HomeMy WebLinkAbout2007-11485 - accessory structures ` PERMIT
C1TY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p11485
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952) 249-4600 Date Issued:
10/24/2007
SITE ADDRESS: 2870 Little Orchard Way Unit#
Wayzata,MN 55391
P��� 09-117-23-21-0008
DESCRIPTION: UBC Occupancy U1
/�
Construction Type VN=
Proposed Use: Residential Census Code 328 �
Pernut Class: Building -�
Pernut T e: Accessory Structures Permit Sub-type(s): Accessory Structure
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DETAILS:
Approved per resolution#:
Separate permits required: Electrical(state)
NOTICES/REMARKS:
Build a 22'x 14'Pool House
FEE SUMMARY: Permit Fee: $ 593.25 Valuation: $ 45,000.00
Plan Review Fee: $ 385.61
State Surcharge Fee: $ 22.50
TOTAL FEE: $ 1,001.36
APPLICANT: Jax Construcrion OWNER: Kevin&Paige Amsler
6600 Oxford Street#100 2870 Little Orchard Way
St.Louis Park,MN 55426 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.
APPLICANT PERMITEE S[GNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
PERMIT
GITY OF ORONO
2750 Kelley �arkway - PO Box 66 Permit Number: p11485
Crystal Bay, Minnesota 55323 Permit Type: Accessory Structures
(952) 249-4600 Date Issued:
10/24/2007
SITE ADDRESS: 2870 Little Orchard Way Unit#
Wayzata,MN 55391
PID: 09-117-23-21-0008
DESCRIPTION: UBC Occupancy U1
Construction Type VN
Proposed Use: Residential
Census Code 329
Permit Class: Building
Permit T e: Accessory Structures Permit Sub-type(s): Accessory Structure
Yp
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DETAILS:
Approved perresolution#:
Separate permits required: Electrical(state)
NOTICES/REMARKS:
Build a 22'x 14'Pool House
FEE SUMMARY: Pernut Fee: $ 593.25 valuation: $ 45,000.00
Plan Review Fee: $ 385.61
State Surcharge Fee: $ 22.50
TOTAL FEE: $ 1,001.36
APPLICANT: Jax Construction OWNER: Kevin&Paige Amsler
6600 Oxford Street#100 2870 Little Orchard Way
St. Louis Park,MN 55426 Wayzata,MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPUANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
� C��--�C �'I ����
A GNATURE ISSUED BY SIGNATURE
Copies: l-File(Sigi�atures Required), 1-Applicant, l-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
Total Fee: $ /D b/. 3,6 Date Received: ��'v?���
Entered By: Permit#: �����
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTO
JOB SITE ADDRESS: Z�s� c� L:�� r�l�� t,� zir: 553�1
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home?
❑ YeS �No lf yes, a special event permit is reguired with Police Department and Ciry Council approval
60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates
sufftcient on-site parking is available. Non permitted events will not be allowed.
NAME OF OWNER: I�ev�� �5�� PHONE: (home)�2' 473- OB��
(work)9S2� 975-395/8'
MAILING ADDRESS: �70 L;-i�c �tc�r� CITY: �('av�p ZIP: S53 1�
W�►� _
CONTRACTOR .��. e�y. 1y` PHONE: 71o3 Z$lo-2.y2�1
CONTACT PERSON: ne.�$ MOBILE/PAGER: SQ.�-��
MAILING ADDRESS: C�p S � le�p CITY:�.loH� r��ZIP: �1�.�p
STATE LICENSE: # 2ps 9S0/O EXPIRATION DATE: �
ARCHITECT/ENGINEER: �n� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure �
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement m y require MCWDr�vie and permits !
PROPOSED WORK(describe in detai�: �u;�� g 2.2� X 1 y` I"eA� �+n$�
STORIES: I SQ.FEET OF EACH FLOOR: � /�,p
NO. OF BEDROOMS: � GARAGE STALLS: ATTACHED � DETACHED�
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ y,5'QUb
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 wark will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: �Z/ ��
31
Sec.13.04 RIGI�TS 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 confidential data conceming himselfshall be
informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legaliy 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 identity of other persons or entities authorized by state or federel 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 place the notice reauired under this subdivision in the individual income tax or prooerty tax refund
instructions instead of on those forms.
Subd.3. Access to data by individual. 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 confidential. Upon his further request,an individual who is the subject of
stored private or public data on individuals shall be shown the data without any chazge to him and,if he desires,shall be informed ofthe 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 theroafter 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 subject of the data. The responsible authority
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
1'he responsible authority shal l comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date ofthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. Ifhe cannot comply with the request
within that time,he shall so inform the individual,and may have an additional five days within 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 contest the accuracy or completeness of public or private data
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature ofthe 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 data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in
disputeshall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
'fhe determination of the responsible authority may be appealed pursuant to thc provisions of the administrative procedure act relating to
contested cases. .
DATA PRIVACY ADVISORY
Ia accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your reyuest
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 City 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. our full name is required to process this application or permit.
First Middle Last
(.(�(KX, � ,�". ���
Address
� Lo� �/� �iv �/Z� 9sZ- 92�o�(cS���'
C��Y Stste Zip Phone
I understand my rights as stated above.
Sign
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� ' �CT-TECK ��'F ifIST FOR ISSUANCE OF' �E��IITS
FOR OFFICE USE ONLY� .
ADDJ�ESS OR LEGAL: ��7f� C�� f��� C`,���P r� �`"' A �
PID:
�ES CRIP'I�ION OF W ORK.: �-'c�1 Z �� � � `S � I �- �oa( 1r1cc.�;sC�
(�- ----------------
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----``--- -- O 'Z 3 01
ZOY�G REVIE�V BY: ----- Qir1" ^-- pATE APP�OVED:
�UTLDING REVIE�V BY� �.,���.�. � . . DA.T`EAPrROVED: �c��zy-o�
� � �T--- ---=-------------------------------
�'EES TO BE CHASGEA: Misc. Fees Calculated By:
PER�.�LIT Yes � No SE�YER COi�INECTION
PLAN REVIEti�T � Yes �/ No tiVATE.RCONNEC'I`ION
STATE SURCHAR.GE Yes — r/� �o
INVESTIGATION FEE Yes No r/� PARK FEE
SAC Yes No � SITEINSPECTION
Number of SAC�Units OTHER (specify)
--------------------------------------
-----------------------------
�OY't��tG� �CTi-�CK LIST Zoaing Districr, � �cxl Utc�s� �--�o�� .
Fire Departmenr. Post.Office: School District: �
L,o� t�rea; Sq.ft. Acres �� Widch Depth
Survey Submitted: Y�s _]� ttlo Date of Survey: �U � v
po�l r'or�� 1'�, � Poc,{ \OC��hw>� .
Proposed Setbacks': �Q � • :
Froat G�: Y�Pr Yl � Side: 1 .
w�s� -��,� 130'
P.ear(�t)� ��'�2- L•eft�Slde:
` ('o ! �r�l 1-(Sv
' `q T'o btw:r� 3c�� ZVPr�a�d: �Ac
.���I.��A4�Cr roni C,�.,r„r-- 3U
•-�Po�_ ' "���...,. .
pa�r Na� f�� ; „ ��_
Buil�in� Height: DeE. H�t, �� ��j f Peal:Ho�•
Lot Covera�e: �'1�___
Gradin�: Scaff Approval Date: U « By:'p.A,�+we�S�o�cii_ Approval Date: '
Sep[ic: S�aff Aporov� Date: !�J F ' __ �Y� ��
7oain� Flle: � Resolutioa: R R?solution Da:e:
Shorziznd Distric�: 1/
� �!�E,SetSack: h /�i L.o:Cove2�e:
Av�. Setbac�:: G'1�
� Proposed
�.�scieo �,,
H�ecover: -7�' v�! �3. `-J`yo �Co���cJ
7 2" ' (�}-
Z- "�.�.;
i
��0-? `C!J'
. ,,_,. _,.
-a e�-a::e�: `iz� `�� �'=-- ��: �.�;�__.. .��_-� —
�-?a�eco�:e- �r'z:_... _� � . - -
���L�:�� rLn ho��e):
� .
t3UILDING REV]�tiV CHECK LIST
usc: — � - �'��� {�.� oNs�uc�orr��: ���
Sq Footaoe $Per Sq Ftg
� Basem.eat . .. X = � .
lst Floar ' . z � _ . � .
2nd Flaor x = .
Garage x = .
z =
TOTAL
Estimated Co�struction Value: $_`�/S,(���
Inspections Required: tiYork Requiring Separate Permits:
5 ite Plumbing Fire
� Hardcover Removal Mechanical Water Coanectio❑
�_Footing ` Septic 5ewer Coanectio❑ ��
� v�_Frami.ng . � Fireplace Lawn Irrigation
_�c Lasuiation ([viasoary) Other
_��Val1 Soard (Mfg.) Well (State Pecmit)
�F�� Grading(Fi11inQ _�Electrical (State PeRnitl
Cther
REMAR.KS (IN HOUSE): �
---------------
RE'VIE'4V SX OTHERS: DA�:
Access: Ezisting New •
Access Approval: Datz �y; �
RE`�LAKKS (TO EE NOTED QN��R�vIT_T}:
�
/� �C � DAT TIME
CITY OF ORONO CALLED IN �
INSPECTION NO IC SCHEDULED �d �D � a0
PERMIT NO. cpMPLETED
ADDRESS ��7O �
OWNER CONTR.
TELEPHONE NO. l0/02 ��So� �S��c�
� DESCRIPTION
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FO�LOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINA� ❑ HARD COVER REMOVAL
v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR W{LL RETURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContr n i e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
�� DA TIME V
CITY OF ORONO CALLED IN / �
INSPECTION Iy.Q�I E SCHEDULED ' -� �-
PERMIT NO. ��� � � COMPLETED
ADDRESS a �O c�
OWNER CONTR. ��Q��
TELEPHONE NO. `�3 ��� �?"a�I
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� DESCRIPTION /��u.��?��
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPIAINT
v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS.
Call for the ne t in ction 24 hours in advance. (952� 249-4600
OwnerlContract sit :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
;
�� DATE TIME V
CITY OF ORONO CALLED IN ��' 'E� �Q•CX�
INSPECTION NO�1�4�,5 SCHEDULED (( 'S��Z 3•�OA�I
PERMIT NO. COMPLETED
ADDRESS � � � �
OWNER CONTR. a-u�
TELEPHONE NO. ��2-'� �L�[Z �
� DESCRIPTION � '� �d �\����UJJ�V�
� ❑ FOOTING � MECHANICA RI ❑ EXCAV RADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL AL ❑ LAKESHORE/WETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
Q ❑ TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
Q ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP
? ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
� ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUfRED.CALLTO ARRANGE ACCESS.
Cal1 for the nex ,inspection 24 hours in advance. (952� 249-46��
�
OwnedContrac s' :
�
Inspector.
White Copyllnspector's File Canary CopylSite Notice
/ ✓�!`��v� �� D T TIME "
CITY OF ORONOP/���� �j ED IN S��
INSPECTION OTI sc DULED � =d
PERMIT NO. � MPLETED
ADDRESS a�7� ��%����I
OWNER CONTR.��J� C�
TELEPHONE NO. � ��3 a��' a�aZ� j(�Q'�'e
� DESCRIPTION ����' ��• S�i ���Q. �'¢�
� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS
y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE
p TREE REMOVAL
Z ❑ WALL BD. ❑ WATER HOOK-UP � SITE INSPECTION
Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT
� � DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOILOW-UP
_ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL
J ❑ PLUMBING FINAL ❑ FOUNDATIOWREMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC01/ERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
inspector. ,�_,� �
White Copyllnspector's File Canary Copy/Site Notice
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