HomeMy WebLinkAbout2005-P08682 - attached deck PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: po8682
Crystal Bay, Minnesota 55323 Permit Type:
Addition/RemodeURepair
(952) 249-4600 Date Issued: 6/29/2005
SITE ADDRESS: 3554 Lyric Ave Unit#
Wayzata,MN 55391
PID: 17-117-23-43-0055
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Deck-Attached
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Pernut Fee: $ 139.25 valuat;on: $ 6,800.00
Plan Review Fee: $ 90.51
State Surcharge Fee: $ 3.40
TOTAL FEE: $ 233.16
APPLICANT: Riverside Construction of Monticello OWNER: Dawn Stilnovich
5424 44th. Street SE 3554 Lyric Ave
Delano,MN 55328 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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APPUCANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Copies: 1-File(Signatures Reguired), I-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
f /
Total Fee: $ .��J� ��`� I3ateReceived: E�`t ''' �'
Entered By: 'i ,���c��i�-;.;�;�i<-'�' Permit#: t� 1 '�(e���.
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will bQ started.
(please print all information)
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THE APPLICANT IS: (circle one) O�VNER O CONTRACTOR
JOB SITE ADDRESS: �S`l ��/�,'G �vc. �i"eno, /�L�, ZIP:
Will this be a Pa�•ade of Homes, Remodelers Showcase Home or other Display Home?
❑ Yes �NO If yes, a special event perrnit is reqz�ir•ed wilh Police Depn�•tment mzd City Council approval
60 davs przor to the event. Shtirttle btrs se�vice will be reqarir-ed unless applicant demonstrates
sa ffr.cierrt on-site pa�-king is available. Non pei�mitted events will not be allo��ed.
NAME OF OWNER: Q��Z _SrG�/ldK.'v,�. __ PHONE: (home) ��5�-ao� -65��-
(work)
MAILINGADDRESS: ,3SSK L�fr� ,��.�_ CITY: C.����,,<< ZIP: -S'S39/
CONTRACTOR: ��-��:�� �s���:�, PHONE: �i1-yi�-.5.��.S��
CONTACT PERSON: �<!c G/,•�s�� MOBILE/PAGER: _
MAILING ADDRESS: .S�°i1 y Y`��r -�,y«�- -S'�� CITY: /J�ik„�, ZIP: s..s3��-<
STATE LICENSE: # �C-3 o y�/1357. EXPIRATION DATE: �-3%-�ao6,
ARCHITECT/ENGINEER: ,�;�% l✓�'1�,, PHONE: �/d- g�4 s�ss _
MAILING ADDRESS: �ti�y ���f� S.;c�lp.t S� CITY: ,D�l�.,� ZIP: Ss3,��.
NAME: REGISTRATION: #
TYPE OF WORK: New � Addition �C Accessory Structure
Move Home Remodel/Alteration
PROPOSED WORK(descr•ibe in detai�: j��, %f �pe�,..� �>;� s,�,�� � ,�/ ��,..z.� p,� _ _
,o,� `<'��� S��z2�a.°rr �G�EcJ'� �[�S D��' �I-�.
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED_
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �, S��o,oU
,
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 pemut;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE:=�`-�e'� �l./�_. DATE: S- y- ��'oS,
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.l. Type of data. The rights of individual on whom the data is storod or to be stored shall be as set forth in this section.
Subd.2. Information required to be givon individua►.An individual asked to supply private or confidential data conceming 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 known consequence arising from his supplying or rofvsing to supply
private or confidential daca;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 investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue may_,place the notice required under this subdivision in the individual income tax or proverty 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 su6ject 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 shal]be shown the data without any charge to him 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 si!c
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
responsihle suthority shall provide copies of the private or public data upon request by the individuai subject of the data. The responsible authority
may requiro the requesting person to pay the actuat costs of making,certifying,and compiling tke copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or�vithin five days of
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that time,he shall so infortn the individual,and may have an additional five days within which to comply wich the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Proceduro when data is not accurate or complete.An individuat may contest the accuracy or completeness of public or private data
concerning himself,To exercise this right,an individual shall notify in writing the responsible authority describing the naturo 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 recipiencs 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
dispute shall be disclosed only if the individual's statement of disagreement is included wich the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the administrative proceduro act relating to
contested cases.
DATA 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 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 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 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
publia
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
City State Zip Phone
I understand my rights as stated above.
�
ignature
32
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
A,DDRESS OR LEGAL: 3SSz{ C_YR-►�- A V 2
PID:
DESCRIPTION OF WORK: ���c.
ZO.�tIvi G REV�W BY: „`. DATE APPROVED: �- Z� -� S'
BUII�DING REVIEW BY: DATE APPROVED: �, •Z,l-o �
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ,/ No
PLAN REVIEW � Yes No SEWER C0�INECTION
STATE SURCHARGE Yes � No WATERCONNECTION
INVESTIGATION FEE Yes No �' PARK FEE
SAC Yes No � • SITEINSPECTION
Number of SAC�Units OTHER (specify)
ZO��TG CH�CK LIST Zoning District:
Fire Department: Post OfFice: School District:
Lot Area: Sq.ft. I 3�'1�� Acres , 3 Width �O o Depth 1 3`f•�
Survey Submitted: Yes�_ No Date of Survey: 6-�o •O S
Proposed Setbacks:
Front(Lake): 33•�6 Right Side: 21.5
Reaz(Sueet): �2� Left Side: �o �
(�ec.tc s't1+t�/L � �'0 (o
Ad;acent Structures: c� S' Wetland: N�A °•�` `�
Buildin;Height: Def. Hgt. �I/� Peak gt. —
L.ot Coverage: ��.b°7�
Grading: Staff Approval Date: /�(�r4 By: Council Approval Date:
Septic: Staff Approval Date: n(��q By:
Zon.ing File: # — Resolution: !� Resolution Date:
Shoreland District: /v c�
Avg. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hazdcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REviA.RKS (in house):
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BUILDING REVIE`V CHECK LIST
�C� - 2' � CONSTRUCTION TYPE: 'VI�)
Sq Footage $Per Sq Ftg
Basement x _ .
1st Flaor x _
2nd Floor x _
Gazage x =
z =
TOTAL
Estimated Construction Value: $_ �,�p a °—°
Inspections Required: �Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
x Footing ' Septic Sewer Connection
_�c Framing Fireplace Lawn Irrigation
Insulation (Masunry,) Other
Wall Board (Mgg,) Well (State Permit)
—�F�� Grading/Fllling Electrical (State Permit)
Other
REMARI�.S(1N HOUSE): .
REV�W BY OTHERS: ~ DA1'E:------- -------------------------------------
Access: Existing New
Access Approval: Date gy;
REI�IARKS (TO BE NOTED Ov PERivIIT);------------------------------------------------------------
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DATE � TIME
CITY OF ORONO CALLED IN 7j'��P`��
INSPECTION NOTICE p/� SCHEDULED -� �'�� "vU
PERMIT NO. ������5 vl COMPLETED
ADDRESS ��J < <-Tf�t L - L��
OWNER CONTR. �%%�%%�Sr�� �n2�f.
TELEPHONE NO. ��� ��/ So��.S�
� DE TION�.�_L-�'�-
� FOOTIN 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 MINZ� 13 MECHANICAL FINAL 19 LAKESNORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the n t inspection 24 hours in advance. (952� 249-4600
OwnerlCon r ite:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
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�A E 0� TIME
� CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED (���2
PERMIT NO._�G tS��.��� COMPLETE
ADDRESS �S� � ��-��� C- �
OWNER CONTR. � i 7���
TELEPHONE NO. (� ��� ������ C��K'�
� DESCRIPTION �-��.�� - ��'� - /�/��{'
l� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/G G/FILLING
Q02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS 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
J 10 PLUMBING FINAL /�' 36 FOUNDATION/REMOVAL
� OWNERICONTRACTORTOMEETYOU;�YES
� COMMENTS:
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR n CITAT�ON ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the n xt spection 24 hours in advance. (952� 249-4600
OwnedCon ract on it :
Inspector.
White Copyllnspector's File Canary CopylSite Notice
355� � r�-
CERTIFICATE OF SURVEY FOR
RICK WILSON
OF LOTS 17 AND 18, BLOCK 4, NAVARRE HEIGHTS
HENNEPIN COUNTY, MINNESOTA
�___� o�� S 89�25' 30" E 100.00
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LEGAL DESCRIPTION OF PREMISES
�� C�pY
------ _`._.
Lot 17 and 18, Block 4, NAVARRE HEIGHTS C�TY OF ORONO
�c SITE �LAN GRADIN� PLAN
o : denotes iron marker ��,p�����p _ ���
❑ ��'�°�{��r'�� V1i�TH REViSIQNS
This survey shows the boundaries of the above described properties, 1� ���Q�4}
and the location of an existing house and garage thereon. It does BY _
not purport to show any other improvements or encroachments. DATE .^___�Z�-o�
GRONBERG &ASSOCIATES, INC. I hereby certify that this survey was prepared by me or under my direct super- f, SCALE I
CONSULTING ENGINEERS,LAND SURVEYORS, vision,and that I am a duly registered Civil Engineer and Land Surveyor under � 20
the�aws of the State ot Minnesota.
SITE PLANNERS
DATE
445 N.WILLOW DRIVE 6/10/05
LONG LAKE,MN.55356
i���,���s� JOB NO.
952-473-4141 05-24 1
Mark S. Gronberg Minnesota License Number 12755
ns—�4�