HomeMy WebLinkAbout2000-P03431 - land alteration ' �� PERMIT
CITY OF ORONO
2750 Kelley Parkway - PO Box 66 Permit Number: Po3431
Crystal Bay, Minnesota 55323 Pe►'mit Type: User Defined
(612) 249-4600 Date Issued: �ilo�2o0
SITE ADDRESS: 2601 Rainey Rd
WAYZATA,MN 55391
P ID: 04-117-23-44-0004
DESCRIPTION:
Proposed Use: Residential
Permit Class: General
Permit Sub-type(s): Land Alteration(SOl+cu yds
Permit Type: User Defined
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
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FEE SUMMARY: Permit Fee: $ 50.00 Valuation: $ 0.00
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TOTAL FEE: $ 50.00
APPLICANT: BOLLi�& soNs, [Nc OWNER: K M&P M B�RTON
11401 COUNTY ROAD 3 38 ADDRESS LINASSIGNED
HOPKINS, MN MN 00000
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.
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APPLICANT PERMITEE SIGNATURE SSUED BY SIGNATURE
Copies: City,Applicant,Assessor,Finance Page 1
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City of Or•ur��
r'.Q. Rux 66
Crystal 8ay MN a,3�3
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Cust�mer: F'Q3431 - Lt�'JD ALTCRRTIOti
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Maii in Fees
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Ir��re5tigation Fee
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Check Received 7;,,�cj
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CLERK�I d2 TkAN5�i ?4�U'3
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, '�'�ial•Fee: $ � � � Date Received:
Entered By: Permit#: ;� - �-� - %
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CITY OF ORONO - BUILDIl�tG PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information) �
_____---________----___- - -_ �������.-�..��,
THE APPLICANT IS: (circle one) OWN OR ONTRACTOR
JOB SITE ADDRESS: Z-�o 1 �� ��`� z�:. 5 S��'J 1
NA.�IE OF OWNER:p�T��'p ��' PHONE: (home)`��� ��-1 �0�-7
.. (work) 2(2-• �lo�j. 19-(o b
MAII.ING ADDRESS: �J l O�C�/��W "�• CITY: Sl�(z7�'�"1 U.s�ZI': 4�d'�
CO\�TRACTOR: ��� �''N� S� PHONE:.�J Z ' ���' �'I�j�
COr�T'ACT PERSON: b � MOBILE/PAGER: � �z �-SU�
M.4II�ING ADDRESS: 1��� ( LD'�3 CITY:�d,��° ' 'g-� Z1P:�
ST?�TE LICENSE: #
ARCHITECT/ENGINEER �� �X�ll�L'F� PHONE: `��Z- �2' ?��a
i�IA.IIrING ADDRESS: r CITY:�I G�7.pQ-� 1.��.1 IP: s� �
N���: REGISTRATION# a Z.
TYPE OF WORK: New Addition Acc�o�Stsuctu�e_
Move RemodeUAlteration /Land Alteration�_
,
___----,�.—_ _
PROPOSED WORK(describe in detai�: �o• �V ll��s � G��v'[l�-f9�01"-�
�� �T��-d�'1'I n�
STOR�S: SQ.FEET OF EACH F''LOOR:
NO. OF BEDROOMS: � � GARAGE STALLS: ATT. DET. . .
ESTL�IATED 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 t 's is not a permit and work is not to star[ without a
perm.it; and that the work wi�I be ' ce ' oved plan. _
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APPLICANT'S SIGNA . DATE: ���� 0�
NOTE! ade of Homes even q ' arate permit approval by Police Department and
City Court,cil 60 days prior to the e en . No permitted event,s will not be allowed.
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�sc-lr4-2d00 11 .18�m From-CITY OF ORON4 +9522494616 T-169 P.022/027 F-850
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�.� " �1� ��>>�'•° G-�" SVeet Address: Mailln� Addrass:
� %''�� P.4. Box 66
��9,���p4F/�� 2750 Kelley Parkway
�f Orono, M N 5 5 3 5 8 C ry s t a i �a y, M N 5 5 3 2 3-0 0 6 6
' DAT� PRN�Y An'VISORY
In accardance with M.S. 13.d4, Subd. 2, "�ights o£ subjects of data", we would like to
inform you that yoLtr request for a permit ar license from the City of Orano or any of its
departments may require you ta furnish c�rtain private or confid�ntial infonnation,
You are notified that;
1, The information you furnish wili be us�d to deterrz�inc your quatiftcatior� for th�
perr,nit or iicense requested.
2. You may refuse to suppl� data, but refusal may require th.at the City deny the p�rn�it
� or liCense. �
3. The in�ormation may be shared vvith othear locai, state ar �'ed�ral agencies to the
' extent neeessary to process the perm�t or license.
4 4, Yf your requested germit or license requires Council �Ciian to approve, some
� information ma� hecome public.
�
' S. You have Gertain rights under M.S. 13A� {see fallowing page) to r�view private data
' on yaursel�
6, Your full name is required to proc ss this applicatic>n or permit.
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C1�� w� State Zip Phone
� I understand my rights as state� above.
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� Telephone(612)249-4600 • �'ax(61?)249-�616 9
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� ' � CHECI� OFF LIST FOR ISSUANCE OF PER1tiIYTS
,. � � � � FOR OFFICE USE ONLY . � .
DRESS OR LEGAL: Z.`01 ti2�A�N c—� iZ�a�
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D�'SCR�'I�ON OF�ORB: (L�C3��c.��+J cfl C�(�O�r�C�
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Z vL1'G REVIEti�B�: D�TE APPROYED: /2 � Zz - o O
B DI�i'G RE'YIEtiV BY: p���/} . � . D4TE APPROYF�: . .
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F�ES TO BE C$4RGED: `�isc. Fees Calculated By:
p RMIT Yes ✓ No :�
p�AN REVIEW Yes � No SEWF.R COVNECTION
S�'ATE SURCHARGE Yes No WATERCONNECTION_
If�V�ESTIGATION FEE Yes No PARK FEE
S�C Yes � No SITEINSPECTION
yNumber of SAC•Units OTHER (specify)
Z�O\�tG CHECK LIST Zoning Disocicc: /vc� G«�e _ .
F�re Department: Post Office: School District: • � •
I.�t Area: Sq.ft. Acres " Width Dcpth _
Surve; Subritted: Yes No Date of Survey:
P�ropvsed Se►.backs:
Froat(La.ke): Right Side• '
Rear (Street); Left Side:
Adjacent Structures: � tland: •
�uildin� Hei�ht: Def. H�c. P a.k Hgt.
t Coveraga:
�'rradin�: Staff Approval Date: y; Council Approval Date:
�5eptic: Staff Approval Date: y:
Zoaing File: � Resolution: : Resotution Date: . .
�Shoreland District:
Av�. Setback: Blufi Setbac LotCoccra�e:
E���? ' Praposcd
Hardcover: 0 75'
� 75 250'
ti0-500' •
500-1000'
� Hazdcover Variance Re uir�d: Yes No Date of Couacil Approval: •
q
' gEtiLA�i S (in house):
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BUII.DING REVIrW CHECK LIST
UBC: "�" - CONSTRUCTTON TYPE: —
Sq Footage $ Per Sq Ftg
Sasement x = _
lst Floor x =
2nd floor z =
Garage z =
x =
TOTAL
Estimated Construction Value: $ --
Inspections Required: Work Requiring Separate Permits:
Site - Plumbing ' Fire
Hardcover RemovaI MechanicaI Water Connection
Footing Septic Sewer Coaaection
Framin� Fireplace Lawn Inigadon
Insulation (Masonry) Other
�Vall Boud (Mfg.) Well(State Permit)
_�C Final Grading/Filling Electrical(State Permit)
Ocher
RE��IA1tKS(Il�1 HOUSE): �
REVIrW BY OTHERS: ' DATE:
Access: Ezisting New
Access Approval: Date By:
RE`�IAR��,S (TO BE 1�'OTED ON PERMT1�:
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