HomeMy WebLinkAbout2004-P07151 - addn/remodel/repair CITY OF ORONO PERMIT
2750 Kelley Parkway - PO Box 66 Permit Number: Po�isi
Crystal Bay, M!�nnesota 55323 PeC'fTllt Type: Addition/RemodeURepair
(952) 24�1-4600 Date Issued: l�i4i2oo4
SITE ADDRESS: 225 Hollander Rd
Wayzata,MN 55391
P I D: 25-118-23-44-0007
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Permit Class: Building Census Code 434
Pernut Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: riumbing iviecnanicai Biecmcai�sraiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 522.55
Valuation: $ 37,200.00
Plan Review Fee: $ 339.69
State Surcharge Fee: $ 19.10
TOTAL FEE: $ 881.34
APPLICANT: Creative Spaces OWNER: Jill&Louis Close
12711 Creek Rd. W. 225 Hollander Rd
Minnetonka,MN 55305 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.
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APPLICA T PERMI E SIGNATURE SSUED DY SIGNATURE
Cooies: 1-File(SiQnitures Reauired). 1-Applicant, 1-Monthlv Reports, 1-Assessin�, 1-Finance Page 1
Jan-06-2D04 11:33am From—CITY OF ORONO +A522A94616 T-5A4 P 006/008 F-608
Total Fee: $ g 8 •3 � Date Receivetl: � '�O' ��
Entered By: Permit#: 0
,
� CITY' OF �RON4 - BUII.DINC PER1ViIT APPLICATYON
All information must be submitted in fuA before plan review will be staRed.
(please print all i�{forniation) �
T� pppJ,ICAN'T YS:� (circle one) OWNER OR CONTRACTOIt •
JOB SIT�ADDRESS: . 22-�✓ � ZII':. 5
NAl1�OF OWNER: L.Ol1 s �!LL GLC•r� PHONE: (hame) `152• �Q� 82°��
� (work)
MA�LING ADDYtESS: CYTX: ��_.�
C4N'TRACTOR: � �J PHONE:_��2• 5'Ef��?l
COy'TACT PERS4N: MOBXY..IiJPAGER: 52• 2 2 • 2 G�
MAII,�NG ADDR'E.SS: . CTTY: �IP:�QS
S'Y'�a1'E LICENSE: 1�_ 7� �
pRCHTi'ECT/ENGri�TEER: P�YOi�tE:
MAILING ADD1tESS: CiT'Y: ZIP:
NA.�IE: R�GISTRATION f�
1`YPE OF WOltK: New Addition Accessory Structure��
Move Remodel/Alreration�_ Land Alteration
$h�E1�/��1`�
PR�POSED Vt►ORY�(describe in detain:
li�_ �u�r� �
sTon�s: �NraSQ.�T o�EAc��.00�:��� ��tr- uN rrit��n s�It�,
NO. OF BEDROOMS: .� . GARAGE STALYS: ATT. ^� 1�ET.
E�S'I'L�IATED C�NSTRUCTION VALUA,TION(excluding land): $ ��7� �.�d
I hereby apply fox a buildin�permit and I acknowledge chat the information above is complete and
accurate; that the work will be in conformance with the ordinat�ces and codes of the Ciry and wich
the Siace Building Code; that I uaderstaad this is not a pe�mic and work is not to start without a
pernnit; and thac the work wilI be in accordance with che approved plan.
'�� DATE:
APPLYCANT'S SIGNATURE: � ��y�� -
NOTE! events reg ' separate permit approvai by Police Department and
City Council 60 days prior to the event. Non peryniaed events will not be aAowed.
5
CHECK OFF LIST FOR ISSUAi�10E OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ZZ S �O LL A N 1�t R R fl
PID:
DESCRIPTION OF WORK: �ow�.�� �.E.v c=-� ��Zx.w��✓��.Z
Z0�1G REVIEW BY: N/A DATE APPROVED:
BUII.,DI�i 1G REV�`� BY: DATE APPROVED; �-?1-o Y
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes �/ No
PL?.i�T REV�W Yes r/ No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC-Units OTHER (specify)
ZONING CH�CK LIST Zoning District: N 0 Glf�4N'6 C::
Fire Department: Post Office: School District:
Lot Area: Sq.fr. Acres Width Depch
Sur�ey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Si
Reaz (Street): Left Side:
Adjacent Structures: �V land:
Building Height: Def. Hgt. P al: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 etback: L.ot Coverage:
Existin Proposed
Hardcover: 0-75'
75-250'
250-500' .
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RENIARI�S (in house):
7
BUII.,DING REVIEW CHECK LIST
�
�C' R`3 CONSTRUCTTON TYPE: �/�
_ Sq Footage $ Per Sq Ftg
Basement � _
lst Floor x _
2nd Floor x _
Garage x _
x =
TOTAL
Estimated Construction Value: $_ 37�Zpp °�`
Inspections Required: 1�Vork Requiring Separate Permits:
Site _�plumbing Fire
Hardcover Removal _�Mechanical Water Connection
Footing ' Septic Sewer Connection
_�Framing ��__ Lawn Irrigation
_�Insulation (Masonry) Other
_�(_Wall Boazd (Mfg,) Well (State Perm.it)
� F�� Grading/Filling _�C Electrical (State Permit)
Other
RENIARKS(ni T HOUSE):
------------------------------- ------
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gy.
� -- ------------------------------------------------
REMARKS (TO BE NOTED ON PER1vII'1�:
8
Jan-06-1004 11:33am from-CITY OP ORONO +6522494616 T-6A4 P_006/008 F-608
See.13.04 RI6l�TS OF SIIBJEC'IS OF DA'�'A
. Subd. 1. Type n[data. The righrs of iadividual on whom rtu dan is nored or[o he swrcd aha[t 6e as sec foesh ia d�is scctioo.
• Subd.2. Ia[ornutia�required w be grsa io�ridual. M individwt uked oo wDD1Y P�vau or coofidemial dan coxecnin�4imself
shal!be intomxd oh (a)d�Wcpuse�nd intcnd�nse ot�e requesud dan wtddn the collecdng snce a�ency.potitical subdivision.or snrswi�
Sysam:(b)whedxr he may rntuse or is tcgslly rcquired w�upply die iequesad dam;(e)my kmwff eonsequeoet a�sig fivm 4is supplyi�or
refusins w supply privaae or ta�Cideeri�i dan;and tm�he idendyr ot o�er persons or encnes�udroei:ed by sna or hderal law Io eeceive rhe dao.
This requiremenc ahall na apply when in iAdividual is a:ked to supply imesdgauve dan.pu�susat to secRon 13.8:,subdivisioa 5,a a hw
eaforeer�n�offieee.
' '1'he comm�ss�n���em�e enav ehee ehe rwtice eewireA onder thi:s�th4ivi.sinn in du individual iCcnrRe ex nr nronr,Yv tix,�ef�gi
;,ncmrctia iimead of nn ihnxe fnrtn.a.
Subd.]. Accas tu data by iadi�iduaL Upoa request m a tespontible aurhoriry,an individuol sba11 be infocnud wpether 6e is the
s�Djeec ol swced da�on individwls,and wheWer it te clusified u publie,privue or conlde�i.il. Upoe sis Nnher reyves4 an iadiv'idu�1 who
is d�e�ubject of stored privaa or publ'�c dam an i�dividwls shW be�lfown d►e dam wid�ouc any charge c�Lim u�d,if he desires,shall be ialomied
o!du coMau md rt�caning o[du�daet. Af�er an individw!Ipu besn shown�hs privau data and iofocmed of ia meaaiaQ,ths d�aaad noc Da
discbsed ao hiro Por aiz maod�a du�Re r imless a diap�me or xqon pws�w�t w this see6oa is pe�dic�or�dditionsl dan on�ke individa9 has besn
colleered'er eeraoed. 'It�respa�s�lc wd�oeity�iU provide eopies o!Wc privae or publie dm upon requeY by d�indi�al subjeet of tlu daa.
�responsible audwr�y may«quire tlsc r�questiqq pe[son m pay rhe�ctvat co�s of matcing.eer6fying.and eompilicg�6e copKy.
The re�pvttsibk su�kwrity sfiaU cvmply i�t�edia�ely,if possible,wirh aay requesc made pursuanc tu�is subdiv�ioo,or wid►ia Rve days
ol rhe due of the request.eretuding Samidays.Swidays�nd legai hnlid.iys.if infinediace eomptiaace is�c pauiDle. It 6e cannat eomply wid►
U�e request widon thac rime,he sl+all so iatorm�he individual,and may have an addidorol five Oays wirhia which w wmpty wirII�he requac,
�xcludiag SaNrdays,5ur�s and legu holidays.
Su6d.4. Pratduee wLw data�eot aaurate or eomplete. Aa iadividwl a�ay coures�du ucuracy or eomp(c�cnru of public oc
privace dara cooce�lut�uolF, To exc�e thj.i cigtn,ao individual shall noufy in wriong d+e reiponsiWe wdari�descnbiag d►e meum of die
dwgreeme�u. The�espons�bk aud�oriry tlull within 30 days cidwr. (a)cartec[d►a drp►found to ba iiaccusste ar mcanplec suW stu�opt w aooty
past recipkncs ol irc►ccurue or iawmpka d�n.ineluding eecipiencs named by�e indiv�dual;or(b)nodfy the individual�sc 6e believes du Aan
W bt eeeemet. Dan in dispute sbaR be discbud oely if Ihe iediv;dual's aneement of d;aagreemeo�Is iaclnded with tlte discloud dan.
'Ihe deteeminuion ot the nesponsibte auqioriry may be appnled pursuut co tAe provisioas of the admiaisaeove proced�re ut relating
m eoettesced c�scs.
DATA PRiVACY ADVTSnRY
ln accordance with M.S. 13.04. Subd.2, "ltigbts of subjects of deta",we woald Ilke to inform you that your
request for a pecmit 4r licen�e from the Ciry ot Orono or any of its depar[meats may require you to fvraish tertaia
privAte or confidential informatien.
You are noafud that: �
1. 7be information you fiunish will be used w determine your qualification for the permit or licease
requested.
2. You may refuse co supply da�a,but refusa!m�y require thAt dte Ciry deny th�permic or lic�nse.
3. ?he informa�ioa aray be sbartd with other local. state or fedeca! ageacies to cbe extent necessary to
process the peruvt or license.
4. If your requesud permit or licease requires Council action[o approve, some information may become
public.
5. You have certain rights under M.S. 13.04(available upon request)to review private data oa yourself.
6. Your full name is required co proceu this applicatioa oc permit.
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Addrcu
�Nt� 1�A� �52• _��`�'
C ry 5ute Zip Phone
I und�rstaad tpy rights as stated above.
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DATE TIME
CITY OF ORONO 7/5. � CALLED IN 9�-D y
INSPECTION N T10E SCHEDULED -� %��
PERMIT NO. �� COMPLETED
ADDRESS aGi�J ���UC.E'L%'S���
OWNER CONTR. �2�UP d7��---
TELEPHONE N0. ��✓� Z�Z Z7`�Z
� DESCRIPTION v ��-��'P T ""�'
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANOS
h
O 03 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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAI 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
ti COMMENTS:
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W ORK SATISFACTORY:PROCEED ROJECT COMPLEfE
� O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
�STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the ext inspection 24 hours in advance. (g52) 249-46��
OwnedConfr r ' e:
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Inspector. �
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