HomeMy WebLinkAbout2003-P06169 - detached garage ITY F R N PERMIT
C', � � � � Permit Number:
2750 Ke�ley Parkway- PO Box 66 P06169
Crystal Bay, Minnesota 55323 Permit Type: Aooessory s�uc�es
(952) 249-4600 Date Issued: 9�26�2003
SITE ADDRESS: 90 Myrtlewood Rd
Wayzata,MN 55391
PID: 36-118-23-33-0012
DESCRIPTION: UBc occupancy ul
Construcrion Type VN
Proposed Use: Residential
Permit Class: Building Census Code 438
Permit Type: Accessory Structures Permit Sub-type(s): Garage-Detached
DETAILS:
Approved per resolurion#:
Sepazate permits required: riumbing iviecnanicai waier Connecuon�ewer wnneciion Eiecaicai�siaieJ
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 209.25 Valuation• $ 11,680.00
Plan Review Fee: $ 135.98
State Surcharge Fee: $ 635
TOTAL FEE: $ 351.58
APPLICANT: Owner/Self OWNER: Kevin Thompson
MN 90 Myrtlewood Rd
Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESf S 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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APPLICANT PERMITEE SIGNATURE ISSUE BY SIGNATURE
Conies: 1-File(SiQnitures Required). 1-Avplicant, 1-Monthlv Renorts, 1-Assessin�, 1-Finance Page 1
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CITY OF ORORO - BUILDING PSHl�lZT APPLICAT�ON
Tot�t�,. `�'a+�s S �JI � � ` Date Received:, `�-IC�-�06 3
�' Date Approved:
� � : � � �� I.fVI,- � �j ��_�
m�ez� �.y: ��� ��< � � �
� � Permit$: � (;� � �
l,$L T�?IOA MDST BB SOSAITrED IM FQLL Bffi�ORE PLAN RRVIEW �iILL BS STARTEO
{See� Check-aff List Enclosed)
?BB aPPLIC�INT IS: (circle one) WIdER �r CDNTR.ACTOR
JOiB -8I?S ADDRFSSs ( � / � C..Wccc� _�. ZIPt ��� � �
c
(work) ySl-��/S"o /6s:
= �1Ai� OF 01�i�: �c/1 i� !"�O j�l'ti �c� 1� PHOI�TS: (horne)7 S:�-��y'- O 1(05
�
} !�lAILI1�G �DDRRSS:`7� �y.�,t(rwd��t Q�, c=�r:Q�a�� sip: SS3��
CaPTR,ACTOR: PHONE:
: l�tlillZ�IriG AUDRBSS: CITYs ZIP:
$TBTS LIC�SB: �
AR�TSCT/SNGINSBR: �/� PHONE:
!lAILING �DDR$S3: CITY: ZZF:
a�gs RSGISTRATIOP �
S'YP$ OF WOR1�: Dlew Additian Accessory 5tructure Move
Dezao Rem�e1/Alteratian Renovate Land lteration
PROP�S$D i�ORR (describe in detail) : `�� (-� ��� C�
�-
$TORIBS: I SQ. FEST OF BACS FLOOR: / ( F� C�
�10. OP BBDROOl15:�_ GARAGE STALI.S: ATT. DET.�.
�
BSt2�lA3'8D CO1qSTRIICTIOI�f Y�LIIAMON (ezclndi.ng land) : $ �� fi�•o�
I hereby apply for a building perniit and I acknowledqe that the infvrmation
abave fs camplete an� acaurate= that the Nork will b� ia conformance with the
er8iaances and codes of the City and with the State Buildinq Gade; that I
'�aderstand this is not a permit and work is not to etart without a permit; and
;.
t2iat the work wi11 be in accordance with the approaed plan. .
EP'P�IC1�1�T'S SIGAATQRt�s DATB: � � Q�
• . .�
CHECK OFF LIST FOR ISSUANCE OF PERMITS
, FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 4o W►y aT c.`w o od (L�� �
PID:
DESCRIPTIONOFWORK: �-�c,�.�`,rs E,,4,�,.r„p
ZO,YIYi G REVIEW BY: DATE APPROVED: 9-/��
BUII.,DIYG REV�W BY: DATE APPROVID: 9-�tr�3 � �
FEES TO BE CHARGED: Misc. Fees Calculated By:
PER11iIIT Yes �/ No
PLAN REVIEW Yes _� No SEWER CONNECITON
STATE SURCHARGE Yes ,/ No WATIItCONNECTION
INVESTIGATION FEE � Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning District: IP/L-//� .
Fire Department: � Post OfFice: School District: • � �
Lot Area: Sq�.ft. Acres /. S� Width Z�7 Depth
Survey Submitted: Yes No Date of Survey: �
Proposed Setbacks: � � � • �
Front(Lake): (b 2 � Right Side: 1 �3 i �
Rear(Street): 10�B� `1= Left Side: Z 3� �
Adjacent Structures: I 1' �Vetland: ,�� .
Building Hei,,g.ht: Def. Hgt. o •7� Peal:Hgt.
Lot Coveraoe: b•`1
Grading: Staff Approval Date: — By: Council Approval Date:
Septic: Staff Approval Date: — By:
Zoning File: # — Resolution: # Resolution Date: �
Shoreland District: /la
Avg. Setback: Bluff Setback: Lot Coverage: L• `f
Existino Proposed
Hardcover: 0-75'
75-250' �
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house): ��
7 . ' . .
� '
BUILDING REVIEW CHECK LIST
UBC: l�- l � CONSTRUCTION TYPE: nl
_ Sq Footage $per Sq Ftg
� Basement � . . x
lst Floor . � x . . . — . . .
2nd Floor X . _ � . . . � �
Garage x — � � �
x
TOTAL � �
Fstimated Construction Value: $_ ( 1. ���
Inspections Required: , �Vork Requiring Separate Permits:
Site oL PIumbing Fire
Hazdcover Removal _�Mechanical
. _�Footing ' � Water Connecdon
� Septic �c Sewer Connection
� _,�Framing Fireplace �
_,�,Iusulation Lawn Irrigation
_�Wall Boazd ��0�`� Other
�C Final � � �fg•� Well(State Permit) _.._ _ __----_._ _ �
Other — Grading/Filling _�Electrical(State Permit) �
RE1�Z;�RKS(�i T HOUSE):
REV�W B """' --------------- � ___---__
Y OTHERS: DATE:
Access: Ezisting New . �
Access Approval: Date �
By: �
""'----------------- -----------�__-------- �
REI��ARI�S (TO BE NOTED ------------------"�""
ON PER1vIIT�;
8 '
Sec.13.04 RIGHTS OF S[JBJECTS OF DaTA
Subd. 1. Type of data. '!he rights of individual on whom the data is stored or to be stoced shall be as set forth in this secaon.
Subd.2. Information reqlrired to be givea individual. An individual�ked to supply private or confidendal dara concerning himself shall
be informed of: (a)the purpose and intended use of the reques�ed data within the collecdng state agency,political subdivisioa,or statewide system;
(b)whether he may refuse oY is legatiy requ'ued to supply the requesud data;(c)any Imown consequence arising from his supplying or refusing to supply
private or confidenaal data;and(d)the idendry of other persoat or enrides authorized by state or fede�al law to receive the data. This requirement shall
not apply when an individual is asked to supply invesagadve data,pursuaat to secdon 13.82,subdivision S,to a law enforcement officer.
The commissioner of revenue mav piace the noace iewired under this rubdivision in the individual income taz or orooertv tax refund
instcuctions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible auchoriry,an individual shall be informed whether he is the subject
of stomd data on individuals,and whe[her it is classified as public,private or confidenoal. Upon his furtber request,an individual who is the subject
of stored private or public data on individuals shall be shown the data wichout any charge to him and;if he desires,shall be informed of the content
and meaning of chat data. After an individual has been shown[he private data and informed of irs meaning,the data need not be disclosed to him for
six monrhs thereafur unless a dispute or acdon pursuanc to[his secdon is pending or addidonal data on the individual has been collecud 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 requesring person to pay the acaai costs of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the nquest,excluding Saardays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
within that tune,he shall so inform the individual,and may have an addiaonal five days within which to comply with the request,excluding Saturdays,
Sundays and legal holidays.
Subd.4. Procedure whea data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data conceming himself. To exercise[his right,an individual shall noafy in wricing the responsible authority describing�h�nature of the disagreement.
The responsible authoriry shall within 30 days either: (a)cornct the data found ro be inaccucate or incomplete aad attempt to noafy past recipienu of
inaccurate or incomplete data, including recipients named by the individual;or(b)notify the individual that he believes the data w be correcc. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The decerminadon of the responsible auchoriry may be appealed pursuant to the provisions of the administrsrive procedure act nlating 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 pemut 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 perm.it.
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g�� � �/ �� Middle Last
p � �Ct,,�o-r�l `
Address
�a s N o n� N �5:��� �j s.�-��/5-o /b 5
C��y State Zip Phone
I understand my rights as stated above.
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Sign�ature
Total Fee: $ Date Received:
Entered By: Permit#: � `
CITY OF ORONO - BUII.DING PERMIT APPLICATIOleT
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ZIP:
NAME OF OWNER: PHONE: (home)
(work)
MAILING ADDRESSc CITY: ZIP:
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: -CITY: - ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move RemodeUAlteration Land Alteration
PROPOSED WORK(describe in detai�:
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIlVIAI'ED 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:
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.
. .
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CITY OF OF�O � ��ALLED IN �/��
INSPECTION NOTIGE �j�(n I� SCHEDULED �-Z O� __��
PERMIT NO. ' �/`�"� "'�COMPLETED r �
ADDRESS ��� l�Y�f'�y�/��`� -
OWNER CONTR. �� �Yv�.,�J�S D'Y)
TELEPHONE NO. � c� �� r ' r'l�l"'/--�
�- t.�� �sN - - ,
� DESCRIPTION --�'�� C � �� �
� 01 FOOTING 11 MECHANICAL RI XGAWC,FYRL7 G/FILLING
Q 02 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 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
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES�I�NO
� COMMENTS:
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W ❑WORKSATISFACTORY:PROCEED Cl PROJECTCOMPLETE
� �CT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR '� CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-46�0
OwnerlContractor on site:
Inspector. � G-�J���
White Copyllnspector's File Canary Copy/Site Notice
./,."' ✓
DATE / TIME
CITY OF ORONO CALLED IN � �C����, —
INSPECTION NOT CE SCHEDULED �112���
PERMIT NO. ' � COMPLETED
ADDRESS ��-� ���I t'`��E' ('�"�' "rT7C..�{'
OWNER fJ i.�5[�� ^ CONTR.
TELEPHONE N0. •P �� � U
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� DESCRIPTION �����-��� `—' C� �� �
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q O5 FINAL 14 SEWER HOOK-UP O6 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEP I FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑ CORRECT WORK&PROCEED '-1 ISSUE CERTIFICATE OF OCCUPANCY
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0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR W4LL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Cal1 for the ne t inspection 24 hours in advance. (952� 249-4600
OwnerlCont ite:
Inspector. f
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