HomeMy WebLinkAbout2000-P03226 - minor alterations ' PERMIT
„ �C,-TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P03226
Crystal Bay, Minnesota 55323 Permit Type: Minor Alterations
(612) 249-4600 Date Issued: �iisi2oo
SITE ADDRESS: 1205 Dickenson St
WAYZATA,MN 55391
P I D: 02-117-23-31-0040
DESCRIPTION:
Proposed Use:
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Buildings Windows
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 153.25 Valuation: $ 7,899.00
State Surcharge Fee: $ 3.95
TOTAL FEE: $ 157.20
APPLICANT: RENEWAL BY ANDERSON OWNER: R&N ANDERSON
350 73RD AVE NE 1205 DICKENSON ST
FRIDLEY, MN 55432 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIF�D
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIItEMENTS.
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L[ ANT P ITEE 'IGNATURE ISSUEDBY SIGNATi1RE
Copies: City,Applicant,Assessor,Finance Page 1
�--= .���Y OF OR�NO � b12473�5�0 09/��/96 �4:00 �1 :��/03 �G;S��
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.. , '��tal F�: � Y)ate Itec�ived:
Entered HY� Permit�: �`�-� (�L
C�T'�' O� OR�NO - �IJd�.D�TG PERMYT A�P�.ICA1'ION
A� �t�foc�aa�on anust be�abmitted ln full befor� plan review dvill be startesl.
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T� ��'LICAlV'I' IS: (circte one) O�VTYER, OR CONTi2ACTOR
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d�8 SI'I'� ADD�S3: ����j �����..C�(l`�`'�l �����-�: ZIP: �j�J3� � ,:.,,.
�. NA11� OF OWNE�L: �C�hY� � �Y>��G-�' C`� PI�OME: (home) �j o�'r���� I
(work)
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�.�a:n���nREss: �a��� �,c,�. �����.`��,c�: a.�: ��
� REAlEWAL 8Y ANDERSEN '
CONTRACT4R: 350�73RD AVE. NE
. CONTAGTPERSON: FRIDLEY, Mt� 55432
� � NLA�.ING ADl}�SS: (6I2� 5Q2�4777 Zjp:
���'AT� I.ICENSE: a LICENSE #20I3Q983
. A�tCHYTECT/ENGINEER: �'I�pNE:
11�AII.ING AUD1tESS: C�TY: ZIP:
NAME: R�GYS'Y'�tATI4N#
TY� OF WORI{: New Addition Accessory Sm�ctnre
Move Remodel/Alterat9an�_ I.ar�d Alteration
Pd�OPOSED�VVORK(deseribe in detai�:�;0�� �.� Q ,,.�� ��.����1�1C`� �� ��1`�1-� `:�
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STOYtIES: SQe FEET OF EACH FI.00�t:
NO. OF BEDAOOMS: GARAG� STALLS: ATT. DET.
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ESTIMATED CONSTRUCTI4N VALU'A'�YON (eaccludfn=6an�: $ j �—"
I h�reby apply for a building petmit and I acknowledge that the information above is complete and
accurate; that the work will be in confor�nance with the ordinances and �odes of the City and wich
. ' the Swte �uild[ng Code; that I understand this is not a permit and work is not ta start without a
pernut; and tl�at the work will be in accordance w�t� the approved plan.
APPLICANT'S SIGNATiJRE: � C�,� ����� DA�: �� `(.��j �) �
�1���3��- ��'�
NOTE! .P�de oi�To� �vents requfre separate p�rnait ap,�roval by Pnlice .�eparhtter�t and
City Cor�r�cll BU days prtor to the ebent. Nnn�rernt�itted�beRts wdll not be �llowed.
Rer.aivari '�'imn Con �� 1 �A7Ah�f Arin4 Tim� C�r 7A t � A�D�(
��u �F �RGMO � ��24��05�� �9I24/96 14:00 �1 :03/03 N0;52�
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Sac.13.04 RIGI�TS OF SUHJEC'�S OF aA'i'a
Subd. 1. Type aP dsts. 2Re eiyh�s of indlveduai o�1�2tam dte data ie srored or ro be scored shall be sx set fotth In thIs seedan.
Subd.�. Inlorpeatlon req�red qo ba gtren lndieidu�l._M Individual askod ro suppiy privece or oonfidenaal d�n cancernlr�g�imaetf ihall
be Inlormed of: (v)dte purpose and inunded use oP fie pequesued d�m+virhin the wllecdnQ snte ageacy, polldcal subdiYision,or stsro�vide system:
(by whether he may nfuse oT is Iegtlly requited m supply rhe roqu�ased dau;(c)�rty fcnown eonsequeai:e arising from h9s supplying or mAtsing ro supply
priva�a or coaPidenci�[data;and(d)�e�donriry of od+c�person�or enddes aurhorized by suie or Pederal I�w m rec:nive the da�a. ThLt reqviremene 5ha11
noe apply when an individuel is eskeJ eo �uppiy lnvesrig�dve dais,pursuan<<o cecdon 13.�2, subdivision S,to a law enforcemenc offker.
�n cs��i s_ignCr 2f ro�enue mav lace ihe nopce s�quired under chis subdiYisiQn in ttee individu�l income rax or oroosm mx:nlSind
` j{�tt�cdona{�sceud of on�iaso forma. "
SuDd.3. Aceeea to data by 6ndlvidual. Upon roques�to a �espansible aurh�nry,�n iadi�iduat shall be informed whether 6e le�he s�tbJeec
ot�wred dau on individuals,and whedfar ie is elassified as public,priva�e or cvnPidendal. Upon his fturher�ues[,an 9ndividual who i�rhe subjzct
of seorod pn�au or public daw nn individuals shall be sho�+rn�he dara wi�houc any char�e w him nnd:if he dealres,shefl be infotmed of rhe conCenc
rnd meaning of d�at dam. Aher�n imiividus!hu been shoWn the pti�ete dQra and infomxd of i��eaning,the dau nand noc bs diselosed w him far
�ix aionrhs thereafur unles�a dispute or�ecion pursuan�ao ihis:eedon is pending or addi�onal dam on the i�dividual lias been eullecced or created.
The mpunsible authpriry ch�ll p�o�ide copies oP du privare or public dara upon reqvesc by the individuat subjacc of rhe dara, The re�onsible aurhoriry
may requiro rha requearing person ro pay ehe x�;ael cosu of making.csrtilyinQ.and eompilfag rho eopies.
'ilte�sp��nsible auth�riry shall comply imrt'►edi�taly, if pussible. aith aay request made pursuant m d�is subdivision,or withln fi�e days of
che date of the;equest,excludin¢Satutdays.Sundays ond Iega[ho�ldays,if immedlue compliance i�not po9sihle. INhe cartnot comply with rhe roques�
wlthin du�dme,he ahall su inform rha indiv9dual,and may ha�e an addlrional five days wid�in which co cornply w1�h the request,excludlpg Saa�rdays.
S1�mleya and legwl holldays.
Subd.4. Ftoeedure ah�n dnla is net accurate or rnmpltte. An individuol mry conusxi�h�accuracy nr compluenos�of public or privu�e
det�sancarn�n�himself. To exarcise rhis right,Pn indi'viduel shall nofify u wridno�ke responsible auehodry desetibing d�a nemro of rhe dlaagreemcnc.
The soApona161e authoriry d�alt withitf 30 days either: (a)conec�the dam found to be inaa�rA,te or ineumplete and attempt to n�lify paie recipients eE
inaeeunte or encumplete dpra, (ncluding recipiencs named by tbe individual;or(b)nodt�the individuat thec ho belleves the dara eo be corree� Dam
ia d�spuce ahall be discloaad only if the indlvidual's sm�emenc of dissareem�►c is included wirh the di9c9osed dara. '
'�'he doterminntion of�he responsible eu�lioriry may bo appealed pursusnt to th�pro�isionc oP itte adminiserative proeeduro tct reladne w
wnmsted cmees. ,
� pAT���A„CY ADYISO�Y
In�ccordance wich A�Y.S. 13.04,Subd.2, "Kighcs of suti]ects af data", we would like to inform you that your requesc
for a petmit or ticense from the City of Orono or any of its departmencs may require you to turnish certain private or
�onfidential information.
'�ou aro na[ified tha[:
1. The infocmatian you fiarnish will be used to determine your qualiftcation for the gcrmit mriicense requosted.
2. Yuu may sefuse to supply daca, but refusal may require tha[ the City deny the permit or license.
3. The inFormation may be shared with otbcr local, state or federal agencies to the excenc necCasnry to process
the pecmic or license.
� 4. . If yout requeeted pecmit or licease requires Cmvncil action co app�ove, some infarmation may becomc
' public.
S. You have certain righcs under M.S. 13.04 (available upon requcst) to reeiew private data on yourself.
6. Y�ur full name is required to process ebis application or permic.
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' i•uaderstand my ri�ht staced above. �
Si�na�u�e
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DATE . TIME _„�
CITY OF ORONO CALLED IN � �0�7�� �
INSPECTION NO SCHEDULED ` ^d! � �:���n.
PERMIT NO. COMPLETED
ADDRESS ��G J ��G%(p yi/JcSy► S`��
��e� � � g5a-a�iy--78�9
OWNER =��n� �tia�'�s CONTR. �-�'�� BL/f�rY.F,
/Y� �f�sfl-� �71�3 5� ' ` �
TEL'EPHONE NO. .��/�/ (�Cv� 'J�C� ��� �� �
� DESCRIPTION �dVJ �i�G� �u )S __ �I
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DtMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� COMMENTS:
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d M/�NORK SATISFACTORY:PROCEED �ROJECT COMPLETE
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� �; CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O Ci CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site:
Inspector.__��C�,�/�' ���
White Copyllnspector's File Canary CopylSite Notice