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Home My WebLink About2004-P08256 - addn/remodel/repair - � � PERMIT `CI7Y UF ORONO Permit ►vumber: 2750 Kelley Parkway - PO Box 66 Pos2s6 Crystal Bay, Minnesota 55323 PG'CCTIIt Typ@: Addition/RemodeURepair (952) 249-4600 Date Issued: 12ii4i2oo4 SITE ADDRESS: 2470 Dunwoody Ave Wayzata,MN 55391 PI D: 20-117-23-21-0005 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Permit Class: Building Census Code 434 Permit Type: Addition/Remodel/Repair Pernut Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: PermitFee: $ 125.25 Valuation: $ 6,000.00 State Surcharge Fee: $ 3.50 TOTAL FEE: $ 128.75 APPLICANT: Owner/Self OWNER: Maria Lueck MN 2470 Dunwoody Ave 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. �1 �� /' �-� � � , , . , ��,: �' _ �� 2 � � �� <<__ ( _�� _ ,';,��--� APPLICANT PERMITEE S[GNATURE �[SSUED BY SIG'�NATURE Copies: 1-File(SiQnitures Required), 1-Anplicant, 1-Monthlv Reoorts, 1-Assessine, 1-Finance Page 1 '� i Total Fee: $ ;; �T, , � -,_,._,.,; � ;� 7`> Date Received: ��T � � � Entered By:��-- Permit#: �,�� CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. � (please p��i�it all i�iforniation) THE APPLICANT IS: (cir•cle one) OWNER ' R CONTRACTOR JOB SITE ADDRESS: � � � � ��~`"''"`��` ' I-U �-- ZIP: � S3 `�� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No � If yes, a special evefrt perinit is ��equired with Police Departnzent an�l City Couricil approt�al 60 days pj�ior to the eve��t. Nofa pef�l�zitted events will not be allowed. NAME OF OWNER: ��`�h d��0.�� , �-'� ��-n� PHON�: (home) �`�Z y?�-��Z��{ (work) �1 2-- 53"6 v -3 f MAILING ADDRESS: 2� � U ��`-�" `�" �' �`� CITY: � C'� i1 � ZIP: SJ`�3�� CONTRACTOR: PHONE: CONTACT PERSON: ��R�� S��ci� sv �-� MOBILE/PAGER: Ct-. I Z -3 2 � - ��.`�i SCo MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: �"``'`` �� v � � PHONE: � '2 ^�� - �C�S MAILING ADDRESS; �3`i1 ��,.��C�S I2u h CITY: �'��-��Cu�r�e ZIP: S.S 3 4 6 NAME: REGISTRATION # � g _�' 2 2 TYPE OF WORK: New Accessory Structure Addition Move Remodel/Alteration � Land Alteration . PROPOSED WORK(describe i�z detai�: ��}�r :�c?� C�.�C ,�e�� CT��,�f, � ; ��t.h I7�r" h'1 e w�b r�{�,� C;�h � �c r �1 c c,J C �:,c r e'r� c:� �� ,o , J� o C�' i�, ,' S+�r � .� fj�� c � �� a ��lU�,h ��,�,�� s STORIES: ( SQ. FEET OF EACH FLOOR: S7� NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ (�, �pD o� � � i�� ¢. � ✓�'�c� �r�o.�_S 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 permit 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: 2- Z - � �{ j . . Sea13.04 RIGHTS OF SUBJECTS OE DATA Subd.l. Type of data. Thc 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 oG• (a)the pw•pose and intended use of thc 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 confldential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supph�investigative data,pursuant to section]3.82,subdivision 5,to a la��enforcement officer. The commissioner of revenue mav nlace the notice required under this subdivision in the individual income tax or pronertv tax refund instructions instead of on those torms. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject o[ • stored data on individuals,and whether it is classified 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 chargc to him and,if he desires,shall be informed of the content and meaning of that data. After an individual has bcen 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. Thc responsible authority shall complV immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date o[thc request,excluding Saturdays,Sundays and Icgal holidays,if immediate compliancc is not possible. If he cannot comply with thc request within that time,he shall so inf'orm the individual,and may have an additional five days within which to comply with the request,excluding Satw•days,Sundays and legal holidays. Subd.4. Proccdure when datn is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notify in writing the responsible authorit}'describing the nature of the disagreement. The responsible authority shall witl�in 30 days cithe�: (a)correct the data found to bc inaccurate or incomplcte and attempt to notify past recipients of inaccurate or incomplete data,induding 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 i[the individual's statement of disagreement is included with the disclosed data. Thc dctermination of thc responsiblc authorih'ma,y be appealed pursuant to thc provisions o(the administrative procedw•e act relating to contested cases. DATA PRIVACY ADVISORY In accordance with M.S.13.04,Subd.2,"Rights of subjects of data",we�vould like to inform you that your request f'or a pernut 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 deternune 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 becon�e 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. l-� �2 v� r S 1'e t�J ble-''� � (,l t 1\ � c�� C First Middle Last L l � � l�vl�-^J U C� � _ � -� . Addmss 1-} q 5'Z^�-('� � -- O 2(e,� (��tc�hv � N .�S^3`1 � c (� LZ - �S�U -3 ( 3� City State Zip Phone I understand my rights as stated above. .��..�., � Signature . � CHECK OFF LIST FOR ISSUANCE OF PER1ti.tITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: Z Y 1 � �O�N u�-o«.� PID: DESCRIPTIO:�%OF �[�OR£�': f'�-�'�e �� ---------------------------------------------------------------------------------------------------------------- - ZOtvINGREVIEti�BY: l/� D.ATEAPPROVED: BUfLDI�vGREVIEWB�': DATEAPPR06'ED: rz-�3-b� -------------------- FEES ?'0 BE CHARGED: �Iisc. Fees Calcu[ated By: pE'R�LIIT Yes _� No PLAN RE VIE iV Y'es �vo � SE yl"ER CONNECTION STATE SURCH.4RGE Yes _r� tVo tiVATER COtVitiECTIOtV IttirVESTIGATIO�V FEE Yes No P�?RK FEE S.�C Yes !Vo SITE NSPECTION Number of SAC U�tits OTHER (specify) ------------------------------------------------------------------------------------------------------------------------ ZO�YI�YG CHECb'LIST Zar�irtg Dist��ict: /(Jo Cffei Fire Deparhnertt: Post Off ce: School Distrlct: ___ Gar.�lreR: Sq.ft. �lcres �Yidth DepNt Survey Subniitted: Yes o Date af Su�vey: Proposed Setbacl;s: Froru(Lal:e): Righ Sr'de: Rear• (Sh•eet): Left Side. Acfjacerit Sn�c�ct�cr•es: Y� land.• Bctildi�ig Height: Def. Ngt. Pea 'K,�t. Loc Coverage: � Gradirig: Staff.4pproval Date: B : Cow2cil rippraval Date: Septic: Staff,4pproval Date: y'� Zo�tiizg File: �* Resoli�tio��: # Resol«tiori Date: Sltoreland Dish•ict: Avg. Setback: Bluff Se bacic: Lot Coverage: Existiit Praposed Har•dcover: 0-7�' 75-2�0' 250-500' 500-1000' Hardcover Varia�ice Reqc�ired: Yes No Date of Couricil Approval: RE�I�fARKS(iri house): 31 L� ��.rrrl�r.�anTo Qa.zon�as os� s,�x�il�au ------------------------------------------------------------------------------------------------------------------------ ::;g ��va :��,�o.,dd�.�Ss��r, n,a.�i eu7�six3 :ssa��,. �3.L�'Q �S2I3KZ O.�S�f13L1�2I ------------------------------------------------------------------------------------------------------------------------ �(3SI10HAl]')S�.l'�"i�11�3?I ---------------------------------------------------------------------------------------------------------------------------------------------- .I�1�J� (�ii«.rad a�v1SJ Iv��.q�a13 �:r��l?.�/�tr�pv.rrJ /vtfrd�— (�rt�r.r�d�Jv�s) ]��1� ('�.IIN.) P.�voB Ilv.d9 .r��i��p (;ituosv��r) uoi7vinsu� cro7�v�z.r.�� t�n1v� a�v�da.n� a�r�tuU.r� uo�a�auuo� .�an:�s �r�d�s �ui�oo,��°— 1101JJr7llilOJ .1�71ll�, jv��uvt��a�� lvnotti��.raao�p.rvH a.��j azriq:.unjd a1?S :sl>>u.rad�Iv.rvdas Dvu�nGa�.y.ro,�g :p�.+�nba�j suo?I�adsrrj �oo� � S :a�Tjv,1 ��o7��r.usiroJ paavrsr�ls,3 7r:zos _ ,- _ � a�v.rv� = 1� .rool.�P�r� = x .rooj j�s� _ � �i�aivasvg -0�,� Gs.�ad� aovaoo,�' GS �/� �3dd.L:ti�OI.L.�!�2LLS.��O� � -�/ �.�ffTl .L SI7,�I,�3HJ�913I�1.��A�IQ7II18 . . �.�a'�` �C, DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED Iz-��-oK o/c�.�S PERMIT NO. P�i�b��_ COMPLETED �� ZY7o ADDRESS 2�`�� DuNwoov��, OWNER Gc-rn�.�r MA.cicc�n�� CONTR. TELEPHONE NO. ` � DESCRIPTION ��QqFOOTING 11 MECHANICAL RI 18 EXCAV/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 06 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO-FINAL 15 SEPTIC INSTAIL. 22 FOLLOW-UP ? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � ��VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK$PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor site• Inspector. White CopyllnspectoPs Ffle Canary CopylSite Notice