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Home My WebLink About2002-P04329 - accessory structures CITY OF ORONO PERMIT Y�750 Kelley Parkway - PO Box 66 Permit Number: Po4329 Crystal Bay, Minnesota 55323 Permit Type: a��esso�-y sm��ures (952) 249-4600 Date Issued: i�i�i2oo2 SITE ADDRESS: 2565 North Shore Dr Wayzata,MN 55391 PID: 09-117-23-41-0004 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residenrial Census Code 328 Permit Class: Building Permit Type: Accessory Structures Permit Sub-type(s): Shed DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 57.05 Valuation• $ 1,600.00 Plan Review Fee: $ 37.06 State Surcharge Fee: $ 0.80 TOTAL FEE: $ 94.91 APPLICANT: Owner/Self OWNER: 7effrey Martineau MN 2565 North Shore Dr 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. t ' � k?,� U� �� t�,�-� �� -� ---� C/�r-.'��-,�-� � APPLICANT PERMITEE SIGNATUR� ISSUED BY SIGNATURE Copies: 1-File(Sienitures Required), 1-Applicant, 1-Monthlv Reports, 1-AssessinQ, 1-Finance Page 1 r Total Fee: ��'�$ q y 9Cl � ��,,�r� 1/�� Date Received: �� oL �� -. Entered By�.�! ' � - `� _ Permit#: r��, � -� �,Z c� , � �� -�C _« /��/ , , �`� r��CITY . � . ��; , � �RO�NO - UILDING PERMIT APPLICATION � � ;�� % �,,��(.i , + , � i, I . .� . ._.. _;�`,,,,,;.-� j;' I /`�All information must t�e�u�mi�ted in full before plan review will be started. ! �,V (please print all information) � �; ---------------------------------------------------------------------------------------------------------------------- THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR JOB SITE ADDRESS: y�(v� /�071� c�✓l�c- �J7/� ZIP: ��i � l.��1�z�'� ��Y�ha� NAME OF OWNER: �� PHONE: (home)qs� LI�3— Z(o Z$ `� (work)�`�-z- Z I v �2�n MAILING ADDRESS: �.�� l�/C l�, ��,�,�� CITY: ZIP:�� (�b�7TIP CONTRACTOR: `�� k'�"'>�..,�,�-- PHONE: ��L Z J I� Z6 Z(� CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: NIAILING ADDRESS: CITY: ZIP: NAI�TE: REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move �� Remodel/Alteration Land Alteration $ROPOSED WORK (descri e in detain: vv �j<,� — �h a E'� l—vc�I- _ �� f.0 ,�,.� STORIES: SQ. FEET OF EACH FLOOR: NO. OF BEDROO�iS: GARAGE STALLS: ATT. DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 1�Ub � 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 ermit and work is not to start without a permit; and that the work will be in accordance with he proved plan. APPLICANT'S SIGNATURE: DATE: `� �� __ , � NOTE! Parade of Somes events re ' e pa permit approval by Police Deparlment and City Council 60 days prior to the event. Non permitted events will not be allowed. � � Sec.13.04 RIGHTS OF S[JB.TECTS OF DaTA . Subd. 1. Type of data. The righrs of individual oa whom the data is stored or co be stored shall be as set forth in this secdon. Subd.2. Information reqirired to be givea individual. An individual asked to supply private or confidendal data concerning himself shall be iaformed of: (a)the purpose and intended use of the requesud data within the collecang ttate agency,polidcal subdivision,or statewide rystem; (b)whether he may refuse otr is legally required co supply the requested data;(c)any lmown consequence arising from his supplying or refusing to suppty private or confidential data;and(d)the idenriry of other persons or enrides au[horized by state or federal law to receive the data. 'Ihis requiremenc shall not apply when an individual is asked to supply invesrigadve dara, punuant to secdon 13.83,subdivision 5,co a law enforcement o�cer. The commissioner of ro�•enue mav place the notice rewired under this subdivision in the individual income rax or nrooertv taz refund instrucdons instead of on those forms. Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed wherher he is the subject of stored data on individuals,and whe[her it is classified as public,private or confidendal. Upon his further request,an individual who is the subject of stored private or public dara on individuals shall be shown che data without any charge to him and,-if he desires,shall be infarmed of[he content and meaning of that data. After an individual has been shown che private data and informed of its meaning,the data need not be disclosed to him for siz months thereafter unless a dispute or action pursuanc to this secdon is pending or addidonal data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon requesc by the individuai subject of the data. The responsible auchoriry may require the roquesdng person to pay the actual coscs of making,certifying,and compiling the copies. The responsible authoriry shall compiy immedia[ely, if possible,with any request made pursuant to this subdivision,or wichin five days of the date of the requesc,excluding Saturdays,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 additional five days within wluch to comply with the request,exc!uding Saturdays, Sundays and legal holidays. Subd.4. Procedure when data is not accurate or complete. An individua!may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall nodfy in writing the responsible authoriry describing che nature of the disagreement. The responsible authoriry shatt within 30 days either: (a)correct the data found m be inaccurate or incomplete and attempt to notify past recinients of inaccunte 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 sta[ement of disagreemenc is included with the disclosed data. The determinadon of the responsible authoriry may be appealed pursuanc 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 pemut or license from the City of Orono or any of its departments may require you to fumish certain private or confidential information. You are notified that: 1. The information you furnish will be used to detecmine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the pemut 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 pemut 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. Signa[ure ' i`1�y�s�1 ., �. �� CHECK OFF LIST FOR ISSUA��ICE OF PERMITS C�� , FOR OFFICE USE ONLY ` ADDRESS ORLEGAL: 25�5 ruofz7-+ af,o� /�/�i v2 PID: DESCRIPTION OF WORK: /Yr a�c: s«� - -______��_-- - ---- ZOr11i TG REV�W BY: C�..�- -------------DATE APPROVED: 9-i�-�� BUII.DI�i 1G REVIE`V BY: DATE APPROVID: 4'-r�g-ot FEES TO BE CHARGED: Misc. Fees Calculated By: PERNIIT Yes ✓' No PLAN REVIEW Yes ✓ No SEWER CONNECTION STATE SURCHARGE Yes � No WATERCONNEC"ITON INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) Z01�1IYG CI�CK LIST zoning Discricc: Na G}��Nc�t Fire Department: Post Office: School District: Lot Area: Sq.ft. Acres Width Depch Survey Submitted: Yes �C IVo Date of Survey: G ` Z o- �t Proposed Setbacks: �Frest (Lake): 132,' �- Right Side: Iv� �ear (Street): �bo = Left Side: J`�7�� Adjacent Structures: ��' Wedand: 0.i� Zb� Building Hei�ht: Def. Hgt. O �(� Peal:Hgt. C�.1�. Lot Covera;e: (>,(� Grading: Staff Approval Date: — By: Council Approval Date: Septic: Staff Approval Date: -- By: Zoning File: 1# � Resolution: # Resolution Date: Shoreland District: y�s Avg. Setback: �rj�- Bluff Setback: ��1`" Lo[Covera�e: �•(� Existing Proposed Hardcover: 0-75' 75-250' �O C 1-Fi4TlCyQ 250-500' � 500-1000' Hardcover Variance Required: Yes No � Date of Council �_?roval: REMARKS (in h0use): 7 M ' + BUILDING REVIEW CI�CK LIST �C� V'� CONSTRUCTION TYPE: ynJ Sq Footage $Per Sq Ftg Basement x _ lst Floor x _ 2nd Floor x _ Garage x _ x = TOTAL Estimated Construction Value• $��o� °-`- Inspections Required: `Vork Requiring Separate Permits: Site plumbing Fire Hardcover Removal Mechanical Water Connection _�C Footing � Septic Sewer Connection Pr�B Fireplace Lawn Irrigation Insulation (Masonry) Ocher Wall Boazd (Mfg.) Well(State Permit) �F�� Grading/Filling Electrical(State Permit) Other REMARI�.S(IN HOUSE): . REVIEW BY OTHERS: DATE: �'-----��___----- -- Access: Ezisting ��„r, Access Approval: Date gy. , - ------------- -- - --------------------------- - REMARBS (TO BE NOTED ON PERMI�: 8