HomeMy WebLinkAbout2005-P08339 - addn/remodel/repair # � - PERMIT
C I TY O F O RO N O Permit Number:
2750 K�Iley Parkway - PO Box 66 P08339
Crystal Bay, Minnesota 55323 Permit Type: ada�c�o�Remodevxepa�r
(952) 249-4600 Date Issued: i�4�2oos
SITE ADDRESS: lo6s Edgewood xills xd
Wayzata,MN 55391
PID: 02-117-23-42-0004
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residenrial Construction Type VN
Census Code 434
Pernut Class: Building
Permit Type: Addirion/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Eiec;iricai(siatej
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 209.25 Valuation: $ 12,000.00
State Surcharge Fee: $ 6.50
TOTAL FEE: $ 215.75
APPLICANT: Gardner&Associates, Inc. OWNER: Anne Ritz
2518 E. 52nd. St. 1065 Edgewood Hills Rd
Minneapolis,MN 55417 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.
� ,� '� ' ��
� - r�� % � �� �- ���-
APYLICANT PERM[TEE S[GNATURE ISSUED BY S[GNATURE
Cooies: 1-File(Sienitures Required). 1-Applicant. 1-Monthlv Reports. 1-Assessine, 1-Finance Page 1
i , .
Total Fee: $ o�l�• �� Date Received: I �//�S�
Entered By: /� Permit#: /���,.�_��
CITY OF ORONO - BUILDIN�G PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pri�it all informatio�z)
-------------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle o�ze) OWNER OR CONTRACTOR
JOB SITE ADDRESS: I O�� �_���>�..r��:c.� I�-�--i.S � ZIP: 5��� (
Will this be a Para e of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �o If yes, a special event per�nit is ��equired with Police Department and City
Council approval 60�lays prior to tl��e everit. Nofi pern�iittecl events will not
be allowed.
NAME OF OWNER: .��� ��j'^�-ti5�� PHON�: (home�S �— ''��3 `-1-1`�,a
(work)
MAILINGADDRESS: ��S" �1������� ��'w�-� ,�z,�ITY: �,�z,��y ZIP: ��3�
CONTRACTOR: V A�+7�+dL '�` ��'�--�t'�-� , � Nc- PHONE: (v IZ -"1 Z`; - i ci`��`�
CONTACT PERSON: ��� MOBILE/PAGER: C�1 z - 2z � - 2-Z ��
MAILING ADDRESS: Z�j 1�d � �2 r=' � CITY: ��` 4 ZIP: � � �
STATE LICENSE: # � l��`�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Accessory Structure
Addition Move
RemodeUAlteration � Land Alteration '
PROPOSED WORK(describe i►z detai�: �"�t~� ����
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
�—
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �2— , m ��
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: y `t �S
• , s
5ec.13.04 RIGHTS OF SUBJECTS OE DATA
Subd.1. Type oi data. Thc rights of individual on whom the data is stored or to bc stored shall be as set(orth in this section.
Subd.2. lnformation required to be given individual. An individual asked to supply private or confidential data concerning himself shall be
in[or�ned oL• (a)the purpose and intended use of thc requestcd data�vithin the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is Iegally required to supply thc requcsted data;(c)any known consequence arising fro�n his supplying or refusing to supply
private or con(idential 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 supply investigative data,pursuant to section 13.82,subdivision 5,to a law enCorcement of[icer.
The commissioner of rcvenue mav place the notice required under this subdivision in the individual income tas or nropertV taa refund
instructions instead of on those for�ns.
Subd.3. Access to data b��individual. Upon request to a responsible authority,an individual shall be informed whethen c�is the subject of
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 charge to him and,if I�e desires,shall be informed of the content and
meaning of that data. A[ter an individual has been shown the private data and informed o(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 bcen collected or created. The
responsible authority st�all 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 o[ma{:ing,certifying,and compiling the copies.
Thc responsible authority shall comply i�nmediately,if possible,with�ny request made pursuant to this subdivision,or within five days of thc
date of thc request,escluding Saturdays,Sundays and Iegal holidays,if immediate compliance is not possible. If he cannot compl��with the request within
that time,hc shall so inform thc individual,and may havc an additional five days within which to comply with the request,excluding Saturdays,Sundays
and Iegal holidays.
Subd.4. Procedure when data is not accurate or complete. Ao individual�nay contest the accuracy or completeness of puhlic or private data
concerning himsclL To esercisc this right,an individual shall notify in writing thc responsible authority describing the naturc of the disagrcemcnt. The
responsible authority shall within 30 days either: (a)correct the data found to bc inaccurate or incompletc and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he bclieves the data to be correct. Data in
dispute shall be disdosed only if the individual's statement of disagrecmen[is included with thc disclosed data.
The determination of the responsible authority may be appcaled 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 pernrit or license from the City of Orono or any of its departments n�ay require you to furnish certain private or
confidential infbrmation.
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 pernut 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 M.S. 13.04(available upon request) to revie�v private data on yourself.
6. Your full name is required to process this application or permit.
1�'��L�1.1t� ��2� �J �--�.�,=TL
First Middle Last
2S < � 1= �Z �� �
Address
_�Q�.--s � S s � �1 �[ Z — � z � � t�'�c7
C�ty State Zip Phonc
I und rstand rights as stated above.
Signature
CHECK OFF LIST FOR ISSUA.�YCE OF PER1tiIITS
FOR OFFICE US�' ONLY
ADDRESS OR LEGAI_: ti o 6s c ���W�o� N��-�s '�}2,
PID:
DESCRIPTIO:V OF G�'ORh': lN ��� (Loo� � ►�' C,o�'� C���
------------------------------------------------------------------------------------------
ZOt�INGRET�IEYVBY: N/I'� D.ATEAPPROVED:
B UILDING RE ti'IEW B Y: DATE APPRO�'ED: � � y -o s
-------------------------------
FEES TO BE CHARGED: �%lisc. Fees Calcul�cted By:
PER.��IIT Yes � No
PLA�V REVIEGV Yes Vo �/ SEYVER CO�VNECTION
STATE SURCH.4RGE Yes �vo tiVATER CO�WECTIOIV
INVESTIGATION FEE Yes tV"o PARK FEE
S.�C Yes �Vo SITE NSPECTIO�V
[V�cmber of SAC U�tits OTHER (specify)
-------------------------------------------------------------------------------------------- -
ZOrYING CHECK LIST Zor<irt,�Disd�icc: /v � G��ti✓m�
Fire Deparhrterrt: Post Off ce: Sc/ioo!District ___.
Lat.drea: Sq.Jt. Acres 6Yicfth Depth
Scuvey Subn�itted; Yes N Date of Scnvey:
Proposed Setbad.s:
Frortt(Lake): Righ Side:
Renr (Street): Left Sid :
Adjaceizt Struct�u•es: etland:
Betildiirg Heiglit: Def. Hgt. eak Hgt.
Got Coverage:
Grnding: Scaff,4pprovctl Date: By: Couiici!App+roval Date:
Septic: Stnff,dpproval Date: BY�
Zati�:g File: # Resolutio��: Resoli�tio�i Date:
S/torelanci Disn•ict:
Avg. Setback: Ble�ff etback: LotCoverage:
Esisti�z Proposed
Ha!•dcover: 0-7�'
75-2�0'
250-500'
500-1000'
Harcicover 1/ariartce Reqceired: Yes o Date of Council�(pproval:
RE�I�IARKS(in house):
31
G�
��srr��r�a n�o Q�s o���s oz> s�u�r�.�au
------------------------------------------------------------------------------------------------------------------------
:.Cg ��vp :J»,1o.�dd�-•ss���r
naa^� oLl7JS]X� :SS�J��.
�3.L�'Q �S21�KL O.�S�f1�L��''?I
------------------------------------------------------------------------------------------------------------------------
�(3S110H�1I)S�l?INI1��?I
-----------------------------------------------------------------------------------------------------------------------------------------
.��'!10
(>>i«.rad a���SI jv�r.rp�a�� �o nt�)11?.�/.�tr)pv.�� pvcr7��—
(��«r.rad a1v�S.1 Il��i9 ('�.�IN) p.mo8]lvd�
.�ay�p (;iiirosv��i) ttouv1��str��Z—
iro>>v�t.r.iJ trn1U7 a�vlda.ri� o���tuv.r�r�-
uoa��auiro� .fana�S �7�d�s �t.rs�oo,�
tror»atitro;�.�a1v�q 1v�iuvi��a1N 1�.1our��.ra,�o�p.rvH
a�r� �'t.rrqrun�d a�ts
:sl>>n.iad��v.rvda,s��n.nnGag y.ro,�q :pa.i�nba�suo�l�adsrrl
�a
0�0 ZI $' :an�v,1 xoJa�n.�Jsuo,�palvrs�7Ts3
7rzos
_ ..
_ � a��.rvrJ
— r .rool.�P���
_ � .roolj�s�
= x �trau�asu9
a�� GS.rad,� aDv�oo� GS
rJ �3dd.l A�OI.ZJ�127.LS.�\TOJ � . �Jff/�
.LSI7�I��H��li3X�13?I�A�IQ7I11 S
� • 4
/
r l��--�
! I il w o
- i.��.--�� � y 1
__� UP � �Y\ �.. � I i.�; `�� .s�1t�
{=A�1rJol�` /'r-`�� __ � Sro�o�.: r.� ,�. f .7'r G-; , ��'�
.. � �� ,;,.� � t �,!....,l
I�JM(� QDoM ' k,RNwaa��- ', . � --- -- -_-
�Q���r+�wJY �V"r
— F3R- .J��.SE 0.00'1� . -
._ � �
7, ��� ��: .•_ t-�- � ;•. ,.
._�� "" ��.:.. ..li� .,�,i
f'l �y/ . .. _.e :..� '___.'_"_-_- _
��\\\�%''�_ , ; ir� . . :': . � i� _'.j
.1._ . . . . . . . . . '
- L� . . . . .. , �-.. ..... l�. ..., . .1..
�.. .A.... L
v'_. . . � . .. - .. ._ . _,. .. . _.. , .'9
. . � � � _ . ' ��' ry�'i � '.�a!3.
� �..� __ _ ��jj/��� '_.,_..� __a I�. . _ . _ . ... ,.. ....., .r -;�:� _ -'.c'1.
i � f � G ASt9 oP�.1�,.�4+ �" ,�.�:I��o��ih.. Ti�.'�:,
7��� � � j
, , } '
� -- • � ''�-LPRPET� �` .- �
-----
.�\\ , , ', `S s _.�
� - _. �, � _ .
_
-- s��L�
,i o wkts ; ; S � �
-.
�---� ; Q ,� � � �2�� ---� 4 S�� �:� _.
' �uR�.i /� ` Q � �._...\� - -- ��..a..r ;
� l3✓ ��J I I40NtaJ/3. � � ...��___ �_..
. . I �{1.t�1kF14ftq 1��G._- , ' j
� �„�o�Jio��s - �r�o�e�ou•� DRoYty'o G��-�,15 i �
w u. , . J 9 1.�.�L'E i� I�� `� i -
- �oneaµTo�.l- � 54
,
3� '� Ydh7Eaf�i� D��,aD f� h
1O w..r� — - - - � .�^�_ ti - —I- - • - - �; � i
0 6`� ���_� � �� ;����� ;�� ��::
� �l�ac_�oo
� � � , , ._ ::�
. _ __ 6�,, `�\ p„a � i
Q �.�`-fit-� FwOK 13 . � �
5 -_- ----- - ! - _�'� � _
, " .�,�.;:.::..�
t� 5 • �,�b �:o a-��t n.��Nr,� 9.:s - -
` c�c.t+,� v��R� �'
�� Individuals 3 coL Individual Rectangular Bin
MEo�r� R-o��r� ��___� L�RPE�t i1 ' - � ms ��,, _'� 8 Case �
�, 54 ��-- ` �� � � s��. with Display with Dispiay Row
- - - _ - _ _ - _ _ � I���, , Row _ -
_. . �__... �`����
, � � ���� �-�
- � � F .,� _ . . ,._ ��'C: .,,.:a ,:,_, :.� .,���
� ���: � ` - -
S�P��E,�� C��3't"� _�L U O !Z P t,�rJ
�,.�a-' ,_ s,����;.:.-->
� ��� J� �+A� a �e; , ..�'�' �. :�i;�e. 'S• � �a,[�E% �/'4'4�� � `�p'r - . . ��.i�_J.
: :.a..,.d'Y _,.�.,� ...<. .E +� � W�terfall
��i'� SM'°1t.C:. i(J�1���2 \• -
��� Gs�t�N�p� —�- �_�G��T�, tNG.
�,� ..� ►-�` y:`��i�,i�.i� � U��'S G{.�5"fOM {��MOD�LINGr
' -._ _ .__ � _ .__...._ _ _.
_ _ a;�aehu�o».�L � • •
�j R��.t r�p d� J vP }�j�`� 2518 EAST 52ND ST • MINNEAPOLIS, MN 55417
/ SCALE: �f 4��=��o" APPROVED BY DRAWN BY �--'�•
/
r---------j -
� DATE: �O(�'���
I I
I � '; TOPS`� S�r,' .J•J 5D� 452 97�i4748
`� to�S E�raG i.JvoD ►t-�[..�', 02�J�
DRAWING NUMBER
W�Nc Ro�m
" Au7fONw[pPlYftiLs7 no.�esw-��x�� � -