HomeMy WebLinkAbout2003-P06767 - addn/remodel/repair T ? PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 po6�6�
Crystal Bay, Minnesota 55323 PeCllllt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: 9i24i2oo3
SITE ADDRESS: 95 Ferndale Green
Wayzata,MN 55391
P I D: 36-118-23-44-0010
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential Construction Type VN
Census Code 434
Pernut Class: Building
Pernut Type: Addition/Remodel/Repair Pernut Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate pernuts required: riumoing iviecnanicai Eiecmcai�siaiej
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 937.75 Valuation: $ 91,400.00
Plan Review Fee: $ 609.63
State Surcharge Fee: $ 46.20
TOTAL FEE: $ 1,593.58
APPLICANT: Bauer Building Co. OWNER: John&Irene Harnett
Daniel R. Bauer 95 Ferndale Green
4628 S Lake Sarah Dr. Wayzata,MN 55391
Maple Plain,MN 55359
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.
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PL T PE ATURE SSUED BY SIGNATURE
Copies: 1-File(Si�nitures Required), 1-Annlicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
Total Fee: $ / �C� � � � Date Received: `�(-��-0�
Entered By: � �� ,� �/ � Permit#: lf<�,�;710 7
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CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information) �
--------------------------------------------------------------------------A---x__==_-�-�--=_— ---------------
THE APPLICANT IS: (circle one) OWNER OR�CONTRACTOR
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JOB SITE ADDRESS:`�� 're�'►�a�� C..�✓� ►�-,v�v ZIP:-
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J � �1 � (� ) � � z�- �� � -Z33�
N�iE OF OWNER: p�1,h a✓��'N e- PHO�]E: ome
(work)
MAII,ING ADDRESS:`'�,r'J �c,�v�o�a �� ��'<<� CITY: (�k-��-�.� ZIP:
7�3 --`17y --�� �'y
GcL�
CO\�'RACTOR: �a,�.t� �v�,�at;� �-v , PHONE: Cv I Z- 3 �Z -Z d ��
COr�TACTPERSON:�o��n �u �.,r 1vIOBILE/PAGER:
NLAII.ING ADDRESS: ��z 3 S,l�ke S�Y�� ��-CITY: .,.�1.�7�-�--y--�IP: �5.3:��'
ST�T'E LICENSE: # Zd 32 G ZSZ.
ARCHTITECT/ENGINEER: `�'��-"`"�—� PHO�TE:
M�II,ING ADDRESS: CITY: ZIP:
�,r���; REGISTRATION#
TYPE OF WORK: Ne�v Addition Accessory Structure
Move Remodel/Alte�ation�G_ Land Alteration
�e wt c;�(c�
PROPOSED WORK(describe in detai�: rM°� � � Z - ��'� '^'�� �" �"� � ,
:-t-t=-�..e..1 ��; �` ti1��„�;�� a,n,� l e.W S �.S
STORIES: ` SQ. FEET OF EACH FLOOR: Z-I�
NO. OF BEDROOviS: � � GARAGE STALLS: ATT. D�T.
ESTL�IATED CONSTRUCTION VALUATION (excluding land): $ � 1 ���� �
I hereby apply for a buildinJ 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
pennit; and that the work wi�I be in�c,prd�,fic� with the approved plan.
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APPLTCANT'S SIGNATITRE: � -�-i �__.� DATE:
,.
NOTE! Parade of Homes events require separate permit approval by Police Department anrl
City Council 60 days prior to the event. Non permitted events will not be allowe.`d.
5
Sec.13.04 RIGHTS OF SUB.TECTS OF DATA
Subd. I. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given indiridual. An individual asked to supply private or co�dential data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the collecting state agency,polidcal subdivision,or statewide
rystem;(b)whether he may refuse or is legally required to supply the requested data;(c)any laown consequence arising from his supplying or
refusing to supply privace or confidendal dara;and(d)the idendry of other persons or endaes authorized by srate or federal law to receive the data.
This requirement shal( 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 mav lace the norice re uired under this subdivision in the individual income taz or ro ertv tax refund
instrucrions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuals, and whether it is classified as public,private or co�denrial. 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 char�e to him and,if he desires, shall be informed
of thz con[ent and meanin�of that data. Afrer an individual has been shown the private data and informed of its meaning, the data need not be
disciosed to him for siY mondu thereafcer unless a dispute or action pursuant to this secoon is pending or addidoc�al data on the individual has been
collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual costs of making,certifyin„and compiling the copies.
'Ihe responsible authoriry shall comply immediately,if possible,wi[h any request made pursuant to this subdivision, or within five days
of the dace of the 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 tha individual, and may have an addidonal five days within which to comply with the request,
eYcluding Saturdays, Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contes[the accuracy or completeness of public or
private dara concerning himself. To exercise this right,an individual shall nocify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authoriry shall within 30 days either: (a)correct che dara found to be inaccurate or incomplece and attempt to noafy
pasc recipien[s of inaccurate or incomplete data,includin;recipienu named by the individual;or(b)norify 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 disciosed data.
The determinaaon of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
to contesced 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 the City of Orono or any of its departments may require you to fumish 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.
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.
First Middle
Last
Address
C�ry State Zip Phone
I understand my ri s s stated ov .
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Signature
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: g S ���0�9 c.i, G2c,��
PID:
DESCRIP'TION OF WORK: ������-
ZO�TING REVIEW BY: DATE APPROVED: S'- �lP-03
BUII�DING REVIEW BY: DATE APPROVED: �, -� `5 -0 3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �,/' No
pL?,N REVIEW Yes ✓ No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATERCONNEC'TION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST zoning District: iV a c��
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres id�h Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Reaz (Street): Left Side:
Adjacent Structures: Wetl d:
Building Height: Def. Hgt. Peak gt.
Lot Coverage:
Gradin�: Staff Approval Date: By Council Approval Date:
Septic: Staff Approval Date: By
Zoning File: # Resolution: # Resolution Date: .
Shoreland District:
Av�. Setback: Bluff Setback: L.ot Coverage:
Exisiing Ploposed
Hardcover: 0-75'
75-2�0'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RE�iARKS (in house): ,
7
BUILDING REVIEW CHECK LIST
�C: rC ' 3 CONSTRUCTION TYPE: �./N
Sq Footage $ Per Sq Ftg
Basement R _
lst Floor x _
2nd Floor R _
Garage x _
R =
TOTAL
Estimated Construction Value: $_9'i+y V p ��
Inspections Required: Work Requiring Separate Permits:
Site „/ Plumbing Fire
Hardcover Removal ��Mechanical Water Connection
Footin� Septic Sewer Connection
_� Framing Fireplace Lawn Irrigation
_�Insulation (Masonry) Other
�c Wall Board (Mfg.) Well (State Permit)
�_F�� Grading/Filling _�Electrical (State Permit)
Other
RE�IARKS(IN HOUSE): ` �' ---------
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REVIEW BY OTHERS: DATE:
Access: Existin� Ne��
Access Approval: Date By:
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RENIARKS (TO BE NOTED ON PERMI�:
. 8 .
. . ���� �
DATE TIME
CITY OF ORONO CALLED IN �
INSPECTION N CE SCHEDULED � •
PERMIT NO. �O COMPLETED
ADDRESS �� f—
OWNER CONTR. Q�X��(.� ��
TELEPHONE NO. 6�Z'� �b d " 5�09 g
� DESCRIPTION � I �
� 01 FOOTING 11 MECHANICAL 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 05 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 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� ❑ KSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
�CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
0 STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call forthe next nspection 24 hours in advance. (952) 249-46�0
OwnerlCon on it : �
Inspector. ``
White Copy/lnspector's File Canary Copy/Site Notice
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