��, �C,�.� APPL CANT P EE SIGNA"1'URG � I UED BY SIGNATURE Cooies: 1-File(SiQnitures Required), 1-Apolicant, 1-Monthlv Reoorts. 1-Assessing, 1-Finance Page 1 CHECK OFF LIST FOR ISSUANCE OF PERIVIITS ' � FOR OFFICE USE ONLY ADDRESS OR LEGAL: PID: DESCRIPTION OF WORK: �. ------------------------------------------------------------------------------------------------------------------------ ZONING REVIEW BY: DATE APPROVED: BUILDING REVIEW BY: DATE APPROVED: ------------------------------------------------------------------------------------------------------------------------ FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes No PLAN REVIEW Yes No SEWER CONNECTION STATE SURCHARGE Yes No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------------------------------------------------------------------------------ ZONII�G CHECK LIST Zoning District: /IK.� ��''��'' � 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 S' e: Rear (Street): Left Side: Adjacent Structures: ' Wetland: Building Height: Def. Hgt. Peak Hgt. Lot Coverage: 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: Exist' Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes i No Date of Council Approval: REMARKS (in house): �� 7 � . BUILDING REVIEW CHECK LIST UBC: CONSTRUCTION TYPE: r _ Sq Footage $ Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection �Framing Fireplace Lawn Irrigation _�Insulation (Masonry) Other _�Wall Board (Mfg.) Well (State Permit) �Final Grading/Filling Electrical (State Permit) Other REMARKS(IN HOUSE): ------------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ------------------------------------------------------------------------------------------------------------------------ REMARKS (TO BE NOTED ON PERMIT): 8 Total Fee: $ Date Received: 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 information) ---------- --------------------------------------------------------------------------------�--�--- -------------------- THE APPLICANT IS: (circle one) OWNER O CONTRACTOR \ � JOB SITE ADDRESS: j��5 C� �,y�.��`�'\ � ZIP: S� ?j�-� .� NAME OF OWNER: C�C�� -�C1�� PHONE: (home) �'1 �—�j�� (work) MAILING ADDRESS: �� G�,N�� CITY: pZp�� ZIP:�� i��t-��A�l j ��HC�� F ty��'��-��1�1�0� �t�C,; CONTRACTOR: PHONE: C� �Z1��q—�2�� CONTACT PERSON: �,1C��'{�G��-�S-� OBIL�/�AGER: ��L MAILING ADDRESS:�-�`I�,��r� ��v ��C C.�' r � ZIP: S�c�l � STATE LICENSE: # -J � L ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration� Land Alteration PROPOSED WORK (describe in detai�: �lvS�(1L L � W � y�'P�r,� ��i(7 �' � G � `� ` � - �� FE T O EAC F OOR: �� '" STORIES: SQ NO. OF BEDROOM : GA�a GE STALLS: ATT. DET. �1��I �-�� l/�- � � -- lq C��il � , �� --J�J EST 1MA�ED CONSTRUCTI N VALUATION (excluding land): $ 2, c% �� 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 will be in accordanc with the approved plan. APPLICANT'S SIGNATURE: DATE: � "l�o' E� NOTE! Parade o Homes events require sep ate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. 1. 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. Information required to be given individual. An individual asked to supply private or confidential data concernin�himself shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,orstatewide system;(b)whether 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 confiden[ial data;and(d)the identity 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 mav olace the nocice reouired under this subdivision in the individual income tax or orooertv 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 classified as public,private or confidential. Upon his further request,an individual 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[hereafter unless a dispute or action pursuant to this secUon 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[he individual subject of the data. The responsible authoriry may require the requesting person to pay the actual cosu 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 Ihe date of the request,exduding 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 additional 5ve 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 completeness of public or private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the dara found to be inaccurate or incomplete and attempt to notify past recipients of inaccurare or incomplete data,including recipients named by the individual;or(b)notify the individua(that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinapon of the respo�vsible authority may be appealed pursuant to the provisions of the administrative procedure act relating ro 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 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. w L1Co� ' � J'��--� ,1 �Csz=��jS�� ::�-�f��;; �1�'�� i�1 l', r � /'�',f—,i,�-�,C�'�,�c—v. ? First��fi�Te�� Last T °�i ��(��.,►�� 1 �, �' � .��. AddrCe�� v �� Ciry State Zip Phone I understand my rights a stated above. Signamre 6 ' �1 . _ . .. .. . - . . . � . .. � .. . � ._ _ � � . " _ _ _"' '_� . .____ ..._ I _ - � . . ` .__ . � . . �_�.� __.. � ' • � ( I I . � " �C A � � �� ' rw �� I ' � I I � � - I —.- L I � -- �'� d•�r � - / a ti�i . . _ ___ . . �-oo►M iJ��d.o� _ �n,��S��E�_�\/�.�0 � _ _ ----- - i��►- � ,�.► � y . �'y Z- `� � � -�� `� ____ �e o �— e�k �e►�- �� nc�rc�� 1��. v . (�� ;�� r�l � � rbZ � r . ND'(�: Go�.j-fR.AC(OR SNOU�D YEE�IF`( wlt�1D��/ DIM�NSIONS AGAINS?. EXI�fiNU � ��DoF��C�IL1�G N�IGN'fS� ►t�f"ERIOR � 1,�lAtL- LoGA'fl�t�S. �� __�_-- � , ul le- hu� C�-) .___�_:_ , ___________- _. , _ .____--�--_. _ � _ _ � �� , � � -.-- �� , --__..___ __-r..__.�-- � I . .-- � , I ______..._ __. --- -- - .r----------- ,_ _. . . . � S6�I}� ��A l�� J ;. . ,. . � . . <��`„ DATE � TIME CITY OF ORONO CALLED IN INSPECTION NOTIC SCHEDULED �� ' PERMIT NO. ��COMPLETED � ADDRESS- � � � ��_� � c�r O�c�-�-� OWNER CONTR. ��-c �'�-/�'ti-�'-�') TELEPHONE NO. �' � �' - �� / g " `� -� �' `� � DESCRIPTION ��iW�� .� �,�/��,�� lti 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING 0 FRAtvtIN_G 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 � 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 � OWNER/CONTRACTORTOMEETYOU:� YES_NO � COMMENTS: � W a � J 0 � � 0 � W � Q � 2 W � W � j d W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT O CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next'nspection 24 hours in advance. (952� 249-46�0 OwnerlContra�n i : Inspector. � White Copyllnspector's File Canary CopylSite Notice ,� n � � �, �rt �-t,,- C� ''w�� \ �1 M �e.co� c��v-�,�1�� ti-,,-�. �; DATE ti TIME CITY OF ORONO CALLED IN INSPECTION NOT�DS�� SCHEDULED I_� � C7� PERMIT NO. COMPLETED /I ADDRESS / 7�� d%7CU�%�.. OWNER CONTR. GC�I�aMw��t.t v� S�Jt�I TELEPHONE NO. ��. =T� � � � �,c� —T� �l C� �' �/v� - � %�'C -.S�r�`� l�� L � � DESCRIPTION � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING ��-- 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS O�03 INSULAT� 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z • 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 2t COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL � � 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:vYES_NO � COMMENTS: � W a � � O �. � O � W � Q � 2 W � W � � �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALlTO ARRANGE ACCESS. Call for the next inspec ' 4 hours in advance. (g52) 249-4600 OwnerlContractor o Inspector. White Copy/lnspector's File Canary CopylSite Notice J�� , DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE �SCHEDULED l� D..3 � PERMIT N0. �Q ��' � COMPLETED ADDRESS � � �-� � C �s-�e c�,-c.�%, c� OWNER CONTR. � ° TELEPHONE N0. � �� •-�/ �T � � � � � DESCRIPTION �/`l��z,( - /�G�/C'-�► � 01 FOOTING 11 MECHANICAL RI 18 EXCA�//GRADING/FILLING Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 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 � 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUM6ING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � a 9 1�.,�1 �` �.L� �.�-4 ` �, . � � 0 �. _ � 0 � W � Q � . - z W � W � � � � �ORK SATISFACTORY:PROCEED ,J�PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED �C ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46�� OwnerlContrac 'te Inspector. White Copylinspector's File Canary Copy/Site Notice