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Home My WebLink About2005-P09248 - addn/rermodel/repair - PERMIT CITY OF ORONO 2i50 Kelley Parkway- PO Box 66 Permit Number: P09248 Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair (952) 249-4600 Date Issued: 11/18/2005 SITE ADDRESS: 3587 North Shore Dr Unit# Wayzata,MN 55391 PID: 08-117-23-34-0056 DESCRIPTION: Proposed Use: Residential Census Code O/S-Building Permit Class: Building Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Addn/RemodeURepair DETAILS: Approved perresolution#: Separate permits required: Electrical(state) NOTICES/REMARKS: Replace Siding&Windows&3 Doors- ROOF AT ENTRY NOT APPROVED FEE SUMMARY: Pernut Fee: $ 492.25 Valuation: $ 35,000.00 Plan Review Fee: State Surcharge Fee: $ 17.50 TOTAL FEE: $ 509.75 APPLICANT: Home Reflections OWNER: Steven&Janna Sundby 5880 Minnetonka Drive 3587 North Shore Dr Long Lake,MN 55331 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. --� ��'� � � � /1 �� f( �? �,. r;. � C ("; �.. ' (' � ` �� t'-�� " APPLICANT PERMI"�E NA7 RiJ�E / ISSUED Y SIGNATURE i _'✓ `J Copies: 1-File(Signatures Reguired), 1-Applicant, 1-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1 CA.,Q-Qe-•�. 9-�-o�' . ��p� �� 5'0�� 1 '�,�� ,�; -i�r-C�S' Total Fee: $ Date Receive� Entered By: �,+1.� Permit#: , G�Dga`�� -dd/,e.a-,�o� CITY O� ORONO - BUILDING PERMIT APPLICATION A❑ information must be submitted in full before plan review will bc started. (please print all information) ------------------------------------------------------------------------------------------------------------------------ THE APPLICANT IS: (cir�cle one) OWNER OR QONTRACTOI� .r._...--_---- �" '_ s l�k- ZIP: `�5 � i I JOB SITE ADDRESS: �5� � I��>�-,H H-,;�.c � � ` Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ YeS � lvo Lf��es, a special eve��rt pe�•mit is req�atired�vith Po/ice Department and City Cozmcil npproval 60 c/ays prior to the enent. Shzdtle ba�s service 1vilT be required ttnless applicani denzonstrates su f cient on-site parking is nvnilnble. Non-permitted events wil!not be allorved. NAME OF OWN�R: �TE�.�'� � ��ti'��%� �v,�ti'JG t/ PHONE: (home) `�`�� i� �7�7�7 5� (work) MAILING ADDRESS: S��Y y� CITY: ZIP: CONTRACTOR: �;> ; K. ��I-c=,�.-�-� ,; ,� .��: � PHONE: `j; _� - � a� � � !1� CONTACT PERSON: °r��q �r;s;�k�� MOBILE/PAGER: �,- �'L - ��,�"7- la 5 A) MAILING ADDRESS: ��S'.>> �,-�,,��,��,��-�;�; �� CITY: 5��a�i:v�_T,�� ZIP: ��:-� s � STATE LICENSE: # � � 3'<, EXPIRATION DATE: �� a��- ARCHITECT/ENGINEER: PHONE: MAILING ADDRF,SS: CITY: ZIP: NAME: 12EGISTI2ATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration .�' PROPOSED WORK(describe in cletain: �1:-�'�-��,E ��,D 1 ti C � �'L' - 1�,' �^Y'J`; 4 _� D£.�'�� 1�% C X T�� :_7 L�i��-F +�f' Sv` i ►.i Ei--S �'I'ORIES: � SQ.�'FET O�+'EACH FI,OOR: NO. OF BEDROOMS: `-! GARAG� STALLS: ATTACHEI) �'' DETACHED CSTIIVIATED CONSTRUCTION VAi,UA�'ION(excluding land): � J��3F C�� . '=�'% 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 accordance with the approved plan. � , �� APPLICANT'S SIGNATURE:;��.iiS c,�:.�� DATE: � c�5� 31 Sec.13.04 RIGHTS OF SUI3JECTS OF DATA , Subd. 1. Type of data. 'I'he rights of individual on whom the data is stored or to be stored shall be as set forth in this section. Subd.2. Infbrmation required to be given individual.An individual asked to supply private or wnfidential datawncerning himselfshall 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 legal ly required to supply the requested data;(c)any known consequence arising f?om his supplying or refusing to supply private or contidential data;and(d)the identity of odier persons or entities authorized by state or federal law to receive die data.This requirement shall not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer. The commissioner of revenue may place the notice required under this subdivision in the individual income tax or prooerty ta�refund instructions instead of on diosc fonns. Subd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be infonned whether he is the subject of stored data on individuals,and whether it is classified as public,private or contidential. Upon his iLrther request,an individual who is the subject of stored private or publ ic data on individuals shall be shown the data without any charge to him and,if he desires,shall be informed of die content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be disclosed to him for six months thereafter unless a dispufe or action pursuant to this section is pending or additional data on the individual has been collected or created. The responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority may require[he requesting person to pay the actual costs of making,certifying,and compiling the copies. The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within tive days of the date of the reques[,e�duding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he caimot comply with the request within that time,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. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data concerning himself. To exercise this right,an individual shall notity in writing the responsible authority describing the nature ofthe disagreement.The responsible authority shall within 30 days either. (a)correct the data found to 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 correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data. The determination of the responsible aidhority 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 pern�it or license from the City of Orono or any of its departments may rec�uire you to furnish certain private or confidential information. You are notified that: l. "I'he information you furnish will be used to deterniine 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. -�-,�.�5 I� k /-�-�� ,� c; �_�� ; � First A4iddle Last `� � �f c� M � f�l ti ��IL�4 �'�'2, A��r�55 '�r+-�'-�—zv�}'j r1�� !� �S-� 3 � a 5�.� - y �� -� 5/ l� City Sts�te "I,ip Phone I understand my rights as stated above. _ __ �,- `- ,—_..____f- / �/�� /� ,-, �'i�cX . L-C� � C..� � Signaturc �2 . CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: �S�e7 rU s/'J � PID: DESCRIPTION OF WORK: /.c�,.�oo ws,� �/J..v�s ZONNG REV�W BY: N/✓�- DATE APPROVED: BUILDING REVIEW BY: ^�/,�l' �,,,,.� . DATE APPROVED: 9• �o-0 5- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ No PLAN REVIEV� /VA� Yes � No ✓ SEWF.R CONNECTTON E SURCH�GE Yes No WATII2 CONNECTION STAT _� INVESTIGATION FEE Yes No PARK FEE SAC Yes No SITEINSPECTTON Number of SAC�Units OTHER (specify) ZOI�TI�IG CH�CK LIST Zoning District: i(10 Gt��v�P ,J Fire Department: Post Offic School District: Lot Area: Sc.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: Front(Lake): Ri ide: Rear(Street): eft Side: Adjacent Structures: Wetland: Building Height: Def. Hgt. Peal: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 S tback: L.ot Coverage: Existin Proposed Hardcover: 0-75' 75-250' 2�0-500' Sa0-1000' Hardcover Variance Required: Yes o Date of Council Approval: REMARKS (in house): � BUILDING REVIEW CAECK LIST ' �C� CONSTRUCTION TYPE: Sq Footaae $Per Sq Ftg Basement x = . 1st Floor x _ 2nd Floor x _ � Garage x = z = TOTAL Fstimated Construction Value: $ '3 S,o 0 0 °� Inspections Required: `Vork Requiring Separate Pecmits: Site Plumbing Fire Hazdcover Removal Mechanical Water Connection Footing ' Septic Sewer Connection � �_Framing Fireptace Lawn Irrigation �Insulation (Masonry) Other Wall Board �._ . (Mfg.) Well (State Permit} _.�F�� Grading/Filling _�Electrical (State Permit) Other REMARKS(IN HOUSE): . ------------------------------------------------------------- REV�W BY OTHERS: DATE: Access: Existing New Access Approval: Date gy; -------------------- -------------- RENIARKS (TO BE NOTED ON PERitiII1�: (L.o o r= ,a T c�v� /Vd�- ,�,W✓�p 8 . i Y, _ .3 � 1 �',r. ' ��'A ty.,i.��?F�.�? ¢�p�� ry. �i � � � � -_ : (_, /� l 1...�.� � �n � w F � �, � � �31A15� �� ' � � �� - �o�s No % ^^-e�-� � � - � t,q,K-� s�"i3`9 c•G�-- � 0. N - f . � � --- fi 3 �" � _._ � �-��= �.e---'`f _. ..-- - ` �,��c��.t�.. __ �� ,— -�-- � � ��. � .��-�� ,�,, � = _ -- - � �� - �� X �-! '' i��; �Ai �-.�.. �'—XTZg _ 1/�1 iQ L L ��"` �� I ---- �L�--1��-__l`_`C�; -r-� N�- o r�y - o �xiG . roUn1�'ATI�►� i x � 5-rr7?�F'+-�� l � . _ � ` � ' c.�pra,� - C�X��;��..� - 5+'�� t _ _� ( �SrJ�N. ' -- - - �s Pl�iJ c�2�i� D�� ---=-�y_ '�;_.�. ( ___ ' 1 i ` ( -- . `_ _ . � ��T�j�s -��-��j --�`--- ��i +-�- y�16�f� LtYI Ll 7.�" --..�iS.l� �-- �:67 �U 1'h Y1 � �j 1 v I��L- ��_-__��o -_-_._._ __ �� _��i��S� Y---k��1�.1��C.�r -- - =-=��z c�ti� s��.�_==------- j � � . i �,� _i� �r��d��ljui•i�i��4=- _. . - _�.____ _....._ r � I- -: - i _ �`�'�f3 ------ � — �_.__ ! + � ! -�