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HomeMy WebLinkAbout2000-P02384 - addn/remodel/repair� � PERMIT CITY OF ORONO Permit Number: 2750 Kelley Parkway- PO Box 66 P02384 Crystal Bay, Minnesota 55323 P@PI'Y11t Type: Addition/RemodeURepair (612) 249-4600 Date Issued: sisioo SITE ADDRESS: 425 Hunter Pass WAYZATA,MN 55391 P ID: 25-11 s-23-31-000s DESCRIPTION: uBC Occupancy �t3 Construction Type VN Proposed Use: Permit Class: Building Census Code 434 Permit Type: Addition/RemodeURepair Permit Sub-type(s): Single Family DETAILS: Approved per resolution#: Separate permits required: riumoir�iviecnanicai Eiecaicai(siaiej NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 181.25 Valuation• $ 9,500.00 Plan Review Fee: $ 117.78 State Surcharge Fee: $ 4.75 TOTAL FEE: $303.78 APPLICANT: ANDERSON MASTER OWNER: S A AND M M HELLRUNG 11177 HOLLAND CR 425 HUNTER PASS EDEN PRAIRIE,MN 55347-0000 WAYZATA MN 55391 TI�UNDERSIGNID 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 BUII,DING CODE REQUIREMENTS. ,� - � ISSL7ED BY SIGNATURE / Copies:City,Applicant,Assessor,Finance Page 1 , a S ' . - Total Fee: $�(. .�, �7�1 Date Received: ,` � z, �, Entered By: L,/, Permit#: , �' �3� CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) THE APPLICANT IS: (circle one) OWNER CONTRACTOR JOB SITE ADDRESS: �I� S` �Vq✓1f�'� ,�/Q�,S ZIP: NANIE OF OWNER: ;�/�� ��I�I�R�� PHONE: (home) �Work) �3 v3-� �7 MAILING ADDRESS: CITY: ZIP: CONTRACTOR: �' � A�JPS r#� p�DIQS PHONE: g �� y ��a CONTACT PERSON: �4,�t � MOBILE/PAGER: �'d� • a� MAILING ADDRESS: '//'9 rrr v QiRt�ITY: �t %CZIP: �" � STATE LICENSE: # � a,_L ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME; REGISTRATION#t TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration�_ Land Alteration � PROPOSED WORK(describe in detai�: �`1N1.3� �1.�,�J!'►��'/'�� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATIO� (excluding land): $ �.sl�'d 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 acco dance with the ap � ved plan. APPLICANT'S SIGNATURE: DATE: �`I;S'' �Q U� 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 SUBJECTS 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 section. Subd.2. Information required to be given individual. An individual asked to supply private or confidenual data concerning himself shall be infortned of: (a)the purpose and intended use of the requested data within the collecting state aeency,polidcal subdivision,or statewide 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 ro supply private or co�dential dara;and(d)the idendty of other persons or ennties authorized by srate or federal law to receive the data. This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer. The commissioner of revenue mav alace the notice required under this subdivision in the individual income tax or orooertv 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 infornted whether he is the subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who is the subject of stored private or public data on individuals shall be shown the data wiihout any charge to hun 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 aceon pursuant to this section is pending or addidonai 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 subject of the data. The responsible authoriry may require the requesting person to pay the actual cosu of making,certifying,and compiling the copies. The responsible authoriry 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 comp(iance 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 witttin 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 contes[[he accuracy or completeness of public or private data concerning himself. To exercise this right, an individual shall notify in writing the responsible authority describing the nature of the disagreement. The responsible authority 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 daha,including recipients named by the individual;or(b)nodfy the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determinadon 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 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 your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the Ciry 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. I��'�t��l 0 /��r����+� First Middle '� Las� ����� �'.���'.II��� �,�� � �.� Ad r��� ���/N���*�� ��/�*� � ���� ���� ���� Ci�y State Z�p Phone ! I understand my ights as stated above. �' � ,� �_ Sign�ture � �/ 6 . : 4 f. . . , . CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: �� E1��►-rG� PIiSS PID: DESCRIPTION OF WORK: F'�w�s K (3r�s�M civT -------------«---------------------------------------------------- ZONING REVIEW BY: � DATE APPROVED: N /A- BUII�DING REVIEW BY: DATE APPROVED: S'- 3•�a FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEW Yes � No SEWER CONNECTION STATE SURCHARGE Yes c,/ No WATERCONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ZONING CHECK LIST zoning Districc: �/v C FG,r�h�� U Fire Department: Post Office: School Disuict: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Right Sid : Rear(Street); Left Side Adjacent Structures: etland: Building Height: Def. Hgt. eak 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 Setbac : Lot Coverage: Existing Proposed Hazdcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS(in house): 7 � . . � . ,� � BUILDING REVIEW CHECK LIST UBC: �Z " � CONSTRUCTION TYPE: �� Sq Footage $Per Sq Ftg Basement x = lst Floor x = 2nd Floor x = Gazage x = R = TOTAL .. � Estimated Construction Value: $ 9', S(?O �' Inspections Required: Work Requiring Separate Permits: Site � Plumbing Fire Hazdcover Removal D� Mechanical Water Connection Footing Septic Sewer Connection X Framing Fireplace Lawn Irrigation �C Insulation (Masonry) Other �_Wall Board (Mfg.) Well (State Permit) �- Final Grading/Filling o� Electrical(State Permit) Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: E�sting New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMIT�: 8 DATE TIME CITY OF ORONO CALLED IN U � INSPECTION NOTICE -O SCHEDULED �� 3'•3� PERMIT NO. O.? fJ COMPLETED ��� � -'�� 3 � � � ADDRESS '��-� � OWNER CONTR./[,�2, TELEPHONE NO. ��/' '�'��� � DESCRIPTION ��r�'a�.ri,�� L� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q2 FR r_� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS � 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 � 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU:_YES_NO Z � C MENTS: � � �� �S' �cJ i 1��� � j l � ct •e � � O � � o � < � � w � Q � z w � W � � d ❑WORKSATISFACTORY:PROCEED �. PROJECTCOMPLETE W � �CORRECT WORK&PROCEED C' ISSUE CERTIFICATE OF OCCUPANCY W O /Cl CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ' I CORRECTUNSAFECONDITIONWITHIN HOURS. ` PHOTOTAKEN INSPECTOR WILL RETURN C CITATION ISSUED �l STOP ORDER POSTED.CALL INSPECTOR I ; INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. 249-46�0 OwnerlContr or on site: Inspector. � White Copyllnspector's File Canary CopylSite Notice DATE TIME .ITY OF ORONO CALLED IN >NSPECTION N ICE SCHEDULED �� � � °d PERMIT NO. 6�'3 � COMPLETED ��� � ADDRESS �a"S ��� ��'� OWNER CONTR. *�CYS�►'t TELEPHONE NO. ��I��� �U - DESCRIPTION �`r-�`�'�'�� � 01 FOOTWG 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING � 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS '� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL � WALL 12 WATER HOOK-UP 17 SITE INSPECTION 1 05 FINAL 14 SEWER HOOK-UP O6 PROGRESS r ; 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 MEET YOU:_YES_NO � COMMENTS: � w � � � O a � O � w � Q � z W � W � � d 1\ W/L��/VORKSATISFACTORY:PROCEED : PROJECTCOMPLETE �� ❑CORRECT WORK&PROCEED f ISSUE CERTIFICATE OF OCCUPANCY W � �] CORRECT WORK,CALL FOR REINSPECTION TEMPORARY v BEFORECOVERING PERMANENT iiCORRECTUNSAFECONDITIONWITHIN HOURS. pHOTOTAKEN INSPECTOR WILL RETURN I I STOP ORDER POSTED.CALL INSPECTOR ' CITATION ISSUED INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. 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