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Home My WebLink About2007-P11142 - addn/remodel/repair � � PERMIT � CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P11142 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 6/20/2007 SITE ADDRESS: 3407 Crystal Bay Rd Unit# Wayzata, MN 553)1 PID: 17-117-23-43-0116 � DESCRIPTION: Proposed Use: Residential Census Code 434 Permit Class: Building Permit Sub-type(s): Permit Type: Addition/Remodel/Repair DETAILS: Approved per resolution#: Scparate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 111.25 Valuation: $ 5,000.00 State Surcharge Fee: $ 2.50 TOTAL FEE: $ 113.75 APPLICANT: Keith Garvais Construction OWNER: Robert&Eniuce Nichols 7070 County Rd 15 3407 Crystal Bay Rd Mound, MN 55364 Wayzata MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERM[SSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL C1TY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILD[NG CODE REQUIREMENTS. �,� � � , �� n � � ,-��--� . �� - �� C�ti� APPLf .ANT PFR!�tITEE SIGNATURE ISSUI:D BY SIGNATURE Copies: I-File(Sig��atures Reguired), ]-Applicant, 1-Monthly Reports, 1-Assessing,([f Septic, 1-Septic) Page 1 , Total Fee: $ � �,�;�J Date Received: i' � 1��'2 (�;' "�.(.i V� Entered By: (�.��,4ti1 Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print al!information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB siTE anv�ss: �� ,T�t,� f �.,T�' c��;�►�v ziP: . 5.��>�I Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ NO If yes, a special evenl permit is reguired with Police Department and Ciry Council approva! 60 days prior to the event. Shuttle bus service will be required unless applicant demonsU•ates su�cient on-site parking is available. Non-permitted events will not be allowed. NAME OF OWNER: ��j n,f� �� J� PHONE: (home) �`' - � � - �� (work) MAILING ADDRESS: `��/�J �� ,��_,� � /'3,�,, ,�CITY: ��'��ry�,� ZIP: :�� — CONTRACTOR: � � • � �' ;; �--� : PHONE: �5��y�.�-�� 7 CONTACT PERSON: � �' MOBILE/PAGER:,(..;��-��.� �-'��.�� MAILING ADDRESS: ��-�1�� r�'�,- ��' /� CITY: �,�;;�y1c� y��LIP: ._� STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) (ny earth mo�men��a��ire MCWD review and permits ! PROPOSED WORK describe in detai : , STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �C�/fJ� 1 hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in confarmance 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: ATE: �'�� ' �� 31 I J 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 dataconceming himselfshall be informed of. (a)the purpose and intended use of the requested data within the col lecting state agency,pol itical 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 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 place the no[ice reouired under this subdivision in the individual income tax or property 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,priva[e or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be sho�vn 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 action pursuant to this section is pending or addi[ional data on the individual has been collected or created. The responsible authority shall provide copies ofthe private or public data upon request by the individual subject ofthe data. The responsible authority may require the requesting person to pay the acWal costs 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 davs 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 additionai 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 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. The responsible authoriry shall within 30 days either: (a)correct the data found to be inaceurate or incomplete and attempt to notify past recipieots of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual 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 determination ofthe responsible authoriry may be appealed pursuant to the provisions of the administrative 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 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: ]. 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. \ � 1 Yl d �1FL��,I�y11 �/��11�/�, First Middle Last ) �- �C� ?�'� Address , �.��7��L�� l y�.�-yl�-�� '�TJ' State Zip Phone I under and my rights as stated above. � ' Sign tu Reset Form 32 � o a T�ME �/ CITY OF ORONO CALLED IN INSPECTION N TI E SCHEDULED � PERMIT NO. Z" COMPLETED ADDRESS D � ` OWNER CONTR. ��[J4l � TELEPHONE NO. lDI o� �I _�7`7�I S � DESCRIPTION _�- � l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 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 � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � �� ___._ � J O �. � O � W � Q � Z W � W � j d W WORK SATISFACTORY:PROCEED I� PROJECT COMPLETE W ❑ CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CAL�TO ARRANGE ACCESS. Call for the n t inspection 24 hours in advance. (952� 249-46�� Owner/Cor�o ite: Inspector. White Copyllnspector's File Canary CopylSite Notice �(�� TIME � ITY OF eRON� CALLED IN � � \ I SPECTION NO �// � �-� SCHEDULED � � PERMIT NO. �� COMPLETED ADDRESS ��~7 � OWNER CONT� . � S TELEPHONE NO. C��l�` � 7 /�� S7�` � � DESCRIPTION �Y)C� � t � 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q 02 FRAMING 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 OS 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 = 09 PLUMBING RI 23 SE C FINAL 35 HARD COVER REMOVAL � 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: A °` �1r c��- ��--r� a � � O a � O � W � Q � Z W � W � j d W ORKSATISFACTORY:PROCEED PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED • ��, ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ,� pH0T0 TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.C LL TO ARRANGE ACCESS. Cal1 for ne inspection 2a hours irt advance. (952� 24J-4600 OwnerlCont ac r on � e: , Inspector. White Copyllnspector's File Canary Copy/Site Notice