HomeMy WebLinkAbout2004-P07501 - attached deck CITY, OF ORONO PERMIT
2"r�5� Keiley Parkway - PO Box 66 Permit Number: Po�soi
Crystal Bay, Minnesota 55323 PeCCTIIt Typ2: Addition/Remodel/Repair
(952) 249-4600 Date Issued: si26i2oo4
SITE ADDRESS: 539 Keene Ave
Wayzata,MN 55391
P I D: 02-117-2 3-31-002 8
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Pernut Class: Building
Permit Type: Addition/Remodel/Repair Pernut Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required: Eiec;aicai�siaiej
NOTICES/REMARKS:
T__1_ O_ '1 (�____"_ T_"__1_
FEE SUMMARY: Perniit Fee: $ 643.75 Valuation: $ 50,000.00
Plan Review Fee: $ 418.53
State Surcharge Fee: $ 25.50
TOTAL FEE: $ 1,087.78
APPLICANT: M.A. Peterson Designbuild OWNER: Dustin&Christina Boyd
6161 Wooddale Ave. S 539 Keene Ave
Edina,MN 55424 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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APPLICANT PERMITEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reoorts, 1-Assessin�. 1-Finance Page 1
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' Total Fee: $ �� '- � " � Date Received: � �
Entered B �� � �
y: ,�' % ,, �'�' Permit#: C�
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CITY OF ORONO - BUILDING PERMIT 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 OR CONTRACTOR
JOB SITE ADDRESS: 5�9 fC��i1lC ,4V� ziP: 5�.5",�9/
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
� Yes � No If yes, a special event perrnit is required with Police Department and City
Council approval 60 days prior to the event. Non permitted events will not
be allowed.
NAME OF OWNER: �VUJ7] �'C.�IYI f�7/�R �Olil� PHONE: (home) j
(work)
MAILING ADDRESS: S�'j /���/'��f}"I�� CITY: ZIP: sS3� /
CONTRACTOR: �t f 0 f � l7,(�U/�Gt PHONE: IS-a'�.z,S –�I�S.S—
CONTACT PERSON: r i G MOBILE/PAGER: �S� -y�,r yaOG ex t'�-D
MAILING ADDRESS: U/U� � �o�dd/�_ A�e�l. ciTY: �dir�K., zir: sS/��1
STATE LICENSE: # �C (0'70� EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Accessory Structure _ ✓�
Addition Move Home
RemodeUAlteration
PROPOSED WORK(describe in detain: (��/�, Qf2� v tf�af(f/'7 ,(JOYG�')
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 'J Q, OU�. aa
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;that thc
work will be in conformance with the ordinances and codes of tbe City and with the State Building Code; that 1
understand this is not a permit and wark is not to start without a permit;and that the work will be in accordance with
the approved plan.
APPLICANT'S SIGNATURE:��L/(Q,/] /ls/ DATE: S �� D
CHECK OFF LIST FOR ISSUANCE OF PERMITS
- FOR OFFICE USE ONLY
` A.DDRESS O LEGAL: k�EN�: �4�&
PID:
DESCRIPTIO OF WORK: �uc. 3 sc�so•�t "o2UJ,
ZO�Tl�Ii G RE W BY: DATE APPROVED: -�" —"�/
BUII�DING VIEW BY• DATE APPROVED; s- —o
FEES TO BE HARGED: Misc. Fees Calculated By:
PERNIIT Yes v No
PLAl�T REVIE Yes �' No SEWER CONNEG"ITON
STATE SURC ARGE Yes � No WATER CONNECTION
INVESTIGAT ON FEE � Yes No PARK FEE �
SAC Yes No STTEINSPECTION
Number of AC�Units OTHER (specify)
ZONING C CK LIST Zoning District:
Fire Department: Post OfFice: School District: •
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted Yes �� No Date of Survey: o�r ���
Proposed Setbac : �
,
Front( e): � � Right Side: 72 �
Rear(Str et): /o�` � Left Side: �30' +
Adjacent Structures: ,4-rr�� �Vetland: N/r�
Building Height: ef. Hgt. n-!Z Peak Hgt.
Lot Coverage: ��
Grading: Staff A proval Date: — By: Council Approval Date:
Septic: Staff App oval Date: — By:
Zoning File: #� Resolution: # Resolution Date:
Shoreland District J��
Avg. Set ack: Bluff Setback: L.flt Coverage:
Eusting Proposed
Hardcov r: 0-75'
75-250'
250-500'
500-1000'
Hardcov r Variance Required: Yes No Date of Council Approval:
REMARKS (' house):
7
. s
BUII.,DING REVIEW CHECK LIST
�C� �' 3 � CONSTRUCTION TYPE: v^�
_ Sq Footage $Per Sq Ftg
Basement . , x, _
lst Floor � x . . _
2nd F1oor x =
Garage x = �
x —
TOTAL
Estimated Construction Value: $_ �,c�v`�-
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechaaical Water Connection
_�Footing ` Septic Sewer Connection �
_0�Framing Fireplace Lawn Irrigation
�_Insulation (Masonry) Other
�Wall Boazd • (Mfg.) Well(State Permit)
� Final Grading/Filling _�Elecuical(State Permit)
Other
12E1�ZARKS(IN HOUSE): .
---_-- ---------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New .
Access Approval: Date gy;
-------------------����--------------------------------
REMARI�.S (TO BE NOTED ON PERMI7�:
8
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Sec.13.04 RIGHT OF SUBJECTS OF DATA
Subd.l. Type ot data. The rights of individual on whom the dats is stored or to be stored sAall be as set tort6 in this sectt n.
Subd.2. nformation required to be given individuai.An individusl asked to supply private or confidential data concerning imself s6s11 be
informed of: (a)t6 purpose and intended use of the requested data within the collecting state agency,political subdivisfon,or state 'de system;(b)
whet6er he may ref se or is legally required to supply the requested data;(c)any known consequence arising from his supplying or re using to supply
private or conSden al data;and(d)the ideeHty of other persons or enHNes authorized by state or federal law to receive 16e data This re uirement shall
not apply when an' dividual is asked to suppiy investigative data,pursuant to section 13.82,subdivision 5,to a law entorcement offi er.
' n f la th ti r i b i n in n
in t ons nstead of on th se forms.
Subd.3. ccess to data by individual. Upon request to a responsible authority,an Individusl shall be informed whether he the subject ot
stored data on indi duals,and whether it is classi8ed as pubHc,private or conSdenNaL Upon his furt6er request,an indivldual w6o t6e subject of
stored private or pu Hc data on individuals shall be shown the data without any charge to him and,it he desires,shall be informed of e content and
meaning of that dat . After an individual has beee shown the private dats and informed of its meaning,the dats need not be disclose to him for sia
months theresfter u ess s dispute or acdon pursuant to this section is pendtng or addiHonal dats on the individual has been collected r ereated. The
responsible authori shall provide copies of the private or public dats upon request by the lndividual subject of the data.The responsibl suthorlty may
require t6e requesH g person to pay the sctual costs of maldng,certifying,and compillng t6e copies.
The resp sible suthority shall comply immedistely,if possible,with any request made pursuant to this subdivSsion,or wtthin Sve days of t6e
date of the request,e cluding Ssturdays,Sundays and legal holidays,tf immediste compliance is not possible.If he cannot comply with th request within
thst time,he shall so nform the individual,and may 6ave an addttiooal five dsys wit6in w6ich to comply with the request,ezcluding Sstu days,Sundays
and legal holidays.
Subd.4. rocedure w6en data is not accurate or complete.An individual msy contest the accuracy or completeness of public r privste data
concerning himself. o ezercise t6is right,sn iedividual shall notify in writlng the responsible aut6ority descrlbing the nature of t6e d' eemenL The
responsible aut6ori shall within 30 days either: (a)rnrrect t6e data found to be inaccurste or incomplete and attempt to notify pa t recipients of
inaccurate or incom lete dsta,including recipients named by the individual;or(b)noHfy the indivldual that he believes the data to be c rrect.Dsta in
dispute shall be disc sed only it the individual's statement of dissgreement is included with the disclosed data.
The deter 'nation of t6e responsible authority may be appesled pursuant to the provisions ot the administrative procedure act relaHng to
contested cases.
DATA PRIVACY ADVISORY
In accorda ce with M.S.13.04,Subd.2,"Rights of subjects of data",we would tike to inform you that y ur request
for a permit or cense from the City of Orono or any of its departments may require you to furnish certai private or
confidential info mation.
You are no 'fied that:
1. Th information you furnish will be used to determine your qualification for the permit or licens requested.
2. Yo may refuse to supply data,but refusal may require that the City deny the permit or licen e.
3. Th information may be shared with other local,state or federal agencies to the egtenf necessa to process
the permit or license.
4. If our requested permit or license requires Council action to approve, some information y become
pu lic.
5. Yo have certain rights under M.S.13.04(available upon request)to review private data on y urself.
6. Yo r full name is required to process this application or permit.
l L�KS��1
Flrst iddle Last
I
Address
'�2 � �- -�0 to l
City State Zip Phone �x.f— �2 j�
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I understand my ights as stated above.
Sig ture
Res+�t Farm '
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, HARDCOVER CALCULATION WORKSHEET
SETBACK ZONE: (CIRCLE ONE) 0-75' '75-250' 250-500' S00-1000'
EXISTING HARDCOVER IN ZONE
A. House x = ��_S.F.
Length Width
x = S.F.
x = S.F.
x = S.F.
B. Gara'e x = S.F.
C. Driveway X = %�-7� S.F.
x = S.F.
D. Sidewalk x = y Q� S.F.
x = S.F.
E. Patio/Deck x = (,�b C� S.F.
x = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - � S'7�3 S.F. A
TOTAL PROPERTY AREA IN ZONE - y y�.;po S.F. B
A = B x100 = i2. �3 %
A = B x 100 = %
PROPOSED HARDCOVER IN ZONE
A. Hous� x = S.F.
Len�th �Vidth
x = S.F.
X = S.F.
X = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
X = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = �9Z., �, S.F.
X = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - (e�j2� S.F. A
TOTAL PROPERTY AREA IN ZONE - <-i 5C)�-� S.F. B
A = B x 100 = . (y %
LK.P+iN�+c'ra.vKA
S.'(�Rt4ME • . .
���'"'� � SAMPLE HARDCOVER. CALCULPsTIONS +
�r�scv. 9z4.y•
,
\ (Note: Use a survey for a base map
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� 75
j1pr Area of 0-75 ` zone:
. _ 75 ' x 110 ' = 8,250 s .f.
� ' Are�a of� 75-250 ' zone: .
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,, ,,p,_�, (112' + 152 ' ) x 100 '
c�--�� 2
� = 13 ,200 s.f .
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CITY OF ORONO CALLED IN �
INSPECTION N C SCHEDULED 7- ZO ' �
PERMIT NO. COMPLETED
ADDRESS E��-�-Q
OWNER CONTR.
TELEPHONE NO. � � ?Z /
� DESCRIPTION � � �
ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLIN
� 02 FRAMING 13 MECHANICA�FINAL 19 LAKESHORE/WEfLAND
y
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 INSTAIL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVA
J 10 PLUMBING FINAL 36 FOUNDATION/REMOV
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
v�, COMMENTS:
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W WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCU NCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the nex 'nspection 24 hours in advance. (g52) 249-4 ��
OwnerlContr n it : i
Inspector. -
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN �L�
INSPECTION NO ICE SCHEDULED �'
PERMIT NO. COMPLETED " y
ADDRESS �J' U .
OWNER CONTR. 1L �
TELEPHONE NO. � 1 a O O�o2
� DES ION � C 1C � r
ty 1 FOOTI 11 MECHANICAL RI 18 EXCAV/GRADING/FILLI G
� 02 FRAMI 13 MECHANICAL FINAL 19 LAKESHORE/WETLAND
y
O 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 O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 WARD COVER REMOV L
J 10 PLUMBING FINAL 36 FOUNDATION/REMOV L
� OWNER/CONTRACTOR MEET YOU: YES_NO
� COMMENTS:
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��S-WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCU ANCY
� ❑COFRECT WORK,CALI FOH REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours irt advance. (952) 249- 6��
OwnerlContractor �
Inspector.
White Copyllnspector's File Canary CopylSite Notice