HomeMy WebLinkAbout2001-P04250 - attached deck � '' PERMIT
C I TY O F O RO N O Permit Number:
2750 Kelley Parkway- PO Box 66 P04250
Crystal Bay, Minnesota 55323 P@�CYllt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: ai3o�2ooi
SITE ADDRESS: 3630 Livingston Avenue
Wayzata,MN 55391
P I D: 17-117-23-34-0027
DESCRIPTION: uac oc�upancy �
Construction Type VN
Proposed Use: ftesidentiai
Permit Class: Building Census Code 434
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Sepazate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 23.50 Valuation• $ 500.00
Plan Review Fee: $ 15.28
State Surchazge Fee: $ 0.50
TOTAL FEE: $39.28
APPLICANT: Owner/Self OWNER: Ernest Debella
MN 3630 Livingston Avenue
Wayzata MN 55391
THE 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.
�s ,�°� � C�.
ISSUED BY SIGNATURE
Copies: 1-File(Signitures Required), 1-Applicarrt, 1-MonthlyReports, 1-Assessing, 1-Finance Page 1
� � -- c � ,��.'��.
- �'I'otal Fee: $ �> � Date Received: � ���}
Entered By: ��',� �- Permit#:
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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 R CONTRACTOR
JOB SITE ADDRESS: �,�Co`� L���,c1C�S�� /�UC ZIP: G�3��
NAI�� OF OWNER: s�,L'�r�� ���G-c_C,4 PHONE: (home)�lZ -�,�7/c��.3 E,
(work) -�f-S2 �133�47D O
MAILING ADDRESS: 363� �.{d�,U(,sr-D,U /�(C CITY: W���-„Q ZIP:SS3�t/
CONTRACTOR: ��� '� PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: �¢I�- PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration ✓ Land Alteration
PROPOSED WORK(describe in detai�: l'�6�c1ic.�j ��� �z?-�+�" �,Q�t{
STORIES: SQ. FEET OF EACH FLOOR:
NU. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ Soo ,�
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 accordance with the approved plan.
APPLICANT'S SIGNATURE: �����%�• DATE: � • Z�'� •p/
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
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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 confidential dara concerning himself
shall 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 legally required to supply the requested data;(c)any lrnown 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 federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigadve data, pursuant to section 13.82, subdivision 5, to a law
enforcement o�cer.
The commissioner of revenue mav nlace the notice reauired under this subdivision in the individual income tax or orocertv tax refund
instrucdons 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 charge to hirn 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 action pursuant to this section is pending or additional data on the individual has been
collected or created. The responsible authoriry 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 widun five days
of the date of the request,excluding Saturdays,Suodays and legal 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 additional five days within which to comply with the request,
excluding Saturdays,Sundays and tegal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the 2ccuracy or complcteness of public or
private data conceming 6imself. To exercise this right,an individual shall notify in wridng the responsible authoriry 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 i�omplete data,i�luding recipients named by the individual;or(b)notify the individual that he believes the daCa
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 administradve procedure act relating
to contested cases.
AATA 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 �ity 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 fumish 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 shazed 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.
First Middle Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
Signature a
6
' '� CHECK OFF LIST FOR ISSUANCE OF PERMITS
.. •
' FOR OFFICE USE ONLY
ADDRESS OR LEGAL: _ 363 o C.,1 v tv�+G S 1'� /�P
PID:
DESCRIPTION OF WORK: (���.�
ZONING REVIEW BY: DATE APPROVED: � `�'�i
BUILDING REVIEW BY: DATE APPROVED: $ - 2.�-�c
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �' No
PLAN REVIEW Yes �/' No SEWER CONNECTION
STATE SURCHARGE Yes ✓ No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC Units OTHER (specify)
ZONL�TG CHECK LIST Zoning District: C,�-(C= (
Fire Department: /�O��I� Post Office: W ary-�-�,�g. School District: W,�5��,/_.
Lot Area: Sq.ft. /�d Glf�rvpp Acres Width Depth
Survey Submitted: Yes ot No Date of Survey: oN Ftu.'
Proposed Setbacks:
Front(Lake): 2y' * Right Side: y Z� r
Rear(Street): �S 3� r Left Side: p
Adjacent Structures: A-r-np c �=,r� Wetland: �1/}
Building Height: Def. Hgt. — Peak Hgt. "
Lot Coverage: —
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: —" By:
Zoning File: # ' Resolution: /f Resolution Date:
Shoreland District: /`1v
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
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BUILDING REVIEW CHECK LIST '
UBC: /Z• 3 CONSTRUCTION TYPE: 'y�
Sq Footage $Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
�
Estimated Construction Value: $ .Sc���—'
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
C Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well (State Permi�)
�Final Grading/Filling Electrical (State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: . Date By:
REMARKS (TO BE NOTED ON PERMIT�:
8
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�� " CERTIFI�ATE OF SURYEY �RON� GOP
� FOR: �j'G�L EE .,g,v�LOE.PS �
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!'�0 �` /Aa.a �c.o LEGAL DESCRIPTION:
Y�st.� — — — o �s�.yz — x�Ss.fc
�, � I � • I � Lots 5 and 6 , Block 1 , NAVARRO
� n,�,f,4 _ . o � according to the recorded �
-�- ---� �st.�
a � plat thereof , Hennepin County ,
���� � i✓�.9S7Z9E � , ; DZinnesota.
�x.sx '-.3D. O - � • •. - =Sa. '
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Sewer and water is available in street' ��`� '`' �Y
;: ;�� ,��� � '
however as built plans are not available . � � - � - � • �
o Denotes iron monument Proposed lowest floor elev. _
o Denotes offset staks Proposed top of foundation.e(ev. _
x 000.o Denotes exirting elev.
(000.o) Denotes Proposed elev. •BENCH MARK:
-� Denotes wrface drainaQe �
Proposed SnreQe floor elev.-
I h�reby certify that this is • true and correct rtprasentation of a wrvey of File No.
the bouncLries ot.thratiovt d�scribed land and of th4 location of all buildinQs, / �9
D�A� -GABRIEL . �f •ny, tht«on, and a11 yitiblt encrwchments, if any, from or on said land. 3�Cp��r
L.Rxp suxvEYORs, uv�. _ QG,�6cr 8 �
As wrvey• b m�thi �� d�y of 19 � Book - Pa
3030 Harbor Lan�No.
Plymouth MN 5�t41 - ��,2�.
Phon�: (612)SS�-OG08 `
Scale
� Minn. . No. /�G� � =����
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AT LEAST (�P•:L- Hf�.r�D^A;L �;�<_?J!�ED
4 ��� GU;AhD;�;4!i. OP=N �l�E�
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SP�C�AL NOTE
SEE ATTACHED SH�ET
FOR�a�N�� r�
CODE REQUIREI�ENTS
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CITY OF Oi;OnO ���=?�
SUILOING P Pr�T l..P.N P.�:Vi�'�N
tNSPECTOR
DATE�'2V`V( _FL•F�:;iT NQ.
G Af'P�C�VCC AS 5.�t","��i i'c!)
�A�FROVrD'Jti�T:•I C0�^�=C':i�•t�;�.A i+:GTcD
C "�T:;F��:7�r Et�---C;�:�'-.:i�C i�ti FC;l:�'�,IT
T'. ���=''.�ar:fe.,o�rr ir.�onn�;:o�. 4if wcrk�ha'I he Cone
in •. . _ • .ritt: ait af;p!;cr;i�,e t;ui!�:ng and �cr.i,g coda
Re:�. _ ;ems no;si�:a�i��ca;;y�rchad in tiiis�view.
K'tcE-��1�'r;�5 NL.r,�v SET OIV SITE AT ALL TlMES
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NQTICE SCHEDULED
PERMIT NO. `+��� COMPLETED ��U� �
ADDRESS � /U��
OWNER CONTR.
TELEPHONE NO.
� TION
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� G 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
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
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
D COMMENTS:
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d �-�IORKSATISFACTORY:PROCEE ❑ PROJECTCOMPLETE
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� �C7 CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS.
INSPECTOR WILL RETURN �' PHOTO TAKEN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on site:
Inspector. /�i�N)�
White Copy/lnspector's File Canary CopylSite Notice