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HomeMy WebLinkAbout2000-P02394 - pool � � PERMIT CITY OF ORONO 2750 Kelley Parkway - PO Box 66 Permit Number: po23aa Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures (612) 249-4600 Date Issued: si9ioo SITE ADDRESS: 1540 Fox St WAYZATA,MN 55391 PID: 02-117-23-32-0003 DESCRIPTION: Construction Type VN Proposed Use: Census Code 329 Permit Class: Building Permit T e: Accesso Structures Permit Sub-type(s): Building-Pool YP rY Accessory Structure DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SU1111MARY: Permit Fee: $ 209.25 Valuation: $ 12,000.00 ��.,���,-� R-e���.,� i�s.`(� State Surcharge Fee: $ 6.00 TOTAL FEE: $ 351.23 APPLICANT: Pooi,& sPa corrcEPTs OW NER: J A NOLarr&J a rroLarr 6415 WAYZATA BLVD 1540 FOX ST ST. LOUIS PARK,MN 55426 WAYZATA MN 55391 THE LJNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPEC[FIED AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. `—] �_ —� �_. APPLI ANT PERMITEE 1 NATURE ISSUED BY SIGNATURE ��;j�/ L..��'�) Copies: City,Applicant,Assessor,Finance Page 1 � ` Total Fee: $ _ _`S/ 3 Date Received: '�����O� Entered By: ��y; Permit#: �}p�^3 G CITY OF ORONO - BUII.,DPtG PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: J� `�� �'G� .�/����J ZIP: 5 S.3L%f NA1�fE OF OtiVNER: .�Gl�l�l� JGff'�I( �GLfj"!� PHOi�tE: (home) `f 7 3 -G.3 7� (work) MAII..�1G ADDRESS: 1 S �v �c x S T���T CITY: c%�c�sl� zIP: � '3�' CONTRACTOR: �'��GL �SG'� GGl�IGE-�� PHONE: �76 l/S� COi�1TACTPERSON: �?cSS �'c-��.5�'��MOBILE/PAGER: ��fS --i�'/ Z . M�iILI11G ADDRESS: 64�l5� w�t�l�t��l4C.�l� CITY: S i����^�ZIP: SS���' . STAT'E LICEl�SE: # ��/� ��.Z�3 ARCHTTECT/ENGINEER: PHONE: 1�iAILII�'G ADDRESS: CITY: ZIP: N�,�: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: �-��7�' �Gc� � STORIES: SQ.�'EET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTII�IATED CONSTRUCTION VALUAT'ION (excluding land): $�?;GGc; � �' _ I hereby apply for a building permit and I acknowled�e 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. APPLICANT'S SIGNATLTRE: l`� -� � DATE: zE' �G NOTE! p�rade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. i � Szc.13.0�i RIGHTS OF SUBJECTS OF DaTa Subd. 1. Tvpe of data. The righcs of individual on w�.�che daci is s.ored or co be smred shall be as sec fonh in this secrion. Subd.'_. Information reqirired to be�ven individual. ?.r individ.:al asked to supply privace or confidendal dam conceming himself shal! be informed of: (a)the purpose and incended use of che czques�i�a Wi�hin'''--colleccing'snrr agency,potidcal subdivision,or sratewide rystem: (b)whether he may refuse or is legally requiced[o supply the reques.�:aci:(c)��+ciown coasequence arising from his supplying or refusing to supply priva�e or conndenrial data;and(d)the idznrity of ocher persoas or e-�es au[he��by ssate or federal law to receive che dara. 'Ihis requiremeoc s6a11 not apply whzn an individual is asl:ed to supply in�•esrigadve daei.,�'suanc to s.-=�on 13.82, subdivision 5, co a law enforcemenc ofFicer. The commissioner of re�e�u mav pla-�the nodc� r�-�-� und�-��s subdivision in the individual income tax or propem taz refur.d instrucdons instead of on �hose forms. Subd. 3. Aecess to data b�individuaI. tipon requesc�i r:sponsib?e aurhoriry,an individual shall be informed whether he is the subjecc of stnred dara on individuais,and whe:her it is class�ed as pubiic. :-va�e or cen:.dendal. lipon 6is further request, an individual who is the subjecc of stord privace or public dara on indir•iduals shall be shown[he c3 wichout aay caarge tD him and, if he desires, shall be informed of the concent and meaning of chat data. After an individual has bezn shown rhe:-•ra�.dat�a=d iniormed of its meaning, [he data need not be disclosed ro hun for six monchs rhereafter unless a dispute or acrion pursuanc to �his scr��is per.c�:.3 or addidooal dara on the individual has beea collected or creaced. The responsibte authoriry shall provide copies of che priva�e or pubi:='_:ca upor..�,sest by the individual subject of che dara. Tne responsible au�horiry may require the requesring penon to pay [he acalal cos�s of maki:.=.:errifYin�.3"-d compiling che copies. The responsiblz auchoriry shall compiy unmedia[ely, if=:�:ble, w:,_^.3^.y requesc made pursuant to this subdivision,or wichin five days of the dar`of cha request,excluding Saturdays,Sundays and legsl holi.'s;s,if is.r-.�3m compliance is not possible. If he cannot compty with the requesc wi[hin cha�cime,he shall so inform che individuai,snd may have a:.-�:�irional fi��e days wi[hin which to compiy wi�h the request,excluding Saturdays, Sundays and legal holidays. Subd.4. Procedure whea data is not accurate or com_iete. An ir�':v:dual may contest[he accuracy or compleceness of pubiic or pri�•ate ' data concorning himself. To exercise�his righ[,an individual shall=_c:'y in wr.==��:e responsible auchoriry dzscribing[he nacu:e of the disagreemeac. . The responsibla authoriry shall within 30 days ei�`:er. (a)correct-�'_ira four_3�be inaccurare or incomplece and aaempc[o nodfy past recipients of inaccura�e or incomplete dac�, inctuding recipiena named by [he i�:_•ridual; or(b)eodfy el:e individual chat he believes che dara to be correct. Data in dispu�e shall be disc'.osed only if che individual's statement of c_�_reemenc is i.cluded wich the disclosed data. The de�erminadon of the responsible au[horiry may be �_ealed pu:ss3:.c to the provisions of the adminisaarive procedure act relacing to contested cases. DAT� PRl�'ACY �,DVISORY In accordance wich M.S. 13.04, Subd.2, "Riah��:subjer's ot data", we would like to inform you that your reauest for a permit or license from che Ciry of Orono or �.� oi its de�z-tments may require you to fumish certain private or confiden[ial information. You are no[ified that: 1. The information you furnish wiil be use�:o decer—�....:=e your qualification for the perm.it or license requested. 2 You may refuse to supply da�a, but re:.:�al may :�quire that the Ciry deny the permit or license. ;. The information may be shared with ot.==Iocal, stac�or federal a�encies to the extent necessary to process the pemut or license. .}. If your requested permit or license re.^_:res Co�.cil action to approve, some information may become public. j. You have certain ri�hts under N1.S. 1:.�� (ava�?able upon request) to review private data on yourself. 6. Your full name is required ro process :� appl:�on or permic. First �tiddla Lasc ?�ddress Ciry S`�.s Zip Phone I understand my ri�hts as stated above. � � � c�9�O _ Signacure � • CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: /S yc� F-�� snu.�7' PID: DESCRIPTION OF WORK: v v � — �pulc,� cx �snn� c� ZO�iI�i'G REV�W BY: DATE APPROVED: S-3 -o0 BUILDTi�1G REVIE`V BY: DATE APPROVED: .5 - 3-v� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes =� No SEWER CONNECTION STATE SURCHARGE Yes / No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ZOt�tI��1G CH�CK LIST Zoning District: GZ/Z. • I� Fire Department: (.� Post Office: (�ca� School District: (�2e�N� Lot Area: Sq.ft. ��1��� Acres Width Depth Survey Submitted: Yes ..c No Date of Survey: vN �< <-�-� Proposed Se[backs: Front(Lake): ZZ� � Right Side: Z'3 � t Rear (Street): I t�5� � Left Side: Z L v` t Adjacent Structures: 1 O S' � Wetland: N�l� Building Height: Def. Hgt. — Peal:Hgt. Lot Coverage: — Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: N � . Zoning File: # Resolution: # Resolution Date: Shoreland District: Avg. Setback: Bluff Setback: L.ot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: RENLARKS (in house): 7 . � BUII.DING REVIEW CHECK LIST �C� � ���'' C ONSTRUCTION TYPE: ��� Sq Footage $ Per Sq Ftg Basement x = lst Floor z = 2nd Floor x = Gazage x = x = TOTAL Estimated Construction Value: $ / 2, v c�u `� Inspections Required: `Vork Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection x Footing ` Septic Sewer Connection - Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) � F�� Grading/Filling Electrical (State Permit) Other REi�1ARKS(IN HOUSE): . REVIEW BY OTHERS: DATE: Access: Ezisting New Access Approval: Date By: REVIARKS (TO BE NOTED ON PERitiII'1�: 8 ��� � � � tr c,S97 ��\` ' \�- t �I �'9S7 � � _ � \ . ��,� �� � � - 956� \ � .,*'� .��y'�" � �\ ,`. \�� 0���0 ���� ��\\ '����,•}, _ ��l.�r��'+a'y y _ \\ \\ �\ � °��/� �` ��.C>,�'�• �,j�> '�,Ief �:?�Sa,� \ \ \ �` � r' \ \ \ � ����',, ,`k,; � � X 959.S ,. 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