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Home My WebLink About2003-P06745 - addn/remodel/repair CITY �F ORONO PERMIT 2750 Kelley Parkway - PO Box 66 Permit Number: Po6�4s Crystal Bay, Minnesota 55323 P@1"CTllt Type: Addition/RemodeURepair (952) 249-4600 Date Issued: lo�i�2oo3 SITE ADDRESS: 3572 Livingston Ave Wayzata,MN 55391 P��: 17-117-23-43-0150 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Pernut Type: Addition/RemodeURepair Permit Sub-type(s): Addn/Remodel/Repair DETAILS: Approved per resolution#: Separate pernuts required: NOTICES/REMARKS: T_"_1___ 1__1_'"__. _"_1___1_ _C1._"___ D. "__"__'..C,._._. O 1___1_ _._i"__ "_"_... _.._. .. ......._ "'. ._..... ......" "_' a�v �.vv...�. vii vuv�.�i: Y'....,., b ................i..,... ........... ::.::.:�::..� FEE SUMMARY: Pernut Fee: $ 97.25 Valuation: $ 4,000.00 Plan Review Fee: $ 63.18 State Surcharge Fee: $ 2.50 TOTAL FEE: $ 162.93 APPLICANT: Owner/Self OWNER: Mark&Karen Cuff M� 3572 Livingston Ave 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. � -e ��'Yl.�ti- APPLICANT PERMITEE SIGNATURE SSUED BY SIGNATURE Covies: 1-File(SiQnitures Repuired), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 M � Tota? Fee: $ '�+" Z � �� 3 Date Received: �'� �,(V 7Y ' Entered By: Z� Permit#: 1;{��%�{5 � �Lf1'�y`}Cy �l ' � �� / � � CITY OF ORONO - BUILDING PERNIIT A.PPLICATION All information must be submitted in full before plan review will be started. (please print all information) � ------------------------------------------------------- ----------------------------------------------------- THE APPLICANT IS: (circle one) OWNE�R CONTRACTOR JOB SITE ADDRESS: ��S-1��-- �--�v�v�c�,�-4-v� f y,J �-- --- ZIP: `-�5 J`� I NAI�SE OF OWNER `1'1�-u--1L � �,� L_�{�- PHONE: (home�s�-�7/--�%7�5� . (work) �.i�—a�S�--�f*c3/ MAILLIIG ADDRESS: ��7�- I-��►vtcs-�� R�1�— CITY: L�r�� ZIP:�� CO\�'RACTOR: � �� PHOI�7E:_ COr�'TACT PERSON: 1�IOBILE/PAGER: 1VL4II,I�i tG ADDRESS: CITY: ZIP: ST�T'E LICENSE: # ARCHITECT/ENGINEER: ,� �-�'"� PFiO�TE: M_4II..ING ADDRESS: CITY: ZIP: l�.e,.�1iE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remo�lel/Alteration�_ Land Alteration ��-12 PROPOSED WORK(describe in detain: _��(.� �.� �� L �—��- � _� '��G+CIL �V1�,�,.,C C�\� �j'�Y�� C/�� STORIES: �_ SQ.FEET OF EACH FLOOR: �� 11 1�:�/L NO. OF BEDROOMS: �( � GARAGE STALLS: ATT. DET. -�-�. ESTLI-IATED CONSTRUCTION VALUATION (exclud.ing land): $ `�C�(,,�,?� _ I hereby apply for a buildin� 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 Buildin� Code; that I understand this is not a permit and work is not to start without a permit; and that the work wi�I be in accordance with the approved plan. � ,�..- APPLICANT'S SIGNATURE. DATE: � � ,. NOTE! Parade of Homes e�nts require separate pernzit approval by Police De�artment antl City Council 60 days prior to the event. Non permitted events will not be allowe'd. 5 ' � � Sec.13.04 RIGHTS OF SiJB,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 secdon. Subd.2. Information reqirired to be given mdiridual. An individual asked to supply private or confidential data concerning himself shall be informed of: (a)the purpose and intended use of the requested dara wi[hin the collecdng state agency,political subdivision,or statewide rysum;(b)whecher he may refuse or is legally required to supply the requested data;(c)any Imown consequence arising from his supplying or refusing ro supply private or confidenaal data;and(d)the idenary of ather personc or enaties authorized by sate or federal law to receive the dara. This requirement shall not apply when an individual is asked to supply invesrigadve data, pursuant to secdon 13.82, subdivision S, W a law enforcement o�cer. The commissioner of reveriue mav�lace the nodce rewired under this�+ibdivision in the individua!income taz or nroceriv tax refund instructions instead of on those forms. Subd.3. Access to data by individuai. Upon request to a responsible authoriry,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 subject 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 the content and meaning of that dara. After an indiv9dual has been shown the private data and informed of its meaning,the data need not be disclosed w him for six months thereafter unless a dispute or acaon pursuant ro this secaon is pending or addidonal data on the individual has been collecud or created. The responsible authoriry shall provide copies of the private or pubtic data upon request by the individual subject of the data. The responsible auchority may require the requesang person to pay the actual cosu of making,certifying,and compiling the copies. '!he responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or wi[hin five days of the date of the request,excluding Saturdays,Sundays and(egal 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 addiaonal five days within which to comply with the request, excluding Saarrdays,Sundays and(egal holidays. Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private daea concerning himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the�nature of the disagreement. The responsible authoriry shal!within 30 days either. (a)coaect the dara found to be inaccurate or incomplete and attempt to nodfy past recipiencs of inaccurate or incomplete data,inc(uding recipienu named by the individual;or(b)noafy the individual that he believes the data to be corzect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. 'Ihe determina6on of the responsible authoriry may be appealed pursuant w the provisions of the adminis�adve procedure act relaang to contested cases. DATA PRIVACY 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 �ity 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 shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested pemut or licease 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 pemut. Y�K.�. L ,�-(-� F�rst M�ddle �� S7 7--�t�1\V�.Q��►..J �� Address C�`r�r� �,J �53�\ ��2--L-f�I-��' C�ry' Srate Zip Phone I understand my rights as stated above. � re � 6 . . CHECK OFF LIST FOR ISSUANCE OF PERMITS . � FOR OFFICE USE ONLY ADDRESS OR LEGAL: 3S�Z t.� v��,�srn N A�..t � . PID: DESCRIP'I'ION OF'WORK: (j�e�p,/a�rt,S ' ZO�tPIG REVIEW BY: �!4 DATE APPROVED: BUILDTivG REV�W BY: DATE APPROVED; GS - i7-v3 FEES TO BE CHARGED: Misc. Fees Calculated By: PER�I�IIT Yes ./ No pLAl�t REVIEW Yes .i No SEWER CONNECTION STATE SURCHARGE Yes ✓ No WATER CONNEC'TiON INVESTIGATION FEE � Yes No PARK FEE SAC Yes No STTEINSPECTION Number of SAC�Units OTHER (specify) ZONING CH�CK LIST Zoning District: N� r�4l�+�.( , Fire Department: � Post Office: School District: • � " � Lot Area: Sq�.ft. Acres � Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: � � Front(Lake): Right Side; � Reaz(Street): I.eft Side: � Adjacent Structures: W tland: . Building Hei�ht: Def. Hgt. Pe •Hgt. Lot Coveraae: Grading: Staff Approval Date: y: Council Approval Date: Septic: Staff Approval Date: y: Zoning File: # Resolution: !� Resvlution Date: � Shoreland District: Avg. Setback: Bluff Setba : L.otCoverage: Existin; Proposed Hazdcover: 0-?5' ?5-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMA.RKS (in house): �� . . . BUII,DING REV�yy CgECg LIST UBC: 2' �!' � CONSTRUCTTON TYPE: 0� _ Sq Footage S per Sq Ftg � Basement � . , x lst F1oor . � x . . . — _ . . 2nd Floor x . - . . . . � . Garage X = - � � x TOTAL � Estimated Construction Value; $_�,dpp� Inspections Required: , `Vork Requiring Separate Permits: Site PIumbing Fire Hazdcover Removal Mechanical Footing ' Water Connecdon � Septic Sewer Connection � � Framing Fireplace � Insulation �.awn Irrigation Watl Boazd ��0�'� Other _�Final � � �MfB•) Well(State Permit) - -- ------�._. __ _. � Other Grading/Filling filectrical(State Permit) � REMARKS(Pi J HOUSE): . REVIEW BY OTHERS• ------------ -------____�__ . DATE: Access: Existing New � Access Approval: Date � By: � ----------� -- ---------___------------- � RENIARKS (TO BE NOTED ON PERivII1�; � �� 8 ' • � FORT F2CATE�EN U F SURVEY �RONo coPY �_�?' i:l %`�� `'� ` "T � ..t�. � v .. ._l.'. :' •) r „� -- 0.00--- '- -- �- D.dO--- ' .` - - � 1 I . �-� !.v"�� }. ��YL/Nf� � Ltt�'�✓CE � .� � ., , � 1 ��?i' :'� , LOT �, /6 � � LOT /7 : �.. �..r.� ;G� �' (�4REA=66G1�SQ.FT.J (AI�A=6600SQ.FT.J � .-. . ; . r) 1 - -- - � o �~�� _ � � � =---- "n' � , \ -?� _._.ry��==:P_c.n.irr� q np, � , $ ; , _ �� g N �, .;•r � . 4- i 1.0 _..-� '— �� cv ' ; `• � 13.�2 �� . 1(�' , � i � � ; � fiZ9ME � ---.,�--- P• ' ; r . � 1.0 ' . aa�E Srr�eY ' . ,�'- .N '- . . � . ,'�. � . � � j GARq6E ry fRA/y!E /�oUSE: cN•, , �`1 �3,� 4 ' � . , � �35 72" : � ' _;13.3U • ia.2 8.4 B,7 - . N "_"'_ - ' . . � : . d'94 . ; � . . . � . . � � . , e`�.� I � � � � �i . . ' . . � . . �I� � . , � . . . ' ' J 1 _ • u � 1 . j♦ ' �� . o c�vano�iron ' N i . � � i ' rn' ,, f� a`� � �� "^f -� . � � �1}� i . `no � � i pT" ` ' ,` -- � � -- SO.00— � -, , -- _ ---- S�AO--- '--� `�I � scale`�1"=20' h �r . � � � �� L/i//NGS TON �AI/ENUE � -- -- • - ,� - � I hereby certify that this is a true and correct representation 'of a survey of the boundaries of the above described land and of the location of. all buildings , if any, thereon, and all visible encroachments , if any, from or on, said=land. As surveyed by me this 25th d �y of February, 1991. . � ' . ' ' Herb F. Lemire RLS Minnccnt� Ro„ �T,. � ��i.n