HomeMy WebLinkAbout2005-P09191 (in-ground pool) PERMIT
CITY• OF�ORONO
Permit Number:
2750 Kelley Parkway- PO Box 66 P09191
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952) 249-4600 Date Issued:
9/20/2005
SITE ADDRESS: 1070 Ferndale Rd W Unit#
Wayzata,MN 55391
PID: 02-117-23-43-0002
DESCRIPTION:
Proposed Use: Residential
Census Code 329
Permit Class: Building
Permit Type: Accessory Struchzres Permit Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate permits required: Electrical(state)
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 643.75 Valuation: $ 50,000.00
Plan Review Fee: $ 418.44
State Surcharge Fee: $ 25.00
TOTAL FEE: $ 1,087.19
APPLICANT: Jyland Distinctive Homes OWNER: Timothy&Rosie P Owens
401 E.Lake St 1070 Ferndale Rd W
Wayzata,MN 55391 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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AP ANT PERMITEE SIGNATUR ISSUED BY SIGNATURE
I
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page ]
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Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please pri��t all information)
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THE APPLICANT IS: (circle one) OWNER O ONTRACTOR�
JOB SITE ADDRESS: ����c +=�� ��:ict i,�, 2�- c.v. zlr: �S ��'-1 �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Z'0S �T10 If yes, a s�ecinl event permit is reguir�ed tivith Police Department and Clty Council app�roval
60 dnys prror to the event. Slnrttle bars service tivill be i�eqttir�ed au�less applicant demonstr�ates
sirff cient on-site parking rs available. Non-permitted events lvill�1ot be allowed.
NAME OF OWNER: I 1�')') �-� �G51�- ��'� ��S PHONE: (home) ��� `-�7� ' `f a 3�
(work)
MAILING ADDRESS: v��s� n���' �� ' CITY:Sh�e�-�=a�°� ZIp; �S�3 �
CONTRACTOR: ��l �GLvI� 7lSt"I v1 C�"l v�. f�vYv(C�, (v►�HONE: �'1�� •'-f��--f �(0 00
CONTACT PERSO : `�j��k� �� ��% Y'1 MOBILE/PAGER: �1 a � �-SU �-{pO I
MA�LING ADDRESS: �-{p I �rr,�S� L-G-I<� �1' CITY: l.t�- za- t�i..ZI�: �S �o �
STATE LICENSE: # �C.— ����-1 coq,2� EXPIRATION DA E: 3%3���Oo�
ARCHITECT/ENGINEER: �'aY rrte�.�1 O�'\ t�C ►'h �tC c-{�pHONE: (o I � 33� � y� -�14
MAILINGADDRESS: a75i'Ytar�l�e•i� S`T- CITY: Nlivi►�er;�Pt>I�s Zip; 55�-FOS
NAME: `Ti n� Nlc �l e c� j REGISTRATION: # ot�l1(��i
TYPE OF WORK: New �_ Addition Accessory Structure �_
Move Home Remodel/Alteration
PROPOSED WORK(describe in detai�: Q��, �, T�R i2�C� + �`�r� �� C,
S'I'ORIES: � SQ.�'EE'�'OF EACH FL,OOR:
NO. OF BEI)ROOMS: � GARAGE STALLS: A'I'TAC�-IED� DETACHED_
ES'TIIWIATEI)CONST�2UCTION VALUA'�ION(excluding lanci): � �O , Ob�
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 rdinances and codes ofthe City and with the State Building
Code;that I understand this is not a permit and ork is not to start w' ut a per-mit;and that the work will be
in accordance with the appro��ed plan. �
APPLICANT'S SIGNATURE: !+ ��'� �J`--�ATE: � ��' d S
31
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Sec13.04 RIGHTS OF SliBJECTS OF DATA
Subd. l. 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.askecLtasupply_pri.vate.or confidential.dataconceminghimselfshall be _ _ ________._�__
informed of`. (a)the purpose and intended use of tl�e requested data�vithin 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 identity of other persons or entities authorized by sta[e or federal law to receive d�e data. This requirement shall
not apply when an individual is ashed to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue may_place the notice required under this subdivision in the individual income tax or propertv ta�refund
instructions instead of on those forms.
Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be infonned whether he is the subject of
srored data on individuals,and whe[her it is classitied as public,private or contidential. Upon his further request,an individual who is the subject of
stored private or public data on individuals sh111 be shown the data without any char�e to him and,if he desires,shall be infonned of die content and
meaning of that data. After an individual has been shown fhe private data and intbrmed of its meaning,the data need not be disclosed to him for six
months thereafter unless a dispute or action pursuant to[his section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible autlloriry
may require the requesting person[o pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,�vith any request made pursuant to this subdivision,or�a'ithin tive days of
the date of the request,excludin�Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he canno[comply with the request
within that time,he shall so inform the individual,and may have an additional five days within�vhich to comply with the request,excluding 3aturdays,
Sundays and legal holidays.
Subd.d. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
concerning himself. To esercise this right,an individual shall notify in�vriting the responsiUle authority describing the nature of the disagreement. The
responsible authoriry shall widlin 30 days eitlier. (a)correct the data found to be inaccurate or incomplete and attempt to notity past recipients of
inaccurate or incomplete data,inciuding recipients 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 decermination of the responsible audioriry may be appealed pursuant ro the provisions of the administrative procedure act relating to
conCested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to infornl you that your request
for a permit or license from the Ciry of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
L The infonnation you furnish will be used to determine your qualification for the pennit 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 ►ocal, 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. 1.i.04(available upon request)to review private data on yourself.
6. I'our full name is required to process this application or permit.
�a�-f- �} _ C a-� I Su ►�
First 1�Tiddle Last
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aad��ss
(.��.�,t��r:�. , �vl I�J 55��i I C�Sa��o�- � �o 0
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Cih State "I,io Phone
i understand my righ as stated ai�ove.
a.Qn��4 � �;.��---,,
Signaturc -
.i?
BUILDING REVILW CHECK LIST
�C� � CONSTRUCTION TYPE: —
Sq Foo[age $ Per Sq Ftg
Basement x _
lst Floor x =
2nd F1oor x _
Garage R =
x =
TOTAL
Estimated Construction Value: $ SD,000 �'
Inspections Required: `Vork Requiring Separate Permits:
S ite Plumbing Fire
Hardcover Removai Mechanical Water Connection
_�Footing ` Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit}
—� F�� Grading/Filling �_Electrical (State Permit)
O[her
REMARKS (IN HOUSE): � ~ �
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RE'VIEW BY OTHERS: DAT'E:
Access: Existing New
Access Approval: Date gY:
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REVIARKS (TO BE NOTED ON PERi��fI1�:
8
• , .
CHECK OFF LIST FOR ISSUAI�ICE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: I o�o F'Ci�O� �� G�es T
PID:
DESCRIPT'ION OF WORK• a, r , �n,�R,,q c,c.r -t ^�-��`'�^�g '� s
__�
ZO.vI�1i G REVIE�V BY: DATE APPROVED: 9•zy o 5
BUILDI�i�'G REVIE�V B . DATE APPROVED: c� -Lea-o ��
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes !/' No SEWER CO�tNECTION
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No �/' PARK FEE
SAC Yes No [/ SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONI�IG CHECK LIST Zoning District: Nd G�-rtru'�C �i¢y SH�"�o'� Q�-��rN/+-(
,.�v S r'r'L: ��
Fire Departmen[: Post Office: f Schoo�Dis[rict: �
Lot Area: Sc.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Stree[): t Side:
Adjacent Structures: etland:
Buildin; Hei�ht: Def. Hgt. Pe - Hgt.
Lot Covera�e:
Grading; Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Da�e:
Shoreland District:
Av�. Setback: B1 ff Setback: I.ot Coverage:
E 'stine Proposed
Hardcover: 0-75 y
7�-250'
2�0-500'
�Oa-104fl'
Hardcover Variance Required: Yes h Date of Council Approval:
RE�iARKS (in house):
�� p,P ✓
CITY OF ORONO CALLED IN �(/ E//�� TIME
INSPECTION NOT CE SCHEDULED M
PERMIT NO. ��� COMPLETED w ,
ADDRESS f (���7 C� ���� /� �C�
OWNER CONTR. �
TELEPHONE NO. l - - S�
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� DESCRIPTION ' C��� �CJC7`�/N�S � ' �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE R�MOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
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 SEP FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YO _YES_NO
� COMMENTS:
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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLET�E
W ❑ ORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPOR RY
� BEFORE COVERING
PERMAN NT
❑CORRECTUNSAFECONDlTIONWITHIN HOURS. ;� pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 952 �49-46QQ
� �
OwnerlContractor on si e:
Inspector. � 7' / �
White Copyllnspector's File Canary CopylSite Notice