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Home My WebLink About2007-P10709 - addn/remodel/repair PERMIT CITY OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: P10709 Crys;�l Bay*Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: l0/19/2007 SITE ADDRESS: 2560 Dunwoody Ave Unit# Wayzata,MN 55391 PID: 20-117-23-21-0023 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: Plumbing Electrical(state) NOTICES/REMARKS: Bath Remodel FEE SUMMARY: Pernut Fee: $ 293.25 valuation: $ 18,000.00 State Surcharge Fee: $ 9.00 TOTAL FEE: $ 302.25 APPLICANT: Lemmerman Const. Inc. OWNER: Jill Estoclet 9037 Cty.Rd 17 SE 2560 Dunwoody Ave Delano,MN 55328 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 CO EQUIREMENTS. �._ '�� APPLICA PER TEE S[GNATURE ISSUED BY SIGNATURE Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 ,Lk.p� ��n, l ' Total Fee: $ `��``�'�� Date Received: �—� �- '�7 Entered By: � Permit#: �70 9 CITY OF ORONO - BUILDING PERMI�' APPLICATION All information must be submitted in full before plan review will be started. ____ _ _ -- ----- - _--- - __---- - --- (ple�rse pr'111I llll l/1fOl��natron - ------------ ------ --- ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle orte) OWNER O�CONTRACTOR, JOB sIT�ADDREss: o� s(�o �v��wo�� .� zIP: S s3 2� �'ill this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ yeS ❑ NO Ifyes, a specia/ever�t permrt is reqi�ired lvith Police De/�cu�h�ient and City Coarncrl nppi�ova/ 60 days prior to the evenL Slnrtlle bi�s service 1�v111 be re�a�ired zrnless applicant demonstrates saifficient on-site parking is available. �Vor7-pe��mitted e1�e��Is 1�vi11 not be allo�ved. NAME OF OWNER: � ` `1 �;`��- l'��- PHONE: (home) (wock) MAILING ADDRESS: �S�o��v�wc� �_ CITY: �-U<:c,Nz�� ZIP: SS �> � CONTRACTOR: �—�-w��c�v� ��j—t PHONE: 7(c 3�� `1 � �C�Io 1 CONTACT PERSON: �a M MOBILE/PAGER: -�- MAILING ADDRESS: `i�3�� C� R� �`7 5 E CITY: `��1�t Y��_ ZIP: S � 3 2 3' STATE LICENSE: # 1-I�S�{ EXPIRATION DATE: ARCHIT�CT/�NGIN��R: PHONE: MAILING ADI)RESS: CITY: ZIP: NAME: REGISTRATION: # 'I'YPE OF WORK: New Home Addition Accessory Structure Move Home Remodel/Alteration (ie: Siding, Windows) �� Any earth movement may require MCWD review and permits ! P120�OSEll WORIC(clescrihe rn detain: ��t�v� ��-�•-.�;c��5�. STORIES: SQ.�'EET OF EAC�I FL00�2: NO. OF BEDROONTS: GARAGE STALLS: A'I'TACHED DE'I'ACHED 1�5�'ili��'ED CONST'RUC'I'ION VALUA'TION(excludin�land): 5 I%�;c�� 'r' I hereby apply for a buildintr permit and I acknowledge that the information above is complete and accurate; that the work�vill be in conformance with the ordinances and codes ofthe City and with the State Building Code;that [ understand this is not a permit and��ork is not to start without a permit;and that the«-ork will be in asc�ordance witl� the approved ��la i. / ,�� AYPLiC�NTos s�G�r7A�ru� : =vv :_„___ ��i�.: �a �.�,�. c-7 �1 � i j� •- e Sec.13.0�! RIGF[TS OF SUBJECTS OF DATr\ ' Subd. 1. Type oY data. The rights of individual on 4vhom the data is stored 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 confidential data concerning himselfshall be informed of: (a)the purpose and intended use of the requested data�vithin the collecting state agency,political subdivision,or statewide system;(b) whether he may retlise or is legally required[o supply the requested data;(c)any known consequence arising from his supplying or refusing to supply private or confidential data;and(d)the idendcy of other persons or entities aud�orized b}'state or federal law to receive die data. This requirement sl�all not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a la�m-enforcement officer. The commissioner of revenue ma� pllce the notice Te�i uired under this subdivision in the individual income ta�or oropertv tax retund instructions ins[ead of on those fonns. SuUd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is the subject of stored data on individuals,�nd whether it is classitied as public,priva[e or confidentiaL Upon his further request,an individual who is the subject of stored private or public data on individuals shall be show�n the data��-ithout any charee to him and,if he desires,shall be informed ofthe content and meaning of that data. After an individual h1s 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 oFthe private or public data upon reyuest by the individual subject of the data. The responsible authority may require the requestine person to pay the actuai costs of making,certif}ing,and compiling the copies. The responsible authoriry shall comply immediately,if possible,�vith any request made pursuant to this subdivision,or�vithin tive days of die date of die request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an additionll tive days within which to comply with the request,e�duding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accura[e or complete. An individual rnay conles[the accurlcy or completeness of public or private data concernin�himself. To exercise this right,an individual shal I noti�y in writing the responsible authority describing the nafure of the disagreement The responsible authority shall wi[hin 30 days eithec (a)correct the data fow�d to be inaccura[e or incomplete and attempt to notity past recipients of inaccurate or incomplete data,including recipien[s named by the individual;or(b)notiry the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreetnent is included with the disclosed data The determination of the responsible authoriN may be appealed pursuant to[he provisions of the administretive procedure act relating to contested cases. Dt1TA PRNACY ADVISORY ln accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request for a pernlit 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. 3. You may refuse to supply data, but refusal may rec�uire that the City deny the permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessaiy 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 NLS. 13.04 (available upon request)to review private data on yourself. 6. Yow•full name is required to process this application or permit. First �liddlc Last Address Cih� Statc Zip Phonc I understanct my ri5hts as st�ted above. � y �..� L-� 2-'l/t �� L/L,-l/ti�'� �'�/�� Sign".�ture '__-,''—� r Reset Forn> >� C'FiEC�K O�'F i,IST FOR ISSUANCE OF PER��IITS FOR OFFICE USE ONLY Ar:DREcS ORLEGAL: Z56c7 r��Nwr,o✓�� (4� PII�: DESCRIPTION OF WORK: (3�rr� �-ix��✓��Z- - ---------------------------------- --------------------- - ZOVNG REVJE`V BY: AA'TE APPROVED: � " 2.� -- v � SUII,DING REVIEtiV BY: DA.TE APPROVED: ► - 2 b �o� � . FEES TO BE CHA�.2GED: Misc. Fees Calculated By: P�g�T Yes �/ No PLAN REVIEtiV � Yes No �/ SE`VER COyNECTION STATE SURCHARGE Yes _� No `VA'I'ERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC�Units OTHER (specify) -------------------------�--------- ------------------------------------------------- ------------------------------- � ZONi�IG CHE.CK LIST Zoning District: N C� �h�«'`� �`'�� r'`'`� . ___�y/� � Fire Deparc.ment: Post Office: School District: � Lot Area; Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Froat(Lake): Ri�t Side: Rear (Street): Lefc Side: Adjacent Structures: Vetland: Buil�lin� Height: Def. Hgt, Peal�Hgt. Lot Coveraoe: Grading: Staff Approval Date: Council Approval Date: ' � (� Sepcic: Staff Approval Date: � � �Y� �" Zoaing File: 7 Resolutioa: n Resolution Da�e: Shoreland District: I.ot Coverz�e: Av�. Setback: Bluff Setback Eustino Proposed Hardcover: 0-75' 75-256' 250-5Q0' �00-1000' ii�:dcover Va::�ce °eq��i;��: Yes No Date o`Ce�cil A«_ov�: F.E�L4R�iS (in ho�e): O (�,J � v �� I } BUII.,DING� REVIEti� CHECK LIST �� - �' � � CONSTRUC'I'ION TYPE: 1(� Sq Footage $ Per Sq Ftg Basemen[ . X = 1st Flaor x . _ 2nd Floor x _ . Garaoe x _ z = TOTAL Estunated Constructioo Value: $ ) �, �o J� Inspections Required: �York Requiring Separate Permits: Sice _�Plumbing Fire Hardcover Removal Mechanical Water Coaaection Foating ` 5eptic Sewer Coanectioa � _�Framiag Fireplace Lawn Irriga[ion �c Insuiation (Masonry) Other `Val1 Board (Mfg.) Well (State Perm.it) —�F�� Gcading/Fillin� �_Electrical (State Permit) O the r R.EMARK� (IN HOUSE): ' -- �- ---------------------------------------------------------------------------------------- REVIE�V BY OTHERS: DAT'E: Access: Existing New Access Approval: Date By: ---------------------------------___------------------------------------------------------------- REI�LARKS (,'I'O RE NQ'�'Fn nv PEF.: �� : 8