HomeMy WebLinkAbout2001-P03659 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po36s9
Crystal Bay, Minnesota 55323 PeC'1111t Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued: sii�i2ooi
SITE ADDRESS: 2420 Dunwoody Ave
WAYZATA,MN 55391
PID: 2o-i i�-23-2�-00�a
DESCRIPTION: UBC occupancy E1
Consri-uction Type VN
Proposed Use: ►nstitutionai
Census Code 437
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: rium�ing iviecnanicai Eiectricai �siaiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 776•�5 Valuation: $ 68,500.00
Plan Review Fee: $ 504.98
State Surcharge Fee: $ 34.25
TOTAL FEE: $ 1,315.98
APPLICANT: The Carpenter's Contracting, Inc. QWNER: CALVARY MEMORIAL CHURCH
1105 County Road 19 2420 DLJNWOODY AVE
Mound, MN 55364 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.
c- �•
.__}_ • .�_. �, Z_ c c�t .<__ r_ . _ .. .�
APPLI ANT PERMITEE [GNATURE ISSUEDBY SIGNATURE
Copies: City,Applicant,Assessor, Finance Page 1
PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po36s9
Crystal Bay, Minnesota 55323 P@ft711t Typ@: Addition/Remodel/Repair
(952) 249-4600 Date Issued: sii�i2ooi
SITE ADDRESS: 2420 Dunwoody Ave
WAYZATA,MN 55391
PID: 2o-i i�-23-2i-oois
DESCRIPTION:
Proposed Use: utner
Census Code 437
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: ���,r�,,, :�rz� 7�G - %' "� Valuation: $ 68,soo.00
I�LAy /'�c�,'� sc'y� �''`I
ST�� S'v/'��"�z
3y-So �j�t ���� �-�--'�`�_
"t . ��'L�� � ��ti�� �Q
� �� �� �G�'
� ��
TOTAL FEE: �-�:98-- ��' '
� ' 3��,� i� � ��-
APPLICANT: Calvary Memorial Church OWNER: CALVARY MEMORIAL CHURCH
2420 Dunwoody Ave 2420 DUNWOODY AVE
Wayzata, MN 55391 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL tMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
.._.�'l,tiv'�� ,�c-- ' C..�/1?�.-�;,;_._ `���'�'�'L�
APPLI ANT PERMI E I NATURE ISSUED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
'i'otal Fee: $ Date Received: � �°-���
Entered By: Pern-ut#: ���� � �;•S�
CITY OF ORONO - BUILDING PERIVIIT 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: °j.�-, t : �'�` �,,:.���� � ;-�:.;;. ZIP: ��3�� (
�r�„� <<_:..
NAI�� OF OWNER: (;4>��`.����� ��>��r";'��w L- ��t������N __ PHONE: (home) r.,�r 2--� 5 6� �16��(o
fl (work) ot�f�<ti �;, �,:� 1�_ 5=: i1
MAILINGADDRESS: '�„�-�Z� ��:�;,;.�;,c�l� �j'�,;;, CITY: �.��:��.,�•����(�;a��� ZIP: �t.��il
CO\�'RACTOR: �-hE (�,',k.,�'�Ef�tti��; C;; .��,1��,r.;� i ti;: PHOI��: (, r�i 1`i- ;�i�,'
COr-TACT PERSON: �F::a,.� �a��� NIOBILE/PAGER�:'�'�� - z c,�i�;
NL�II.ING ADDRESS: ,�.�;, �,�,�`•� ,�� CITY: �7� c._�-� ZIP: ;;3�,�
ST�TE LICENSE: # '"5 t, ��--
ARCHITECT/E`GliYEER: " PH0�1E:
l�IAII..I�i 1G ADDRESS: CITY: ZIP:
N�`LE: REGISTRATION#
TYPE OF `VORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
PROPOSED`VORK(describe in detai�: t-1� '�. L� ►�%J'��` , � �-'`�'�w � f r��`"```���`�'�
'���i� � � —
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
EST�IATED CONSTRUCTION VALUATION (excluding land): $� �� �; .�.o�� ��"'
I hereby apply for a buildin� 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 wiR be in accordance with the approved plan.
�,
� . �,_.
APPLICANT'S SIGNATURE: ;' .. .i � �� �`�, , DATE: 1 � �� �' �
NOTE! Parade of 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 sectioo.
Subd.2. Information required to be given indiridual. An individua!asked to supply private or confiden[ial 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
rystem;(b)whecher he may refuse or is legally required to supply the requested data; (c)any lmown consequence arising from his supplying or
refusing co supply private or coofidendal dara;and(d)the idenury of other persons or entides authorized by snte or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
Thz commissioner of revenue mav olace the norice reauired under[his subdivision in the individual income raz or oronertv tax refund
instrucrions instead of on those fortns.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuals, and whether it is classiFied as public,private or co�dential. Upon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown the data wi[hout any charge to him and, if he desires,shall be informed
of the contenc 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 uniess a dispute or acaon pursuant to this secaon is pending or addirional data on the individua!has been
collected or created. The responsible au[horiry shall provide copies of the privace or public data upon request by the individual subject of the data.
The responsible authority may require the requesring person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediarely,if possible,with any request made pursuant to this subdivision, or within five days
of the dace of the request,excluding Samrdays, Sundays and legal holidays, if immedia[e compliance is not possible. If he cannot comply with
the request wi[hin that cime, he shall so inform the individual, and may have an addicional five days within which[o 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 pubiic or
private data conceming himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing the nature of the
disagreement. The responsible authoriry shall wichin 30 days either: (a)correct the dara found to be inaccurate or incomplece and attempt to noafy
pasc recipiencs of inaccurate or incomplzte dara,includin;recipients named by the individual;or(b)nocify 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 determinadon of the responsible authoriry may be appealed pursuant to the provisions of the adminis�arive procedure act relaang
to contested cases.
DATA PRIVACY ADVISORY
In accordance wich 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 pemut or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
�. 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.
���,a..i ,) ����?(,(:��l
First Middle Last
(C�> �;t�_�Gi:� L '�
Address
n � C- n r'G,
X^"��c.��r�til ��'� ���� :t �,'j (- �_ ��t: .—�r�a
���Y State ' Zip Phone
I understand my rights as stated above.
�f \��
t.'. t. 1 Z'.�'!n, l:''„��.{S . .
�
Signature
6
! CHECK OFF LIST FOR ISSUANCE OF PERMITS
' FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z'� Z O r� v N C,v o O�`f ��
PID:
DESCRIPTION OF WORK: ( ��e2 c�vcL r i r�t 51�
ZO�iING REVIEW BY: DATE APPROVED: s•��_ v�
BUII�DING REVIEW BY: DAT'E APPROVED: � -��- �'t
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
pL?,N REVIEW Yes �/ No SEWER CONNECTTON
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZOti�ING CHECK LIST Zoning District: �tJ v C`/-,f�
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 Sid :
Rear (Street): Left Side:
Adjacent Structures: etland:
Buildin; Heiaht: Def. Hgt. P • Hgt.
Lot Covera�e:
Grading: Staff Approval Date: y: Council Approval Date:
Septic: Staff Approval Date: y:
Zonin; File: � Resolution: # Resolution Date:
Shoreland District:
Av�. S<<back: Bluff Setbac : L.ot Coverage:
Existin� Proposed
a
Hardcover: 0-75'
75-2�0'
250-500'
500-1000'
Hardcover Vaziance Required: Yes No Date of Council Approval:
REMARKS (in house)•
7
�
.
BUILDING REVIEW CHECK LIST
UBC: L CONSTRUCTION TYPE: 1!�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor R =
2nd Floor x =
Garage x =
R =
TOTAL
��
Estimated Construction Value: $ (�� S�O
--�
Inspections Required: �Vork Requiring Separate Permits:
Site �_Plumbing Fire
Hardcover Removal �_Mechanical Water Connection
Footing Septic Sewer Connection
_,Zc Framing Fireplace Lawn Irrigation
� Insulation (Masonry) Other
,t Wall Board (Mfg.) Well (State Permit)
� Final Grading/Filling �Electrical (State Permit)
Other
RE�IARKS(IN HOUSE): -________
----------------------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existina New
Access Approval: Date By;
----------------------------------------------------------------------------------------------------------------------
REv1AR�iS (TO BE NOTED ON PER1�II'I�:
8
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED ��
PERMIT N0. ' COMPLETED '�J��-a I / I/ \
ADDRESS NKJ�
OWNER CONTR.
TELEPHONE N0.
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCA�//GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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 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 OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
� �
a f`���?�i���r�
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
d
�WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
C�CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Cail for the next insp ction 24 hours in advance. (952� 249-46��
OwnerlContract
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
V ATE TIME
CITY OF ORONO CALIED IN �/
INSPECTION NO � E SCHEDULED `- � '
PERMIT N0. ��7 COMPLETED -' � �
ADDFiESS ���C� c�=? C,l �(;�.�« F-f-,�
OWNER CONTR.��_�) �,�`�,S
TELEPHONE N0. �(��� - ��_Si ��
� DESCRIPTION _ ���'t l�"�9}
� 01 FOOTING 11 MECHANICAL RI 8 EXCA�//GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL 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 PLUMBfNG FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� C MEI�I,T.S�
4 -2 C ��5.�
� py�, J
0
�
� '
0
W �SS
� G �� ,
Q
�
z
W
�
W
�
1
�
d
W� ❑ ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARAANGE ACCESS.
Call forthe next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContr or on site:
Inspector.������G.G� Zl��
White Copyllnspector's File Canary CopylSite Notice
S
•
17
r
r
4
4
1a�7 U � t..ia S S 1G :.�.:. r.•'
T'r„� GLKlSSf:G�?nS
t
f
a`
r
,j
t
+
i
}
j
.S
0
t�
F
tt�
4
S
•
17
r
r
4
4
1a�7 U � t..ia S S 1G :.�.:. r.•'
T'r„� GLKlSSf:G�?nS
it
IV Of
OF ORONO '
BUILDING P T N REVIEW �
INSPECTOR `
DK- % PERIMIT NO
❑ r;FMOVED As 31 t2 ITTE0 �
C FILE 0T!()N0 AS t40TFJ �v
❑ ! `�i /fir fir J�YCr C( .R.EUCT7-
P
T ASEs C�t'lir fir :f i r� r,i n.i X! W, -);k Si"';.: t 1,,, r .
t
f
a`
r
it
IV Of
OF ORONO '
BUILDING P T N REVIEW �
INSPECTOR `
DK- % PERIMIT NO
❑ r;FMOVED As 31 t2 ITTE0 �
C FILE 0T!()N0 AS t40TFJ �v
❑ ! `�i /fir fir J�YCr C( .R.EUCT7-
P
T ASEs C�t'lir fir :f i r� r,i n.i X! W, -);k Si"';.: t 1,,, r .