HomeMy WebLinkAbout2005-P09428 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kell�'y Parkway- PO Box 66 Permit Number: P09428
Crystal Bay, Minnesota 55323 Permlt Typ2: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
12/28/2005
SITE ADDRESS: 509 Ferndale Rd N Unit#
Wayzata,MN 55391
PID: 36-118-23-13-0011
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved perresolution#:
Separate permits required: Plumbing Mechanical Septic Electrical(state)
NOTICES/REMARKS:
Gar. &BR Addn-NOTE: 30' Setback issue-Must sign septic form B4 framing insp
FEE SUMMARY: Permit Fee: $ 1,553.75 val�ation: $ 200,000.00
Plan Review Fee: $ 1,009.94
State Surcharge Fee: $ 100.00
TOTAL FEE: $ 2,663.69
APPLICANT: Danberry Company OWNER: Geo Sutton
4410 Shoreline Dr 509 Ferndale Rd N
Spring Park,MN 55384 Wayzata, MN 55391
THE UNDERS(GNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK [N STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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A LICANT PE MITGL S[GNATU E I SUED BY SIGNATURB
Copies: 1-File(Signatures Reguired), I-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page 1
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Total Fee: $ r1��' - �' Date Received: f"'����J ����
Entered By: Permit#: �`- /!F� G��
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review wi(1 be started.
(please p��int all i�zfor»zation)
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THE APPLICANT IS: (ci�•cle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: `-=� �� � (rt'�" �<<��� ���; ZIP:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ I�eS ❑ NO 1�:ves, a special eve��t pern�rt is reqi�ir•ed x�rth Police De�ar�nier�t and Cih�Council approval
60 days prior to the event. Shuttle bz�s service wil!be regirired zrnless app(ica�zt demor�strntes
sarJJicier�t on-site pai�kin,�is availnble. Non�ermitted evei�Ls will not be allowed.
NAME OF OWNER: � ����' C '�� t��` �" PHONE: (l�ome)
� (work)
MAILING ADDRESS: � � �� � �`���`�`� CITY: ti�'�,��ti`/ ZIP:
CONTRACTOR: � �t �,4 �,�✓�� y PHONE: `�� �-�'' � Z-
CONTACT PERSON: �c� MOBILE/PAGER: i��� � � s"� ��'�'7
MAILING ADDRESS: y'- /Ct S�u � CITY: ZIPo
STAT��,ICENSE: # �[.�,� EXPIR.�'I'ION DATE:
ARC�IIT'EC'T/ENGINEEl�: — PHONE:
MAiLiNG fODDRESS: C'I'I'I': ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition _ �C Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
PROPO��Fr���RK(descr•iGe in cletai�: C'� � -�'��� �5-��"�'-�ti•.
�
S'TORIES: �Q.F�E'�'OF'�ACI3�I.00I�:
I�10. OF �ED1200MS: GAI�GE ST'A�,��: E!'�"'I'AC'�IEI) I)E'I'AC�IEl�
C �
�S'�'ili�.�'I'ED C��1S'I'I�UCTI0�1 V���J�'TIOI�(exeluding land): $ �2cJU� ��c+ ��
�—,
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 witl� the ordinauces and codes of the City and�vith the State Buildine
Code;that 1 understand this is not a pennit and work is not to start without a pennit;and that the work will be
in accordance with the approved plan. � �
,,. /�/ >
APPLICA�i'�''s�IG1iA'�'LTI�: C,.;' ' `i� DAT'E: /� o� �C'S^�
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Sec.]3A4 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 foiKh in this section.
Subd.2. Infoi�nation required to be given individuaL An individual asked to supply private or confidential data conceming himself shall be
informed of: (a)dte pu�pose and intended use of the requested data within the collecting state agency,politica]subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identiry of other persons or entities authorized by state or fedeial law to receive the data.This rzquirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.32,subdivision 5,to a]aw enforcement officer.
The commissioner of revenue mav alace the notice required under this subdivision in the individual income tax or proper[v tax refttnd
inscructions instead of on those fornts.
Subd.3. Access to data by individuat. li pon request to a responsible authority,an individual shall be informed whedier he 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 sliown the data without any charge to him and,if he desires,shall be infomied of the content and
meaning of that data. After an individual h1s been shown the private data and informed of its meaning,the data need not be disclosed to him for six
months dlereafter unless a dispure or action pw�suant to this section is pending or additional data on the individual has been collec[ed or created. The
responsible authoriry shall provide copies of die private or public data upon request by the individual subject of the data. The responsible authoiity
may require the requesting person to pay the ac[ual costs of makine,certifying,and compiling the copies.
The responsible audlority shall comply inunediately,ifpossible,with any request made pursuan[to this-subdivision,or within five days of
the dare of the request,excluding 5aturdays,Sundays and legal holidays.if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so infonn the individual,and may have an additional five days within which to comply with the request,excluding Saturdays,
Sundays and lzgal holidays.
Subd.4. Procedure when data is not accurate or complzte. An individual may contest the accuracy or completeness of public or private data
concerning himself. To exercise this right,an individual shall notify in wiiting the responsible authocity describing the nature of the disagreement.The
responsible audioriry shall within 30 days either: (a)conect the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccw�ate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be coiTect. Data in
disoute shall be disclosed onlv if the individuaPs statement of disagreement is included with the disclosed data.
Thz detennination of the responsible auchority may be appealed pursutmt to the provisions of the adininistrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",tive would like to inforni 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
confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the pernlit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the pernlit or license.
3. The inforniation may be shared with other local, state or federal agencies to the extent necessary to
process the perniit or license.
4. If your rec�uested pernlit or license requires Council action to approve, some information may become
public.
�. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Youi•full name is required to process this application or pernlit.
�-�r=�= J �{ ,t h����, ,,
Firs[ Nliddle Last
Address
����' State 7ip Phone
I une�e!-stand e��v riehts as�stat d a�ove,
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Sienatui
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BUILDING REV�tiy CHECK LIST
��� _ �2 � � CONSTRUCTION TYPE: `/✓�
Sq Foota�e $ Per Sq Ftg
Basement x =
lst Floor R =
2nd Floor R =
Garage x _
z =
TOTAL
Estimated Construction Value: $ Z o� ,opd °O
Inspections Required: `Vork Requiring Separate Permits:
Site _�Plumbing Fire
Hardcover Removal _ v�Mechanical Water Connection
�_ Footing ` _,�Septic Sewer Connectioa
o( Framing Fireplace Lawn Irrigation
_�( Insulation (Masonry) Other
_�Wall Board (Mfg.) Well (State Permit)
� F�� Grading/Filling �-Electrical (S[ate Permit)
Other
RENIARKS (IN HOUSE)e —`-- --------
-------------------------------------------------------------------------------------------------------------------
RE'VIEW BY OTHERS: DAT'E:
Access: Exis[ing Ne,�.
Access Approval: Date gy:
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REI�IA.RKS (TO BE NOT'EI) ON PERt�fi'I�: s-�,-, � fa�,,,.....� .-�,�.�s, �
S►(�N��9 Q--e� ,t.� �=(��c,.,��nr S t ^� s�e�-rt o�
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CHECK OFF LIST FOR ISSUAI�ICE OF PER1l�1ITS
FOR OFFICE USE ONLY
.-
ADDRESS OR LEGAL: So� F�Zcv,p,��, ,Zo,�,o -
PID:
DESCRIPTION OF WORK: �yy,�J�(J�T�o�v 5
ZO.�tIvi G REV�`V BY: DA'TE APPROVED: �Z - � 3-�s'
BLTILDI�'G REVIE`V BY: DATE APPROVED: i 2 -r 3-o S
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes _� No
PLAN REVIEW Yes ,� No SE`VER CONivECTION
STATE SURCHARGE Yes ✓ No WATERCOiVNECTION
INVESTIGATION FEE Yes No ✓ PARK FEE
SAC Yes No � SITEINSPECTION
Number of SAC Units OTHER (specify)
---------------------------------------------------------------------------------------------------------------------
ZO\�i TG CH�CK LIST Zonin; District:
Fire Department: Post O�ce: School Districr.
Lot Area: Sc.ft. Acres Width Depth
Survey Submitted: Yes_� No Date of Survey: �j• Z3 •�b
Proposed Setbacks:
Front (-�e): Z��' # Righ[Side: ��� ±
Rear (Str�t): �j n Lef!Side: 3c��
Adjacent Structures: N I J� Wedand: /�1 ( ✓�
Buildin; Heighr. Def. Hgt. (�.� Peak Hgc. —
Lot Covera;e: /�J 1✓�
Grading: Staff Approval Date: /J �✓a' By: — Council Approval Date:
Septic: Staff Approval Date: ,eo�/Z•1 Z-o S By: (�•C�•
Zonina File: � � Resolution: # – Resolucion Date:
Shoreland District: �/�J
Avg. Setbacy: Bluff Setback: L,o[CoveraQe:
Eeistin� �roposed
Hardcover: 0-7�'
7�-250'
2�0-500'
�00-1000'
Hardcover Variance Required: Yes I�o Dace of Council Approval:
���5 �an hotise):
7
Page_ of_
DFNTS
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I NTE RTEC Daily Field Notes
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Project No.: �'�' Report No.:
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Location: - -_`? %`� ' `'� ` �" Date: = -
Personnel Classification Regular Hours Overtime Hours
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Areas and work performed this day: ---�� ~C�
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Weather: � ` `-'` :f c •- ` Performed By:
Submitted To:
White copy to Braun Intertec file. Blue copy to Projed Site Representative.
' Providing engineering and environmental solutions since 1957
G� µi�w�'� � DATE IME
CITY OF ORONO CALLED IN =�
INSPECTION TICE a SCHEDULED '
PERMIT NO. a-0 COMPLETED �'-��'�3 �
ADDRESS ��SD g \��� �-/a�
OWNER CONTR. ����°�-�i �
TELEPHONE NO. (Ola 4��SZ� 7DO �
� DESCRIPTION �����—.
l� 01 FOOTING 11 MEC ICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINA� 19 LAKESHORE/WETLANDS
�
Q 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
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W�C CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46��
OwnerlContractor o site:
Inspector. �/���
White Copylinspector's File Canary CopylSite Notice
n Lv;1 l�� � '� ✓
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l:' DAT TIME
CITY OF ORONO CALLED IN � UCP
INSPECTION NO�CE // Q SCHEDULED ���=(%(a i =�� %�'�
PERMIT NO.�,!'�?`�� V COMPLETED
ADDRESS .�'�-%� /-��l''�< -� ' ���
OWNER CONTR. � _rr�� l-�' %%"�-%
TELEPHONE N0. `��S �� �l � / OS _�j�,
� DESCRIPTION r�f',�"G�--E%�' .
�
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q'"b2 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O03 I ULATION 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNOATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. r pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATfON ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 2a hours in advance. (952� 249-4600
OwnerlContractor ali site:,
,
Inspector. � �`�� �� -
White Copyllnspector's File Canary CopylSite Notice
��LLI'" DAT TIME V
CITY OF ORONO CALLED IN � ��
INSPECTION NOTIC Q SCHEDULED `�%OO
PERMIT NO. O O COMPLETED �� UG3 �C1. t_,CJ
ADDRESS �D� ��dl�-e- K–� /V
OWN ER CONTR.
TELEPHONE NO. -1�2 �7� �5�0�
� DESCRIPTION 1 YI��L'� —
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
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
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �-; pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-4600
Owner►Contractor on site:
Inspector. „��_�i� c
White Copyllnspector's File Canary CopylSite Notice
�' LC/{�� D E TIME "
�, �a �
CITY OF ORONO ALLED I�N,�,�.., , �
INSPECTION N IC�j �����HEDULE�D � -��! �����
PERMIT NO. -1 � COMPLETED � � ��Z �
ADDRESS 5U�1 �P�✓'nG�'�Q- � /� '
OWNER CONTR.
TELEPHONE NO. lP�� ZSD �OD 7 �Q,
� DESCRIPTION D J�<
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINA 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 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 FOUNDATION/REMOVAL
� OWNEHICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �j PHOTO TAKEN
INSPECTOR WlLL RETURN
�STOP ORDER POSTED.CAL�INSPECTOR �� CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnedContractor on site:
Inspector. C�.� �,r"� ���5
White Copyllnspector's Fiie Canary CopylSite Notice
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,,�,�+ ` :,` !' , f �: .. ; I hereby certifv that Ihiti �ur��e�� �ti��� F,repared b�� nir �,r undrr m�� di�ert supc�r_
_ {' �' 1►,� ��� ' �i ; vislon, and.th�t[am a duly reKisterrd Civil Lngineer and Lanii Sun�cyui under
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, the laws of thr 5tate uf tilinnetiota. �
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'Mark S. Gronber� Minn�sota License Number 12755
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