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Home My WebLink About2004-P07281 - addn/remodel/repair PERMIT CITY t7F ORONO Permit Number: 275d Kelley Parkway - PO Box 66 Po�2gi Crystal Bay, Minnesota 55323 P@Cllllt Typ@: Addition/Remodel/Repair (952) 249-4600 Date Issued: 3i3i2oo4 SITE ADDRESS: 75 Ferndale Rd N Wayzata,MN 55391 PID: 36-118-23-44-0006 DESCRIPTION: UBC Occupancy u3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: ..-,--- ------ � �--- �—��---- -- n--��- �-�--�--- - , --- �-�--� __ .. . — - -- ---- - �::.: - — ..r......, ..rr.,. .,.,..,...,. .,..�....,.,.... _..................::�::.. �,. ...,r., FEE SUMMARY: Permit Fee: $ 23�25 Valuation• $ 14,000.00 State Surcharge Fee: $ 7.50 TOTAL FEE: $ 244.75 APPLI�:ANT: Steel Construction Services,Inc. OWNER: lohathan&7ennifer Havice 3448 Steel Street 75 Ferndale Rd N Minnetonka,MN 55345 Wayzata,MN 55391 TfIE LJNDERSIGNED IIIItEBY REQLTESTS PERMISSION TO MAKE THE RFAI,IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND Sl'ATE OF MINNESOTA BUII.DING CODE REQUIREMENTS. . % �'�� '�_ �. � C�"�� (�!7 �� APPLICANT PERMITEE SIGNATURE ISSU BY SIGNATURE Copies: 1-File(Siu�iin�res Reauired). 1-Applicant, 1-Monthlv Reports, 1-Assessin�. 1-Finance Page 1 � . � ` Total Fee: $ Date Received: Entered By: Permit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) O`VNER OR ONTRACTO JOB SITE ADDRESS: �� Fr,��l�:/�. /��:�;,1 N. ��n,�a� /7?N ZIP: .S�'3`�/ Will this be a Par de of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes, a special event permit is reqt�ired with Police Department and City Council approva160 c�ays prior to the event. Non permitted events will not be allowed. NAME OF OWNER: C��dy �r;,��v�==ti PHONE: (home) `��"Z y/�a�I -06�� (�,`e�k��/�)��r z) Tlv- �3�-�:� MAILING ADDRESS: �S- -{�:�-N�l.�t� ��'. iv. CITY: v�c;,,� � ZIP: ;-�'� �/ CONTRACTOR: S��'el�' �'on»fi�u,cfi4�� .�.�.�v,u,� �;�. PHONE• (�lL>.S`Qd'—l�'G'� CONTACT PERSON: _�'l+r>1 lT/e/!u/�.. MOBI /PAGER:•�G►z� S`�'� `"/�� MAILING ADDRESS:3yY� S��Je S�y-�Qf- CITY:�;��,p��k�: ZIP: .S�';�`jS STATE LICENSE: # Z�'�/�/jE ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION # TYPE OF WORK: New Accessory Structure Addition Move RemodellAlteration_� Land Alteration PROPOSED WORK(describe in detai�: ��ol�� Q�,,. �,,,G,( /,,,,�,_,,. ��,,,,,,,s. i�,�L,�,�,ti, �,e,., �- � �;N �T ) y � 2�,s�,�v� �i�c�,I�c C�✓L7lN•��I� T/�•r_tJD � C� �i,�1+./r-S Cr.�i l' b� �<��cc.r w+ a-<.N�:C Tb.:�L Z.�T�Y'�.w• J �.o., TYLt'�. �Y'fGK 7u Tlc,(c�SfO:X.�j�'c.w�C.�Y, STORIES: y SQ. FEET OF EACH FLOOR: ,�',�p»x, � NO. OF BEDROOMS: �f GARAGE STALLS: ATT. � DET. ESTII�IATED CONSTRUCTION VALUATION (excluding land): $ /7��,-`= I hereby apply for a building pernut and I aclrnowledge 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 pernut; and that the work will be in accordance with the approved plan. APPLICANT'S SIGNATURE:l-� �-�-��. DATE: � / �`� / E • ' � Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd.1. 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. ,1n individual azl.ed to supply private or confidential data concerning himself shafl be informed of: (a)the purpose and intended use of the requested data within the mllectis�state a;ency,polltical subdivision,or statewide system;(b) whether he may refuse or is legally required to supply the requested data;(c)an��l-nawa consequence arising from his suppl�•ing or re[using to supply private or confidential data;and(d)the identity of other persons or entities author¢ed b�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 mav olace the notice reaaired under this sub�{'nision in the individual income ta� or orooertv tar refund instructions�nstead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible aothoritc,an individual shall be informed w hether he is the subject of stored data on individuais,and whether it is classified as public,prn�ate or con(idential. L-pon his further request,an indi�-idual who is the subject oC stored private or public data on individuals shall be shown the data without an}•cha se ro 6im and,if he des(res,shall be informed of the content and meaning of that data. After an individual has been shown the pricate data and informe�o[its meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this secrion is pending or additioaal data on the individual has been collected or created. The responsible authority shall provide copies o[the private or public daLa upon request b}•thT individual subject of the data. The responsible authority may require the requesting person to pay the actual costs of making,certifying,and compiling t6e copies. The responsible authority shall comply immediately,if possible,with an.-requtst made pursuant to this subdivision,or within five days of the date of the request,escluding Saturdays,Sundays and legal holida�s if immediate rnmpliznce is not possible.If he cannot comply with the request within that time,he shall so inform the individual,and may have an additiooaJ five days N ithin w hich to comply with the request,eccluding Saturdays,Sundays and Iegal holidays. Subd.4. Procedure when data is not accurate or complete. An Individual may-cootest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notif}-in writing the respoo.n"ble authority describing the nature o(the disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inac�nrate or incomplete and attempt to noti(y p�st reciplents oC inaccurate or incomplete data,including recipients named by the individual;or(b)notif}-the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement oC disagreement is incloded K�ith the disclosed data. The determination of the responsible authority may be appealed pursuant to rhe provisions of the admin(strati�•e procedure act relating to contested cases. DATA PRIVACY AD�TSORY In accordance with 11�I.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform�-ou that your request for a permit or license from the City of Orono or an�-of its departmenu may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish�vill be used to determine your quali5cation for the permit or license requested. 2. You may refuse to suppiy 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 acuon to approve, some information may become public. 5. You have certain rights under M.S. 13.0-3 (available upon request) to review private data on yourself. 6. Your full name is required to process this application or permit. S-�� ,us'�✓u.c��`�� .Ze�—u�?�s �. � s�� Z✓ • ��li,^is' F�rst Nliddle Last _ }`,T�� S��GI� .5�,�-�.f Address �li��'b�,k� 1�'N S`�-'�i)' �F i z) 5`0,� j��r C��' State Zip Phone I understand my rights as stated above. . 1�� -�� S�gnature � , ' CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESSORLEGAL: -75 �-=t=,—n�v,�.�c.�:, /Lc,� PID: � DESCRIPTION OF WORK (k,�1,t.�•�7.e L /,Z,L;�c c..c:�.�-z: --------------------------------------------------------------------------�---------------------------------------------- ZONING REVIEW BY: �% j ✓� DATE APPROVED: B UILDING REVIEW BY.• DATE APPROVED: FEES TO BE CHARGED: / Misc. Fees Calculated By: PERMIT Yes ✓ No PLANREVIEW Yes No � SEWER CONNECTION STATE S UR CHAR GE Yes ,/� No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITE INSPECTION Number of SAC Units OTHER (specify) ------------------------------------------------------------------------------------------------------------------------ ZONING CHECK LIST Zoning District: tU:% c..t-i-►4�t�L' Fire Depanment: Post Office: School District: LotArea: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Sacrvey: Proposed Setbacks: Front (Lake): Right ide: Rear (Street): Left e: Adjacent Structures: etland: Building Height.• Def. Hgt. Peak gt. Lot Coverage: Grading: Staff Approval Date: By: � Council Approval Date: r Septic: Staff Approval Date: By; Zoning File: # Resolc�tion: # / Resolauion Date: Shoreland District: Avg.Setback: BI Setback: Lot Coverage: isti�tg Proposed Hardcover: 0-75' 75-250' ZSO-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: \ REMARKS(in house): �1 32 . B UILDING REVIEW CHECK LIST UBC: /� " � CONSTRUCTION TYPE: '�i� Sq Footage $Per Sq F�g Basement X _ 1 st Floor x _ 2nd Floor x _ Garage x = x = TOTAL Estimated Construction Value: $ �L/,C'�`� �"' Inspections Required: Work Requiring Separate Permits: Site h Plumbing Fire Hardcover Removal Mechanical Water Connection '�g Septic Sewer Connection �_Framing Fireplace Lawn Irrigation _,�Insulation (Masonry) Other .'r Wall Board (Mfg.) Well (State Permit) Final Grading/Filling � Electrical (State Permit) Other ---------------------------------------------- ------------------- REMARKS(INHOUSE): -------------------------------------------------- -------- --- REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By. ------------------------------------------------------------------- REMARKS (TO BE NOTED ON PERMIT): 33 LU" ' � � �DA EO TIME CITY OF ORONO CALLED IN ' ( INSPECTION TI E SCHEDULED -3 -�ti8`l� /�� PERMIT NO. Z� � COMPLEfED ADDRESS 7� � D. •�/ OWNER CONTR. ��-� C� TELEPHONE N0. �� l C� �-S � DESCRIPTION ��'«� � C�yt,�-�t�G� l� 01 FOOTING 11 MECHANICA RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z �- 12 WATER HOOK-UP 17 SITE INSPECTION Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a J �,�J � o r— � � ° c� - G� ` ''l� � C`�'� lt� W � Q � 2 W � W � j d W� WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE ❑COflRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR �INSPECTION REQUIRED.CA LTO ARRANGE ACCESS. I Call for the n t nspection 24 hours in advance. (g52) 249-4600 Owner/Cont n i • Inspector. ' White Copy/inspector's File Canary CopylSite Notice Lv �/� � �K./► AT� TIME CITY OF ORONO �f CALLED IN � INSPECTION NOTICE / SCHEDULED - " �� 4� PERMIT NO. (��0�,� I COMPLETED ADDRESS � � /�e��'t-d-�'� � (v ' OWNER CONTR. �-P ��• TELEPHONE NO. 10�� SO8 /�lo.S� � DESCRIPTION ��'"`�"L � �� l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS h Q 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 INSTALL. 22 FOLLOW-UP i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J �0 PLUMBING FINAL 36 FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O � � O � W � Q � Z W � W � � d W WORKSATISFACTORY:PROCEED f� PROJECTCOMPLETE � ❑ CORRECT WORK&PROCEED !- W i ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next i spection 24 hours in advance. (952� 249-46�0 Owner/Contr r s : Inspector. White Copyllnspector's File Canary CopylSite Notice