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Home My WebLink About2001-P03616 - addn/remodel/repair • PERMIT CITY OF OI�ONO 2750 Kelley Parkw�y - PO Box 66 Permit Number: Po3616 Crystal Bay, Minnesota 55323 Pel't111t Typ2: Addition/Remodel/Repair (952) 249-4600 Date Issued: 4�si2ooi SITE ADDRESS: 575 Ferndale RdN WAYZATA,MN 55391 P��: 36-118-23-14-0001 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Kesidentiai Buildin Census Code 434 Permit Class: g Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 542.75 Valuation: $ 40,000.00 State Surcharge Fee: $ 20.00 TOTAL FEE: $ 562.75 APPLICANT: Anderson Woodcraft Inc OWNER: J G& M M DAYTON 1438 85th St Nw 575 FERNDALE RD N Buffalo, MN 55313 WAYZATA MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AN A O DO ALL WORK IN STRICT COMPLIANCE WITH ALL CTTY OF ORONO ORDINANCES AND ST OF MI SOTA BU[LDING CODE REQUIREMENTS. � � � � �� -t /� ,?��:� ,,�,�� APPLICANT PERMI E:IGNATURE ISS D BY SIGNATURE Copies: City,Applicant,Assessor, Finance Page 1 , c - ' � Total Fee: $ �� -(� ��.� - �� ' Date Received: � ( Entered By: ,�i, � i ,r� !,- ' Permit#: / 'C� `� '�� !,- ' . . �.16" : � 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) OWNER OR NTRACTOR___� �----._ _ JOB SITE ADDRESS: ��('�C�VI��-v ZIP: NAME OF OW�1ER �� PHONE: (home)��_ (work) MAILING ADDRESS: �� 1�2�}`�Q,�}(�;CITY: �.� ZIP:�� CONTRACTOR: � PHONE: �Q12 ��Z�ZZ CONTACT PERSO\': MOBILE/PAGER: G,�yy� MAILII\TG ADDRESS: �4 8��j. �.w. CITY:�� ZIP: �� STATE LICENSE: # ARCHITECT/ENGL\�ER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration� Land Alteration � PROPOSED VVORK (describe in detai��(�'F "�C1`J�1�'1)�n ��F1� b��l l'(��o T1�,�u t� T� �u�.� �?-�� t�.,�3��- �1 i �m�, � 1�'��,�� ... � STORIES: �� SQ. FEET OF EACH FLOOR: �_� NO. OF BEDROO�iS: �_ GARAGE STALLS: ATT. � DET. � ESTIMATED CONSTRUCTION VALUATION (excluding land): $�t� 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 und rst is is not a permit and work is not to start without a permit; and that the �vork will be i corda ce i the pproved plan. APPLICANT'S SIG\TAT DATE: � NOTE! Parade o Homes events require separate permit approval by Police Deparlment and City Council 60 days prior to the event. �'�'on permitted events will not be allowed. 5 ' , Sea 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 gi�-en indi�idual. An individual asked ro supply private or confidential data conceming himself shall be informed of: (a)the purpose and intended use of[he requested data within the collecting state agency,political 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 ro supply private or confidenaal data;and(d)the idenriry 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 mav�lace the no[ice reauired under this subdivision in the individual income tax or nrooertv tax refund inswetions instead of on those forms. Subd. 3. Access to data by individual. Upon request ro a responsible authority, an individual shall be informed whether he is the subject of stored data on individuals,and whether i[is classified as public,private or confidenaal. Upon his further request,an individual who is the subject of stored private or public data on indi�iduals 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 iu meaning,the data need not be disdosed to him for six months thereafrer unless a dispute or acrion pursuant to this sectiun is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of[he private or public data upon reques[by the individua►subject of the data. The responsible authoriry may require the requestin�person to pay the actual cosu of makine, certifying,and compiling the copies. The responsible authority shall comply immediately, if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,exduding Saturdays,Sundays and lecal holidays, if immediate compliance is not possible. If he cannot comply with the request within that time, he shall so inform[he individual, and may have an additional five days within which to comply with 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 private data conceming himself. To exercise this ri_�ht,an individual shall notify in writi�g the responsible authority describing the nature of the disagreemenL The responsible auihority shall within 30 days either: (a)correct the data found to bz inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,induding recipiznts named by the individual;or(b)notify 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 disclosed data. The determination of the responsible authoriry ma} be appealed 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 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: l. The information you fumish 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 �z-ith 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 ----11� t�� . U V •�A 7 � Add � �.� � V 11�J ` �� Z.. � Z�� Ciry S[ate Zip Phone I understand m ' ts as stated ove. Signature 6 � � � CHECK OFF LIST FOR ISSUANCE OF PERi'�ZITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: S 7 5 /V(�R7�� rERN/,/-�C� � P'ID: ' DESCRIPTION OF WORK: (?� p� t� i�� ----------------------------------------------------------------------------------------------------------------------- ZONING REVIEW BY: N /l4 DATE APPROVED: BUILDING REVIEW BY: DATE APPROVED: ��(� -c�� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ( No PLAN REVIEW Yes No � SEWER CONNECTION STATE SURCHARGE Yes _� No WATER CONNECTION INVESTIGATION FEE Yes I�To PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ---------------------------------------------------------------------------------------------------------------------- ZONING CHECK LIST Zoning District: No C �-I'�fr�� Fire Department: Post Office: School District: Lot Area: Sq.fr. Acres Wid h Depth Survey Submitted: Yes tio D te of Survey: Proposed Setbacks: Front (Lake): RiQht Side: Rear (Street): Left Side: Adjacent Structures: ��'etland: Building Height: Def. Hgt. Peal:Hgt. Lot Coverage: i Grading: Staff Approval Date: By: 'Council Approval Date: Septic: Staff Approval Date: By: Zoning File: # Resolution: #� Resolutio�Date: Shoreland District: Avg. Setback: Bluff Setback: � L.ot Coverage: E�isting Proposed Hardcover: 0-75' ! 75-250' 250-500' � 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): 7 BUILDING REVIEW CHECK LIST • � UBC: � ' 3 CONSTRUCTION TYPE: �//� Sq Footage $Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Garage x = x = TOTAL Estimated Construction Value: $ y�, �Vv� Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection yC Framing Fireplace Lawn Irrigation _�Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) _�LFinal Grading/Filling Electrical (State Permit) Other REMARKS(IN HOUSE): ------------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: ------------------------------------------------------------------------------------------------------------------------ REMARKS (TO BE NOTED ON PERMIT�: 8