HomeMy WebLinkAbout2004-P08080 - new structure ' PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Pososo
Crystal Bay, Minnesota 55323 Permit Type: NeW sm���ure
(952) 249-4600 Date Issued: iiii6i2oo4
SITE ADDRESS: 2170 Minnetonka Ave
Wayzata,MN 55391
PID: 10-117-23-31-0093
DESCRIPTION: UBC Occupancy R3
Proposed Use: Residential Construction Type VN
Census Code •� ���
Permit Class: Building
Pernut Type: New Structure Permit Sub-type(s): New Home-Single Family
DETAILS:
Approved per resolution#:
Separate permits required: rium�ing iviec;nanicai �ewer i,onnecnon irrigation w eii�siaiej Eiecmcai�staie�
NOTICES/REMARKS:
EE SUMMARY: Permit Fee: � 965.75 Valuation: $ 96,000.00
Plan Review Fee: $ 627.83
State Surcharge Fee: $ 48.50
TOTAL FEE: $ 1,642.08
PLICANT: Woodland Homes OWNER: Michael&Jeanie McClelland
P.O. Box 600 2170 Minnetonka Ave. (P.O.Box 45)
Wyoming,MN 55092 Crystal Bay,MN 55323
�E UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
VD AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND SI'ATE OF
NNESOTA BUILDING CODE REQUIREMENTS.
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A L PE TEE SIGNATURE i ISSUED BY SIGNATURE
s: 1-File(SiQnitures Required), 1-Applicant, 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
. . �, �i-�5-o�f � s� ,�- �� G ?
� /o � /�,o ,os►,o �_,c-tdG
Total Fee: $ l�Oy�� �� Date Received:
�o -/S-D
Entered By: Permit#: D �
CITY OF ORONO - BITrT 7'T"`V - i
All information must be submi s ��(✓� `ed.
(please � u-S� U
------------------------------------------------------- �i�"_' '^ ------------------
THE APPLICANT IS: (circle o�:e) � / n �Q.
��/�
JOB siTE ann�ss: a ( Zo l�.�U��e �
�r� �
Will this be a Parade of Homes, Remodeler;
❑ Yes � No If yes, a speczal �nent antl City
Council app�rova �vents will not
be czllowecl.
NAME OF OWNER: p��;I� �- ���.�'e- , ,��-Y7S'-o�/�
(work)
MAILING ADDRESS: �6 �aX yS CITY: ZIP: Ss3z 3
CONTRACTOR: �JS l cr�e S PHONE: (qS1-�f�z-4�a �
CONTACT PERSON: v-� /k,' 1VIOBILE/PAGER:
MAILING ADDRESS: (�C5 ��c (sKX� CITY: aw�� f't•l/ ZIP: Ss G 2
STATE LICENSE: # $C ,zvo(, �}Q6�(
ARCHITECT/ENGINEER: ��dv�A �2 S PHONE: rC� - �f 4�- (�z �
MAILING ADDRESS: CITY: � .-���..� W�ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New � Accessory Structure
Addition Move
Remodel/Alteration Land Alteration
PROPOSED WORK(describe i�z detai�: ,��w � � .�.9cavo-r�p
STORIES: I SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $
I hereby apply for a building permit and I aclrnowledge 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: �d -/.� �
. r
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd.l. Type of data. The rights of individual on whom the data Is stored or to be stored shall be as set forth in this sectton.
Subd.2. Information required to be given individual. An individual asked to supply private or conFde�tial data concerning himself shall be
informed ot: (a)the purpose and intended use of thc 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 consequeoce arising irom his supplying or retusing to supply
private or confidential data;and(d)the identity of other perso�s 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 otficer.
The commissioner o[revenue mav olace the notice reauired under this subdivision in the individual income tax or aroaertv 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 classiTied as pubiic,private or confidential. Upon his further request,an lodividual 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 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 add(tional data on the individual has been rnllected or created. The
responsible authority shall provlde 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 ot making,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,wlth any request made pursuant to this subdivision,or within eve days ofthe
date otthe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible.Ithe cannot comply with the request within
that time,he shall so inform the individual,and may have an additional fve days within which to comply with the request,excluding Saturdays,Sundays
and legal holidays.
Subd.4. Procedure whco datu is not accurate or complete. An individual may rnntest the accuracy or compieteness of public or private data
concerning himself. To exercise this right,an individual shall notify in writing the responsible authority describing the nature of the disagreement. The
responsible authority shall within 30 days either: (a)correct the data found to bc inaccuratc or incompletc and attempt to notify past recipients of
inaccurate or inrnmplete 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 dlsclosed only it the iodividusl's statement of disagrecment is included with the disclosed data.
The determination ot the responsible authority may be appealed pursuant to the provisions of the administrative procedure 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 notitied 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. 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.
Signature
CHECK OFF LIST FOR ISSUANCE OF PE.K1tiIITS
FOR OFFICE USE ONL Y
ADDRESS OR LEGAL: �i1 v ���G�"°'�� �'"
PID:
DESCRIPTIONOF 6VO.RK: N�w �=� � ��5'T'' a�'ap
------------------ ----- ----------------------------------------
ZOtVINGREVXEtVBY: DATEAPPROVED: /v-Z/• oy
B UILDIrYG RE VIEW B Y: DA TE APPRO VBD: �v• Z�- �Y
---------------------------------
FEES TO BE CHARGED: Nlisc. Fees Cc�lczclated By:
PERI�IIT Yes ✓ No
PLANREVIEGV Yes ✓ tVo SEYVER GON�VECTION
STATE SURCHARGE Yes t/ tVo tiVATER CO�WECTION
I��IVESTIGATIO[V FEE Yes [Vo �� PARK FEE
SAC Yes �Vo oC SITE NSPECTIOtV
Nu�nber of SAC Units ,+�A �-�a•�d� �lt.r,w�T '�'r t�sb�f OTHER (specify)
----------------------------------------------------------------------------------------- -
ZONING CHECh'LIST Zor�ingDistrict: /«'��
Fire Departmerrt: Post Office: Schoo!Dish'ict: __..
Lot.�tren: Sq Jt. Z�;�4'� _Acres $� 6Yidth Depth
Su�vey S«brnitted: Yes�_ No DRte of Survey: g"f�" �'Y
Pr•oposecl Setbacks: �"`'� GM��
Front(Lake): � •S 1�3 Riglit Side: SO.� S�sS
Renr(Street): 6�1 ��•`� Left Side: 30•5' `'�-2
Adjncent Sn•ucteu•es: 10` G�etland: N�1�19
Bctilcfing Height: Def. Hgt. �•�`' Peak Hgt. �
Lot Coverage: � N °?a
Grading.• Staff Approvct!Date: Lb•/S '0�'l By: �._ Counci!Approval Date:
Septic: Stnff�lpprovn!Date: I✓ ��' BY� —
Zoning File: # �Y- 30� Resolution: # Resoltition Date: g'27• d''�{
Shoreland Dish•ict:��S
Avg. Setback: N'I✓� Bl uff Setbc�ck: /✓��' Lot Cover•age: ���o
Elisting Proposecf
Har•dcover: 0-7.i'
�s-zso� �o �z. s�a
2SO-SOO' Z�'�
500-1000'
ffardcover �ariance Requireci: Yes No Date of Council Approval:
REII�lARKS(irt hOuse):
31
B UILDI�VG RE VIE tY CHECh'LIST
UBC: � '3 CONSTRUCTIO!Y TYPE: �/�
Sq Faotc�„e .�Per Sq F{;
Basenie�it � _
Ist Floor ,r =
�nd Floor x =
Garcge � _
� _
TOT.AL
Estimated Constrc�ctio�c Value: ,S c'1�.�04� ��
Irespectio�is Required: 6York Requir•ing Separate Pern�its:
Site D� Plumbing Fire
Kardcovei•Removal p� Nlechaaicnl GVater Cainection
� Foo[ing Septic _�c Seti��ei•Co�irtection
_�e Frnntirig Fii•eplace _�c Lativn b•rigation
Inse�lation (A�lasoniy) Other
Wafl Board (A�Ij'g•) _�t 6•Vell(Stnte Perrnit)
_�CFinal Grading/Fillina �Elech•ical(State Pern�it)
Otlrer
REtYIARliS(INHO USE):
REI�iTEYV SY OTHERS: DATE:
.4ccess: E.ristin; New
Access�{pproval: Date B�•:
------------------------------------------------------------------------------------------------------------------------
RE�'�IARh'S (TO BE NOTED ONPE1�tilIT):
3?
OCT-15-04 FRI 01 �30 PM CHALLENGE PRINTING FAX N0, 6129420973 P, 03
,
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tir��.13.0•1 NlGlITSOi�SULi.JJECTS(TF DA'f�l
uu;�d. 1. 1'y��C Of daW. 'll�c ri��l i of iu►i�idu:►1 an who�n shc daw is sl�red or u,bc s�or�d sl�nll bo as acl Conh in Uiis sectian.
Sul•rL 2.lnfv�,�,al io:�rCUui�C�!to be�ir�;1 individ�l;tl, tin iiulividual uskal M cupP�Y p�i v�'�e or w�ifidcn�ial da�o conccrnin�Islm�c�lf sl�:�il b;
i►tl'�nn�:d o f (,i)ll��e pLrpus�:�nd iut�n�!:d u�o of Ihc:nyu.,lcd da��willf'tn lfio co1l�:ctinG slal�n�rncY,potiticnt sub�ivision.or sta�cwidc systcu�:(b
whrq�u hc ni,cy n Futa or is k�,��lty rc:quir«l lo supply dta rrqu��,ted data;(c)a��y imowm m�c�quence aricing fibm his su�lyipC or rcfuci��g to sqpplY
p�'ivatuu�conlid"tiliald�ll.l;��y�(d)ti�ol3�hdilyofelh�rpc►��nsbrrntilt�y�ulhorl7.cdbystuleorf����'�ll�wtvrxeivclhcd��i.Thiy�yuiremc�i�xh�dl
not apE�ly wh�:n�u iud'tvidual is 7sk�d Co S4pply inre511�1lIvC daG�,pursuant lo scctiur�13,A?,sul�division 5.to a lrtw rnfoiccmcn��fGc�r.
�r,�r.mq�j':�inr,�;r 1�f Lv�q�p•�r�7ys,(,ice�,f�<+n��se,r,yq�)jrcd undP' hi id�}livjcinn in thr,ln�livicla1l jl�r��mc y1�,4C.1ti�.I�4l�Y 4i'S..Cci�
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ir��lr��alinn�,jm:i:���9 nFnn thi',ct!,f�nn�.
S�bd.3, Acc�•::e�u Jara hy i�dividu�l. U�on r:qu�t W s r4sp�m�ib1�oulhnrjly,nn in,iiviJu�l sh�ll bo info��mv�d wl�ethen c�is�ho subjcci oF
s�nn'�da���•�in�{ivitlu:�l�,«nd w����l�c�it is elo•�sif�4d��publia.priv�ld or cnnlid�nli�il. Upon his fiinher reqaest,an InJividual who is llio snbjrcl of
sccr��d rn i�orc�,r publlC d tt:1 Gn indlVldu lls Sha111 b�s��OWiI 1j1�da41 N'ith0�t Sny Ch11:,��Iiinl af1Q,if he J�xir�.5,�hall bu inf'uim��l of�hc conlcul and
,r��ai;inf�uf lli,,t�nla. AOu�n in:i�iJu�d h�+bc��i shown ll��privnly d:�la�nd inf�mn�d Of 1�5 mL�Itil1�l,thv d:da na•J no�bc disclosrd W llim for sir
,nunll�s II��'�c'7�41'unlctiS u A�spul:ot^ctin�pur�uoi�t lu ll�is scclion i,pcndii�$vr adJition�l d�l.�cii Ilu:individu�I ha5 be�n coll�xled or cn;�r�:a. 7'�,�
rc,;J�u�i'S!�o�!thciritysh��Iprwir.Iccup:��+ofthcprnatrarpubliccL•taupnnrGyu��tby�hriudividiialsubj��:loFlhcd�la.TI1CTrtiPo�1SIIlICAu�horily1110y
reyui��111P fr:;uC�li�1�p�:�snn u��,�y�'+�acru^t ce.rlS of�r,�kinL.Cei1i('yin�.rnA cPmrifing U�¢�c+pics.
't 1���:��wn+i�l��au�h,,rity el�a0 co�ply immrdialnly.if possiblu,witb any rvqu�st m�dc pursu�nl to��is sub�l'svision,ur wilhin fivc d:►ys of�he
d,�tc of Qi4��quc�.t,rxcl�,rli�sG Salu�Yioys,$uad:�y0 and(eN,;d hnfidayS.iC imm��diata oon,ptianca is nar possiblc. If ha ounuot comp{y wi14 lhc iti•t�uryl
��•dl�i n IL1t tin��,hc shaU�A iufoi�»Iho inJivi�lunt,nn�mny 1��vu an arlcli�ional I iva d�ys wi�l�in which W com��ty�vitl�tt�s rcquc�l,excluclins Salu�days,
<<���d:,ys an�f lc.��ol hc;liJ:�y�„
5�bd.4. Praccthfl'�wlirn�•�•n is noc aC��u::tu nr coiapl�:le. An indivi�lual m�y eOnlht lhc a��CNi:'�y oreo�nplvKrncSs ofpubl;c orpri�JlC dola
con.:rPnilt,�hims�:IL To��ut�:i�e[his ri�lit,�:n individual sD.'►II Rc�tify in w�if inp lhe re5ponvih;e authori�y d�:seribin�r tha�:tlw�of lh�dis��tt'�h:i11rD�. 1'h�
(u,pPnaibl�.lulhority eh�dl tivithin 3U ILqti euh�r. l�)c�n�:z�lhe d.iGi fo�md�ho i»nCcu1'�lle�r inw��iple•�e and ultcirpL W nrnily p�st Rcipicut5 0l'
i,iacc�,r�t�:r.r incctmpl�tc do��.inr.l�idir.,:r�r:ii+iontx namud by thu inJividunl;or(b)nulif'y�nu inclividu:�i that hc:bciicvcs d�u d�lo lo be currec:t. n,til�in
cli:,palc sl:�,ll bc dixcta��.1 only if ll�s irt�tivi�lu�l's s61�c���.n�of d'Is�9�,1'u�m�u[is InCluticQ WI(h Ul+:divclOscd d,i��.
'�1,�d��annin�ri�r,��f lUc rc:;punsiLlc aurhority u�ay b��pp�7lcd punu�ut ro�,c provi�ions ol'th�adminir,�r:��ivc procalurC uci rcla�fig lo
canu:tiicd csicc,*�,
u �rA PR V, ,ACV AI)V1Sl�RY
Jn r�ccordance witli M.S. 13.0�,Subd.2,"Ri��h�s uf suUjccts of data",wc���uld like to inforinyou thal'your roquc;st
i'ur a l�cxn�il�c licu�s� fy'�m tfr:Ciry af Oronn or hny of il3 dcp��'�mcnts in�y rcquire you to Cu��iisli c�rt�in priv,�te or
C(lI]�(.��il�ll� II7fOCf1'I��In�l-
Y�u�rv�tolificd lh�t;
1. 'I'hr; infornlado.7 you fu[ni,h will I.ic uscQ [o d�G:nuine your qu�liFcation !'oc tho pennit ar li�a»sa
rcq,�ea�e►i,
2. You�nay rcfiiso to supply dais,but refusal m�y requira d�at llu:City dcny tlle l�crmi[or license:,
3, 'I'ha inf�nn�tio�1 m�y be sh;sr�d wi�h odter la:�l, state or f�d�r�l agcncies to the exieni n�a�ssaty t�
p�ucc:.�tlti�periziit or l;c�n�.c.
4, tf your r�y�:estcd purn�it or liccusc requir�s Cou��cil flcfion to�pprov�,some infvm�ation may b�c�mc
pub(ic.
5, You h�vr cei lain ciGhts unc3ct h4.S. 13.p4(�tvailable upon reque5�)to review�rivate daea an yours�lf.
G. Yo�r ful!na�n�:is renuircd to procc:ss dlis�pplicatioxi ar permi�.
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DATE TIME
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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 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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❑STOP ORDER POSTED.CALL{NSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cat1 for the next inspection 24 hours in advance. (952) 249-4600
OwnedContr r on ' e:
Inspect i�
White Copyllnspector's File Canary CopylSite Notice
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DATE TIME
CITY OF ORONO CALLED IN l. ��5-0_��
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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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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INSPECTOR WILL RETURN
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❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-4600
Owner►Contra o site:
Inspector.
White Copyllnspecto File Canary CopylSlte Notice
� � � D TE TIME v
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Z04 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
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Call for the next inspection 24 hours in advance. (952) 249-46��
OwnedContra site:
Inspector.
White Copy/lnspector's Fiie Canary Copy/Site Notice
� � � ✓
DATE TIME
CITY OF ORONO CALLED IN L/ T�S
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Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
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? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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❑ INSPECTION REQUIRED.CALL TO ARR GE ACCESS.
Call for th 'ns ctio 24 hours in advance. (952� 249-46��
Owner/Contracto site:
Inspector. �
White Copyllnspector's File Canary Copy/Site Notice
Cl� L!�� v
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�� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
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`� � D TIME M
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INSPECTOR WlLL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContract s' e
Inspector. ..
White Copyllnspector's File Canary CopylSite Notice
a�70 /'r�nn��-lc�,���
�� CERTIFICATE OF SURVEY FOR
� JEANIE M � CLELLAND
IN LOTS 4, 5, 8c 6, BLOCK 8, MONTEREY ON MI_NNETONK
,
HENNEPIN COUNTY, MINNES TA �� OFOR��O
� SIT� PLAN � GR OING PL�N
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r9 �C� S 89° 21'08" E C,� 175.0 " �
49�J . l9yM�1 985.5)
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,n — �� — — .=- PROPOSED (956.4) ���
�"? / PROPOSED HOUSE o i � \
� GARAGE I
� ..i :5' � ,��9 .•' 2170 �'� � � �� c0 (eae.e)
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`�6 N Ei9" 25'02" W 175.00\ineas. 176A �962•4) '
� (982.8) —/
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� (96��� INNET�NKA AVE. o � � �
(962.2) �
(981.9)
PROPOSED ELEVATIONS :
LEGAL D�SCRIPTION OF PREMISES . (962.8)
1) Qetached Garage = ss4.o
Lots 4, 5, and 6, Block 8, MONTEREY ON MINNETONKA, 2) Top of foundation = ss4.o
EXCEPT the North 12.00 feet of said Lots 4, 5, and 6
3� Basement = 955.2
o : denotes iron marker
(gqg.3) : denotes existing spot elevation, mean sea level datum
910.8 : denotes proposed spot elevation, mean sea level datum
- - -g�7— - -: denotes existing contour line, mean sea levei datum
904 . denotes proposed contour line, mean sea level datum
Bearings shown are based on an assumed datum.
Lot area = 24,200 sq. ft.
This survey sf�ows the boundaries of the above described property,
and the proposed location of a proposed house and garage thereon.
It does not purport to show any other improvements or encroachments.
SCALE
G R O N B � R G A N D I hereby certify that this survey was prepared by me or under my �►�=30�
A S S C] C I AT E S, � nl [�. direct supervision, and that I am a duly registered Civil Engineer
�nd �and Surveyor under the laws of the State of Minnesota. oATE
CON5ULTING ENGINEER5, 'IO-26-04
LAND SURVEYORS,
AND SITE PLANNERS �
445 N. WILLOW DRIVE LONG LAKE, MN, 5535 ,G/���� �_ , JOB N0.
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952-473-4141 Mark S. Gronberg Minnesota Licen e Number 12755 04-337A
04-337A