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Home My WebLink About2005-P08617 - foundation only PERMIT CITY �F ORONO Permit Number: 2750�:elley Parkway - PO Box 66 Pog6i� Crystal Bay, Minnesota 55323 P2fCTllt Typ@: Addition/Remodel/Repair (952) 249-4600 Date Issued: 4ilsi2oos SITE ADDRESS: 3473 Crystal Pl Wayzata,MN 55391 P I�: 17-117-23-43-0009 DESCRIPTION: Proposed Use: Residential Pemut Class: Building Census Code O/S-Building Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Foundation Only DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: !11_I,1 T__T"____ va�uuJ �a�.a�v FEE SUMMARY: Pernut Fee: $ 69.25 Valuation: $ 2,000.00 Plan Review Fee: $ 44.98 State Surcharge Fee: $ 1.50 TOTAL FEE: $ 115.73 APPLICANT: Shawn Feely OWNER: Melissa Hemsworth 2074 Clover Ct 3473 Crystal Pl Chanhassen,MN Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE 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. ' �� ` � ;��%� � �� -� ��'��l�"? C,e� /�. APPLICA E 1TE SIGNATURE ISSUE BY SIGNATURE Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1 �� Q��. . � �V�` 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 OR CONTRACTOR � _ ___ _ � JOB SITE ADDRESS: ��-I 1� � r`L�,�� - l ZIP: `� �.�`"� � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ NO If yes, a special evenl perntit is reqarired with Police Departmer7t and City Council approval 60 days prior to the event. Shzrttle bzis service will be reqa�ired zrnless ayplicant demonstrates suffici�ent on-site parking is available. Non pennitted events will not be allowed. NAME OF OWNER �� 1L � �`>>�� "�'l��V"��v��) PHONE: (home) (work) MAILINGADDRESS: �'��T �'�>�� CITY: �(�,/1C: ZIP: �;>j�`�1 � � �ONTRACTOR: `�1�C2(;U�1 -�- ��i�i PHONE: �`CONTACT PERSON: �1 1, ►c � l�_,��,:,,� ,r-h-� MOBILE/PAGER ��,(,�- ��- I�Jc�y MAILING ADDRESS: ��'��j C(uv C'�" L f CITY:(_'(��;.,;; id�i.t��;, ZIP: �'}� ✓� STATE LICENSE: # EXPIRATION DATE: ARCHITECT/ENGINEER: PHONE: MAILIi�1G ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure �(1 Move Home Remodel/Alteration �_ �� PROPOSED WORK describe in detai : � f E ��.,� �(,��d�`�� 11��, �� c��:" �(�,�7 �.�v��r �'�, � _ � ��CIP r�st �'l�rnF' � �' ,� � STORIES: I ---� SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: I GARAGE STALLS: ATTACHED DETACHED�� ESTIMATED CONSTRUCTION VALUATION(excluding land): $ !� (-}O(i� 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 pennit and work is not to start without a permit;and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE�'�� ' DATE: `��I� I �I - �j 31 ,� 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 shal(be as set forth in this section. Subd.2. Information 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 confidential data;and(d)the identity of other persons or entities authorizcd by state or federal law to receive the data.This requirement shall not apply when an individual is asked to suppty 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�ropertYtax refund instructions instead of on those fomis. 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 dassified 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 becn 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 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 legal holidays,if immediate compliance is not possible. I£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 when data is not accurate or complete. An individual may contest the accuracy or cotnpleteness of public or private data concerning himself.To exercise this right,an individual shail notify in writing the responsible authority desciibing the nahire of the disagreement.The responsible authority shall within 30 days either. (a)con�ect the data found to be inaccurate or incomplete and attempt[o notify past recipients 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 of the responsible authority may be appealed pursuant to the provisions of[he 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 fumish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the pernzit 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 1 name is required to process this appiication or permit. First j � Middle r Last %� �� .�� Address C��y State Zip Phone I understand my rights as stated above. � n '�;� Signatu � � ��L-_' �� y��L-�-C�� — 3� �J T � TIME V CITY OF ORONO CALLED IN � INSPECTION TIC�O��7 SCHEDULED - - �'� PERMIT NO. COMPLETED ADDRESS �T7� «��"e �� OWNER CONTR. TELEPHONE NO. la� o� gg� (��D� � DESCRIPTION � �� D � 01 FOOTING 11 M ANICAL RI 18 EXCAV/GRADING/FILL NG Q 02 FRAMING 13 M CHANICAL FINAL 19 LAKESHORE/WETLANDS y 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 v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � � O � � O � W � Q � Z W � W � � d W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the ext inspection 24 hours in advance. (952� 249-46�� OwnerlCont site: Inspector. � ` White Copyllnspector' File Canary CopylSite Notice