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Home My WebLink About2000-P02802 - addn/remodel/repair ` PERMIT C I T�Y O F O RO N O Permit Number: 2750 Kelley Parkway - PO Box 66 Po2so2 Crystal Bay, Minnesota 55323 P@1'Clllt Typ@: Addition/Remodel/Repair (612) 249-4600 Date Issued: gi23ioo SITE ADDRESS: 3405 Crystal Bay Rd WAYZATA,MN 55391 P ID: 17-117-23-44-0022 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Per►nit Sub-type(s): Single Family DETAILS: Approved per resolution#: Separate permits required: riumoing iviecnanicai Eiecu�icai�siaiej NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 223•25 Valuation: $ 12,500.00 Plan Review Fee: $ 145.08 State Surcharge Fee: $ 6.25 TOTAL FEE: $ 374.58 APPLICANT: P�ekkenpol Builders OWNER: ALOMA J DARLING 401 E 78th St 3405 CRYSTAL BAY RD Bloomington, MN 55420 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. ` .. / � i �, ' Cc:'��- t - ' , - L �i l'1��- :'' / „ t_ � /f� APPLICANT PERMITEE I A URE [SS ED BY SIGNATURE Copies: City,Applicant,Assessor, Finance Page 1 r . � Total Fee: $ ��7 a ,�� Date Received: g"� v� Entered By: Permit#: �a. `a 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 � CTOR JOB SITE ADDRESS: �� ' �� ZIP: �s�9( NAME OF OWNER �� l.(/C>�'� ��'I Cl� PHONE: (home) �7��3c��/ 3 ��5 ,, (work) f/S�' G S�. MAILING ADDRESS: �' '��' � �� >��(� �CITY: (�";�v�,zc; ZIP: S� CONTRACTOR: �1 �� k's� PHONE: ��`�� a� CONTACT PERSON: ti MOBILE/PA:G,ER: 3 c�- 3�.� MAILING ADDRESS: � � $ �5 � CITY: I��UC>�LCi ZIP: Jj 3Gj STATE LICENSE: # �Cic.ii�Z Q� � ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAIVIE: REGISTRATION# T�'I'E OF WORK: New Addition Accessory Structure Move Remodel/Alteration�� Land Alteration P�OPOSED WORK(descr'be in detai�: ��V� I �ct�'swur� � � �s�,�' �.e L�u� -S�� L � ��'E'�``� �c � n '� a� STORIES: �— SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. X DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��,��' ` 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 co dance with the approved plan. aPPLICANT'S SIGNATURE: ' DATE: �� NOTE! Parade o,�Homes events require separate 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 concerning himself shall be informed of: (a)the purpose and intended use of the requested data within the collecring state a2ency,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 confidential dara;and(d)the idendty of other persons or entities authorized by state or federal(aw to receive the data. This requirement shall not apply when an individual is asked to supply investigative dara, 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 individuai income tax or nrooertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon request to a responsible authority,an individuai shall be informed whe[her 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[he content and meaning of that data. After an individual has been shown the private dara and informed of its meaning,the data need not be disclosed to him for six months thereafrer uriless a dispute or action pursuant to this section is pznding or additional data on the individual has been collected or created. The responsible authority shafl provide copies of the privare or public dara upon request by the individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of maldno,cercifying, and compiling the copies. The responsible autttoriry 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 legai 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 five days within which to comply with the request, excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure�vhen data is not accurate or complete. An individual ma} contest the accuracy or comple[eness of public or private data concerning 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 data fourd to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual:or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disasreement is included with the disclosed data. The determinaUon of the responsible authority may be appealed pursuant to the provisions of the administrative procedure act rela[ing 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 }�our 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 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 appro��e, 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. � / � �c��i� �� " l� �. First Middle Last ' � > Address Ciry State Zip Phone I understand y ight�as at ove� 9 � Signature 6 J . CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: 3�l OS G(�S�x_ (3►44 PID: DESCRIPTION OF WORK: �Zt,�vvt��-2L_ Z.��9 �' i�t.c,, --------------------------------------- --- �---------------------------------------------------------------------- ZONING REVIEW BY: DATE APPROVED: �v� c.l�,r BUILDING REVIEW BY: DATE APPROVED: g -�7- �� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes c� No PLAN REVIEW Yes v� No SEWER CONNECTION STATE SURCHARGE Yes �/ No WATERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ----------------------------------------------------------------------------------------------------------------------- 'LONING CHECK LIST Zoning District: /11I) GI�Z�i�i�t/t�G 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: Rear (Street): Left Side: Adjacent Structures: W tland: Building Height: Def. Hgt. Pe � Hgt. Lot Coverage: Grading: Staff Approval Date: B : Council Approval Date: Septic: Staff Approval Date: B : Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setback: L.ot 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 REVIEW CHECK LIST UBC: � ' 3 CONSTRUCTION TYPE: \!N Sq Footage $ Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Garage x = x = TOTAL 0 Estimated Construction Value: $ ( 2-, �v� Inspections Required: Work Requiring Separate Permits: Site _�Plumbing � Fire Hardcover Removal o.�Mechanical Water Connection Footing Septic Sewer Connection � Framing Fireplace Lawn Irrigation _� Insulation (Masonry) Other _�r 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 -- . r ._____---_. ._---�—. ._.,_..--m...�n„a..v--�a�...rt-..o......__._.._� L6Ll#�!l NW SZZZ-888 � N I S � 3 4 l I fl B �ua��d �"_ -, � �E�€�a�� u��. �� p ' .- - i,� �� — FS�=►E �XI`� Fi�'L�+.J4� --'r' � O� � � I " � � �1 �: �.XD'0'�`� 2�`� hJ'�Rl. C�f=Li�.-u''+1i� �-,� �sNoisin3a � f?.:�." E`,l�s��. �L..�:�'�F �-"•.��'3- ..;' Fl`. �1Y HV. ��i�, O� �'hi :�.� SQ. _ SPECIAL NOTE -�- Z 4�� ,�A;�. ;IL!_ F!E1C-��" 5EE ATT�C��'D a}-��T -- R'O R } nn�t� A�. 2 � COt)E F4EQ f Rk��PiTS C� rlE.v�'ri��kc.��►J�,�,,; t1r:�.rC��c.u.t�.1v�. 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DATE TIME CITY OF ORONO CALLED IN -ae ^� ''� Q v INSPECTION NOTIC SCHEDULED � -�� PERMIT NO. a COMPLETED � ADDRESS �'�'' s� � OWNER CONT . r ��-�1�'� TELEPHONE NO. �`�'-�=- �a� � DESCRIPTION LL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 2 FRAMING i 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Z Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 4Qi 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL = 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL J Q OWNERICONTRAC�T TO MEET YOU•_YES NO � C M M • i `C��'K�`�, '�1 �� -, � a � � � C�C -e. � ' J 0 r �+ � ; � e� ____--- 0 � W � Q � Z W � W � j � ❑WORK SATISFACTORY:PROCEED � PROJECT COMPLETE W � � ORRECT WORK 8 PROCEED �', ISSUE CERTIFICATE OF OCCUPANCY W [� CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. , PHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED �� INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-460� OwnerlContra tor on site: Inspector. � N White Copyllnspector's File Canary CopylSite Notice DATE �ME �� CITY OF ORONO CALLED IN �"��"�� INSPECTION NOTICE, scHE�u�E� �i -/7��-[�c.� GU PERMIT NO. �� COMPLETED 'T,�� D4 -_�� ADDRESS -��C� �?� -�< f"Ck / ��;� �� OWNER (�. �C(i f i�ICIN CONTR. 1�%��'C.c{��%� �/l.� TELEPHONE NO. � �� Z Z C� � DESCRIPTION _ -.��z-f /��c:'C� i�'1 �-- (Ci!r�I �'�' L� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � Q2 FRAMWG � 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT J 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP 4Qi 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL = 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL J Q OWNERICONTRAC R TO MEET YOU:_YES_NO ��,, COMMENTS:� r� �' Z `�� /a- bs � � �� - 3 � > �.� � j �( O '' �� ,Q � 0 � w � Q � z W � W � j � f 1 WORK SATISFACTORY:PROCEED : PROJECT COMPLETE W � �ORRECT WORK&PROCEED I ' ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL RETURN C STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-4600 OwnerlContractor on site: Inspector. � �%/ �,. White Copyllnspector's File Canary CopylSite Notice DATE TIME�/ CITY OF ORONO CALLED IN ��—�Z�� ' r� INSPECTION NOTI,� SCHEDULED �//�� ►-, PERMIT NO. U� COMPLETED k 'L � ADDRESS � ��. .�� C_ � -�r �J 1 �-a ( !>/-� �� C-� OWNER �1 �- �,L .C�1''�I�ti"i�►1CONTR. V-�I�C �L��r.�f�, I TELEPHONE NO. � �U � �Z�_� � � DESCRIPTION �-i-1��< <cZ fi�GY� �� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS Q •�NSU ION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q 05 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 J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z � COMMENTS: � w a � � O a � O � W � Q � Z W � W � � d NORK SATISFACTORY:PROCEED r PROJECT COMPLETE W ��l CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY O Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERINC'i PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN INSPECTOR WILL REfURN ❑ STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. 249-46�0 OwnerlContract n i : Inspector. White Copyllnspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN / GU � ��o INSPECTION NO ICE SCHEDULED /5�vv � PERMIT NO. � ��COMPLETED /S�� ADDRESS -3 0-5 � OWNER CONTR: -c�-�� TELEPHONE NO. �� -�-�--5 � DESCRIPTION G�n-L1itti�� LL 01 FOOTING 1 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q O5 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 Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z � COMMENTS: � w � � � O a � O � W � Q � Z W � W � � d ��/VORK SATISFACTORY:PROCEED - PROJECT COMPLETE � �C] CORRECT WORK R PROCEED ISSUE CERTIFICATE OF OCCUPANCY O C; CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTOTAKEN INSPECTOR WILL RETURN C;STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-460� OwnerlContra t r on site: Inspector. U"`''� �� White Copyllnspector's File Canary CopylSite Notice