HomeMy WebLinkAbout2007-P10953 - addn/remodel/repair PERMIT
CITY UF �RONO Permit Number:
2750 Kelley Parkway- PO Box 66 P10953
Crystal Bay, Minnesota 55323 Permlt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: 5/15/2007
SITE ADDRESS: 2420 Dunwoody Ave Unit#
Wayzata,MN 55391
PID: 20-117-23-21-0018
DESCRIPTION: UBC Occupancy E1
Conshuction Type VN
Proposed Use: Religious
Census Code 434
Permit Class: Building
Addition/Remodel/Re air Pernlit Sub-type(s): Addn/Remodel/Repair
Permit Type: P
DETAILS:
Approved per reso(ution#:
Separate pennits required: Electrical(state)
NOTICES/REMARKS:
Finish Youth Room
FEE SUMMARY: Pernut Fee: $ 125.25 valuation: $ 5,200.00
Plan Review Fee: $ 81.41 �
State Surchaige Fee: $ 2.60
TOTAL FEE: $ 209.26
APPLICANT: The Caipenter's Connacting, Inc. OWNER: Calvary Memorial Church
1085 County Road 19 2420 Dunwoody Ave
Mound,NN 55364 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPL[ANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILD(NG CODE REQUIREMENTS.
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APPLIC�U\'T PlR1tITEE SIG� TliRE ISS ED[3Y S[GtiATURE
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Total Fee: $ ����a�' Date Received: ���"( ��
Entered By: Permit#: �C���
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all i�zformation)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
✓,�!
JOBSITEADDRESS: i-\ 1�C� �kv�rti.c)�v � �� ZIP� ��4 �
Will this be a Para e of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �O lf yes, a specia!event perniit is required ivith Police Departn7ent and Ciry Counci(approval
60 davs prior to tl�e event. ShaEttle bus service will be required unless appficay�t dernonsU•ates
sir�cient on-site parking is avnilable. Non-permittec�eve��ts lvill not be allowed.
NAME OF O WN�R: ��UG/`�i ��Gt�,�:�,� C�u V'c:G� PHONE: (home) lS Z'- oZ-�SS( (
,L (work)
MAILING ADDRESS: ��(�c� �c�vtnw��'��S � CITY: �Cc v�v"�'� ZIP: S� �'
CONTRACTOR: �1.e_ C_��r�c t.-� �dri�v'��=(,°�� PHONE: �j o�2-- o2-ts�(J
CONTACT PERSON: :1�.� ��-����_ MO LE/PAGER: 6la 3��� --�6 5�,6
MAILING ADDRESS: ,�/�&�� C.'r�`�r'� l�t CITY: ,l�t��,��� ZIP: ��3/0�
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)
Any earth movement may require MCWD review and permits !
PROPOSED WORK(�lescribe in detain:��;n ,�.tc In;1,� ��u� ��r�-� S�� C✓'eus C;r'<
;v�:..� ��;(�s - C�7 4`-�c � S [•� a(r��,�-,
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_
ESTIMATED CONSTRUCTION VALUATION(excluding land): $��flv �
I hereby apply for a building permit and I ackno�vledge that the infonnation above is complete and accurate;
that the�vork will be in conformance �vith the ordinances and codes of tl�e City and with the State Building
Code; that ( unclerstand this is not a permit and��ork is not to start without a permit;and that the work will be
iii accordancz �vith the approved plali.
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AI'PLICANT'S SIGNATURE: � DATE: ���r
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Scc.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. I. Type of data. The rights of individual on whom d1e data is srored or to be stored shall be as set forth in this section.
Subd.2. Infonnation required to be given individual. An individual asked to supply private or contidential dataconcerning himselfshall be
inPormed of: (a)die purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b)
whecher he may refuse or is le�ally required to supply the requested data,(c)any known consequence arising from his supplying or reFusin�to supply
private or confidential data;and(d)the identiry of other persons or entities authorized by state or federal law to receive the data. This requirement shal I
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 mayplace die notice required under this subdivision in the individual income tax or properri tax refund
instructions instead of on those fonns.
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 classitied as public,private or contidential. Upon his fiirther request,an individual who is the subject of
stored private or public data on individuals shal I be sho�vn che data without any diarge 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 infonned of its meaning,the data necd not be disclosed to him for six
mond�s lhereafter 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 die data. The responsible authoriry
may require the requesting person to pay the actual costs of making,certifying,and compil ing the copies.
The responsible authoriry shall comply iimnediately,if possible,with any request made pursuant to this subdivision,or within tive days ol'
the date ofthe request,escluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request
within that time,he shall so inform the individual,and may have an additional tive days within which to comply with the request,escluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure 4vhen data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
concerning himselE To exercise this right,an individual shall notity in writing the responsible authority describing the nature of the disagreement. The
responsiblc authority shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notity 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 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 tlle City of Orono or any of its departments may require you to furnish cerfain private or
confidential information.
You are notified that:
l. The information you furnish will be used to determine your qua(ification 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 pernlit or license.
4. If your requested permit or license requires Council action to approve, some infannation may become
public. �
5. You have certain rights iu�der 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 �'[iddle LAst
Address
City State "I_ip Phone
I understand my rights as stated above.
Si;�n:iture
Reset Form .i-'
• •
CHECK OFF LIST FOR ISSUANCE OF PERIVIITS
FOR OFFICE ZISE ONLY
ADDRESS OR LEGAL: 2`�� ��/N w0 O O V Ati-e
PID:
DESCRI�TI0�1�'OF WORK: �,�,��„ �t.�...,.,. .,., l.m w$. L�e�-
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ZONWG REVIEW BY: n� lR _ DATEAPPROVED:
BUILDING RE[�IEW BY: DATEAPPROVED: S• ►�•��
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FEES TO BE CHARGED: tl�Iisc. Fees Calca�lc�ted By:
PERMIT Yes ✓ No
PLAN REVIEYi� Yes ✓' No SEWER CONNECTION
STATE SURCHARGE Yes !/ No WATER CONNECTION
INVESTIGATION FEE Yes No ✓ PARK FEE
SAC Yes No_� SITE INSPECTION
Nau7�be�•of SAC Unils OTHER (specify)
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ZONIIVG CHECK LIST 7_or�ing Dis�rict: Nb C k�/vG e
Fire Departrnent: Post Off ce: School District:
Lot Area: Sg.ft. Acr-es Gi%idth Depth
Scrrvey Submitted: 1'es No Date of Sztyvey:
Proposed Setbncks:
Frazt (Lnke): Right Sic�e: •
Ren�•(Street): Left Side:
Adjncent Structzu�es: i'etland:
Building Flerght: Def Hut. Pectk Hgt.
LoI Coverage:
Grnding: Stnff.4pproval Date: B}: Coirncil,<lppr•oval Date:
Septic: Stnf f.�ipproval Dn1e: �y
7_o��ing File: � Resolution: �` Resolarlion Date:
Sl�or�eland DisU•ict: il-lCGVD Per•�riit:
,•1 tig. Setback: B(a�ff S'etback. Lot Coverage:
Exrsti�:g P��oposed
Hardcove,•: 0-%�' —____
ji_7j�'
�5�-����
;oa�ono�
flardcover I'crr•ia��ce Reqtrired }'es ,\'o D�rte of Cocrncil.4pproi�al:
RE�LI,4RKS(i�� Irocrse):
33
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.,
B UILDL'VG REVIEW CHECK LIST
UBC: �= CONSTRUCTION TYPE: V/^�
Sg Footnge �'Per Sq Ftg
Bnsement r =
Ist Flaor x =
?r1d Floor x =
Garage C =
t =
TOTAL
Estir�iated Co�tstricctio�i [�alue: $ s�u��
If:spections Required: 6i'ork Requiring Sepnrate Permits:
Site Pltmrbing Fire
Kardcover•Renroval rGlechnf�ical Water Caznection
Footing Septic Se�ver Connection
�FrafrTing Fir�eplczce LmvfT Irrigntiorr
Insulatior� (d�Iasoniy) Other
�c 6Nnll Boc�rd (�l'ffg.) YY'el!(State Per�mit)
� Final Gr•adi�Tg,'Filling OC�'lech•rcal(State Permit)
Othe�•
REMARXS(INHO USE):
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REVIEW BY OTHERS: DATE:
Access: Exrsti��g Nerv
Access Approval: Date By:
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RE�YIARKS (TO BE NOTED ON PERNIIT):
3-1
C�� �L� DATE� TIME y
C OF ORONO CALLED IN � l l��
SPECTION NOT CE SCHEDU�ED yG f����
�3.vt
PERMIT NO. COMPLETED
ADDRESS Z ZG I�-L�.v� �-�-%���'�' • �
OWNER CONTR. � ��� ff'� �c-`7�'/
TELEPHONE N0� � � a' � � � —��' `T
�icR ' �a - �_/ �� - � "7 �S
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� 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
� 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
"� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEP IC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU� YES_NO
� COMMENTS:
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� WORKSATISFACTORY:PROCEED CI PROJECTCOMPLETE
W b CORRECT WORK&PROCEED ^; ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. -; PHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i pection 24 hours in advance. (J52) 249-46�0
OwnerlCon c n si :
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
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- BUILD�(`G �'-�n:�,�.T�}�PI_%\;��! ��'r_:`i�cV'J ''�
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tNSPc � ���-1�=-_/1"="`;�,=;.;,y,-- -- �os �"J�R� (`(�Cr��:,�'�.',.'�,, l,'',, ��;,G� ybUrn r:.�b�r
eF,T�_ S_l o_01 ___-• � � � ----- THE CARPENTER'S
� � � ��� ��� J� :: �? , � CONTRACTING, INC. SHEET NO. _ OF
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' I - ��' /� ����� i j'�' !`: � ��.:)`r. �f! � T� r. . .�- +r. iv�J i.uuntV h08�i := CALCULATED BY QATE l c7 �GO'G.UVb
� � /i/ � / �?�Q�, f�� " •` ' `- '. i � i ;; C ; �= � : !iT � MOUND, M/NNESOTA 55364
. l' � . . ; ,: * hI 1!� `�.�>�da� (952)472-2910
t`'w '� CHECKED BY QATE
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Fax(952)472-2910 ,
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� � „yd in this revi�v. � � �_�''
F.`L-:_�• ,r!:._ r�.t.,v o�i Uf� �,,� ;11 ALL Tit�IES SCALE � J