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HomeMy WebLinkAbout2002-P05588 - accessory structures CITY OF ORONO PERMIT 275� Kelley Parkway- PO Box 66 Permit Number: Posssg Crystal Bay, Minnesota 55323 Permit Type: a��essory s�u�cures (952) 249-4600 Date Issued: 9ii3i2oo2 SITE ADDRESS: 3410 North Shore Dr WAYZATA,MN 55391 P I D: 08-117-23-43-0017 DESCRIPTION: UBC Occupancy x3 Proposed Use: Residential Pernut Class: Building Census Code O/S-Building Pernut Type: Accessory Structures Permit Sub-type(s): Building Undefined DETAILS: Approved per resolution#: Separate permits required: NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 23.50 Valuation: $ 500.00 State Surcharge Fee: $ 1.00 TOTAL FEE: $ 24.50 APPLICANT: Owner/Self OWNER: DANIEL F REGAN&WIFE � 3410 NORTH SHORE DR WAYZATA MN 55391 THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED AND AGREES TO DO ALL WORK IN STRICI'COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF MINNESOTA BUILDING CODE REQUIREMENTS. '� , �� � � � � ' � r"` ,,J .. �_/�'" `� ' � % ,� � ,, ��� ✓ ; -. � � i�� �'!�' APPLICANT PE ITEE SIGNATURE ISSUED BY SIGNATURE � J Copies: 1-File(SiQnitures Required), 1-Apnlicant 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1 Total Fee: $ Date Received:_��-�/�-�- <% � , Entered By: � Permit#: �L%�;�>��"�' - � CITY OF ORONO - BUILDING 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: � �� ( v /����r�4 S ���� �r- ZIP: � .� 3 1' � (�szl NAME OF OWNER:�-,-� � � ��=r�-� (��9�,.t PHONE: (home) �/7/ -9 3 / � �WOI'k��t S�� �{7 S� / $� a MAILING ADDRESS: ��t{� �1��-�-4 S 1��,,_���- CITY: (.�e i� �� ZIP: .��7 7`� / 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 Remodel/Alteration Land Alteration PROPOSED WORK(describe in detai�: �r��--,� /r �G� -��-�--,c� �-, (`�>� � ��s��.� r; `�� Q�L' '�.l lG c� PX�_:�-.s� (/c i�,l�tc'�aI Y.` --c-.✓ �rssc.c.� �.c�G �/rc�,�..� r STORIES: •--- SQ. FEET OF EACH FLOOR: — NO. OF BEDROOMS: GARAGE STALLS: ATT. — DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ _— - s�'�, Y � 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 oXdinances 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 accorSiance with the approved plan. ,��=/ i , APPLICA.NT'S SIGNATURE: �' ��� DATE: ' � �' �--- �� � L /,� % 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. 5 Sec.13.04 RIGHTS OF SUBJECTS OF DATA ' , Subd. 1. Type of data. The rights of irxlividual on whom the data is stored or to be siored shall be as set forth in t}as secdon. Subd.2. Information required to be given individual. An u�dividual asked to supply private or confidential data concerning 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 laiown consequence azising from his supplying or refusing to supply private or confidenaal dara;and(d)the idenary of other persons or enades authorized by state or federal law to receive the data. This requirement shall not apply when an individual is asked to supply invesrigative data,pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of reverrue mav�lace the notice reauired under this subdivision in the individual income tax or nro�ertv hax refund instrucrions 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 coafidendal. Upon his further request,an individual who is the subject of swred private or�blic 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 iu meaning,the data need not be disclosed ro him for six months thereafter unless a dispute or acuon pursuant to dtis section is pe�xling or additional dara on the u�dividual has been collected 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 authority may require the requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsibie authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and legal holidays,if icnmediate compliance is not possible. If he cannot comply with the request within that dme,he shall so inform the individual,and may have an additional five days within which to comply with the request, excluding Saturdays,Sundays and legal holidays. Subd.4. Prceedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data co�eming himself. To exercise this right,an individual shall nodfy in writing the responsible authority describing tha nature of the disagreement. The responsible authoriry shall within 30 days either. (a)correct the data found ro be inaccurate or incomplete and attempt to notify past recipients of inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be conect. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determina6on of the responsible authoriry 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 �ity of Orono or any of its departments may require you to fumish certain private or confidential information. You aze 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 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. •-�!/`-v""�'� �,r—C'vt,c�..,S' � ����-� First Middle Last 3�I � v ��('o �� 5�.� r� �r Address l.�Q..� z�.�-� /`Ul� .�'S'3� / 5.�ti� �/�/ 'S3/o Ciry State Zip Phone I underst r' as ted above. :�' � G o ~ _ Signature 6 ' CHECK OFF LIST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY � ADDRESS OR LEGAL: 3ti 1 v No t2-�-t st�-odL� ,0[�., - PID: DESCRIPTION OF WORK: ,q-r,� ZONING REVIEW BY: DATE APPROVED: 9- t 3•�z. BUII�DING REVIEW BY: �V"/� DATE APPROVED: FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes � No PLAN REVIEW Yes No � SEWER COrfNECITON STATE SURCHARGE Yes � No WATER CONNECTION INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ZONING CHECB LIST zoning District: Fire Department: Post OfFice: School District: Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes_� No Date of Survey: S'-l6-�a Proposed Setbacks: Front(Lake): �pp' +- Right Side: /5 � �' � Reaz(Street): /00 ` 'F'- Left Side: � ' fi Adjacent Structures: �� Wetland: Building Height: Def. Hgt. Peak Hgt. Lot Coverage: Grading: Staff Approval Date: By: Council Approval Date: Septic: Staff Approval Date: By: Zoning File: � Resolution: �I Resolution Date: Shoreland District: Avg. Setback: Bluff Setback: L.ot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 0•� � 250-500' 500-1000' Hazdcover Vaziance Required: Yes No Date of Council Approval: REMARKS(in house)s �- (2��a�. o� cx�a,�n� _�� rNt��,�+�, �ws 7jl/►!�Q blcl' i�p� ($d1��^O Ct�.�� 7 � � . BUII.DING REVIEW CHECK LIST UBC: — CONSTRUCTION TYPE: — . Sq Footage $Per Sq Ftg Basement x = � lst Floor x = 2nd Floor x = Gazage x = R = TOTAL Estimated Construction Value: $ ,�o°'t' Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Septic Sewer Connection Framing Fireplace Lawn Inigation Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) _�Final Grading/Filling Electrical(State Permit) Other REMARKS(IN HOUSE): REVIEW BY OTHERS: DATE: Access: Eusting New Access Approval: Date By: REMARKS (TO BE NOTED ON PERMII�: 8 . ' , .F'�.�'. . . • � t����w�i,a,'.� t� F.;��.:.�,i:�i.r�V�,r•r;�•. .. .,�, . •j.M .. ' �.. 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Regan � � ' ��';�..rj� �_• _ ► � . . �.. •�-::;�.:.;.. :' . . � . %. _ •; . . in Lota:.7.L aAd Z5, I,�ydi�erd's Park � ��i.��� ` � . - "rn�` �.;�.�`•E_ }• Henneoin Couiity�' Mizu�eeota i '� TY V `�^''''•�:.:,��' • ��: • . ,r�� � 1 1'..� :i.� �' . _ /�,� •.f:• ` �� r'�' � � �'�'- - • y / v� . . .:�:,. p� glT C , Lfna� .— � � .��:�_�� •I• ����� ���� i� `• �i:r'� - ; `-'-;�•'}'•�;�D P�1�1 ',:`;. ��� r .i,,, � `C�, .�. . 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