HomeMy WebLinkAbout2002-P05736 - addn/remodel/repair � PERMIT
CITY O� ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: Pos�36
Crystal E3ay, Minnesota 55323 PefCYllt Typ@: Addition/Remodel/Repair
(952) 249-4600 Date Issued: iiit3i2oo2
SITE ADDRESS: 267s Fox st
Wayzata,MN 55391
P I D: 04-117-23-43-0003
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Pernut Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: i'iumoing iviecnanicai Eiec;u-icai(siaiej
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 923.75 Valuation: $ 90,000.00
Plan Review Fee: $ 600.53
State Surcharge Fee: $ 45.50
TOTAL FEE: $ 1,569.78
APPLICANT: Gentry Construction OWNER: Peter Slocum&Erin Gilligan
603 E. Lake Street 2675 Fox St
Wayzata,MN 55391 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGRE L WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
M TA BUILDING ODE REQUIREMENTS.
, �,�,�
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PL [T S(GNATURE �DBYSIGNATURE
Cooies: 1-File(SiQnitures Required), 1-Apolicant, 1-Monthlv Reoorts, 1-Assessine, 1-Finance Page 1
e
Total Fee: $ l��P�� 7(� Date Received: j-j�� �' � ��L
Entered By: �3�',,r. Pernut#: ! � ' � -�!i�
� Qa� CITY OF ORONO - BUILDING PERMIT APPLICATION
�,� ;,�
:�, All information must be submitted in full before plan review will be started.
��1 (please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: �;�� -��. ZIP: �,S-�'C �
NAME OF OWNER���Q� � HONE: (home)
(work)
MAILING ADDRESS: ��S �px �-�- CITY: ZIP:SS�q�
CONTRACTOR: VC v `J Y� PHONE: �s'�-�-{7 C9 `Sc{�(,g
CONTACTPERSON: ..e ` MOBILE/PAGER:(Q(Z- 3�S-���
MAILING ADDRESS: (Q p �. (,�,.(c CITYW ZIP: ��
STATE LICENSE: # 2�ZG�(��(
ARCffiTECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration�_ Land Alteration
PROPOSED WORK(describe in detai�:
� ,
STORIES: _� SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �(� ��j
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 u d this is not a permit and work is not to start without a
permit; and that the work w' e in acc r nce with the approved plan.
APPLICANT'S SIGN DATE: ��`7���
NOTE! Parade of Homes events re separate permit approval by Police Department and
City Council 60 days prior to the ev . Non permitted events will not be allowed.
5
2
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 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 ro supply the requested data; (c)any known consequence arising from his supplying or
refusing to suppty private or confidential data;and(d)the identity of other persons or endties 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 mav olace the norice reauired under this subdivision in the individual income tax or oropertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be inforcned whether he is the
subject of stored data on individuals,and whether it is classified as public,private or co�dential. 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 hun and,if he desires, shall 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 need not be
disdosed ro him for six months thereafter uriless a dispute or action pursuant to this secaon is pending or additional dara 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 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,excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot compty with
the request within that time, he shall so infornt 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 exetcise this right,an individual shall notify in writing the responsible authority describing the nature of the
disagreemenL The responsible authority shall withirt 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 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 detertnination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
ro 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 Gity 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. 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.
�-¢.. .e� �
Fir ' dle Last
Address
Ciry State Zip Phone `�
nderstand m rig s stated above.
Signature
6
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Zt�"t5 F ox sz.
PID:
DESCRIPTION OF WORK: i2�,,,.t,o,�e�
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ZONING REVIEW BY: DATE APPROVED: �v� z�• o Z
BUILDING REVIEW BY: DATE APPROVED: ,�. z� _ 0 2_
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �' No
PLAN REVIEW Yes </ No SEWER CONNECTION
STATE SURCHARGE Yes c�No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONING CHECK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes p< No Date of Survey: �'��'92-
Proposed Setbacks:
Front (Lake): 2 I� Right Side: 8 0` +
Rear (Street): �hp� Left Side: y�{p
Adjacent Structures: pT-�7�G�f� Wetland: ^!(/�
Building Height: Def. Hgt. o•�C.. Peak 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: Lot 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
� +
BUILDING REVIEW CHECK LIST
UBC: /?• 3 CONSTRUCTION TYPE: V�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $ ciO,Ooo O0
Inspections Required: Work Requiring Separate Permits:
Site _�Plumbing Fire
Hardcover Removal iC Mechanical Water Connection
x Footing Septic Sewer Connection
�Framing Fireplace Lawn Irrigation
�Insulation (Masonry) Other
�Wall Board (Mfg.) Well (State Permit)
_�Final Grading/Filling � Electrical (State Permit)
Other
REMARKS(IN HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
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REMARKS (TO BE NOTED ON PERMI�:
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MNcheck COMPLIANCE REPORT I I
Minnesota Energy Code � Permit # I
MNcheck Software Version 3.0 I I
I I
I Checked by/Date I
I I
COUNTY: Hennepin
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
DATE: 10-10-2002
DATE OF PLANS: 10-9-02
TITLE: C4285
PROJECT INFORMATION:
Peter & Erin Slocum
2675 Fox Street
Orono, Mn
COMPANY INFORMATION:
Gentry Construction
NOTES:
Interior remodeling, window & door replacements
COMPLIANCE: PASSES
Required UA = 316
Your Home = 283
10.4% Better Than Code
Area or Cavity Cont. Glazing/Door
Perimeter R-Value R-Value U-Value UA
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CEILINGS: Raised Truss 1443 38.0 0.0 36
WALLS: Wood Frame, 16" O.C. 1702 19.0 2.0 95
BSMT: Conc. 8.0' ht/7.5' bg/8.0' insul 1064 10.0 0.0 67
GLAZING: Windows or poors, Above Grade 186 0.350 65
DOORS 58 0.350 20
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COMPLIANCE STATEMENT: The proposed building design described here is
consistent with the building plans, specifications, and other calculations
submitted with the permit application. The proposed building has been
designed to meet the requirements of the Minnesota Energy Code.
Builder/Designer Date
� DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT E SCHEDULED "` �� v�
PERMIT N0. �� COMPLETED
ADDRESS a� 75 �"�'X -Sf �
OWNER CONTR. f .
TELEPHONE N0. /o� - -� �
� DESCRIPTION � � � ��� "` I� /
�
� OyFQOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q ��2 MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEP IC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
O CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL�NSPECTOR
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call fo�the next inspection 24 hours in advance. (95Z� Z49-46�0
OwnedContrac i e:
Inspector.
White Copyllnspector's ile Canary Copy/Slte Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NO E SCHEDULED ✓i '/SG� � -�S
PERMIT NO. �C �?3L COMPLEfED
ADDRESS v�C Ln 7� ��� ��T -
OWN ER CONTR. G�h �r�> �a�st,
TELEPHONE NO. I�ra �� ��'S� �'��%
� DESC ION /����—� l
�OOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q "0'£��� G 13 MECHANICAL FI L 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
`� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL , 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL �� 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEf YOU:_'YES_NO
� COMMENTS: ('C � ��
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W� WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Ca11 forthe next in ction 24 hours in advance. (952� 249-4600
OwnerlConUa tor o it •
Inspector.
White Copy/lnspector's File Canary Copy/Site Notice
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a �� �„ ;�,f.,.�,�j�; ep en G. Kaster
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DATE a- �� PEF2f�11'Y NO. ,"„�,,.. ° .
n��Ro�,��� �s sllENlI�fTF�J �9
a�r-�ROVEU WITFI CQ;?f2CCTI0N� A� NOTED
NOT F,l�P11UV�D — C�Rf2��1" & i��SUBt�91T u��.a+�, ���.I,
These comments nr� for your infornnition.i111 viork sftial)h.e sion• pro�e���. I�rie ' t.r ..,,,��. ,� �
In full eompllance w;t1i a!I e��>p1leaUr. buHelP,��g k•zorlf+�R tGQa rs• : � �� ;0.0 � � ��,;,?... 1.�!a� �`"?'
3 � ) )� ��j, �y �
quireninnts inctuiliriri i�en�s iwt 5{�eClti��fly YtUtOl) tn lnif leVl��i � b qn�c� !j �j�;,',f}� G`A'��d �!rw��
KEEP i'HI5 PLAN S�T Ot�l �ir�N18' �AL� �IMES.
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f•.�;�,4.�, 1�.,,�/.��11t �.y �� Y'
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LEGAL DESCRIPTION OF PREMISES SURVEYED :
That part of the Southeast Quarter described as follows : Beginning at a
• point in the West• line of said Southeast Quarter distant 796 . 125 feet
(48Y� rods ) North of the Southwest corner of said Soui:heast Quarter ; thence
East 940 . 5 fcet ( 57 rods ) ; thence North 391 . 875 feet ( 23 3/4 rods ) ; tl�e�ce �
West 940 . 5 feet ( 57 rods ) ; thence South 391 . 875 feet ( 23 3/4 rods ) to
point of beginning , except the West 398 feet thereof , Section 4 , Township
117 North , Range 23 West of the 5th Principal Meridian .
This survey intends to show the boundaries of the above described property ,
and the location of an existing house and garage thereon .• It does not
purport to show any other improvements or encroachments .
o : Iron marker
Bearings shown are based upon an assumed datum
.;� ,4;,
I hrrchy crrtify that this tiurv�y was preparc�i by mr c�r undrr m���lirrrt suprr- ��n r��: 8- 1 1 - 9 2
(! � � , � .
� � ,�„ vision, and that t��m a�iuly rr�;istrred Civil En};inccr and Land Survcv<�r un�lcr
�� thc I��vs c�f th�� Statr c�( Miiuir�c�ta. ticni i: 1 "= 1 00 '
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� ,� . . � ,. - --- -— — �c iit h'i�.
� ,fi y�- Y�� � Mark S. Grc�nb��r}; Minncsc�ta Lic�ns�� Numb��r 127�5
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