HomeMy WebLinkAbout2008-P12045 - attached deck � ° PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway- PO Box 66 P12045
Crystal Bay, Minnesota 55323 Pe�mlt Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
5/8/2008
SITE ADDRESS: 3359 Crystal Bay Rd Unit#
Wayzata,MN 55391
PID: 17-117-23-41-0025
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): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Replace deck boards,railing,footings, change stair direction
FEE SUMMARY: Permit Fee: $ 118.00 valuation: $ 5,000.00
State Surcharge Fee: $ 2.50
TOTAL FEE: $ 120.50
APPLICANT: Owner/Self OWNER: Rick Luzaich
� 3359 Crystal Bay Rd
Wayzata,NIN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK W STRICT COMPLIANCE WITH ALL CITY OF ORONO ORD[NANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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V APPL[CANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Sig�iatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
Total Fee: $ Date Received: O�
Entered By: Permit#: D
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) WNE OR CONTRACTOR
JOB SITE ADDRESS: ��5� �:('�r�1��- t�z�� i-'��i� z�: S�S a�i �
Will t6is be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes �NO Ifyes, a special event permil is required ti��ilh Police Deparimen�and City Council approi�al
60 days pria•to the even�. Shirltle bus se�vice i+�iN be i•equired z�nless applicant demonslrntes
su�cient on-site parking is m�ailable. 1Von permitted ei>enls irill noI be alloi��ed
NAMEOFOWNER: ��1'�- U}��11C(� PHONE: (home)
�Work) .z 1�- �9 S�
MAILING ADDRESS:� C(Z-Y,SZac-i3�'`t �r� CTTY: C1�1;.�v� ZIP: SS3`�I
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATTON DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: 1 CI'TY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home RemodeUAlteration(ie: Siding,Windows) �-
Any earth movement may require MCWD review and permits!
PROPOSED WORK(describe 'n detain: ��{-�t�+C(t�Z� (�f.� �c:.1�� �:SC;�.��
�''" �C z�ti�'C t-r D:z=-i�- R�!1 U N C,7 �- �t�SC(!�� G t-�4r.�c,a S rV+�2 I(J�YLrCx��'�
--�
STORIES: SQ.FEET OF EACH FLOOR:
NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � (�- ��
1 hereby apply for a building permit and[acknowledge that the informarion above is complete and accurate;
that the work will be in conformance with the or ' ances and codes of the City and with the State Building
Code;that I understand this is not a permit and is not to start without a permit;and that the work will be
in accordance with the approved plan. �
APPLICANT'S SIGNATURE: DATE:
`� � Q �
31
Sec.13.04 RIGH7'S OF SUBJECI'S OF DATA
Subd.1. Type of data. The rights of individual on whom the data is stored w to be stored shall be as set forth in this section.
Subd.2. Infortnation required to be given individual.An individual asked to supply private or confidential data conceming himself shall be
informed of. (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide 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 conf deritial data;and(d)the identity of other persor�s or entities authorized by state or fedetal 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 place the notice required under this subdivision in the individual income tax or property ta�c refund
insVuctions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infom�ed 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 informetl ofthe 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 crea[ed. The
responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,ifpossible,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 reyuest
within that time,he shall so infortn the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure when data is rrot accwate or oomplete.M individual may corrtest the accivacy or completeness of public or private data
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement.1'he
responsible authority shall within 30 days either (a)corract the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,inetuding recipienu named by the individual;or(b)norify the individual that he believes the data to be wrrect. Data in
dispute shall be disclosed only if the individual's statement of disageement is included with the disclosed data.
The determination of the responsible authority may be appealed purs�ant to the prmisions of the administrative prceedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance witt�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 Omno or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
l. 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 ful(n e is required to process this application or permit.
_ ��Xl� 1 C�--+� � �U 7 C--�C.�
First iddk Last
? � ` �� ��I C��-� �<---lJ�
Address • C 2 '
� � �� � ,, �� ��S��� I �-�� i
City State Zip P6one
I understand my rights as stated abova
Signature
Reset Form 32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 3 35� G�(5��. (3 A� �aa
PID:
DESCRIPTION OF WORK: Q e �-t- S o�p ��
_____�--__-____----__�_w________�______________�_�______�____________________Q�� 7-t�ltN
ZONING REVIEW BY: DATEAPPROVED:
BUILDING REVIEW BY: DATEAPPROT�ED: S- �,u B
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW �es No r/ SEWER CONNECTION
STATE SURCHARGE Yes_�� No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (spec�)
ZONING CHECK LIST Zoning District: �/C�
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 S' e:
Adjacent Structures: Wetland:
Building Height: Def Hgt. Peak Hgt.
Lot Coverage:
Grading: StaffApproval Date: By: Council App��oval Date:
Septic: StaffApproval Date: By:
Zoning File: # Resolution: Resolution Date:
Shoreland District: MCWD Permit:
Avg. Setback. luffSetback: LotCoverage:
isting Proposed
Hardcover: 0-75'
75-250'
2.i 0-�DO'
500-1000'
Hardcover ��ariance Reguired: Yes No Date of Council Appi�oval:
REMARKS(in house): (.4rv/)inJG' 0 U P�_ L X�5 T7NS /�r/�2d Gf v Pi(
33
BUILDING REVIEW CHECK LIST
UBC: �' 3 CONSTRDCTION TYPE: �((�ll
Sg Footage $Per Sg Ftg
Basement . x =
Ist Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ S,v�O "'�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical W'ater Connection
_�Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
_�Final Grading/Filling Electrica!(State Permit)
Other
REMARKS(INHOUSE):
RET�IEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT):
34
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