HomeMy WebLinkAbout2004-P07547 - new structure ' ' PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P07547
Crystal Bay, Minnesota 55323 Permit Type: New sm►�ture
(952) 249-4600 Date Issued: 6i23i2oo4
SITE ADDRESS: 865 Ferndale Rd N
Wayzata,MN 55391
PID: 25-118-23-44-0002
DESCRIPTION: UBC Occupancy A3
Construction Type VN
Proposed Use: Industrial
Census Code 319
Permit Class: Building
Permit Type: New Structure Pernut Sub-type(s): Church
DETAILS:
Approved per resolution#: 2920
Separate pernuts required: riumoing iviec;nanicai vJaier i,onnec;non inigauon cieciricai(siaie j viner-��HC,i,redii�+
Units-SAC Paid#11755-08/16/99)
NOTICES/REMARKS:
i.T___./�l___.__1_ T__'l./�.. /ll]T___"_]_a"_"'
FEE SUMMARY: Permit Fee: $ 6,868.75 Valuation: $ 1,400,000.00
Plan Review Fee: $ 4,464.53
State Surcharge Fee: $ 660.50
TOTAL FEE: $ 11,993.78
APPLICANT: Harlan Construction Services Inc. �WNER: ST Edwards Episcl Church
7456 Basswood Lane 865 Ferndale Rd N
Greenfield, MN 55373 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE TI�REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
M SOTA BUILDING CODE REQUIREMENTS.
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A LI A T PERMITEE SIGNA"fURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Requirec!). 1-Applicant, 1-Monthlv Revorts, 1-Assessin�, 1-Finance Page 1
A •
Total Fee: . � /� � %�3 � ��`�J Date Received: �'Z�'C1`
Entered By. �l�v� �'C7 Permit#. �]
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CITY OF ORONO - BUILDING PERMTT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all infor�nation)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: S�S t�1 ocZrl-1 FE�nI�JN�.E R.L� ZIP: �5'J�t 1
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes ❑ No If yes, n special event perm.it is rec�uired witli Police Depart»ze�zt and
City Coccncil app�•oval 60 days p�-ior to the event. Non-pernai.tted
eve�zts will noz be allowed.
NAME OF OWI��ER: ��� �`a�T1�E.Cs�n1►=�,���,�R PHOI�TE: (home)
� 4 `' (work)�Z-q 73-Z.Z6 Z
MAILINGADDRESS: IZS � �.1AYZATA E��vD CITY: I•�IAYZATA ZIP: �S�`1 �
CONTRACTOR: ���.t��a Co.JS�c.Tto�► ��.e.�fie.��, ��. PHONE: 7G3-41�-3353
CONTACT PERSON: �O� t-I�+.►Z�e•r.1 MOBILE/PAGER: 7103•G�7-Zo b 3
MAILING ADDRESS:�45L ��S Wauv u� CITY: �-,fZ��J �i�;� ZIP: '� 3
STATE LICENSE: $� GOMMF"1ZLIAl_ EXPIRATION DATE:
ARCHITECT/ENGINEER: R�C'LI�� C���ta�I PHONE: �SZ-o4S-260�
MAILINGADDRESS: IZq00 PoRs�h.►n AVE S CITY: �,�r�,.►�,J�t�E ZIP: 55337
NAME: �IA�I TL., �d�..1,.iso..� REGISTRATION# I SOSO
TYPE OF WORK: New _ � Addition Accessory Structure
Move Home Remodel/Alteration _�
PROPOSED WORK(describe i�z detail): t��rJ L1�aoU �"IrlAwt� GIs�uR.c,H �LT ai.l
�x���t�G ch� wn� a�r� �dk fliLEt.k*�? f-'��►.11L Fl.t�oR. F�.1�.�,0.�
STORIES: � SQ.FEET OF EACH FLOOR: ��I°ID
NO. OF BEDROOMS: J GARAGE STALLS: ATTACHED � DETACHED �
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � 'g'DC� �o
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 rk is not to start without a permit; and that the work will be
in accordance with the approved plan.
APPLICAl\TT'S SIGNATURE: DATE: S�2�"�-
9
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Sec.13.04 RIGATS 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 fonh in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himseif shalt be
informed of: (a)the purpose and intended use of the requested data within the collecung state agency,poli[ical subdivision,or statewide system;(b)
whether he may refuse or is legally required to supply che tequested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities au[horized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply investigacive data,pursuant to section 13.82,subdivision 5,to a law enForcement officer.
The commissioner of revenue mav place the notice required under this subdi��ision in the individual income tax or prooertv tax reFund
instructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority,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 rcquest,an individual who is the subject of
stored private or public data on individuals shaU be shown the data without any charge to him and,if he desires,shatl 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 nced not be disclosed to him for six
mon[hs thereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been coilected or created. The
responsible authority shall provide copies of the private or puUlic data upon request by the individual subject of the data. The responsible authoriry may
require the reques[ing person to pay che actuai cos�s of making,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
da[e of the request,excluding Sa[urdays,Sundays and legal holidays,if immediate compliance is not possible. (f 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 responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days either: (a)caTect the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in
dispute shall be disdosed 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 administra[ive 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. You may refuse to supply data,but refusal may rec�uire 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
I understand my r' ts sta d a ve.
5ignature
1�
' . .
CHECK OFF LIST FOR ISSUANCE OF PERMITS
' FOR OFFICE USE ONLY
ADDRESS OR LEGAL: `�6S r L���Ru �.w�,p �v�
PID:
DESCRIPTION OF WORK: I�V w �t-e.(.� �.., =x�s,—t�.t 6 �.v ,4 �.�
--------------------------------- ----- ----------------------------------------------------------------------------
ZONING REVIEW BY: DATE APPROVED: 6—Z3 �o Y
BUILDING REVIEW BY: DATEAPPROVED: G -z 3 ���
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes f No
PLAN REVIEW Yes � No SEWER CONNECTION
STATE SURCHARGE Yes� No WATER CONNECTION
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No� SITE INSPECTION
Number of SAC Uni.ts OTHER (specify)
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ZONING CHECK LIST ZOIlUt� D(St!'iCl: R""�'J
Fire Departrnent: Post Office: School District:
Lot A�•ea: Sg.ft. Acres Width Depth
SLu-vey Subn�i.tted: Yes�_ No Date of Sun�ey: �- Z"3
Pr•oposed Setbacks:
Front(L,ake): Right Side:
Rear(Street): Left Sirle:
Adjaceiit Structieres: Wetla�:d:
Buildi�:g Heig/ir: Def. Hgt. Z ro � Peak Hgt. 3 8�
't0 Lot Covernge:
1' y.�
j�O
G�p� Gradirtg: Staff Approval Date: By: Couricil Approval Date:
Septic: Staff Approva!Date: By:
Zonirig File: # l93'z-�� Resolc�tioic:# Resolc�tioiz Date:
Shoreland District:
Avg. Setbnck: Ble�ff SetUack: L.otCover•age:
Existing Proposed
Hnrdcover•: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Re�uired: Yes No Dnte of Council Approval:
REMARKS(in house):
31
B UILDING REVIEW CHECK LIST
UBC: ____� N� - 3 CONSTRUCTION TYPE: v�
S9 Footnge $Per Sq Ftg
Basenteitt x -
1 sr Floor � -
2nd Floor a -
Garage ,r =
� -
TOTAL
0
Estinrated Co�zstruction Vali�e: $_1 `'�V v,�O0 �
L:spections Required: Work Requiring Separate Permits:
Site _�PlumGi�ig Fire
Hardcover Removal .�_Meclia�iical _�Water Connectiai
_�Footing Septic Sewer Connectiai
_�Fra�riing Fireplace �Lawn Irrigntiat
_,�lrtsctlatiai (Maso�i�y) Ot/2er
_.� Wall Board (Mfg.) ' Well(State Per�nit)
�` Final Gradi�ig/Filling _,G�Electrical(State Perniit)
Other
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REMARKS(INHOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approvnl: Date By:
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REMARKS (TO BE NOTED ON PERMIT):
32
��'" DATE TIME �
CITY OF ORONO CALL-Eo iN 7 � ,
INSPECTION NrQ TICE SCHEDULED --Z�� �. �-
PERMIT NO. �-Jl�: 7� �'"' V� COMPLETED
ADDRESS ��f'�����''�'►'� r�If�' �� � �
OWNER CONTR. �--�a r ��rrY"��
TELEPHONE NO. � ( Z- - z��S�-�G� I I C�� �
� DESCRIPTION �U�U�-,
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP
r09 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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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContr ite:
Inspector.
White Copyllnspector's Fil Canary CopylSite Notice
DATE TIME �
CITY OF ORONO CALLED IN 7 a'� �� ,,��
INSPECTION N SCHEDULED —�- __<__✓���
PERMIT NO. -� COMPLETED
ADDRESS ��1c UXIC- F-('►'1 /�/.
OWNER CONTR. �/GZ� ��''�
TELEPHONE NO. � ��Z � Z-Z cS� 69�1
� DESCRIPTION ��
l� Oi FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/NJETLANDS
�
O 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
i09 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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� ❑C�FRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
� CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Call forthe next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContra n 'te:
Inspector.
White Copyllnspector's e Canary CopylSite Notice
DA TIME V
CITY OF ORONO CALLED IN —�
INSPECTION N £ SCHEDULED 7/S�� :Da
PERMIT NO. J COMPLETED
ADDRESS �� � 0��
OWN ER CONTR.9���2iLQl�i1
TELEPHONE NO. �O�Z �7S D / ��
� DESCRIPTION �� � �
l� 01 FOOTING 11 MECHANICAL I 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 05 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
� 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� V�/ORK SATISFACTORY:PROCEED C i PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED C; ISSUE CERTIFICATE OF OCCUPANCY
O ❑Ct�RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
C INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the next� spection 24 hours in advance. �952� 249-46Q�
Owner/Contract si :
inspector. �
White Copyllnspector's File Canary CopylSite Notice