HomeMy WebLinkAbout2006-P10559 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: P10559
Crystal Bay; Minnesota 55323 Permit Type:
Addition/Remodel/Rep air
(952) 2��-4600 Date Issued:
12/21/2006
SITE ADDRESS: 3496 Lyric Ave Unit#
Wayzata,MN 55391
P��� 17-117-23-43-0071
DESCRIPTION: UBC Occupancy R3
Consri-uction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
DETAILS:
Approved per resolution#:
Separate permits required: Plumbing Electrical(state)
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 69.25 Valuation: $ 2,000.00
Plan Review Fee: $ 45.01
State Surcharge Fee: $ 1.00
TOTAL FEE: $ 115.26
APPLICANT: Owner/Self OWNER: Eric Houland
MN 3496 Lyric 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.
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PUCA__ M(TEE SIGNATURE ISSUED BY SIGNATURE
Copies: 1-File(Signarures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
• Total Fee: $ � � ,�(.�/' DateReceived: ����`1 ��i��
Entered By: � � Permit#: �%;��
CITY OF ORONO - SUILDING PERMIT APPLICATION
All information must be submitted in full befoi�e plan revie�v will be started.
(plecrse���i�it all ijifot•mation)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle o�ze) WNE OR CONTRACTOR
JOB SITE ADDRESS: 3`��� Ly�� � ��''� ZIP: SS�9' l
Will this be a Parade of Homes, Reznodelers Showcase Home or other Display Home?
❑ Yes �C No /f yes, a specicrl ever�t permil is regarired�vitl�Police Depnrt��rei�t arid City Coarnci!n�provnl
GO days prror•to t/1e eve»t. Shzrttle btrs ser•>>ice rvill be reqi�ired trn(ess applrcant dernonst�•ates
szrfficiellt a�-srte pai•Ici»g is avnilable. 1\�`o��-pern�ilted e>>ents 1vil1 not be allotii�ed.
NAME OF OWNER: ��'� �°J�"�'�`� PHONE: (home)6�Z-96�-1�y2
(wocic) —
MAILIVG ADDRESS: 3��(� �I''�� �� CITY: C�ro�.� ZIP: 5539)
,
CONTRACTOR: - PHONE:
CONTACT P�RSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # �XPIRATION DATE:
ARCHITECT/ENGINEER: -- PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows) X
Any earth movemenc may re uire MCWD review and per;nits !
PROPOSED �VORK(describe in detain: � 5��� �t wv �,uv-� �vtv� i�...
�ge�k��.,,, � �[o� co�.��,�-��, g0.� -f-� -�� ��-k "h-� h��L� I�,�.s
STORIES: � � SQ.FEET OF EACH FLOOR: �j So
NO. OF B�+DROOIl�i�: � GAi2AGE ��'ALLS: A�CTAC�I�I) D'£TACHED X
��e.c�w•��a. 1�
ESTI�IATED CONSTRUCTION VALUATIO�'(excluding land): � ��o �S ��� ��������� 1
-� �ou rSJ
I hereby apply for a building permit and I acknowledae that the information above is complete and accurate;
that the`vork�vill be in conformance �vith the ordinances and codes of the Citi� and with the State Buildin�
Code; that I understand this is not a permit and�vork is not to start without a permit; and that the�vork�vill be
in accordance ���ith the approved plan.
APPLICANT'S SIGtiATURE: g�A��: I � S o 6
31
Sec.13.0a RIGHTS OF SUBJECl'S OF DATA `
Subd. 1. Type of data. The rigl�ts of individual on whom Nie data is stored or to be stored shall be as set foRh in tliis section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming himselfshall be
infonned ofl (a)tlle 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 requirod 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 federal law to receive d�e data.This requirement shal I
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 may�lace the notice required under this subdivision in the individual income tae or pro�ertv tax refund
instructions instead of on those forms.
5ubd.3. Access to data by individuol. Upon request to a responsible authority,an individual shali be informed�vhether he is the subject oE
stored data on individuals,and whether it is classitied as public,private or confidentiai. Upon his further request,an individual who is the suUject of
stored private or public data on individuals shall be sho�vn the data without any charge to him and,if he desires,shall be infortned 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 ro him for six
months thercafter 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 publ ic data upon request 6y the individual subject of the data. The responsible auchority
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possib(e,with any request made pursuant to this subdivision,or within tive days o£
the date of the request,e�cluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shail so inform the individual,and may have an additional 2ive days within which to comply with the request,escluding Saturdays,
Sundays and legal holidays.
5 ubd.4.Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private dtita
concerning himsel£ To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement.The
responsible autliority shall within 30 days either: (a)coRect the data found to be inaccurate or incompiete and attempt to notify past recipients of
inaccurate or incompiete data,including recipients named by the individual;or(b)notify the individuai that he believes the data to be correct. Data in
dispute shail be disclosed only if tlie individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisioiu of the administretive procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. l 3.04,Subd.2,"Rights of subjects of data",we would like to inforn�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 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 1�I.S. 13.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
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First 4liddlc Last
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Address
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Cih� Siatc 7.ip Phone
I underst d ri t ed abov
Si� s
Reset Form 3'
�CHE��K OT`k` i�IST FOR ISSUANCE O�F �ERi.�TS
FOR OFFICE USE ONLY� . .
,�,pp�LESS ORLEGA.L: 3`Iqb Ly�Z��- �v�=
PTD:
DESCRIP'I�IO�T OF WORK: — . —
--N a--_--_—._--_------
Z4�Ti`IG �'��'V BY: r DATE AP'PROVED: .
� . . DA.TE APPROVED: I i-Zt - ��
�LTII,DIN'G REVIEti� BY: �
-------- --=---------- ---- ---;--- ----a culated By: -----------------------------
F'EES TO BE C'HARGED: Misc. Fezs C 1
PERMIT Yes _� No
PLAN REVIEtiV � � Yes ,/� No _ SEWER COYNECTION
STATE SURCHARGE Yes _� No �VATERCONNECI'IOi�1
II�IVESTIGATION FEE Yes No ,� PARK FEE
SAC Yes No —� SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZON�i iG CT�CK LIST Zoning District: d �2 •
' Post Office: School District: • �
Fize Department: �
Lot Area: Sq.ft. Acres Width Depth
Survey 5ubmitted:� Yes No Date oE Survey: _
Proposed Setbacks: �Q �Sid ' �
Froat(Lake): � �
Rear(Street): Lcft Si :
Adjacent Structures: tiVetland:
Buil�lin;Hei�.t: Def, Hgt. _ Peal:Hgc.
Lot Covera?e:
Gradino: Scaff Approval Date; y: Council Approva?Date: _ '
Sep�ic: Staff Approval Date: ��
Zoaing File: � _ Resolutioa: � Resolution Date:
Shorelzr+d Districc: _ Lot Coveca�e:
Avg. Setback: Bluff Setback
Eustina Proposed
Hz�caver: 0-75'
75-250'
2�0-500' ---
500-l OC�J'
�: �� D��� nF�o�c�� a•PC�OVZ.
�^1��l:COY�i `1�L'.�Co P�qui;� �:es .����
RE�L�Rk�S (in housel:
� . +
BUILDINC RE'VIEti'V CH.ECK LIST
�C� — ��' � � CONSTRUCTION TYPE: �Yv .
Sq Footage $ Per Sq Ftg
' Basement • . . ,, x u . .
lsc Floor ' . x • _ . • . � '
2nd Floor x _ � � ,
Garaoe X � ,
x —
TOTAL
Estimated Construction Yalue: $ Z,C)oo `'—�
Inspections Required: Wark Requiring Separate Pec-rnits:
Site _�Plumbing Fire
• Hardcover Removal Mechanical Water Coanection
Footing ' Septic Sewer Cannection �•
—�Fr�° • Fireplace Lawn Irrigation
�Insulation (Masoary) Other
_,�Wall Boazd (Mfg.) Well (State Perm.it)
—�F�� Grading/Filling _�Etectrical (State Permit)
Other
-------- .-------
REMARKS (IN�-IOUSE): � ' .
-----------------------------------------------------------------
REVIE'4V}3Y OTHERS: DATE:
Access: Eusting New .
Access Approval: Date gy; '
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REI�IARh'.S (TO SE NO'�'ED O�PERiI�Il�:
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CITY OF ORONO CALLED IN
INSPECTION I SCHEDULED ��� • ��
PERMIT NO. � �� COMPLETED
ADDRESS
OWNER CONTR.
TELEPHONE NO. lo� a `"llp� �l/� T �"�
� DESCRIPTION �I�..S���o
l� 01 FOOTING 11 MECHANIC RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHA ICAL FINAL 19 LAKESHORE/WETLANDS
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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 INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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� ❑Ct�RRECT WORK,CAII FOR REINSPECTION TEMPORARY
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❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 24Q-46QQ
Owner/Contractor on site:
Inspector. w /r �
White Copyllnspector's File Canary Copy/Site Notice
�� � A TIME V
CITY OF ORONO CALLED IN /��
INSPECTION TI � SCHEDULED l ^� %�fl
PERMIT NO. COMPLETED
ADDRESS � �1 /�G
OWNER l�. � � . CONTR.
TELEPHONE NO. � �� ��� �� T �'
� DESCRIPTION Gl/G2-E%c-Qu L�?G+LC1�'
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 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 O6 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITtON WITHIN HOURS. C PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the ext inspection 24 hours in advance. (952� 249-46��
Owner/Con site:
Inspector. �
White Copylinspec or's File Canary CopylSite Notice