HomeMy WebLinkAbout2000-P02625 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: P02625
Crystal Bay, Minnesota 55323 Permit Type: Addition/Remodel/Repair
(612) 249-4600 Date Issued: 7/17/00
SITE ADDRESS: 2300 Olive Ave
WAYZATA,MN 55391
PID: 17-117-23-44-0069
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Census Code 434
Permit Class: Building
Permit Type: Addition/Remodel/Repair Permit Sub-type(s): Deck
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 83.25 Valuation: $ 2,560.00
Plan Review Fee: $ 54.08
State Surcharge Fee: $ 1.30
TOTAL FEE: $ 138.63
APPLICANT: JIM JAGODZINSKI OWNER: JIM JAGODZINSKI
2300 OLIVE AVE 2300 OLIVE AVE
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.
ISR T UT
APPLICANT E NATURE ISSUED BY SIGNATURE
�.
Copies: City,Applicant,Assessor, Finance Page 1
Total Fee: $ /31. ?P3 Date Received: 7 _5-_07-)
Entered By: 44 • Permit#: 'a,ta-a.s"
CITY OF ORONO - BUILDING 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: Gia O e)(..( ''F" fTY ZIP: SS31
NAME OF OWNER: :. it-'1 ii-{,7 o/72 it.S/C( PHONE: (home) 4-11 -of 3-3
work)
MAILING ADDRESS: Zoo otAue A.V CITY: SkVIKT 4 ZIP: S 5311
CONTRACTOR: irt A-(..-o02-e tv>/G/ PHONE: 4�- ) 0/ _a
CONTACT PERSON: ( rte 3 �-(a opL(w$t1 MOBILE/PAGER:
MAILING ADDRESS:23cio B L(lam X13- CITY:\Ivk(2A-i/ ZIP: SS 3t I
STATE LICENSE: #
ARCTIITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure 1 k
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): ( i. L — 94,,,„,, ,1)2..ciluatewj,'
STORIES: SQ. FEET : Z
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ /yU�
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be ' :onfo ance with the ordinances and codes of the City and with
the State Building Code; that I no ersta I this is not a permit and work is not to start without a
permit; and that the work will se n a I rdan • with the approved plan.
APPLICANT'S SIGNATURE: DATE: 7 7c /0 a
irgila a
NOTE! Parade of Homes events requ re sepa%e permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
♦ f
Sec.13.04 RIGHTS OF SUBJECTS 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 section.
Subd.2. Information required to be given individual. An individual 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 known consequence arising from his supplying or
refusing to supply private or confidential data;and(d)the identity of other persons or entities authorized 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 5,to a law
enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the individual income tax or property tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidential. 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 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 its meaning,the data need not be
disclosed to him for six months thereafter unless a dispute 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 the 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 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 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 notify in writing the responsible authority describing the mature of the
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 authority 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 City 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 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.
t tci-i -ems O PZ-(NSI--/
First Middle Last
200 0Ll v6— A yr
Address
\IN//A—� M'J Ss 59( 411 -0133
ity State Zip Phone
I unc a stand my rights as st ed above.
SignaiCe4111TO
6
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: OLl
PID:
DESCRIPTION OF WORK: b F GSC,
ZONING REVIEW BY: . DATE APPROVED: ') - /0 -oa
REVIEW BY: DATE APPROVED: _ -�0
BUILDING � �o
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓' No
PLAN REVIEW Yes ✓' No SEWER CONNECTION
STATE SURCHARGE Yes ✓ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: L R- 1
Fire Department: ►Mio e.,,D Post Office: (v ievi7a q-1--A11--A1School District:
Lot Area: Sq.ft. /fro C Ors (Acres Width Depth
Survey Submitted: Yes p� No Date of Survey: OAr 1=t Vlr
Proposed Setbacks:
Front(Lake): toy t Right Side: 140 t
Rear(Street): cj ' t Left Side: y I:-
Adjacent
Adjacent Structures: 4--77Y4c F/�, Wetland: N
Building Height: Def. Hgt. — Peak Hgt. —
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District: L/�S
Avg. Setback:' jV 6n Bluff Setback: A../bel- Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000' ?_-), 12 2-8 13
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
•
BUILDING REVIEW CHECK LIST
UBC: A - 3 CONSTRUCTION TYPE: VA.'
Sq Footage $Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
OIL-LAG. Zsb x f 0 o0 = 24•5"6 o
TOTAL
Estimated Construction Value: $ 2.7s76,O'3
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
x Footing Septic Sewer Connection
oC Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
Final Grading/Filling Electrical(State Permit)
Other
REMARKS(IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS (TO BE NOTED ON PERMIT):
8
HARDCOVER CALCULATION WORKSHEET
SETBACK ZONE: (CIRCLE ONE) 0-75' 75-250' 250-500' 500-1000' .
INEXISTING HARDCOVER IN ZONE
A. House x = L 4 f- S.F.
Length Width
I o 4- x - S = S . S.F.
T«" o mor_ 4-- x 3 -3 = 13 , Z- S.F.
sc.-0 c/C, 1 bx q = 10 S.F.
B. Garage x = 5 3 S S.F.
C. Driveway x = S.F.`2--SS$
x = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = I -1 ( S.F.
I;L0LC- 1")f}—rt9 X - S.F. _.
F. Landscape x = 17 Z_ S.F.
Underlain x = S.F.
By Plastic x - = S.F.
Or Fabric
G. Other v4�� o v1 c-o-.J c x = > --/ S.F.
s-rb n1E S n'f'S -13 . o
TOTAL HARDCOVER IN ZONE - 5 1 4 l , '1 S.F. A
TOTAL PROPERTY AREA IN ZONE - l °b `I 6 . o S.F. B
A _ B x 100 = 1L-7 , t 2�
PROPOSED HARDCOVER IN ZONE'
A. House x = S.F.
Length Width
x = S.F.
x = S.F.
x = . . .-S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
x - S.F. ..
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = 2 S'fo S.F.
x = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other . x = S.F.
TOTAL HARDCOVER IN ZONE - 7....S S.F. A
TOTAL PROPERTY AREA IN ZONE - I $GI (e v S.F. B
A -1_5--(,, = B I$(tbo xloo = o • c2t35" %
13 _.
\\ n-,
t:'-v 2'-n'
4. 5'-5 1/2" \ 7
CITY OF ORON 41 - -- - --- —
BUILOIN •PE' i IT PLAN REVI W -,V?
INSPECTOR or r 4 A --- — - — — 'T}_ ,-- �� - - _0 t 1 �f✓+- g-,pii
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❑ APPROVED AS SUBMIT ED \ Ai • ,
(PROVED WITH COR ECT;ON1S AS NOTED - �-e thikyuoo Jr '' ; : C6 2
G NOT APPROVED---CO'RECT&RES 1BMIT
These comments are for your info anon. All work hall be done - \t d J 5
in full compliance with a9 app car'a building and "ening code. I C) _- ' - 2 x t--
IA
Requirements including items not s'•citically noted i this review. • in ' 2 - 2 n
KEEP THIS PLAN SET 0 SITE AT A TIMES v
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICESCHEDULED 7/7-ea
PERMIT NO. PDQ' - , COMPLETED >/7-ea /,, c)
ADDRESS 7j60 Oft ?/-Q Ate_
OWNER 7/ CONTR.
TELEPHONE NO.
Ok Pt
01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
• 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
• 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
LU 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
(4• COMMENTS:
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CC (ORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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r❑�C'ORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
u BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. Ci PHOTO TAKEN
INSPECTOR WILL RETURN
CI STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-4600
OwnerlContrac or o �
Inspector. �)
White Copy/Inspector's File Canary Copy/Site Notice
seeaea 2-1 OLD v k.vA _
ORONO
COPY
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❑ APPROVED WITH REVISIONS
1 x.--1. 0 DISAPPROV SITE PLAN
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00 . ' <9/ // / LEGAL DESCRIPTION OF PREM1,C
`O ,rd. the '4tIrth.estrt lY 10 re,t nr L�' 11. Lo
GO� • altered by the )ud�enent and decree as
G)6 O recorded In Book 1)7 „iscelIntteoua Pec°
/ oe most Easterly corner thereof. teen[
/�� fSoutheasterlyLotI , h line or Lot 13to thence No
J CC 0 of Lot II, thence Southeasterly alone tl
Place of brelnnln`; all In Nllry's Novo
O� Also that part of Lot 1. flock I. 'Nova
Minnesota. and that part of Lot 12. Wit
'S)) Also
that port of Lot 20. Wallace', AdIdI
described as brflnning at the Southeast
Northeasterly IS feet parallel with the
Northwesterly to a pulnt on the Norther
Southwesterly frost the Northeast corner
qn and 1S/100 feet parallel with the Nortln
Southwesterly line Of said Lot 20. them
parallel with the Northwesterly line of
point 2S feet Westerly of the nest Usti
a line parallel with the Northwesterly
Northeasterly on a line parallel with tl
the most Easterly corner of sold Lot 12
Southeasterly line of said Lot 12 to lh,