HomeMy WebLinkAbout2003-P06049 - addn/remodel/repair CITY OF ORONO PERMIT
+►2750 Kelley Parkway - PO Box 66 Permit Number: Po6o49
Crysta! Bay, Minnesota 55323 Permit Type: addicio�emoaevxepair
(952) 249-4600 Date Issued: 2/26�2003
SITE ADDRESS: 1005 Heritage Lane
Wayzata,NII�155391
PID: io-ii�-23-i2-000s
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential '
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: i'iumoing iviecnanicai Eiecu-icai(sraie�
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 111.25 Valuation• $ 5,000.00
Plan Review Fee: $ 72.28
State Surcharge Fee: $ 3.00
TOTAL FEE: $ 186.53
APPLICANT: Eric Wordeen OWNER: Mr. &Mrs. Larson
5146 Valley View Rd 1005 Heritage Lane
Minnetonka,MN 55345 Wayzata MN SS391
THE UNDERSIG D HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES T DO ALL WORK IN SI'RICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA ILDING CODE REQUIREMENTS.
1
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� APPLICANT PERMI"I'EE SIGNATURE ISSUED f3Y SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Aoblicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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Total Fee: $ � � ��- _ �� � Date Received: �'1�� ��'���C� �
' Entered By: ,4 'r` � Permit #: '�� � �, f��
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
- (please print all information)
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THE APPLICANT IS: (circle one) OWNER O ONTRACTOR ,
�-'
JOB SITE ADDRESS: /�'�� ���t i��� Lit� , ZIP: JS 3 �//
NAME OF OWNER: �ti��ti� PHONE: (home) y'�� -�%73-:�s�j"
(work) --
MAILING ADDRESS: 5��, a5 1��.(�, CITY: — ZIP: -
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CONTRACTOR: ���� ���� PHONE: �.s��y�`7-�i/ �
CONTACT PER�:7N: n.d '��i��.,,� MOBILE/PAGER: ( ��.-�i 5---�>� �y
MAILINGADDRESS: 5/y� ,����,�,,1�. CITY: ,�.��1�•� f,�Z� ZIP: ;�����—
STATE LICENSE: # kyr 7
ARCffiTECT/ENGINEER: PHONE:
MAILItiG ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration_�_ Land Alteration
/' �, r
PROPOSED WORK(describe in detai�: S�� yl�yh� ��' '� ��i-������ c���lw��✓y��
�
STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: � GARAGE STALLS: ATT. 3 DET. „
� �% ,
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ .k�' d �!����=.J ���
�7GG`'0�`� ���'c���c 5�1c;�:t�;��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 understand t s is not a permit and work is not to start without a
permit; and that the work will be in ac�o � e with the approved plan.
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APPLICANT'S SIGNATURE: � �DATE• � �L'�'
. �
�yna�j�i�Cn�;.; ft��-�1«i,:��%,��,�
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events wi11 not be allowed.
9
CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: i u�s I-{�(Z�T I�C�G (�►��
PID:
DESCRIPTION OF WORK: Lo w 2c. [,Ev V C.- i�+v�s l4 i
ZO1`ING $EVIEW BY: N � DATE APPROVED: 2-zs-03
BUII..DPi tG REV�W BY: DATE APPROVID; _�-Z s -�3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes �' No
PLAi�t REVIEW Yes � No SEWER COi�TNECITON
STATE SURCHARGE Yes _,C No WATFIZ CONNECTTON
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No c/ SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning District: /U� c I-Fr4rv�j�Q
O
Fire Department: Post Office: School Districr. �
L,ot Area: Sq.ft. Acres idth Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: �Vetlan�l:
�
Building Hei;ht: Def. Hgt. Peal:H�t.
Lot Covera�e:
Grading: Staff Approval Date: By: � Council Approval Date:
Septic: Staff Approval Date: By: �_
Zoning File: # Resolution: # �tesolution Date:
Shoreland Distric[:
Avg. Setback: Bluff Setback: _� L.ot Coverage:
Existing Proposed
Hardcover: 0-75'
I
75-250' ;
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RENIARKS (in house):
7
BUII,DING REVIE`y CHECK LIST
UBC: R-� CONSTRUCTTON TI'PE: U/V '
,� Sq Footage $ Per Sq Ftg
Basement x _
lst Floor x _
2nd F1oor x _
Garage z _
x =
TOTAL
Estimated Construction Value: $ �c��o `�=
Inspections Required: `Vork Requiring Separate Permits:
Site _�Plumbing Fire
Hazdcover Removal p< Mechanical Water Connection
Footing ' Se tic
°c Framing P Sewer Connection
�_Insulation Fireplace Lawn Irrigation
_�Wall Boazd ��0�'� Other
_�F�� � (Mfg•) Well (State Permit)
Grading/Filling _p�Electrical (State Pemut)
Other
R.E1�L4RKS(ni T HOUSE):
________ ------------
----------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New
—_
Access Approval: Date
By:
------- -------------------------------------------------------
RE�IARKS (TO BE NOTED ON PERitiIT1�;
8
Sec.13.04 RIGHTSOFSUBJECTSOFDATA
, Subdivisron 1. Type ojdata. The rrghts oJindividual on whom the data is stored or to be stored shal!be as set forth in thrs section.
Subd.2. lnjormation required to be given individuaG An indrvidual asked to supply private or confrdentral data concerning himself
shall be informed oj.• (a)the purpose and intended use of the requested data wrthin the collecting state agency,polrtical subdivision,or statewide
system;(b)whether he may rejuse or is lega[ly required to supply the requested data;(c)arry/rnown consequence arising jrom his supplyrng or
refusing lo supply private or confrdential data;and(d)the identity oJother persons or entities authorrzed by state orfederal!mv to receive the data.
Thrs requirement shall not apply when an indrviduaf rs asked to supply investrgative data,pursuant to section 13.82, subdivrsion 5, to a lmv
enforcement officer.
The commissioner of revenue mav place the notice required under this subdivision in the individual income tax or property tax rejund
instructrons instead ofon those forms.
Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shal!be informed whether he is the subject
ojstored data on indivrduals, and whether it is classifted as public,private or conf dential. Upon his further request,an individual who is the
subject of stored private or public data on rndivrduals shal!be shown the data wrthout any charge to him and, if he desires,shall be informed of
the content and meaning oJthat data. Aj1er an individual has been shotivn the prrvate data and rnformed oJits 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 individua!has
been collected or created. The responsrble authorrry sha[I provide copies oJ'the private or public data upon reguest by the individual subject of
the data. The responsible authoriry may require the requesting person to pay the actua!costs of makrng,certifying,and compilrng the copies.
The responsible authority shall comply immediately,ifpossible,with any request made pursuant to this subdrvision,or withinJive days
oJthe date of the reguesl,excluding Saturdays,Sundays and legal holydays,if immediate complrance is not possible. Ifhe cannot comply with the
request tivithrn that time,he shall so injorm the rndrvrdual,and may have an additronal five days�vithin whrch to comply�vith the request,excluding
Saturdays,Sundays and legal holydays.
Subd.4. Pracedure when data is not accurate or complele.An individual may contest the accuracy or completeness ofpublrc or private
data concerning himself. To exercise thrs rrght, an individual shal!not�in w�iting the responsible authorrty describing lhe nature of the
disagreement. The responsible authority shall ivithin 30 days erther: (a)correct the datafound to be inaccurate or rncomplete and attempt to not�
past recipients of inaccurate or incomplete data,including recipients named by the indivrdual;or(b)not�the indivrdual that he belreves the data
to be correct. Data rn dispute shal!be disclosed only if the individual's statement ojdisagreement is rncluded wrth the disclosed data.
The determination ojthe responsible authoriry may be appealed pursuant to the provisions of the admrnrstrative procedure act relating
to contested cases.
DATA PRIVACYADVISORY
In accordance with M.S.13.04,Subd.2, 'Rrghts ofsubjects of data';we would lrke to rnform you that your request for a permrt or license
from the City of Orono or any ojits departments may require you to furnish certain private or confidential informatron.
You are notified that:
/. The information you furnish will be used to determrne your qua/ifrcation for the permit or license reqt�esJed.
2. You may refuse to supply data,but refusa!may requrre that the City derry the permit ar license.
3. The rnformation may be shared with other local,state or federal agencies to the extent necessary to process the permit or
license.
4. I,f your requested permit or lrcense requires Council actron to approve,some informatron may become pu6lic.
S. You have certain rrghts under M.S. 13.04(see followrng pageJ to revietir prrvate data on yaurselj.
6. Your full name is required to process this app/ication or permit.
PLEASE PRlNT
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First I � Middle Last
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Address
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City , State Zrp Phone
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/under.s�a ' ights as stated above.
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Signature,�' ��+� �����
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICF� /� SCHEDULED �� __1�
PERMIT NO. (�r COMPLETED
ADDRESS �C�C%�J �.--�-%�� � � '�'�
OWNER CONTR. �rf� �"�`%��=��'�°7
TELEPHONE NO. (f�i /,,7 -- �/J� -" C7 /�
� DESCRIPTION ' '��-�u-
�� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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= 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W �CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O tNSPECTION REQUIRED.CALL T ARRANGE ACCESS.
Ca11 for the next ins ection 24 hours in advance. (952� 249-4600
OwnerlContractor Qr s�:
Inspector. - �
White Copyllnspector's file Canary CopylSite Notice
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DATE TIME
CITY OF ORONO CAL�ED w '' N���
INSPECTION NOT CE SCHEDULED � 2:O�
PERMIT N0. COMPLEiED
ADDRESS ��)�`~7 I�f'0��?k�G �,� L..c_.
OWNER CONTR. �r� �. IL,ric�.%L
TELEPHONE NO. �l� �I S ULr��y
� DESCRIPTION
� 01 FOOTING i i MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
O03 INSULATION � 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z A � 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PFiOJECTCOMPLEfE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Ca11 for the ne t inspection 24 hours in advance. (952� 249-4600
OwnerlContr o ite:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
�;;�t cQ � i Ic..2._ ;'��,'t �'F p c>�,'c;l�
. ATE .� TIME
CITY OF ORONO CALLED IN '•z y�
INSPECTION NOTIC SCHEDULED `�f=,�5�� �7 ,1 �/5:��1
PERMIT NO. I�? ��y�� COMPLETED
ADDRESS 1��J� �Es-/�i�l�� ti�, �z�t�
OWNER CONTR. ���� �•�G'���'C'/'�
TELEPHONE N0.___l���� 7I Sr C�fP�7
� DESCRIPTION / G��,�n t��Cj /�`�f,
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRAOING/FILLING
Q 02 fRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WO00 BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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
? UMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v � � A� 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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W� WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOA REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITNIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for t ne inspection 24 hours in advance. (JSZ� 249-4GOO
OwnerlCo r o ite:
Inspector. '-
White Copyllnspector's ile Canary CopylSite Notice