HomeMy WebLinkAbout2001-P03706 - addn/remodel/repair � -� PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 P03706
Crystal Bay, Minnesota 55323 P@CI711t Typ2: Addition/Remodel/Repair
(952) 249-4600 Date Issued: 4�2�i2oo1
SITE ADDRESS: 575 Ferndale Rd N
WAYZATA,MN 55391
PID: 36-118-23-14-0001
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: ►cesicientiai
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: riumoing iviecnanic;ai rirepiace irrigaiion Eiec;iricai�siate�
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 2,673.75 Valuation: $ 400,000.00
Plan Review Fee: $ 1,738.03
State Surcharge Fee: $ 200.00
TOTAL FEE: $ 4,611.78
APPLICANT: Anderson Woodcraft Inc OWNER: 7 G& M M �AYTON
1438 85th St Nw 575 FERNDALE RD N
Buffalo, MN 55313 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISS[ON TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
ST TE O INNESOTA BUILDING CODE REQUIREMENTS.
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_ APPLICANT ITEE ISSUEDBYSIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
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,'I'otal Fee: $ y�o // Date Received: - -/G� ( %
Entered By: �7v Permit#: i=l�� _� �-_ -
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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 one) OWNER O QNTRACTOR
JOB SITE ADDRESS: �'�) Y�CJ�� 1�1 "�" ZIP: �
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NAME OF OWNER: �IVI+ � PHONE: (home�„�„��j
(work)
MAILING ADDRESS: ,_ ,��� � CITY:(����} ZIP: *j
CONTRACTOR: 1 l(V C� PHONE:
CONTACT PERSON: MOBILE/PAGER: �"Z. 'Z
MAILING ADDRESS: T , CITY:� l,O ZIP: 'F'►�'�(�
STATE LICENSE: # �
ARCHITECT/ENGINEER����,/'��� PHONE: Q� ���
MAILING ADDRESS: CITY: ZIP:
NAlVIE: REGISTRATION#
TYPE OF WORK: New Addition!� Accessory Structure
Move Remodel/Alteration Land Alteration
c n��!���c�� c
PROPOSED WORK d cribe in de ai �j�� � �(�t� l,�')[Cl-!
STORIES: Y SQ. FEET OF EACH FLOOR: l�J�'S'F� ` �ct1� � $l(oSF
NO. OF BED OOMS: O GARAGE STALLS: ATT. DET.
�
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ESTIMATED CONSTRUCTION VALUATION (excluding land): $ � ,
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 under nd t ' is not a permit and work is not to start without a
permit; and that the work will be in c danc wit e ap roved plan.
APPLICAI�IT'S SIGNATURE DATE:
NOTE! Parade o�Homes events require separate pernzit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
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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. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the purpose and intended use of the 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 to supply private or confidential data;and(d)the identiry of other persons or entiries authorized by state or federal law to receive the data.
This requirement shall not apply when an individual is asked[o supply investigative data, pursuant[o section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav olace the notice required under this subdivision in the individual income tax or orooertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon reques[to a responsible a�thority, an individual shall be informed whether 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 i�dividuals 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 ro him for six months thereafrer unless a dispute or action pursuant to this section is pznding or additional 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,certifying,and compiling the copies.
11ae responsible authority shall comply immediately,if possible,with any re4uest made pursuant to this subdivision, or within five days
of the date 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 the 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 concerning himself. To exercise this right, an individual shall notify in writing the responsib(e authoriry describing the nature of the
disagreement. The responsible authority shall within 30 days either. (a)correct the data found ro be inaccuiate or incomplete and attempt to notify
past recipients of inaccurate or incomplete data,including recipients named by the individua(;or(b)notify the individual that he believes the data
to be correc[. Data in dispute shal(be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authority may 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:
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. � Xou 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 a�encies 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
City State Zip Phone
1
I underst my rights state a o e.
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Sig re
6
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' ' � CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: S-1 S F e(2ns OAv� (L�� No
PID:
DESCRIPTION OF WORK: �p,p�-r-�p,J (Z,t,-w�•�2�.
------------------------------------------------ ---------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: 'c-('- Z.�{-p{
BUILDING REVIEW BY: DATE APPROVED: t-(--Z�(� 0(
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/' No
PLAN REVIEW Yes ✓' No SEWER CONNEC'TION
STATE SURCHARGE Yes � No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District: (Z(Z.-��
Fire Department: pu ,a--r-63 Post Office: �qH-Z,a,�q School District: �-�., c�
Lot Area: Sq.ft. �p G�,r.�G,�l Acres Width Depth
Survey Submitted: Yes p�- No Date of Survey: y-b-O S
Proposed Setbacks:
Front (Lake): Zop` Right Side: � 2.0.$
Rear (Street): ZS-jq.(o Left Side: � Zz•S
Adjacent Structures: /���' Wetland:
Building Height: Def. Hgt. (�. � Peal:Hgt. ��!�
Lot Coverage: (�,k
Grading: Staff Approval Date: '—' By: Council Approval Date:
Septic: Staff Approval Date: --- By:
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: /�O
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
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BUILDING REVIEW CHECK LIST
UBC: �Z'-3 CONSTRUCTION TYPE: �/�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ �-/(�p�(�Oo=�°
Inspections Required: Work Requiring Separate Permits:
Site _�(Plumbing Fire
Hardcover Removal �Mechanical Water Connection
X Footing ��e Sewer Connection
�_Framing �Fireplace �_Lawn Irrigation
�Insulation (Masonry) Other
oC Wall Board (Mfg.) _$-Well (State Permit)
oL Final 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�:
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CITY OF ORONO CALLED IN 5�`� 6 / // Z_Ci ,q,�
INSPECTION NOTICE . SCHEDULED �7 b 1 -�f��'� �'—
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OWNER CONTR. �,�I<�°C/L4GYT �.( �t%
TELEPHONE N0. � �� i ��C'��� �'� ��
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Q 02 FR,4MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATIGN 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
v 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
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR W{LL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContra t on site:
Inspector., � �
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �/,�-7 > /¢ir
INSPECTION NOTICE SCHEDULED �Z� -11'�j.3c.�
PERMIT N0. /��`��Z�-'7 O�% COMPLETED 30-o a
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TELEPHONE NO�!a'��e `��-� r��� c�U?�� -�--�'�J'7
� DESCRIPTION �n 7���
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y 03 INSULATIGN 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q O5 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FO�LOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p 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
OwnedContrac r on site: —
Inspector.�//���.��
While Copyllnspector's File Canary CopylSite Notfce
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTIC SCHEDULED �—�]�T' v�� 3 �
PERMIT N0. �� COMPLETED �. � 3�
ADDRESS -��S— l-P r/1 GEa.�_ l�'.� r(� .
OWNER CONTR. ��1��e� Sc►� GJa�c�C��y�.
TELEPHONE N0. l,P ��' � 7�-C� �_� �,1��'/eJ� �
� DESCRIPTION l��S °b`�� ��p �.�.
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP O6 PFOGRESS
� 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
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PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance. (952) 249-46�0
Owner/Contr c or on site:
Inspecto ���
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N �ICE SCHEDULED —I '2�I \``
PERMIT N0.��_ COMPLETED 't� ��v`�)
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ADDRESS —
OWNER CONTR. .
TELEPHONE N0.— LP I c� — � O C1 — � �0��
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� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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� 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 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES�NO
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INSPECTOR W{LL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContr tor on s' :
Inspector. �� �
White Copyllnspector's File Canary Copy/Site Notice
✓
DATE TIME
CITY OF ORONO CALLED IN ��,.
INSPECTION NOT /'' SCHEDULED - '
PERMIT NO. ( ���O� COMPLETED '�TJ� S: ��
ADDRESS .5�`_-� -f �— -�'%h_�'�Cc�_� /c�.X /V
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TELEPHONE NO. �D �c�- — ��C�J���c�-��
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0 LATION 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
v 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
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INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContra�or on site:
Inspector. �/ =�!�'� ���!'' �
White Copyflnspector's Ffle Canary CopylSite Notice
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N, I E —7� SCHEDULED
PERMIT NO. �� G � COMPLETED �'�%Z -�1 f'
ADDRESS � �� �v �Z���-� I� - �
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TELEPHONE NO.
� DESCRIPTION
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Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 5 FINAy, 14 SEWER HOOK-UP __D6 PROGRESS
� MO-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
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. n pH0T0 TAKEN
INSPECTOR WILL RETURN
❑ STOPORDER POSTED.CALL INSPECTOR '- CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlCon ractor on sit -
Inspector.
White Copy/lnspector's File Canary Copy/Site Notice