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Home My WebLink About2004-P07331 - addn/remodel/repair ' ` PERMIT CITY O� ORONO 2750 Kelley Parkway- PO Box 66 Permit Number: Po�331 Crystal Bay, Minnesota 55323 PeC'C111t Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 4i6i2ooa SITE ADDRESS: 262o Fox Street Wayzata,MN 55391 PID: 04-117-23-42-0010 DESCRIPTION: UBC Occupancy R3 Proposed Use: Residential Construction Type VN Census Code 434 Pernut Class: Building Permit Type: Addition/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: riumoing r.iecQicai�s[aiej NOTICES/REMARKS: t�.f__�_"_(�__"a_ Tl_�l_.___ _ T_ _]_1 FEE SUMMARY: Pernut Fee: $ 251.25 Valuation: $ 15,000.00 State Surcharge Fee: $ 8.00 TOTAL FEE: $ 259Z5 APPLICANT: Boyer Building Corporation OWNER: Mr. &Mrs.Jaffray 3435 County Road 101 2620 Fox Street Minnetonka,MN 55345 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. . � �r �J ' % �� `�U�'�jJG ��' ��G'tti--- ~(�/'� Z,_ � C.=—t � ��. APPLICANT ITEE SIGNATURE ISSUED BY I NATURE � Copies: 1-File(SiQnitures Required), 1-Apnlicant, I-Monthlv Revorts, 1-AssessinQ, 1-Finance Page 1 , _ .. �l�C�i1/ED iv�,��d 2 5 �004 � �� .�� , .��=� Total Fee: $ �/ Date Received: 3 -ZS-O � CITY OF ORpNO Entered By: � �� Permit #: f}p 7 3,3 f CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (p/ease print a//informafion) ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (cirde one) OWNER OR CONTRACTOR JOB SITE ADDRESS: ��p ol� �� cj�i�" ZIP: �JJ3� I � NAME OF OWNER: �rG�� 9�-�p�I�� , �rcl�� PHONE: (home)�5� - ��(„—�j3 -�j (work) MAILING ADDRESS: �v� �"U`� `-..��e-�� CITY: C�or,p ZIP: S�� CONTRACTOR: ��Z1� �J U��h� C-�`r P PHONE: `�� `�'1;� �� CONTACT PERSON: i orn Nev�U rv� ` MOBILE/PAGER: �I Z- �3 - ��5� MAILING ADDRESS: �,�-�-3� C`�. �. IG1 CITY: Y111'��. ZIP: __`��`�'S STATE LICENSE: # f;�j�3Q� ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRAT[ON # TYPE OF WORK: New Addition Accessory Structure -------- Move Remodel/Alteration � Land Alteration PROPOSED WORK (descrrbe in defai�: MGIS-�i/ 5�.,1�� - � 1�� f�1'�1C�QX STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ��, OOO • �� 1 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. APPLICANT'S SIGNATURE: ' ' � � DATE: � D NOTE.� Pa�ade of Homes e vents require sepa�ate permit appro va/by Po/ice Department and City Courrci160 days prior to the e vent. Non permitted e vents wiU not be allo wed. CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: Z�z� r-�� T�� PID: DESCRIPTION OF WORK: �sZ.-cZ 5��-rc- /l3a;,-�r�� f�-�ww�e�- ZO�tIt�1G REVIEW BY: DATE APPROVED: �� 3 i•o y BUII.,DING REVIEW BY: DATE APPROVED; 3 . ��-o� FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes r/' No PLAN REVIEW Y�e�- No � SEWER CONNECTION STATE SURCHARGE Yes �/ No WATE�ZCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPEC"TION Number of SAC�Units OTHER (specify) ZONING CH�CK LIST Zoning District: o c .Q . Fire Department: Post Office: School District: � Loe Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No �ate of Survey: Proposed Setbacks: Front(Lake): Right Side: Reaz (Street): L.eft Side: Adjacent Structures: Wetland: Building Height: Def. Hgt. Peal:Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: 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: REMARKS (in house): 7 BUII,DING REVIEyV CHECK LIST UBG R� CONSTRUCTION TYPE: �� _ Sq Footage $ Per Sq Ftg Basement x _ lst Floor x _ 2nd Floor x = Garage x _ z = TOTAL F.stimated Construction Value: $ ( S,0 O o �" Inspections Required: `Vork Requiring Separate Permits: Site �_Plumbing Fire Hazdcover Removal Mechanical Water Connection Footing � Septic Sewer Connection K Framing Fireplace Lawn Irrigation _�Insulation (Masonry) Other �_Wall Boazd (Mfg,) Well (State Permit) '�" F�� Grading/Filling �_Electrical (State Permit) Other REMAR��S(IN HOUSE): . -------- --------------------------------------- REV�W BY OTHERS: DATE: Access: Ezisting New Access Approval: Date By; ---- ----------------------------------------------------------- REIVIARK.S (TO BE NOTED ON PERivIIT�: 8 Sec.13.04 RIGHTS OF SUBJECTS OF DATA Subd. I. 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 shall 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 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 fie data. This requirement shall not appiy when an individual is asked to supply investigative data,pursuant to section I 3.82,subdivision 5,to a laa�enforcerrent officer. The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or �roperty tax refund instructions instcad 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 piblic, private or confidential. Upon his furlher request,an individual who is ihe 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 informed oF the content and meaning of that data. AKer an individual has been shown the private data and informed of its 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 individual has been collechd or created. The responsible authority shall provide copies of the private or pubiic data upon request by the individual subject of (he data. The responsible authority may require the requesting person to pay the actual costs 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 date oF the request, excludinfi Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within that time, he shall so inform the individuai,and may have an additional five days within which to comply wflh 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 individ�el shall notify in writing the responsible authority describing tFe nature of the disagreement. The responsible authority shall within 30 days either. (a) correct the data found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data, including recipienis 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 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 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 require that the City deny the permit 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. [f 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 1 understand my rights as stated above. Signa ✓ D� TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED �'=�-D�f � PERMIT NO. pc>733� COMPLETED H K ADDRESS� 1 1-C),1� �/� OWNER CONTR. ��C1-�f TELEPHONE NO.(d/� ��0 3 �4��I � 7�r✓� � DESCRIPTION l� 01 FOOTING 11 MECHANICAL RI 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 � 5 FINAL 14 SEWER HOOK-UP 06 PROGRESS � 0 EMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT � 07 DEMO—FINA� 15 SEPTIC INSTALL. 22 FOLLOW-UP = 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a W � J V f� O a � O � W � Q � Z W � W � � GW WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED f i ISSUE CERTIFICATE OF OCCUPANCY W � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR W{LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-460� OwnerlContra o site: Inspector. White Copyllnspector's Fiie Canary CopylSite Notice � • � j _ _, � � ; — � ,!%+ , j'...—� I� — � I i, � ��i ` I� � � � / ` � � ; � ; �� ,�� '� ��"� � � , � ; � ; � � � G � l � � � ' %� � I �� I �I � ; ' ' 'I , S �: � -� �; ' � � i� � �� _ ��' i , � � � � � ; j� �� ,�- � - - '-� � � � , i � j d � � �.; • � ; � ' ` � ; � / K � ; .__._�...__ � i � � . _ � l,�} , i - I� V°' �_� 1 , I G '(rlC;i �1 � '� .�;� �I✓Y � ,."(+4 ' � � ' ; � . I 1 �I , � � � ; s -� r �5- f � � f , a 1�� ~ I i� _ , � � !, , � � � � � f ,f �9�C � � l '' "�',j� � N_c•� lo - � �� _ _ � .�` C� � _"'�-�`i"_---- � . ._ .._.. _ . _.._....._. 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