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Home My WebLink About2003-P06422 - addn/remodel/repair CITY OF ORON PERMIT � Permit Number: 2750 Kelle;�Parkway - PO Box 66 P06422 Cryst�al Bay, Minnesota 55323 PePf711t Type: Addition/RemodeURepair (952) 249-4600 Date Issued: 6i26i2oo3 SITE ADDRESS: 3570 North Shore Dr Wayzata,MN 55391 P I D: 08-117-23-34-0019 DESCRIPTION: UBC Occupancy R3 Construction Type VN Proposed Use: Residential Pernut Class: Building Census Code 434 Permit Type: Addition/RemodeURepair Pernut Sub-type(s): Addn/RemodeURepair DETAILS: Approved per resolution#: Separate permits required: riumoing iviecnanicai r,iecuicai�siaiej NOTICES/REMARKS: FEE SUMMARY: Permit Fee: $ 657.75 Valuation: $ 51,022.08 Plan Review Fee: $ 427.63 State Surcharge Fee: $ 26.05 TOTAL FEE: $ 1,111.43 APPLICANT: Owner/Self OWNER: Thomas&Marylou Lutz M� 258 Cygnet Pl Long Lake,MN 55356 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. a t,� � �� /v'A ..� `� " '{\I1YYv�,✓� _�_...y _ ; ' � 1 � , . i"'� �> �. , APPLICANT PERMITEB S]GNATURE ISSUE BY SIGNATURE Cooies: 1-File(SiQnitures Required), 1-Anplicant 1-Monthlv Renorts, 1-Assessine, 1-Finance Page 1 � � i � `� � Total Fee: $ Date Received: �o-�� -()� Entered By: �,'r , �` �� Permit #: �j`Lj�C( Z Z_ a ��`)�� '�,1, � � CITY OF ORONO - 'SUILDING PERMIT 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: '� .. ►,i N' �rr t �-''` , D'-- ZIP: �a`�=':'�'�� NAME OF OWNER: �t'� r�t �-'.a �; � PHONE: (home)`��4'I� �2�;:-�� (work) C�I� • �.�7-.� ,,� �r�,.��; MAILING ADDRESS: 2� � G't�►�,�.- �" i,�-��t�� CITY: �ri�'�<'� ZIP: ��,";"�� CONTRACTOR: �iAr+E 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 �C Land Alteration PROPOSED WORK(describe in detai�: �;��:..;c.,��t�� ,CxT�t�l��l� W��'- , (��'!'�"�� '��' {�A��'"',',� � ��n� ' � , �� t�� (�I(�. , t�+� �,; 9�T ��n�- ��!��;��tlNc , f{��,r, ..�. �qT�;r�q,�� , � :"� . �� , i, . _ . ,,� ... STORIES: I �/�' SQ.FEET OF EACH FLOOR: NO. OF BEDROOMS: '�; GARAGE STALLS: ATT. >C DET. ESTIMATED CONSTRUCTION VALUATION(excluding land): $ 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 permit and work is not to start without a permit; and that the work will be in ac�ordance w th the approved plan. � _- / APPLICANT'S SIGNATURE: '� �""�' DATE: � " l��' �� NOTE! Parade �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. 9 Sec.13.04 RIGHTSOFSUBJECTSOFDATA Subdrvision 1. Type ojdata The rights of individual on whom the data is stored or to be slored shall be as set jorth in this section. Subd.2. Injormation required to be given individuaL An indivrdual asked to supply private or confidentral data concernrng him3i j shall be informed of.� (a)the purpose and intended use of the requested data within the collectrng state agenty,political subdivision,or statewide system;(b)whether he may refuse or rs legally required to supply the requested data;(c)any known consequence arisrng from hrs supplying or refusing to supply private or confidential data;and(d)the identity of other persons or entities authorrzed 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 S, to a!mv enforcement o�cer. The commissioner ofrevenue mav place the notice required under this subdivision in the individual income tuz or property tax refund instructions instead of on those forms. Subd.3. Access to data by individuaL Upon request to a responsible authoriry,an indivrdual shall be informed whether he is the subject of stored data an individuals, and whether it is classifted as public,private or conftdential. Upon his further request,an individual who is the subject ofstored private or public data on rndividuals shall be shown the data without any charge to him and, if he desires,shall be informed of the content and meaning of fhat data. After an individual has been shown the prrvate data and informed of its meaning, the data need not be disclosed to him for six months thereafter unless a dispute or actian pursuant to this section is pending or additronal data on the individual has been co!lected or created. The resporuible authorrry shall provide copres ojthe private or public data upon request by the individua!subject oj the data. The responsible authoriry may requrre the requesling person to pay the actual costs ojmakrng,cert�ing,and compiling the copies. The responsible authorrty shall comply immediately,ifpossible,wrth any request made pursuant to thrs subdivision,or within five days of the date of the request,excluding Saturdays,Sundays and lega!holidays,if immedrate compliance rs not possible. I,fhe cannot comply with the request within that time,he shall so inform the individual,and may have an additional frve days withrn whrch to comply with the request,excludrng Saturdays,Sundays and legal holidays. Subd.4. Procedure when data is not accur4te or complete.An individual may contest the accuracy or completeness ofpu6lic or private data concerning himselj. To exercise this right, an individua!shall notify in writing the responsrble authority describing the nature of the disagreement. The responsible authority shal!wrthrn 30 days either: (a)correct the datafound to be inaccurate or rncomplete and attempt to not� past recrpients of inaccurate or incomp/ete data,includrng recipients named by the rndivrdual;or(6)not�the individual that he believes the data to be correct. Data in dispute shall be disclosed only if the indivrdua!'s statement ojdisagreement is rncluded with the disclosed data. The determination of the responsrble authoriry may be appealed pursuant to the provisions of the administrative procedure act relating lo contested cases. DATA PRIVACYADVISORY InaccordancewrthM.S./3.04,Subd.2,"Rightsofsubjectsofdata",wewouldliketoinformyouthatyourrequestforapermrtorlrcense from the City of Orono or any of its departments may require you to furnish certain private or confidential rnformation. You are notifred that: /. The information you furnish wi!!be used[o defermine your qualifrcation for the permit or lrcense requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The rnformation may be shared with other local,state or federal agencies to the extent necessary to process the permit or lrcense. 4. Ijyour requested permit or license requires Council action to approve,some information may become pu6lic. 5. You have certain rights under M.S. 13.04(see jollowing page)to revrew private data on yourselJ. 6. Your ju(l name is required to process this applrcation or permit. PLEASE PRINT j c�t c ri� S J 1.,i,1 T?o First Middle Last �ti� �� U�� ti�-r p�-��-� Address �� z o r—io �--t t�- '.��'�� l S 2 — `��l �J � Z�° l`� Crty S1ate Zip Phone I u�stand my rig s ated above. r �"Y�- .�-�l.� Signature t 10 CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY - ADDRESS OR LEGAL: 351 O �v o tz�-t 5�w� �J R . �: � . ' PID: -- --- -- - DESCRIPTION OF WORK: ,'�,�-y�,�a�Z,.' ZO�.�tI�i TG REVIEW BY: (Q�,�.._ � � DATE APPROVED: G-ic -�3 BUILDI�i 1G REVIEW BY: DATE APPROVED; � -/6-0 3� . FEES TO BE CHARGED: � Misc. Fees Calculated By: PER11iIIT Yes ✓ No PLAi�1 REVIEW Yes �/' No SEWER COrfNECTTON STATE SURCHARGE Yes_/ No WATERCONNECITON INVESTIGATION FEE � Yes No PARK FEE SAC Yes No SIT`EINSPECTTON Number of SAC�Units OTHER (specify) ZO�TING CI�CK LIST Zoning District: �v a C�.�-,syvs�C Fire Department: � Post Office: School District: • � Lot Area: Sq.ft. Acres ' Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: � � � Front(Lake): Right Side: Reaz(Street): Left Side: Adjacent Structures: �Ve land: , Building Height: Def. Hgt. Pe �Hgt. Lot Coverage: Grading: Staff Approval Date: y: Council Approval Date: Septic: Scaff Approval Date: Zoning File: # Resolution: # Resolution Date: � Shoreland District: Avg. Setback: Bluff Setbac : Lot Coverage: Ezisting Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: RENL!�.RKS(in house): 7 � BUII.D�tG-R�V�W CHECK LIST ' . • � UBC: R • j � CONSTRUCTION TYPE• i/^1 . _ Sq Footage $per Sq Ftg � Basement . . . x . 1st F1oor 2�-I x 4 9- 1 �52 a . . . 2nd Floor �_ 'f�-1.2 g = S l,o Z z.�o g - � . . Gazage x - � ' � x TOTAL � � Estimated Construction Value: $ 5 I� 022.o g Inspections Reqnired: , �vork Requiring Separate Permits: Site _�pI�b�g Fire Hazdcover Removal _�MechanicaY F��g - , Water Connection � Septic Sewer Connection � _�Fram.ing Fireplace Lawn Irri ation . t _o�Insvlation (Masonry) Other g . _�C Wall Boud . 1- Final ' (141fg J Well(State Permit) - --_ _------,._ ._. . � Other Grading/Filling _�.Elec�ical(State Permit) � --- - REMARKS(.�i T HOUSE): . REV�W BY OTHERS: DATE: ---- � Access: Existing New � Access Approval: Date By: - - -- ----- ---------- � RENIARKS (TO BE NOTED ON PERNIII�; �� 8 ✓ DATE TIME CITY OF ORONO CALLED IN ^ INSPECTION NOT E SCHEDULED — �� %0 0 PM PERMIT N0. a� COMPLETED ADDRESS_ 3 S 7C� �c.�o K>�/<�'jCc/�'� D2 OWNER_,/D/1� Gc.�f"Z CONTR. �GcJ�'�e �'' TELEPHONE NO._ �� {?� o��d' � DESCRIPTION 1/i"t r��0� � � 01 FOOTING 71 MECHANICAL RI 18 EXCAV/GRADING/FILLING Q�� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION Q OS 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 2 OxWNERICONTRACTOR TO MEET YOU: YES_NO y COMMENTS: � � j 0 a � 0 � W � Q � a W � W � � d W� WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. O PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION RE�UIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�0 Owner/Contrac n_��e: Inspector � v White CopyllnspectoPs File Canary CopylSite Notice � � (�'" � AT�j TIME V CITY OF ORONO f�aLLED IN Z 7 l� INSPECTION TIC �� SCHEDULED � PERMIT NO. '��'�r LETE ADDRESS � OWNE TEI�cEPHONE NO. �� ^ �l� CONTRACTOR a DESCRIPTION ' �D � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ S�TE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � �INAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W C � � O � • C� � '1��-�-e�-4-or� �4-� � ° t-� �� i � �� .: �1'-�- W � Q � �Z�� cx.��ves i� ��,�L� W � W � � � ❑WORKSATISFACTORY:PROCEED �OJECTCOMPLEfE W O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on s' e: � Inspector. White Copyll�spector's File Canary CopylSlte Notice