HomeMy WebLinkAbout2004-P07567 - addn/remodel/repair PERMIT
CITY OF C•�ONO
2750 Kelley Purkway - PO Box 66 Permit Number: Po�s6�
Crystal Bay, Minnesota 55323 Permit Type: aaa�t�o�xemodevRepa�r
(952) 249-4600 Date Issued: 6i22i2oo4
SITE ADDRESS: 3435 Crystal Bay Rd
WAYZATA,MN 55391
P�D: 17-117-23-43-0120
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Pernut Class: Building
Permit Type: Addirion/Remodel/Repair Permit Sub-rype(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#: '
Separate permits required: niecuicai(siaie�
NOTICES/REMARKS:
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FEE SUMMARY: Perniit Fee: $ 251.25 Valuation: $ 15,000.00
Plan Review Fee: $ 163.28
State Surcharge Fee: $ 8.00
TOTAL FEE: $ 422.53
APPLICANT: scoTT a Bxowrr OWNER: scoTT a BxowN
3435 CRYSTAL BAY RD 3435 CRYSTAL BAY RD
WAYZATA MN 55391 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.
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APPLICANT PERMITEE SIGNATURE IS UED BY SIGNATURE
Cooies: 1-File(Si�nitures Required). 1-Applicant. 1-Monthlv Reports, 1-Assessin�. 1-Finance Page 1
Total Fe�: $ �ao� � 5� DateReceived: �� � -U��
Entered By: :j� �� Permit#: � � � -�j(�,�
CITY OF ORONO - BUILDING PER'VIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please priizt all iiiformation)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
� �� ��'�=�-y ���� J �i��y � � �-�;� �
JOB SITE ADDRESS: '-' ZIP:
Will this be a Para of Homes, Remodelers Sho�vcase Home or other Display Home?
❑ Yes [�No If yes, a special event permit is required tivith Police Department and City
Council approval 60 days prior to the event. Non permitted events will�zot
be allowecl.
. �1 �' � /� �' t7'�'1/✓� �S'2, '��� ���
NAME OF OWNER. � PHON home)_�,� r
yy? �> (work)��� �L�" / �L��
MAILING ADDRESS: � ' � CITY: ZIP:
c- D ��''' v �.�
CONTRACTOR: PHONE:
CONTACT PERSON: 1VTOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Accessory Structure
Addition ,� Move
RemodeVAlteration Land Alteration,.,
PRO OSEp WORK (d crib e in detai�: ��w v���� r ��`",� ��yv���v'✓'�� ,
;� ��� I �i�-�"- � A � �� �'w°Dj� �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �j/� � r�
,
I hereby apply for a building pernut and I aclmowledge 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 pernut; and that the work will be in accordance with
the approved plan.
"�`" - ,�./ L� G r? _ i> L�
APPLICANT'S SIGNATU . �` - -- DATE:
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 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 arisin;from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entitics 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 alace the notice required under this subdivision in the individual income tax or propertv 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,privatc or conGdential. Upon his further request,an individual who is the subject of
stored private or public data on individuals shall be shown the data rvithout any charge to him and,if lie 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 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 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 immediatcly,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,iC immediate compliance is not possible. [f he cannot comply with the request within
that time,he shall so inform[he individual,and may have an addi[ional five days within which to comply with the request,excluding Saturdays,Sundays
and legal holidays.
Subd.4. Procedurc�vhen data is not accurate or complete. An i�dividual may contest the accuracy or completeness o(public or private data
concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days either: (a)correct the data tound to be inaccurate or incomplete and attempt to notify past recipients o(
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 onlv if the individual's statement of disagreement is includcd with the disclosed data.
The determination of the responsible authority 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:
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.
First Middle Last
Address
City State Zip Phone
I under tand my rights as stated above.
�:,�����f� _—_�--.
Signature
� CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: _s`13 � `'r:'�,.�;:�J t. i�;���� ,�_'�='��=?
PID: '
DESCRIPTION OF WORK: �/L c.,�� /�,,;;= ,-r�.�v ,-L��Z�
_ — __ _ ___________-------------------------------------------------------------
Z0.�1I�1i G RE'VIEW BY: ,r�� ' ,,�_ DAT'E APPROVED: w -;y, � y
BUII.DING REVIEW BY: ,., �; l �,��_ DATE APPROVED: � -r y- �>y
�
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FEES TO BE CHARGED: Misc. Fees Calculated By:
PERiV1IT Yes r/^' No
PLAi�1 REVIEW Yes �/ No SEWER CONNECITON
STATE SURCHARGE Yes I% No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECT'ION
Number of SAC Units OTHER (specify)
ZONING CH�CK LIST Zoning District: rt-��: �.--�1r�.��
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: Wetland:
Building Height: Def. Hgt. Peal:Hgt.
L.ot 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:
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 REV�W CHECK LIST
�C: �' . �� CONSTRUCTTON TYPE: ��'.�L�
_ Sq Footage $Per Sq Ftg
Basement x _
1 st Floor x _
2nd Floor z _
Garage x =
x —
TOTAL
Fstimated Construction Value: $ / 5 � �.: o � _
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing ` Septic Sewer Connection
�C Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
Y Final Grading/Filling �_Elecuical (State Permit)
Other
REMARKS(P1 HOUSE): .
------------------------------
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy;
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REMARKS (TO BE NOTED ON PERivIIT�:
8
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J p(�E�/r„� TIME
CITY OF ORONO CALLED IN l i [����-
INSPECTION NOTICE SCHEDULED �y �
PERMIT N0. l�"`��`~�% � COMPLETED
ADDRESS_ �� , � � �C� I _�-�-I/�(,Y
OWNER ��'f ; ��'u-'�NTR.
TELEPHONE NO. c1-r�-�- =�`_�� � ��TS
� DESCRIPTION ��� Y�- �,� � `
� 01 FOOTING 11 MECHANICAL RI 1 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 9 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALI 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
J 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPIETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR W{LL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
�INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call forthe next i spection 24 hours in advance. (952) 249-46�0
OwnerlContra�t n si e
Inspector.
White Copy/lnspector's Ffle Canary CopylSite Notice
DATE TIME �
CITY OF ORONO CALLED IN =�
INSPECTION NObiCE G� �J SCHEDULED � /�� OP
PERMIT NO. � � 7✓� / COMPLETED
ADDRESS ���J� ��C�S� � 1�-�-�
OWNER .�� �'� /.�/dJ.�� CONTR.�f�L-e.�c
TELEPHONE NO. �S � L��� ,��1 �S^�-�'
� DESCRIPTION �C�� �
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
��FRAMI IG 13 MECHANICALFINAL 19 LAKESHORE/WETLANDS
O ION 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� WNER ONTRACTOR TO MEET YOU: ES_NO
c�.,r y�ENTS:
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W WORK SATISFACTORY:PROCEED I_l PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED !- ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. `� pH0T0 TAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContra on�ite:
Inspector.
White Copyllnspector' ile Canary CopylSite Notice
_ �� ;.�.r : <.
030006 17/117/23 BROWN,SCOTI' ', ;� - .`."
AD VANCE S UR VE YING 8c ENGINEERING CO. _ I.�1K�' hfINNETDNXA '��:�"�:, .a� '�
5 H .No. 101 Minnetonka,MN 55345 Phone 952 474 7964 Fax 952)474 8267 � l-mrE oF,cF � 1 ������� ��� .,
300 S, wy � ) � I
'suRVEY FOR: SCOTT BROWN � I �-
� .���_w�°���,, �IT� OF ORONO
�' diWNOUS ROAD AS iRA�EIfD I � .
�SURVEYED: January,2003 DRAFTED: January 9,2003 � •• � - • •� -....'• —�► ���� I � �� �f rE PI.AN GRADING PLAAI �
.. . , � �
� ���. �,��;m....� .�•: ; �'A��'�F�tJV��� -Ni:tN �?0�1 F ST1W crv�
LEGAL DESCRIPTTON: \ " .��' . , .� ..�:` - . I
..,.!. o� . � :_
�� . � ��va+ �: ._ �
,-; �,.��,�.� . , . ; ❑ �F°��;O�IEG �ITH REUI�IOPIS
That part of Lot 3,lying South of the road and northerly of a line running from a point on the �i r+d'`��� � • ' p F `�
�. Fw!D . - . ;.'�..'�- , � I i� �I�l'1i'�� V���
westerly tine thereof distant,73 feet northerly of the Southwest corner thereof to a point on the �
easterly line thereof,distant 35 feet northerly of the Southeast comer thereof,Block 1,Wiley's � I � � gY
Pa.'ic Lake Minnetonka,Hennepin County,Minnesota. �t '
S�OPE OF WORK&NOTES: � I Y';o RpAD � DATE_ � - i�-o�l.
l. Showing the length and direction of boundary lines of the above legal description. The �I r YSTAL � �� �, I
scs>pe of our services does not include determining what you own, which is a legal matter. J (i� I '1 I '
Please check the legal description with your records or consult with competent legal counsel,
if necessary,to make sure that it is coaect,and that any mattecs of record,such as easements,that i I I � I
-you wish shown on the survey,have been shown �
2. Showing the location of existing improvements we deemed important. � I ' �ND"i0N
3. Setting new monuments or verifying old monuments to mark the corners of the property. �i„wp+���;Yi+o�+�° I �
4. Showing and tabulating hard cover and area of the lot for your review and for the review of �I �"O� �aON ����,t�T ps°F,,,�s I
such govemmental agencies as may have jurisdiction over hard cover requirements. �� ; � � � ,; �'���ow•P�'P11'
5. The location of Crystal Bay Road was determined by using platted dimensions on Wiley's Park I
Lake Minnetonka. Existing monumentation shows some evidence that this is the correct location � ,,55�4���
of the dedicated mad. We have shown on our survey all existing monumentation found in the area � � ,, , - -, ' N �5'4a 36' I
of the dedicated road,the iron monuments we have found and show on this survey are not in �� ; ""� ,o.s
complete agreement,and while we have shown and monumented the boundary of this property as " `� �„c � � -- I
best we can from this incomplete and conflicting information,we can't be sure that a judge would _ � , � " �
agree with our reasoning if the survey were challenged. If this unceRainty is something that you oECK I
would like to remove,it is possible to go to court and have a judge rule on the matter,but like all ., _:. oosrn+c �
legal proceedings,time and money would be involved. ' - -"='- °�� I �
i / �13.1'..� 13.$. N
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� � .I3.0 � � .. .
STANDARD SYMBOLS&CONVENTIONS: � � � , I � ;
°�"Denotes 1/2"ID pipe with plastic plug bearing State License Number 9235,set,unless ' °° - � �tic i I �I �
otherwise noted.
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I hereby certify that this plan,specification,report or survey was prepared by me or under my direct o N �
supervision and that I am a licensed Professional Engineer and Pmfessional Surveyor under the]aws of �\ 3 � � W I I
the State of Minnesota. ,� � z F i I
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J es H.Parker P.E.&P.S.No.9235 `°� �� 2 ° � � � I f x
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EXISTING HARDCOVER TABULATION .. � � �.�
2�.2. I .
House 1,094.0 Sq.Ft. ` i �
Existing Deck 454.8 Sq.Ft. � GqRAGE ^! I '`'
Landscaping w.Plastic under&misa 163.7 Sq.Ft. r �;
Bituminous Driveway 1,540.8 Sq.Ft. oe I '�;
' Garage 585.1 Sq.Ft. -- a..2 I z;
TOTAL EXISTING HARDCOVER 3,838.4 Sq.Ft. � a, '��
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AREA OF LOT 8248.4 Sq.Ft. � �,_' I �
a � I � 7
r %HARDCOVER 46.5% 3� �'65.pp_` j ` ��
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