HomeMy WebLinkAbout2004-P07702 - addn/remodel/repair PERMIT
C;I Y O F O RO N O Permit Number:
2750 Kelley Parkway - PO Box 66 Po��o2
Crystal Bay, Minnesota 55323 PeCCTIIt Typ2: Addition/RemodeURepair
(952) 249-4600 Date Issued: ��i4�2ooa
SITE ADDRESS: 745 Ferndale Rd N
Wayzata,MN 55391
PID: 36-1 ig-23-i2-000�
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Pernut Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Pernlit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: i'ium�ing
NOTICES/REMARKS:
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FEE SUMMARY: Pernut Fee: $ 391.25 Valuation: $ 25,000.00
State Surcharge Fee: $ 13.00
TOTAL FEE: $ 404.25
APPLICANT: Patrick Hanily&Associates,Inc. OWNER: Karen Frey
P.O.Box 784 745 Ferndale Rd N
Excelsior, MN 55331 Wayzata,MN 55391
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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APPLICAN PERM E SIG TURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
� �otal Fee: $ �o�, Z S Date Received: 7-/3-D�
Entered By: _ _�� Pernut#: ,�q07ZnZ.
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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)
THE APPLICANT IS: (circle one) OWNER O CO TRACTO
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JOB SITE ADDRESS: ��S NO� f"��t� �: �S�J 1 1
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NAME OF OWNER: � ►� PHONE: (home) -0���
(work)
MAILING ADDRESS: ��S �C�Zri►� CITY: ZIP: �S'39 �
CONTRACTOR: • � .PHONE: �SZ, 3 't7i9 �
CONTACT PERSON: ' MOBILE/PAGER:S,p��_�Z-S�j(a
MAILING ADDRESS: ,O� I�.a�IC CITY: E�cip�� ZIP: �3�j�
STATE LICENSE: # p
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration � Land Alteration
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PROPOSED WORK(describe in detai�: ST. �Gd'�'O�V�.• ��. �
�r��C� C��.�.' '
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (ex ): $� ��-�
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 understand this is not a permit and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
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APPLICAl�"T'S SIGNATURE: . DATE: IZ o
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
City Counci160 days prior to the event. Non permitted events will not be allowed.
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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
sha11 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 coasequence arising from his supplying or
refusing to supply private or confidenUal data;and(d)the idznary of other persons or entides authorized by srace or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investieative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav olace the nodce reauired under this subdivision in the indi��idual income tax or orooerN tax refund
instructions 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 srored data on individuais, and whether it is ctassified 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 shown the data without any charge to hun 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 to him for six months thereafrer unless a dispute or action pursuant to this section is pending or additional data on the individual has been
collected or created. The responsible authority shall provide copies of the privare or public data upon request by the individual subject of the data.
The responsible authority may require the requesting person to pay the actual cosu of making,certifying, and compiling the copies.
The responsible authority shall compty immediately,if possible,wiLh any request made pursuant co this subdivision,or within five days
of the date of the request,excluding Saturdays,Sundays and legal holidays, tf 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 Sa[urdays, Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individua(may conrest the accuracy or completeness of public or
private data conceming himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authoriry shall within 30 da}s either. (a}correct the data found to be inaccurate or incomplete and attempt ro notify
past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy 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 may be appealed pursuant to the provisions of the administrative procedure act rela[ing
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 ma}� 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. 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 aaencies 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 hi.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
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C�n, • State Z�p Phone
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I understan rights as stated above.
Signature
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� �" CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ��r pVJ/Z�N f-"f�/u4�!�
PID:
DESCRIPTION OF WORK: �/��45�lZ � �
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ZONING REVIEW BY: DATE APPROVED:
BUILDING REVIEW BY: DATEAPPROVED: 7-l3 -0�
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 ' � , �io. PARK FEE
SAC Yes No; SITEINSPECTION
Number of SAC Units OTHER (sgecify)
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ZONING CHECK LIST Zoning District: �� G(.t?�b./'�
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes o Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adjacent Structures: Wetl d:
Building Height: Def. Hgt. Pe Hgt.
Lot Coverage:
Grad;r.g: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setbac : 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):
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BUILDING REVIEW CHECK LIST
UBC: fG�� .• CONS'1'RLt�TLON TYPE: -, v�
.
Sq Footage $ Per Sq Ftg
Base�ent, � x =
1st Floor ' x = '
2nd Floor x =
Garage x =
R =
TOTAL
Or
Estimated Construction Value: $ 2 5`dDc� r
Inspections Required: Work Requrring Separate Per�nits:
Site �,Plumbing Fire
Hardcover Removal Mechanica.l Water Connection
Footing Septic Sewer Connection
_�Framing Fireplace Lawn Inigation
�Insulation (Masonry) Other
�Wall Board (Mfg.) Well (State Permit)
L Final Grading/Filling Electrical (State Permit)
Other
REMARKS(IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMIT):
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DAT/ TIME ✓
CITY OF ORONO CALLED IN !D�`�
INSPECTION N ��7�� SCHEDULED D- -O��
PERMIT NO. cornP�ErEo
ADDRESS � _-ir—�' �
OWNER CONTR.
TELEPHONE NO.___ ���0� �(f�c� ��D')
� DESCRIPTION /-� '_'
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/N/ETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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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
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J �0 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED � PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED - ISSUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
'7 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS.
Ca11 for the n xt inspection 24 hours in advance. (J52� 249-4600
OwnerlCo �ite:
,
Inspector. �
White Copyllnspector' File Canary CopylSite Notice