HomeMy WebLinkAbout2007-P10809 - remodeling kitchen bathroom PERMIT
CITY QF ORONO
275� K�Iley Parkway- PO Box 66 Permit Number: p10809
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
4/20/2007
SITE ADDRESS: 2720 Ethel Ave Unit#
Wayzata,MN 55391
PID: 20-117-23-24-0040
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit T e: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair
YP
DETAILS:
Approved per resol�tion#:
Separate permits required: Electrical(state)
NOTICES/REMARKS:
Remodeling Kitchen&Bathroom
FEE SUMMARY: Pernut Fee: $ 181.25 valuation: $ 10,000.00
Plan Review Fee: $ 117.81
State Surcharge Fee: $ 5.00
TOTAL FEE: $ 304.06
APPLICANT: Owner/Self OWNER: Dennis&Cynthia Bremer
MN 2720 Ethel 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 REQUTREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED Y SIGNA7'URE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page l
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Total Fee: $ �-?�''L/ � C ( Date Received: � -
Entered By: Permit#: D
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle on OWNER OR CONTRACTOR
JOB SITE ADDRESS: ,� J � � ' � ZIP: .5 J ���
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes �NO Ifyes, a specia[event permit is required with Po[ice Department and City Council approval
60 days prior ro the event. Shuttle bus service will be required unless applicant demonstrates
sufficient on-site parking is available. Non-permitted events will not be allowed.
NAME OF OWNER: ��������s C�� �-�ri/zi��, % <�'��rE;% PHONE: (home)%�-`/7�``�7� 7
(work)1;�/'�7-S��(a� �/�r���
MAILING ADDRESS: ? �,�� i��'1"`��v�� CITY: �(�w� ZIP: .S3 3Ci/
r
CONTRACTOR: `�� �-- r PHONE:
CONTACT PERSON: �'7c����.�:�� ;��r .�, �,� MOBILE/PAGER: l���a_��;'�^ `! (c � l I
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: �C:' C_. 1 ��� t i } 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 rev�ew and permits!
PROPOSED WORK(describe in detai�: i"�a«;����<<���; /��'��-<, G�s�� !Sr �%.-'���� �-- �� ��.��1-,��
STORIES: ''�'�� C�"`�� SQ.FEET OF EACH FLOOR: � �G3C)
NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED � DETACHED�
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ' � v��v
1 hereby apply for a building permit and 1 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 1 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: � ��'�y'� C��-��-- DATE: -`•-���� 7
.`
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. l. Type of data. The 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 orcontidential dataconceming himselfshall be
informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b)
whe[her he may refuse or is legally required to supply the reyuested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential 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 enforcement officer.
The commissioner of revenue mayplace the notice required under this subdivision in the individual income tax or prooertv tax refund
instructions instead of on those forms.
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 da[a 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 he desires,shall be informed of the content 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 unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible au[horiry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may reyuire the requesting person to pay[he actual costs of making,certifying,and compiling the copies.
The responsible au[hority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [fhe cannot comply with the request
wi[hin that time,he shall so inform the individual,and may have an additional five days within which to comply wi[h 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 public or pnvate data
concerning himself. To exercise this right,an individual shall notify in wnting the responsible au[hority descnbing the nature ofthe disagreement. The
responsible authority shall within 30 days either (a)correct the data found to be inaccurate or incomplete and a[tempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the datato 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 thc responsible authority may be appealed pursuan[to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance�vith 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
con(idential information.
You are notificd that:
1. The inf'ormation you furnish �vill 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 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 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.
e nn i s (f.�I.��/�s' � /Qme,.�
First MidJle Last
c?�(�.� ��vn wcx�c(,y� /7 vc
Address
d�v�� d�.v SAS'.�P� 9s�.�-Y 7,� -9��a
City State Zip Phone
I underst d my rights as stated above.
�' c'�'��._
Signature
Reset Form 32
, �HEC� OF� i�TST FOR ISSU.A.I�i CE 4� PER.��ITS
FOR OFFICE USE ONLY
ApDRESS ORLEGAL; Z�Zr� cr+�Ez. Avc —_
�ID: � 6 A►�-�s + ru.o� (1 e D(L:mo�-�
DESCRLP'T�IO,i O�'WORK: (ZG�✓�-<<- k�-r-�►-�e.•�
ZO�G REVIE�V BY: ---�N (A _____�..__ J�E,�T� APPROVED: _
�UILDING REVIEtiV BY: � . DA'�E APFROV�D: '�,- �.3-o�
FEES TO BE C�-LARGED:� ^ Misc, Fees Calculated By: � ________
PE�T Xes r� No
PLAItiT REVIEtiV � Yes � No S�VF�R COyNEC`I`ION _--_._--- .____
STATE SURCH?�RGE Xes � Na ��'ATERCONNECTIO�T ^
INVESTIGATION FEE Yes Na _� P�K FEE
SAC Yes No � SITEINSPECTION
Number of SAC•Units OTHER (specify)
ZONI�IG CHE.CK LIST Zaning Discrict: n�o G I-ti4N62
Fire Depar'�ent:
Post Office: Scheol District: � ___ �___.�_�_
Acres idch Dep.h �_ _
Ifot Area: Sq.ft. �
Survey Submitted: Yes No ate oE Survey:
Proposed Secbacks;
Froat{Lake): Right Side:
Rear(Stree[j: Left Side: .
fidjaceat Structt!res: �, ettand'
�u'tl�lir:� Hei�.t: Det. Hgt. P �.Hg�.
Lot Covzra�e:
Grading: S�aFf Approv�i Dz`e; B;: Cou_eci� Apgroval Date: -
Sepuc: 5�af� Approval Dace: EY� '
µ Reso!u:ioa: r esolut;on D�:e:
Zoc�.ng F�le' R
Shoret�^.d Dist�:ct: _ .
Bl��;t Serback: +�:�,over��,e: - --- ---
r�.Vv. Se��cC�: _. - -- --
r�`�`�a DCO�C�S2C
�t�CO'/�., O-�S� _____
(�-Z�Q�
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r.�.��'�P.�.� ;L.hou�c):
EUI�I7ICi G- REVIEti�' CHECK LIST
�ra�c: R- 3 coNs�Uc�ox z�E: •ln.�
Sq Footage $ Per Sq Fcg
Basement • X _
lst Floor z _ .
2nd Fioor x _ .
Garaoe z _
x =
TOTAL
Estimated Constructioo �alue; $ ► O,QOO�
Insgections Required: �York Requiring Separate Permits:
5 ite ,,,��R
Fire
Hardcaver Removal Mechan.ical Water Coanectioa
Footing ' Sepcic Sewer Coaaection
x Framing Fiteplace Lawn Irriga[ion
Insuiation (Masonry) Other
�c �Vall Board (Mfg.) Wetl (State Permi,)
� F�� Grading/Filling � Eiecrrical (State Permit)
Other
R.EMARKS (L�'HOUSE):
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REVLE'�V SY OTHERS: DA'�E:
Access: Existi.ng New
Access Approval: Date gy:
----------------------------------------------------------------------------------------
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CITY OF ORONO CALLED IN �� QO
INSPECTION N ICE SCHEDULED — U /•��
PERMIT NO.��'a� COMPLETE
ADDRESS � 7�� �/ �/�
OWNER���S �1'��'Vt�.J� CONTR.
TELEPHONE NO. �� — ���— ����
� DESCRIPTION ����
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q �FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL
Z ❑ WAIL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �WORK SATISFACTORY:PROCEED C7 PROJECT COMPLETE
W ❑ CORRECT WORK&PROCEED ^ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ;� pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector. � � ��i��f�S
White Copyllnspector's File Canary Copy/Site Notice