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Home My WebLink About2006-P09544 - addn/remodel/repair . PERMIT CITv OF ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: po9544 Crystal Bay, Minnesota 55323 Permit Type: Addition/xemodel/Repair (952) 249-4600 Date Issued: 1/30/2006 SITE ADDRESS: 1570 Fox St Unit# Wayzata,MN 55391 PID: 02-117-23-32-0007 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Census Code 434 Permit Class: Building Permit T e: Addirion/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair YP DETAILS: Approved perresolution#: Separate permits required: Plumbing � Electrical(state) NOTICES/REMARKS: Remodel 2 Baths FEE SUMMARY: Permit Fee: $ 391.25 valuation: $ 25,000.00 Plan Review Fee: $ 254.31 State Surcharge Fee: $ 12.50 TOTAL FEE: $ 658.06 APPLICANT: Yerigan Construction OWNER: Randy&Dorset Kurth 27741 University Ave NE 1570 Fox St Isanti,MN 55040 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. � � � , , �� . � ��,i '� l,L1 //�� -�APP�ICANT PERMITEE SIGNAT ED E3Y SIGNATURG Copies: 1-File(Sig�iatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 i � � Total Fee: $ ��"" � ` �� Date Received: � "�'- t��" , Entered By: , � �''''"� �,�3��,�, Permit#: _�� [%��L��, CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all infor�nation) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: �,j 7(� 1 �' � ZIP: `� ^'%' Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � NO If yes, a special even(permit is regzrired with Police Department ar�d City Council appr•oval 60 days pr•ior to the event. Shuttle birs service will be reqi�ired trnless applicant den�onstrates sz ff cient on-site parkir�g is available. Non permitted events wi11 not be allowed. NAME OF OWNER: � i�_��rt��-.. PHONE: (home)� S� � �� ,.�.,�- ?� ':';� (work) MAILING ADDRESS: y�cr M e CITY: (J.p�, � ZIP: CONTRACTOR: �'�� ,-��,��, C c�<��`��r� t�1.r �y „�-_., PHONE. �7 i� ' ._ ,� J f -�� CONTACT PERSON: ,�C`,� `� C�t;`..~ �,h�, , ; MOBILE/PAGER: ;�� ; �J �l C� MAILING ADDRESS: �'� "��:.� ; )r, ,� , .:, �' CITY: I ZIP: �'� STATE LICENSE: # �: - � EXPIRATION DATE: ARCHITECT/ENGINEER: /V� .r i ��•�� M�,,-�=� PHONE: ;�� ,� • 3 �f I � �J�SI MAILING ADDRESS: �-�;-� �-; t� '�-�} �, CITY: - :�;; : ZIP: � NAME: REGISTRATIO : # TYPE OF WORI�: New Home Addition Accessory Structure Move Home Remodel/Alteration(ie: Siding, Windows) � PROPOSED WORK(describe in detai�: ��y,�;�, , d� % � ' �� ; ��r, `: STORIES: SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): $ � �,:��:.� ' I hereby apply for a building pennit 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 pennit;and that the work wi11 be in accordance with the approved plan. /] l ',� � ! APPLICA.�iT'S SIGNATURE: �� f i /�- DATE: ' ' � �� /,� i , ' . , 31 � 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 conceming himself shall be infonned 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 identity 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 mayplace the notice required under this subdivision in the individual income tax or property tax refund insttuctions instead of on those fonns. Subd.3. Access to data by individual. Upon request to a responsible authonty,an individual shall be infotmed whether he is the subject of stored data on individuals,and whether it is classified as public,priva[e 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 him and,if he desires,shall be infornied of the content and meaning of that data. After an individual has been shown the private data and infornted of i[s meaning,the data need not be disclosed to him for six months thereafter unless a dispute or action pursuant to this section is pending or additional data on the individttal 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 authority may require the requesting person to pay the actual costs of making,ceitifying,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,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request within that titne,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 wri[ing the responsible authority describing the nature of the disagreement.The responsible authority shall within 30 days either: (a)con�ect 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 disclosed only if the individual's statement of disagreement is inclttded witlt 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 infornl 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 require that the City deny the pern�it or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested pemiit 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 pemlit. Eirst Nliddle Last Address C�� State Zip Phone I understand my rights a�st ted above. , '/ ��,'� � SignatuYe �- % ` 32 CHECK OFF LiST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: I 5�o F o x s-c-: PID: DESCRIPTION OF WORK: (Z.�wwoct z ,3 A� 5 ZO�tG REVIE�V BY: DATE APPROVED: ,��/� BUII�DING REVIE`V BY: DATE APPROVED: I-z`-�6 FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes / No PLAN REVIEW � Yes ✓ No SEWER CO�TNEC"ITON STATE SURCHARGE Yes ,� No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) -----------------------------------_—__--------------------------------------------------------------------------- ZOtvI�tG CH�CK LIST Zoning District: N v c��vc�Q U Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Dep[h Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Froat (Lake): Right Sid : Rear (Street): Left Si e: Adjacent Structures: Wetland: Buildin� Heiaht: Def. Hgt. Peak Hgt. Lot Covera�e: Grading: Staff Approval Date: B : Council Approval Date: Septic: Staff Approval Date: By, Zoning File: # Resolution: �# Resolution Date: Shoreland District: � Avg. Setback: Bluff Setback:l I.ot Coverage: Ezisting I Proposed Hardcover: 0-75' � 75-250' 2�0-500' 50a-1004' Hardcover Variance Required: Yes No Date of Council Approval: RE`�L4RKS (in house): 7 BUII,DING REV�W CHECK LIST �C� - I��3 CONSTRUCTION TYPE: �N Sq Foo[aoe $ Per Sq F[g Basement x _ lst Floor z = 2nd Floor x = Garaae z = x = TOTAL Estimated Construction Value: $ 25,poc7 °� Inspections Required: �York Requiring Separate Permits: Site �_Plumbing Fire Hazdcover Removal Mechanical Water Connection Footing � Septic Sewer Connection _� Framing Fireplace Lawn Irrigation �Insulation (Masonry) Other Wall Boazd (Mfg.) Well (State Permit) —� F�� Grading/Filling � Electrical (State Permit) Other REMARKS (IN HOUSE): � --------------------------------- RE'VIEW BY OT�iERS: DATE: Access: Ezisting New Access Approval: Date gy; -------------------- REI�IARKS (TO BE NOTED ON PERil�II1�: 8