HomeMy WebLinkAbout2001-P03637 - re-roof PERMIT
CITYf OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po363�
Crystal Bay, Minnesota 55323 Per'mit Type: Minor Alterations
(952) 249-4600 Date Issued: 3�23�2oot
SITE ADDRESS: 3222 NORTH SHORE DR
WAYZATA,MN 55391
P I D: 08-117-23-41-0004
DESCRIPTION:
Proposed Use: Kesidentiai
Census Code 434
Permit Class: Building
Permit Type: Minor Alterations Permit Sub-type(s): Building Re-Roof
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 9�•25 Valuation: $ 3,500.00
State Surcharge Fee: $ 1.75
TOTAL FEE: $ 99.00
APPLICANT: �CHARD ANDERSON OWNER: NORTH SHORE MARINA INC
3222 NORTH SHORE DRIVE 3224 NORTH SHORE DR
WAYZATA, MN 55391 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.
. �� / \�
� � �
/\_ , l",-, G.`�l-�,_�_,^ ��l^�
, __._ ' �
APPLI ANT PERMITEE SI NATURE ISSUED BY SIGNATU
Copies: City,Applicant, Assessor,Finance Page 1
. :� �Z� � ��
'l ota� Fee: $ Date Received:
' Entered By: ;�, �� Pernut#: S(�_��
CITY OF ORONO - BUII�DING PERNIIT APPLICATION
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: '��Z Z� I,l� ���z 1��'� z�:_ �5�� 1
, It
NAl�iE OF OWNER: ��,Q�-�} C?�c� �,�/1��-�..(�� PHONE: (home) �7! �`����-�
(work) �i I - Z L�7�
MAILING ADDRESS:���Z �•���}�jJ ,L�' , CITY: ZIP: �S��
CO\'TRACTOR: C�1��-- PHOI�'E:.����- �'11 ��52
COti�T'ACT PERSON�C�,�� �;,,��-�Lv�J MOBILE/PAGER: �;,i �z ��:U ��(�
M.4II�ING ADDRESS:��,� �`' �`t'-C,LfZ,�,�I�Li CITY: l��� �Rl'fi� ZIP: �`c
ST�T'E LICENSE: #
ARCHIT'ECT/ENGINEER: PHO�tE:
NIAII.,Pi tG ADDRESS: CITY: ZIP:
NA.I�iE; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration, �.� Land Alteration
PROPOSED WORK(describe in detai�:�'`�x���.:
STORIES: Z.- SQ. FEET OF EACH F'LOOR: � � �`�����-�
1�T0. OF BEDROOviS: GARAGE STALLS: ATT. DET.
ESTL�IATED CONSTRUCTION VALUATION (excluding land): $ .`_�5��
I hereby apply for a buildin� pernut 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
permit; and that the work wiII be in ccor anc e approved plan.
APPLICANT'S SIGNATURE: �' � DATE: � �� ��/
NOTE! Parade o Homes vents require separate permit approval by Police Department and
Ciry Counci160 days prior to the event. Non permitted events will not be allowed.
5
. . . .
� -
Sec.13.04 RIGHTS OF SCTBJECTS OF DATA '
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information reqirired to be given indiridual. An i�ividual asked ro supply private or confidendal data sonceming himself
shall be infarmed of: (a)the purpose affi incended use of the requesud data within the colkcdng state agency,poliacal subdivision,or sratewide
rysum;(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising from his supplying or
refusing to supply private or confidenaal dara;and(d)the identiry of other persons or entides authorized by state or federal law to receive the data.
'Ibis requirement shall not apply when an individual is asked to supply invesagadve data, pursuant to secdon 13.82, subdivision 5, to a law
enforcement o�cer.
The commissioner of revenue mav olace the nodce reauired under this subdivision in the individual income tax or nrocertv qz refund
instrucaons instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidenrial. Upon his further request,an individual who
is the subject of stored private or public data on individuals shall be shown the data without any charge ro him and,if he desires,shall be informed
of the content and meaning of that data. Aher an individua!has been shown the private data and informed of itc meaning,the data need aot be
disclosed to him for six momhs thereafter unless a dispute or acaon purnant ro this section 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 requesc by the individual subject of the data.
The responsible authoriry may require che requesdng person to pay the actual cosu of making,certifying,and compiling the copies.
The responsible authoriry shall comply immediately,if possible,with any request made punuant to tivs subdivision,or within 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 wi[hin that time,he shall so inform the individual,and may have an addidonal five days within which to comply with the request,
excluding Samrdays,Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may coatest the accuracy or compieteness of public or
private data concerning himself. To eaercise ttus right,an i�ividual shall noafy in wridng the responsible authority describing the�nature of the
disagreement. The responsble authoriry shall wi[hin 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to noafy
past recipiencs of inaccurate or uicomplete data,including recipients named by the individual;or(b)noafy the individual that he believes the daa
co be correct. Daca in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinaaon of the rosponsible authoriry may be appealed pursuant to the provisions of the adminisuarive procedure act relating
to contesced 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 �iry 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 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
C��Y State Zip Phone
I understand my rights as stated above.
Signature
6
�►' - CHECK OFF LIST FOR ISSUANCE OF PERMITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL:
PID:
DESCRIPTION OF WORK:
ZO�TING REVIEW BY: DATE APPROVED:
BiTII.,DING REVIEW BY: DATE APPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes No
pLAN REVIEW Yes No SEWER CONNECTTON
STATE SURCHARGE Yes No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZOti�1G CHECK LIST Zoning Districr.
Fire Department: Post Office: School District:
Lot flrea: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Reaz(Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
Lot Covera;e:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: BY�
Zoning File: # Resolution: # � . Resolution Date: � . .
Shoreland District:
Av�. Setback: Bluff Setback: L.ot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RENI.ARKS(in house):
7
_ -.f - -
.
BUII..DING REVIEW CHECK LIST �
� �C� CONSTRUCTION TYPE:
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
R =
TOTAL
Estimated Construction Value: $
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical R/ater Connection
Footing Sepdc Sewer Connection
Frazning Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
F� Grading/Filling Electrical(State Permit)
Other
RENIARKS(IN HOUSE): .
----------------------------------
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date gy;
------------------------ ___���____����--------------------------------
REMARKS (TO BE NOTED ON PERMIT�:
8
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT E SCHEDULED ��
PERMITNO. ���� COMPLETED r -Z� L ��-'
ADDRESS �Z22 �j-
OWNER CONTR.
TELEPHONE NO.
� DESCRIPTION
ly 01 FO , G 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 0 RA G 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 3 TION 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
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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� C F{�1TS: -
a � �`� � -� ��.
� 2., �Z� c S � �.-� '
0
� p�
�
0
�
W
�
Q
�
Z
W
�
W
�
�
d
W L]WORK SATISFACTORY:PROCEED C PROJECT COMPLETE
� f�ORRECT WORK&PROCEED 1 ISSUE CERTIFICATE OF OCCUPANCY
W
� �7 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
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. 249-46��
OwnerlContra on site:
inspector. �����/� ���
White Copyllnspector's File Canary CopylSite Notice