HomeMy WebLinkAbout2004-P07402 - pool PERMIT
CIT� O� ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 Po�4o2
Crystal Bay, Minnesota 55323 Permit Type: A��essory sr�u�cures
(952) 249-4600 Date Issued: s�4�2o04
SITE ADDRESS: 290 Hollander Rd
Wayzata,MN 55391
PID: 25-118-23-43-0011
DESCRIPTION:
Construction Type VN
Proposed Use: Residential
Pernut Class: Building Census Code 329
Permit Type: Accessory Structures Permit Sub-type(s): Pool-Outdoors-In Ground
DETAILS:
Approved per resolution#:
Separate pernuts required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00
Plan Review Fee: $ 208.78
State Surcharge Fee: $ 10.50
TOTAL FEE: $ 540.53
APPLICANT: Dolphin Pool&Spa OWNER: Dale& Susan Mahaffy
3405 Highway169 North 290 Hollander Rd
Plymouth,MN 55441 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEIVIENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessing, 1-Finance Page 1
� -^ --- -
Total Fee: $ ��fC� :S=' Date Received:
Entered By: ili> Permit#:
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CITY OF �R�NO - B�TILDIti'G PERi�1IT APPLIC:�TION
All information must be submitted in full before plan review «-ill be started.
(please print all information)
------- ---------- ------
THE APPLICANT IS: (circle o�:e) O`VNER O CO`"TRACTOR
JOB SITE ADDRESS: Z�]�� {-��1� ��� �� , ZIP:J S��
Will this be a Parade of Homes, Remodelers Sho�`�case Home or other Display Home?
❑ Yes � No If yes, a special event permit u required with Police Department and City
Cozcncil approval 60 days prior to tJie event. Non permitted events will not
be allowed.
�
NA1vIE OF OWNER: I�-}C� � S��/��j MA�A.���Y PHONE: (home) `TSZ-�75-'�a5(
(work)
NIAILING ADDRESS: 2�0 f-�0��(�N��/Z 21� CITY: pl�b ZIP: �2�9/
CONTRACTOR: �F�11� ��C.,S PHO�`E:��3�S4�Z-9a�
CONTACT PERSON: _C+fRI S Fr,STE� i IOBILE AGER: 763-3q� -qoo$
MAILING ADDRESS: 3�o S' �E�w�Y ►�9 N IT�': t�Ly�ou�'1� ZIP: S'�
STATE LICENSE: # p,(' �Zp�4„� c�sZ
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAi�IE: REGISTRATIO\�
TYPE OF �VORK: New � �ccessory Structure
Addition l�Iove
RemodeVAlteration Land �lteration
PROPOSED WORK(describe in detai�: _ZDX4� ldl�,(�yuNlJ V�til S� L1 N£p Sw�rn in iiu 6
`FbO�-
STORIES: � � SQ. FEET OF EACH FLOOR: N��
NO. OF BEDROOiVIS:� GARAGE STALLS: �TT. � DET. q
ESTI�IATED CONSTRUCTION VALUATION (escluding land): $ 2('j,pQ
I hereby apply for a building pernut and I acknowledge that the infc-_nation above is complete and accurate; that the
work will be in conformance �rith the ordinances and codes of t�:� Cit�• and wzth the State Building Code; that I
understand this is not a permit and work is not to start w-ithout a per.^.it; ar.d that the work R711 be in accor�nce with
the approved plan.
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APPLICANT'S SIGNATURE: �G`—"' DATE: �" �9- n�
•�--^ �
Sec.13.04 RIGHTS OF St�BJECTS OF DATA
Subd.1. Type of data. T6e rights of indi�3dua1 on whom the dars La stored or to be stored shali be as set forth in this sectiom
Subd.2. I�formadon required to be given individual. An indi�idaal asked w supply private or confidenUal data concerning himselis6all be
informed of: (a)the purpose and intended use of the requested data wit6ia t6e collecbng state agency,political subdivision,or statewide system;(b)
whether 6e may refuse or is legally required to supply the requested data;(c)iny known rn�sequence arising from his supplying or refusing to supply
private or rnnRdenttal dau;and(d)the identity ot other persons or enHties aathorized by state or federal law to receive the data.This reqairement shall
not apply when an indicidual is asked to supply investigative data,pursuant w section 13.82,subdivision 5,to a law enforcement ofFcer.
The commissiooer of revenue ma lace the notice r uired onder this subdivisioo in the(ndividual income tax or ro ertv tax refund
instruMions instead of on those Corms.
Subd.3. Access to data by individual. Upon request to a respoas3le authority,aa individual shall be iaformed whet6er he is the subject of
stored data on individuals,znd whether it Is classified as public,private or eonfidential. Upon his further request,an Individual who Ls the subject of
stored private or publ(c data on individuals shall be s6own the data wit6oat any charge to hlm and,if 6e 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 disciosed W him for six
months thereafter unless a dispute or action pursuant W this sectlon is peufiing or additional data on the individual 6as been coUected or created. The
responslble authority shall provide rnpies of t6e private or public data upon request by the Individual subject of the data. T6e responsibie authortty may
require the requesting person to pay the actual costs of making,certifying.and rnmpiling the copfes.
The responsible authority shall comply immediately,if possible,RitL any request made pursuant to t6is subdlvision,or wlthin frve days of the
date of the request,excluding Saturdays,Sundays and le;al holidays,(f immediate compllance is oot possibie.If he cannot rnmply with the request within
that time,he shail so inform the individual,and may har-e an additiooal five da�s within which to comply with the request,excluding Saturdays,Sundays
and legal holidays.
Subd.4. Procedare when data is not accurate or complete.An indis-idual may contest t6e accuracy or completeness of public or private data
concerning himself. To ezercise this right,an lndividual shall notify in writing the responsible suthority describing the nature of the disagreement. The
responsible suthority shall within 30 days elther: (a)correct the data found W be inaccurate or Incomplete and attempt to notify past recipients ot
Inaccurate or incomplete data,including recipients named by t6e individual;or(b)nodfy the individual that he bel�eves the data to be correct. Data in
dispute shall be disclosed onty if the indlvidual's statement of disagreement is included with the disclosed data.
T6e determination of the responsible authority may be appealed parsuant to the provisions of the administrative procedure act relating to
contested cases.
D�TA PRIVAC�AD�TSORY
In accordance�ith l�I.S.13.04,Subd.2,"Rights of subjects of data",we would like to inform you that�our request
for a permit or license from the City 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 furnish will be used to determine cour qualification for the permit or license requested.
2. You ma�-refuse to supply data,but refusal ma�require that the City deny the permit or license.
3. The information may be shared with other locaL,state or federal agencies to the eztent necessan 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 ha��e certain rights under�I.S.13.04(a��ailable upon request)to review private data on�oursetf.
6. Your full name is required to process this application or permit.
���( � I�OO�S
First �fiddle Last
Address
C�ty Stau Z�P Phone
I understand my rights as stated above.
r---- '
�
Slgnature
• • • . CHECK OFF LIST FOR ISSU�VCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: _ Z�,o (�� (�,�,,,,�
PID: '
DESCRIPTION OF WORK: ��r���,�,,,p p,�`
--- ------------ ----
ZONING REVIEW BY: ��„� �� DATE APPROVED: �l-2 43 -o�
B UILDING REVIEW BY: .v�.a DATE APPROVED:
- ------------- ___
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/' No
PLANREVIEW Yes � No SEWER CONNECT70N
STATE SURCHARGE Yes � No WATER COIVIVECTION
INVES77GA770N FEE Yes No PARK FEE
SAC Yes No SITE INSPECTION
Number of SAC Units OTHER (specify)
--------- -----
ZONING CHECK LIST Zoning District:
Fire Departmenr: Post Office: School District:
Lot Area: Sq.ft. Acres Wid-h Depth
Survey Submined: Yes a No Dc:e of Survey: p� ����{;
Proposed Setbacks:
Front (Lake): _(Od � r Right Side: yS � '�
Rear (Street): 235'' � Left Side: IYv' '–
Adjacent Stractures: Z� � Wetland: �' � �`"
Building Height: Def. Hgt. – Peak Hgt.
Lot Coverage: —
Grading: Staff Approval Date: ' By: Council Approval Date:
Septic: Sta,�`'Approval Date: �- By;
Zoning File: # — Resolution: # Resolution Date:
Shoreland District: N�
Avg.Setback: Bluff Setback: �- Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
zsasoo�
500-1000' .
Hardcover Variance Required: Yes No Date of Council Approval: �
REMARKS(in house):
32
. � .
BUILDING REVIEW CHECK LIST
UBC: �-- CONSTRUCTION TYpE; —'
Sq Footage $Per Sq FIg
Basement x
1st Floor x —
2nd Floor x —
Garage x =
x
TOTAL
Esti�rtated Constncction Value: $Zr,��� o_
Inspections Required: Work Requiring Separcrte p¢rmits:
Site Plumbing Fire
Hardcover Removal Mechanical
ac Footing Water Connection
Septic Sewer Connection
Framing Fireplace
Iruulation �+'n ImB�on
Wall Board �MQS°n'y� Other
o<Final �fg•� Well (State Permit)
Grading/Fi[ling Electrical (State Permit)
Other
REMARKS(INHOUSE):
__________�__------------------------------
-------------------
--------------------------------------
REVIEW BY OTHERS: DATE:
Access: Fxisting Ne�a,
—_
Access Approval: Date
- ----------- By:
---------------------------
-----------_---w------------------------
REMARKS (TO BE NOTED ON PERMIT); _r
33
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� NATIONAL O
3405 Highw�y 169 Nor�h, Plyrnou�h, IViIV 554r4'i SPA&POOL
office (763) 542-9000, fax (763� 542-9001 �NSTITUTE
Minnesota Contractors License#BC-20266452
CUSTOMER .��.tS�,�/ &;,I��P. �FlI4' /UI/-1YtfFC��� DATE `�/ '°I�`9
ADDRESS .,�-`�IU f/e//�4,����r^ '��.
CITY C%Zc;��c"> STATE �L��- ZIP ����� /
PNONE#NOME �'rs 1- y��"- �lv�. OFFICE CELL
SALESMAN ���:Z2;(- /�-%sc•,-.- . SUBMITTED BY
POOL DATA
POOL SIZE���`.. � ` �" POOL SHAPE ��c� ,��� �-
STEP TYPE 5 1�� f ���n�.; ` LOCATION � 'S S '(Ilv�..- ��
���
CAPACITY 33,�p GALS. TURNOVER RATE �c HRS
PERIMETER I S� LIN. FT. RATE OF FLOW 7"7 GPM
SURFACE AREA $$� SQ. FT. MANIFOLD&SIZE 3 y��1re 1���2`�
,_ COMSTRUCTION EQUIP�IIEN7
PANELS !M :. � L •
LINER !:'i c"�-C��2���1.•• �J�lC �/�(�,^ N��1r3c�,-. �,1�; 5�-� 4i:,ti� L
COPING A Itit•v.. ,�,,,..�.
BOTTOM MATERIAL c,���n�� c��.���-
DECK BRACES _�v�.. �-
ADDITIONAL EXCAVATIO
FILTERATION EQUIPMEfVT
►1 CITY OF ORONO
I�UNiP t .2 N � I-��. �..r�-c�
FILTER �.i'. R, , r� , .� ., � .- �' ,. .-i_:a �:.
NEATER �-��t;<� , ? -� n,:;l� � --- - -------- ----
SKIMMERS -T-�4� r1--_.__._.__. -- --___ _ . � ,..., .. .�__�___._,_
INLEI'S T�I rc�� . . :r.: .�'�:.. �::�
MAIN DRAIN c%ti� ", ._ . , ,�:: _ ,..: ;::J
SANITATION 7 c,� C'i - `;� `� .. ;i
� DECK EQUIPMENT ,� , r�f r��c 10f�
DIVING BOARD_ � �,N� 7 2 �,v,�l} , R , � , ;�.. ;,�r���r�.�n s��p„��.
SLIDE__ .G���.ti,,; �F`-� t r,:� r-�..��d �E�Gi�9if�AT A�L T!M&'S
LADDER CU,�'=
NANDRAIL (�:�s
ANCHOR CUPS&ESCUT ~t��iZ ,
UfJDERWATER LIGHT 5(aM �.- Cc ���t.
07HCR
MAINTENANCE EQUIPMCNT
AU'�'O CLEANER_�v�,t.S ��"(.'` .
SOL4R COVER c� ��
SO�.AR R�EL �-v n�- . ����- � '`
WIPJTER COVER rt�Z'�=' "
AU�I"OIViATIC COVER ,(� c ���r�n� � c i.�-�(��r ''�� -c- LID TYPE I�I�c,,,,,ti;,.,�.,,.
CI-�IEMICAL KIT �,..,-
MAIIVTENANCE KIT'
07MER - � �5 i ���a-�c;r- ,'�� �.`l �,� �r t,(;.S. ,� � .j ��-�`� l
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EL�CTRICAL �� c:>J7�'r'�-s� . GAS LINE '�`�� G�7'"�a� S �
FENCIIVG �i�>,L;; . �_RETAIN.�NG�WAL�WORK T�i Y� ��7�-�.=,��c
DECK WORK � .5 �} �►lus -� —-- � :c� �vN�L �rc�� `5� �;�� �-� �'�-
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