HomeMy WebLinkAbout2000-P02277 - addn/remodel/repair CITY OF R N PERMIT
O O O
2750 Kelley Parkway - PO Box 66 Permit Number: Po22��
Crystal Bay, Minnesota 55323 P@CCTIIt Typ@: Addition/Remodel/Repair
(612) 249-4600 Date Issued: 4ii2ioo
SITE ADDRESS: 275 Hollander Rd
WAYZATA,MN 55391
P ID: 25-118-23-43-0025
DESCRIPTION: UBC Occupancy It3
Construction Type VN
Proposed Use:
Permit Class: Building Census Code 434
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Single Family
DETAILS:
Approved per resolution#:
Separate permits required: riumoing Eiectricai�siaiej
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 853.75
Valuation: $ 80,000.00
Plan Review Fee: $ 555.03
State Surcharge Fee: $ 40.00
TOTAL FEE: $ 1,448.78
APPLICANT: SYLVESTRE CONSTRUCTION INC OWNER: P F BRUER& L J MILLER
7708 STH AVE SOUTH 275 HOLLANDER RD
MINNEAPOLIS, MN 55423 WAYZATA MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AN D AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE OF MINNESOTA BUILDING CODE REQUIREMENTS.
�- - �/�%l�-�/�
APP CANT PE MITEE SI NATUR ISSUED BY SIGNATURE
Copies: City,Applicant,Assessor, Finance Page 1
�
Total Fee: $ � ��8, 78 Date Received: ,3 - 3� ' p �
Entered By: � Permit#: p��--7
CITY OF ORONO - BUILDING PERNIIT 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 `CONTRACTOR
�� LL . �.�o �? �
JOB SITE ADDRESS� /� �-Ov��C_"� I'YJ�ZIP: � ��� � �
NAME OF OWNER��+.�L,�,�u��e a-L%�1 1�1�L1.�,�'PHONE: (home)
� (work)
MAILING ADDRESS��.� /�'1[,¢ti��J�� � CITY:��d �c.,� d ZIP.���3 �/
CONTRACTOR� ��`'•�s i�� �a✓ST, �',�,,��� PHONE�/� f0�—�/��
� � �
CONTACT PER N: T�i� s i MOBILE/PAGER:
MAILING ADDRESS: � 0 � T�' -�' CITY: ✓�'J S ZIP:._'��� �3
STATE LICENSE: # �1�'
ARCHTI`ECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition '/ ccessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai���l�%� �=-%�Q�� �
�/,4u L�i - C3 �-�' L ►� ��-
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
� G,�
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� �QD, -
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 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 SIGNAT + • � DATE: �'=3 �% o��d d
NOTE! Parade of Homes evd ts re uire separate permit approval by Police Department and
City Council 60 days prior to the ent. Non permitted events will not be allowed.
5
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Sec.13.04 RIGHTS_dF SUBJ�CTS OF DATA
Subd. 1. Type of data. T'he 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 i�ividual 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 dara;(c)any known consequence arising from his supplying or
refusing to supply private or wnfidenaal data;and(d)the idendry of other persons or entities authorized by state or federal law to receive the daha.
This requirement shall not apply when an iadividual is asked to supply invesdgative data, pursuant to secdon 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revettue mav olace the notice reauired under this subdivision in the individual income taz or orooertv tax refund
i2m,crions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuats,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 him 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
disclosed to him for six months thereafter unless a dispute or action pursuant to diis section is pending or addidonal data on the individual has been
collected or created. The responsible audioriry shall provide copies of the private or public daha upon request by the individual subject of the data.
The responsible authority may require the requesting person to pay the actual cosu 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 comply with
the request within that time,he shall so inform 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 exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authoriry 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 recipients named by the individual;or(b)notify the individual that he believes the data
to be conect. 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 authoriry 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 �ity 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 fumish will be used to determine your qualification for the pemut 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.
First Middle Last
Address
C��y State Zip Phone
I understand my rights as stated above.
Signaare
6
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: Z�'1S .t-E o{(W n►C��P2
PID:
DESCRIPTION OF WORK: 'K�TGI�C.N �?�w�.�,��
----------------------------- ---------------------------------------y_�-o o---
ZONING REVIEW BY: !��n,�_ DATE APPROVED: /-
BUII.DING REVIEW BY: DATE APPROVED: y-1�•UO
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes �/ No SEWER CONNECTION
STATE SURCHARGE Yes r/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: fr o Gl�h41vG l.°
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Reaz(Street): Left Side:
Adjacent Structures: Wetl d:
Building Height: Def. Hgt. Pe Hgt.
Lot Coverage:
Grading: Staff Approval Date: Council Approval Date:
Septic: Staff Approval Date:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setbac : Lot Coverage:
Ezisting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
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. M. .
BUII..DING REVIEW CHECK LIST .
UBC: R'3 CONSTRUCTION TYPE: �N
' Sq Footage $Per Sq Ftg
Basement z =
lst Floor x =
2nd Floor x =
Gazage x =
R =
TOTAL
0
Estimated Construction Value: $ '�0,�G�O �
Inspections Required: Work Requiring Separate Permits:
Site a( Plumbing Fire
Hardcover Removal Mecl�anical . Water Connection
Footing Septic Sewer Connection
nc Framing Fireplace Lawn Irrigation
o� Insulation (Masonry) Other
o Wall Boazd (Mfg.) Well(State Permit)
o— Final Grading/Filling �Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMII�:
8
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT E SCHEDULED �� �
PERMIT NO. O o�a COMPLETED � '�'�
ADDRESS ��S D` �"e
OWNER CONTR. <SV LUCrS�
TELEPHONE NO. �10���!��
� DESCRIPTION
lL 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 2 FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/N/ETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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�/�RRECT WORK&PROCEED �l ISSUE CERTIFICATE OF OCCUPANCY
uY �
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
Cl CORRECT UNSAFE CONDITION WITHIN HOURS. i PHOTO TAKEN
INSPECTOR WILL REfURN
❑ STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-4600
OwnerlContractor on site:
Inspector. /��� -� �,/� .i�,<
White Copylinspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N IC SCHEDULED 5��� ��
PERMIT NO. v COMP TED � �
ADDRESS a�S � �C
OWNER CONTR. S�--F ��S '
TELEPHONE NO. ���"" L 3� ^ g�a'a
� DESCRIPTION Rer��(��' .SL �
L� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
ti
03 INSULATI N.� 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
= 09 PLUMBING RI 23 SEPTIC FINA� 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� C1 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, pHOTO TAKEN
INSPECTOR WIL�RETURN
i= CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
L; INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContra or on site:
Inspector. �C�
White Copyllnspector's File Canary CopylSile Notice
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CITY OF ORONO
IBUILDING $E Mi RE -VIEW
tNSPECTQR "'
DATE Ll 11- L"D PERMIT NQ.-,_
D APPROVED AS SUMMED
Q,I,PRROVED VV,TH CORRECTIONS AS NMI-)
010, NOT ,' PPRC-LIEU ... CJi-IREC ! & rcSttC:AT
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SEE ATTAcH,=D SHEET _
CODE IREQ'UIREMENTS
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