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HomeMy WebLinkAbout2003-P06134 - addn/remodel/repair PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P06134 Crystal Bay, Minnesota 55323 Permit Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 4/4/2003 SITE ADDRESS: 280 Hollander Rd Wayzata,MN 55391 PID: 25-118-23-43-0012 DESCRIPTION: UBc occupancy R3 Construction Type VN Proposed Use: Residential Permit Class: Building Census Code 434 Permit Type: Addirion/RemodeURepair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate pernuts required: riumoing r,iecmcai�s�ej NOTICES/REMARKS: T�"a_7__"_ T_"___�_1 i t�_lCa_ l�T.__'�il""'./.'_" 11.f__"_ T__"" T""_"___ TT iiii:v��vi�i�vi��v�iv� � vviii�v�i':vi� ��uiuvi��i�iv�v iivv�� �-•••� • ai FEE SUMMARY: Pernut Fee: $ 72�•�5 Valuation• $ 62,000.00 Plan Review Fee: $ 473.13 State Surcharge Fee: $ 31.50 TOTAL FEE: $ 1,232.38 APPLICANT: Kitchens By Design OWNER: Byron&7i11 Payne 201 Silver Lake Road 280 Hollander Rd New Brighton,MN 55112 Wayzata,MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CTI'1'OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. 1 ��-������ i� APPLI T PERMITEE SIGNATURE ISSUED BY SIGNATURE Covies: 1-File(SiQnitures Required), 1-Atmlicant, 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1 . ♦ f t ...- �� � `'%� . , , � � C<�/� � Total Fee: $ � Date Received: � Entered By: /_f J Permit#: � / -� �� � �� _�> �.� ;�, _; ` . CITY OF ORONCS',B r �� DING PERIVIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) � ---------------------------------------------------------------------------------��_----t------------------------ THE APPLICANT IS: (circle one) OWNER O�ONTRACTOR �'� �_� JOB SIT'E ADDRESS: � �G ff��G�/�✓,��i�. /�a�� . z�:_ S�3 �l �r�l'/L'� 'f GG /�f� %f'�— PHONE: (home)`�S� - ��� "- ��y�' NAME OF OWNER: �' . � � � (work) C t��` �/.�- %' '��'.�S��{- ,ii�L MAILING ADDRESS: ,���Cl �G�Gft�,lk��� �E'l�� CITY: G'�'�/� ZIP: SS,� / CO\"TRACTOR: /�`/ lL'/�ENi �f� ��S/lN' _PHONE:. � S�_�G°���-� �Z��' COr�'ACT PERSON: 9----re�� � � YIOBILE/PAGER: �5/ �.��� ��-3 �Z MA.II.,ING ADDRESS: ��� S/GL'�/� �/�}��� D.CITY:�eW c`�iP/��fiC/v�IP: �S�v� ST�iT'E LICENSE: # < -- ,`. �13/S'� 4C' i�e-�/��%��� ARCHITECT/ENGINEER: C�'���'' /`EN/�/ZGSr PH0�1E: G',�/��:�� " ��3�,Z MAILI�i tG ADDRESS:,;�c`�/ S/G�'�,P G�r� ��. ciTY:/ytr✓ b�k�/�ior�ZIP: �,T���; /��Tl-lft=/�S ,f�i' G S«�/� REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration�_ Land Alteration PROPOSED WORK(describe in detain: �/ %CN�/L' �'c����L j�' ��'�'Gc�/J� j��ul" � St''�Fi iS �t�/ W D�i t�G�4C'� �'iSri•ulA-- 5�4 � cl/�EiU%��/ (�l C�UE"" �J�">�'�/� -- /�E l�/ C%f'E/ �ito`L (stc�'L�ti nI/c.E��i . IZ�-f-y��4�u� c��cx�j ` STORIES: �_ SQ. FEET OF EACH FLOOR: �C�'�'C DET.G�/ S�' r/ ���IN 1`'O. OF BEDROOMS: � S GARAGE STALLS: ATT. �_ N�'� ESTL�1_ATED CONSTRUCTION VALUATION (excluding land): $ �� U��� �� ���� ��/�l� I hereby apply for a building permit and I acknowledge that the information above is complete and fl�W� accurate; that the work will be in conformance with the ordinances and codes of the City and with Gtl the State Buildin� Code; that I understand this is not a permit and work is not to start without a permit; and that the work wilI be in ccordance with the a�proved plan. , �A,, APPLICANT'S SIGNATURE: . �:--. /Gf// � -DATE: .�` �� -�� NOTE! Parade of Homes events require separate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. 5 Sec.13.04 RIGHTS OF SfJB.TECTS 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 secaon. Subd.2. Informadon required to be given indiridual. An i�ividua!asked to supply private or confidendal data concerning himself shall be informed of: (a)the purpose and inteaded use of the requesud data within the collecting state agency,poliacal subdivision,or sratewide rystem;(b)whecher he may refuse or is legally required to supply the requesud data;(c)any Irnown consequence arising from his supplying or refusing to supply private or confidenUal data;and(d)the idendty of other persons oc end6es authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigaflve data, pursuant to secaon 13.82, subdivision 5, to a law enforeement officer. The commissioner of revenue mav�lace the noecs rewired under this���division in the individual income tax or orooertv ax refund instrucdons instead of on those fortns. Subd.3. Access to data by indivtdual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidenaal. Upon his further request,an individual who is the svbject 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�e 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 acaon pursuant to this section is pending or addiaonal data on the individuai has been collected or created. The responsible authoriry shatl provide copies of the private or public data upon request by the individual subject of the data. The responsible au[horiry may require the requesdng person to pay the actual cosu of making,certifying,and compiling the copies. The responsible authoriry shall compiy immediately,if possible,with any request cnade pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Su�ays aad 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 W comply with the request, excluding Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is not accarate or complete. An individual may contest the accuracy or compieteness of public or private data coacerning himself. To ezercise this right,an individual shall aodfy in wridng the responsible authoriry describing the�aature of the disagreeme�u. The responsible authoriry shall withiit 30 days either: (a)correct the data found to be inaccurate or mcomplete a�aaempt to notify past recipients of inaccurate or incomplete dara,i�luding recipienu named by the individual;or(b)noafy the individuat that he believes the data to be correct. Data in dispute shali be disclosed anly if the individual's statement of disagreement is included with the disclosed data. The determinadon of the responsible authoriry may be appealed pursuant w the provisions of the administrative procedure act relating to contested cases. DATA PIZiVACY ADVI ORY 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�iry of Orono or any of its departments may require you to furnish certain private or confidential information. You aze 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 shazed 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. �r��G-�/2 j' �T- j�'�%��'�5 F�rst , Middle �,ysi �f�/ S/LvL,i� G/f/`�C �(J�f,CS Address /1/�l'✓ /.�iP/�i`�i�/v; /�'�/11 SSlI�- �5/-�3/- Sa-�+� C��' Srate Zip Phone I understand my rights as stated ab ve � Signature 6 CHECK OFF LIST FOR ISSUANCE OF PERMITS ' ' FOR OFFICE USE ONLY . ADDRESS OR LEGAL: Z�i 6 N-o�1 w�n���:� '��✓� PID: DESCRIPTION OF WORK: {�,=m,.o v�e� 1L.•-�-�•�-� + ('/��•v Q, �iw�..�� .w L•1... . _______-------- - ----- ------------------------------------------____ ZO�TING REVIEW BY: � DATE APPROVED: ti• 3 -v 3 BUII�DING REV�W BY: DATE APPROVED: y. -z-.3 FEES TO BE CHARGED: Misc. Fees Calculated By: pEgMIT Yes _�� No pLAN REVIEW Yes �/ No SEWER CONNECTION STATE SURCHARGE Yes _� No WATERCONNECTTON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SI'TEINSPECTTON Number of SAC Units OTHER (specify) ZOr'ING CHECK LIST Zoning District: N� c���P Fire Department: Post Office: School Disuict: Lot Area: Sq.ft. Acres dth Depth Survey Submitted: Yes No ate of Survey: Proposed Setbacks: Front(Lake): Right Side: Rear(Street): Left Side: Adjacent Structures: Wetland: Building Height: Def. Hgt. Peak Hgt. Lot Covera;e: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: BY: Zoning File: # Resolution: # R olution Date: . . . Shoreland Disuict: Av?. Setback: Bluff Setback: I.ot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Vaziance Required: Yes No Date of Council Approval: REMARKS (in house): 7 , � f BUILDING REVIEW CHECK LIST � . UBC: .1�• 3 CONSTRUCTTON TYPE: �!/'� Sq Footage $Per Sq Ftg Basement x = lst Floor R = 2nd Floor x = Garage x = R = TOTAL Fstimated Construction Value: $ (,2,(�Oo `�° Inspections Required: Work Requiring Separate Permits: Site �_Plumbing Fire Hardcover Removal Mechanical Water Connection F���g Septic Sewer Connection _�Framing Fireplace Lawn Inigation Insulation (Masonry) Other Wall Boazd (Mfg.) Well(State Permit) _�F� Grading/Filling oc Electrical(State Permit) Other RENIARKS(IN HOUSE): . ------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date gy; � --------------------- REMARKS (TO BE NOTED ON PERNIII'): 8 . , . ,,; a: Y �m � �� �;5:. ,;<. � pcs q�_� . !��� � ;,Cr �> �:e ' ' G , , - G , �-, • . . .... ... .... .._ . .��. � ����� � � .. - o � �_. _ �,a� ` � /1 P' ,.} ) 3Q %2_,�� 7�'fi�F�'U.�'� ' ,� �I 7<v �Z.�i��'J�d` „� �, �> ���'Y AF c�R��vo E�i..�t►_C1iVv� ''E^�:�i/`�T P�_r,i� ,;t�����W . � � ���"J'rl+�";';r.g_ � �]24�^.—.�---- � � �.>� D `{--3•°3 ._ r� :,r r��.__._.._, _ `�..�. ' r�, ; ;:�� :'„ _ � �ts'- - ,t. �, � 1's .� . t_, �' , ��' :� . �:�. '\ ��� � , �.. r r _t� � _ , , c'; ` �` :( 3fl'' �/) ���///)�� ���,,,y,,��++r ` r `< � �� , , � , ,,� � , /`l!C/ ,_.(�� /" /'• ' �� �7 tJ I � . � . 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