HomeMy WebLinkAbout2005-P08822 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P08822
�- Crystal�t3ay, Minnesota 55323 Permit Type:
Addition/RemodeURepair
(G�2) 249-4600 Date Issued: 7/l i/2oo5
SITE ADDRESS: 280 Hollander Rd Unit#
Wayzata,MN 55391
P��� 25-118-23-43-0012
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Mechanical Irrigation Electrical(state)
NOTICES/REMARKS:
Septic Area- Sac Pd#4087-9/13/79
FEE SUMMARY: Pernut Fee: $ 1,81135 valuation: $ 246,000.00
Plan Review Fee: $ 1,177.38
State Surcharge Fee: $ 125.00
TOTAL FEE: $ 3,113.73
APPLICANT: Creative Spaces OWNER: Byron&Jill Payne
12711 Creek Rd. W. 280 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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9 A T PERMIT E SIGNA ISSUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septiq 1-Septic) Page 1
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Total Fee: $ � � ` � �n �Z� Date Received: ����
Entered Ey: termit#: , p��
CITY OF ORONO - BUILDING PERMIT APPLICATTON
All information must be submitted in full before plan review will be started.
(please pri�Zt all infort�zation)
T�iE APPLICANT IS: (circle o�ie) OWNER OR ONTR.A.CTOR
JOB SITE ADDRESS: �O �j_L��.d��� �Z,� ZIP: J'r
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �NO If yes,a special event permit is required wit1�Police Department and City Council approval
60 days prior to the event. Sharttle bzrs sertiice will be required unless applicant den:onstrates
sa�cient o�z-site par•�ing is available. Non pen�zitted events will not be alloti+�-ed.
.
NAME OF OWNER: �s�,)����E PHONE: (home)
� � . (work)
MAILING ADDRESS: ^ , b CITY: _��tJ ZIP: S�
CONTRACTOR: � E PHONE: �52•j�''�-0D2�
CONTACT PERSON: MOBILE/PAGER: ��2 - � �
MAILING ADDRESS: CITY: ..��_ZIP: ���j
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: �f(�� PHONE:
MAfLING ADDRESS: CI a Y: ZIP:
NAM�: REGISTRATION: #
TYPE OF WORK: New Addition _� Accessory Structure
Move Home Rem�o_deUAlteration �_
r
PROPOSED WORK(descl•ibe in detai�: �'
G • i
STOI2YES: � SQ.�EET O�'EACIi�LOOR:
NO. OF�EDROOI�IS: _� GARAGE STALLS: ATTACHED� DETAC�-IED_
ESTIMATED CONSTRUCTION VALiJATION(excluding land): $ �p, p�a�
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work�vill 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.
APPLICA��1T'S SIGNATURE: DATE: (p�'j_O�_
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.1. Type of data. The righcs of individual on whom[he dlta 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 conceming himself shall be
informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,orstatewide 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 identiry of other persons or entities 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 13.32,subdivision 5,to a law enforcement officer,
The comm�ssioner of revenue mav ntace the notice requ�',red under this subdivision in the individual income taY or nronertv 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 informed�vhether he is the subject of
stored data on individuals,.and whether it is classified as public,private or confidential. Upon his further ceques[,an individual who is the subject oi
stored private or public data on individuals sha[t be sho�vn the data without any charge to him and,if he desires,shall be informed of the concent and
meaning of that data. After an individual has been sho�vn 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 collected or created.The
responsible authority shall provide copies of the private or public data upon request by the individual subjec[of the data. The responsible authority
may requit�e the requesting person to pay the actval costs ofmaking,certifying,and compiling the copias.
The responsible authority shail comply immediately,ifpossible,with any request made pursuant to this subdivision,or within five days of
the date of the request,e�cluding 5aturdays,Sundays and legal holidays,if immediate complianca is not possible.If he cannot compty with the request
within that time,he shall so inform the individual,and may have an additional five days widiin which to comply with the request,excluding Sacurdays,
Sundays and legal holidays.
Subd.4. Procedure whe�data is not accurate or complete.An individual may contes[the accuracy or completeness of public or private data
conceming himself.To exercise this right,an individual shall no[ify in writing the responsible authority describing the naturo of the disagreement.The
responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attemp[to notify past recipients of
inaccurate or incomplete data,including recipients named by che individual;or(b)notify the individual that he believes the daca to be correct.Data in
dispu[e shall be disclosed only if the individual's statPment of disagreement is included wich the disclosed data.
The determination of che responsible authoriry may be appealed pursuanc to[he provisions of the administ�ative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S.13.04,Subd.2,"Rights of subj ects of data",we would like to inform you that your request
for a pemiit or license&om the City of Orono or any of its departments may require you to fumish 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 liceas�
requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. The infortnation 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 acrion 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,
��, 5� . 51 l�l.. ��t�
First Nliddle Last
�.&� � o��� •
Address
� 5�5� I
C��, State Zip Phone
I under y rights as stated above.
A C /
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Signature
32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
" FOR OFFICE USE ONLY
� ADDRESS OR LEGAL: Z�a C� �� uL�,q,�,o�� 2oA✓�
PID:
DESCRIPTION OF WORK: �,�� �-r �ovJ
ZOr1�i TG REVIE`V BY: ,.._ DATE APPROVED: 6-Z�- os
BUILDING REY�`V BY: DATE APPROVED: �.e.,�}o i
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes ,// No SEWER CO�TNECTION
STATE SURCHARGE Yes �/ No WATERCONNECTTON
INVESTIGATION FEE Yes �v, �/ PARK FEE
SAC Yes , �I�o��� SITEINSPECTION
Number of SAC Units ��, i.U✓ OTHER (specify)
----------------------------------------------------��,�-�-------------------------------------------------------------
ZONI�IG CH�CK LIST Zoning District:
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes �' No Date of Survey: �l-3c3•'7y (o� P�c�J
Proposed Setbacks: �
Front (Lake): -�'j� � Right Side: �iS� �
Rear (Street): yoS� fi- Lef[Side: /3�(� �
Adjacent Structures: i4rnc��-fc,.� Wetland: i✓/�
Buildin; Height: Def. Hgt. �•� Peal:Hgt. '—
Lot Covera�e: N�/a
Grading: Staff Approval Date: �- By: Council Approval Date:
Septic: Staff Approval Date: — ������/By: ��
Zonin; F1e: # — Resolution: !# Resolution Date:
Shoreland District: nJ a
Av�. Setback: Bluff Setback: Lot Covera�e:
E�isting Proposed
Hardcover: 0-7�'
7�-250'
2�a-500'
50a-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RE�1AR�iS (in house):
�
BUILDING REV�W CHECK LIST
�C� - 2' � CONSTRUCTION TYPE: �//\(
Sq Footage $Per Sq Ftg
Basement x _ .
1st Floor x _
2nd Floor x _
Gazage x =
z =
TOTAL
Estimated Construction Value: $ 2 y 6, boa°�
Inspections Required: �Vork Requiring Separate Permits:
Site _��Plumbing Fire
Hardcover Removal _,,L Mechanical Water Connection
� Footing ` Septic Sewer Connection
_�o Framing Fireplace � Lawn Irrigation
�_Insulation (Masonry) Other
_y�Wall Board (Mfg.) Well (State Perm.it)
'� F�� Grading/Filling ,� Electrical (State Permit)
Other �
REI�ZARKS(iN HOUSE): .
-------------- -------------------------------------
REV�W BY OTHERS: DATE:
Access: Existing New
Access Approval: Date gy; �
-------------------------------------------------------------
RENIARKS (TO BE NOTED Ov PERiVII1�:
8
DATE TIME ✓
CITY OF ORONO CALLED IrN` CCT ��' �' ��- ��'
INSPECTION N Si�( SCHED�IL"ED� � � ' \�
PERMIT NO. > r1 '��� COMPLETED
ADDRESS Z �'1� �"�I `C.��{.�: �c{.
OWNERI��tic�.. (ctu r, CONTR. ( '[U�,.�^L ��.��.:L<.�S
TELEPHONE NO. Cr`'��- 3°� 1. 1�(��J—
� DESCRIPTION --.--� ���Vl I Cz", l u �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�93 �NSULATION � 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
� 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
� OWNER/CONTRACTOR TO MEET YOU:_�'ES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
O CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CAIL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next i pection 24 hours in advance. (952� 24J-4600
Owner/Contra r e
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION N TICE SCHEDULED
PERMIT NO. d� COMPLETED 7-J�'�� �2�
ADDRESS z� l��I!'�Y�t �2'°''g'�
OWNER CONTR.
TELEPHONE NO.
�
� DESCRIPTION
ty 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 2 FRAMING 13 MECHANICAL FINAL 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 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 OEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAI 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
� IfJSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContra it :
Inspector
White Copy/lnspector's File Canary CopylSite Notice
✓
DATE TIME
� CITY OF ORONO CALLED IN � O '��� G�
INSPECTION NOTI SCHEDULED /O-/�/-�J.S �
PERMIT NO. 22- COMPLETED '�� " ��� �%J �L� ���' %��!
ADDRESS �iPC� �U��Gc,���2r" �P _
OWNER CONTR. ��c�]v� ,C��C
TELEPHONENO. ��-s o� ��c� o��/L�:�— ����� Tc`r f�
� DESCRIPTION �CC��U� ,
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� FRAMIN 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
Q 03 LATION 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-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J �0 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOl1RS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46��
OwnerlContractor on site:
Inspector. � , .- � � l���
White Copyllnspector's File Canary CopylSite Notice
� I (,v/LL/t� �DAT TIME �/
CITY OF ORONO CALLED IN ��Z
INSPECTION N TIC SCHEDULED ��-0� 3:�
PERMIT NO.�� CY� COMPLETED �-3o'6S �_
ADDRESS a�d
OWNER CONTR.
TELEPHONE NO. �'�"/'' —G�
� DESCRIPTION � � L L � (
ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLIN
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h
Q 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-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 MEEf YOU:_YES_NO
v�, COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerlContractor on site:
Inspector. �� � �
White Copylinspector's File Canary CopylSite Notice
G�,,c.u.� r/
D�A� TIME
CITY OF ORONO CALLED IN
INSPECTION TI SCHEDULED �4.� �
PERMIT NO. COMPLETED �' V'vG9 /O'taJ
ADDRESS �
OWNER CONTR.
TELEPHONE NO. -��a'rf�� 7'(Oo2..
� DESCRIPTION (�C
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/ ING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKES ETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.GALL iNSPECTOR �GTATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
Owner/Contractor on site:
Inspector. (�r� �/ � e J
White Copyllnspector's File Canary Copy/Site Notice
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� � s-�� a � o�+� � � T�IS �1f� ��E� .
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�31,f;�..dINl�ii PE IT Pq,.AN ��VIL� I hereby cert i fy �hat th i s i s a true and correct repr��sentat ion of a survey of the boundar i cs of:� �
P �.��.o� . ���o��a���
:' - Lot 3 , Block l , HOLLY ACRES, HenneFin County, Minnesota. �
' 179/i1R'E � PYfICt�AYI' N'Q. �„�,�„�,.�,r
' APPR01lEa AS SUBMITTED .
j � And of the location of all buildings, if any, thereon , and all visible encroachments , if any, from or on sa�id`�lar
; APPFtOVED WtTN CORRECTiONS AS NOTED It shows the location of the stakes as set for a proposed builcin3. As surveyed by me this 30th day of August°, 1
[] NOT A,PPRQV�t3 -� CORRECT�4 RESUBMtT
�
These comtt�ents ere for your iriformatlon,l41!rwrk shall be dor�� � � '*, ��� ��
in lulf eompiianca wfth �ti{ ap�icaW� buildMg le�4ning code re- LJ
quirements including Items not f�ieci#iCatl�r rfsted In this review. � T homa s S. B e r 9 q u i s t `
KEEP 1'HIS PLAN SET ON SITE AT ALL TtMES. �� �� Land Surveyor, M i nn. Reg. No. �725
, .� � v � ��.� �'l�C� `1
', I � DESIGNEO CHECKED I HtREBV CERTIFV THAT THIS PLAN WA$ PqEPARED f3V �AE GR � SCAI.E /� (� C
— — - --��� --- .—�- UNUERMVDIRECTSUPERViSIONANOTHATIAMADULVREGISTER �'' SO' CERTIFIC/"'Y / Li OFVU/ 1 VEy SH
� � ED PROFESSiOtiA�ENGtNEER UNDEF THE LAWS OF 7HE S7nTE OF � �
� - --- --- -- � --- DRAWN qPPqOVED M11iNNESOTA
.._______ BOOK PAGE
; _ ---- _
�' McCOMBS-KNUTSON ASSOCIATES, INC. /42 ,�O FOR
--- —-- . ______ ---
N6. UATE BV PEMARKS DATE COMM, i )�7�� LONSUIiING ENGINEERS ■ LANO SUFVEVORS ■ SITE PIANNEflS
/ F"E"° /VI RS ROY �-/OLLA/i/D,ER °F
/� MINNEAPOLIS enA HUTCHINSON.MINNESOTA A��p
' REVISIONS ��0�/9 oATE__ __ REci.NO. ��` r o
:
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