HomeMy WebLinkAbout2000-P03425 - deck • � PERMIT
CITY OF ORONO Permit Number:
2750 Kelley Parkway - PO Box 66 P03425
Crystal Bay, Minnesota 55323 Pefl711t Typ@: Addition/Remodel/Repair
(612) 249-4600 Date Issued: t2i26i2o �`
�
SITE ADDRESS: 2138 Shadywood Rd
WAYZATA,MN 55391
PID: 17-117-23-42-0013
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use:
Buildin Census Code 434
Permit Class: g
Per►nit Type: Addition/Remodel/Repair Permit Sub-type(s): Deck
DETAILS:
Approved per resolution#: ����3.�
Separate permits required:
NOTICES/REMARKS: - � :,�.,-r.�a���� � e�� U.� � �.. �; �.�: � � �, ,�-, ��c ���� ` i� �a
� ft�s:-� ;C'< �c-� 1-
�>1�-t � � n �rr� ��' 'r`r`� .
FEE SUMMARY: Permit Fee: $ 139.25 Valuation: $ 6,500.00
Plan Review Fee: $ 90.48
State Surcharge Fee: $ 3.25
TOTAL FEE: $ 232.98
APPLICANT: JEROME LAGUE OWNER: JEROME J LAGUE& WIFE
2138 SHADYWOOD 2138 SHADYWOOD RD
MN 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 REQU[REMENTS.
R�'PLI A MITEE SIGNATURE SSUED BY SIGNATURE
Copies: City,Applicant, Assessor,Finance Page 1
�
, � .-, � .. �.��, � '7
. Total Fee: $ ���� � Date Received: %��=��`���C��
Entered By: !'/. Permit#: r�L% -7`l��
:
� � ��� _ � � � � ! < � • !`�� - ��� ' - '-� ;c� � _
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
--------------'��G-�Q��__J�l�e�r���ormation)-----------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS:Z ZIP:
�!
NAME OF OWNER J . � �7C�� PHONE: (home /Z— �7���
;��, (w�rkl. �L__c�"�'�'� ��°S���_.
��--��z`� �'�
MAILING ADDRESS: �,,.1 �S_`7�f i?�.;� . • IP:
,�,� ; �� � ---�-�'�
,�
�-
CONTRACTOR: � �p�� ..�.—
CONTACT PERSON: C��.�' . �'1'VLt��`
MAILING ADDRESS: /�e,�.aP��� ZIP:
STATE LICENSE: # ��
1 ---�'_
ARCHITECT/ENGINEER����`���_�/�`��k<; PHONE: `�7� - � � � �
MAILING DRESS:�=1 ' � CITTY:/ c-, i�•,/ �,e,:-ZIP: �";3 5�,;
AA , � �1.,v�.�I;t���Y�'-= �' �' �,
NAME: 1�"�; ,•,�"t.� c���rf�c�iC� ���C�� REGISTRATION# ,' �� �7�. S�`�"
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
ROPOSED WORK (describe in detai�:��j-L��{',�;,"�2'1(.�C��� �%t- �x f `S T/��G,�
I c--�(` �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: -/ GARAGE STALLS: ATT. ��__ DET. C.
=��1 �:;-,
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ G,�C.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 cordance with t approved plan.
'
APPLICANT'S SIGNATURE: � � ...--�`__ DATE: / / �.� �' --
' �J
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.
9
• M �
Sea 13.04 RIGHTS OF SLJBJECTS 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 suppiy private or confidential data concerning hunself shall
be informed of: (a)the purpose and intended use of the requested data within the collecring state agency,polidcal 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 identiry of other persons or endties 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 ievenue mav place the notice requued under this subdivision in the individual income tax or propertv tax refund instructions
instead of on those forms.
S�bd.3. Access to data by individual. Upon request to a responsible authority,an individual shall be informed whether he is the subject of
stoied data on i�ividuals,and whether it is classified as public,private or co�dential. 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 iu meaning, the data need not be disclosed to him for six months
theceafter unless a dispute or acaon 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 cesponsffile authority shall comply immediately, if possible,with any request made pursuant to this subdivision, or within five days of the
date of the request,exctuding Satutdays,Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within
that time,he shall so inform die 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
conceming himself. To exercise this right,an individual shall notify in writing the responsible authority describing the naNre of the disagreement. The
responsible authoriry 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 decermination of the responsib(e authority may be appealed pursuant to�e provisions of the administrative procedure act relaring 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 aze 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 pemut 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.
First Middle Last
Address
Ciry State Zip Phone
I understand my rights as stated above.
Signature
10
, � , CHECIi OFF LIST FOR ISSUA.��'CE OF PERlI'IITS
_ FOR OFFICE USE ONLY . � .
ADDRESS OR LEGAL: z�� g 5�.�A�y�,�n d f2�o�0
PID:
DESCRZP7�4N OF�ORK: ��C�c �?�P tJ�c.�
.
ZONI:\'G REY�ti�BY: DATE APPROVED: t�-Z2-c�o
BUII,D�'G REY�tiV BY: . D4TE APPROYED; /z•iz-�n�
FEES TO BE CH.4RGED: biisc. Fees Calculated By:
pEgMIT Yes ,/ No :.
PLAN REVIEW Yes �/ No SEW�CONNEG"TION -
STATE SURCHARGE Yes �/ No WATF.RCONNECITON
II�iVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC•Unics OTHER (specify)
ZO��LIIG CH�CK LIST Zonin�Districc: LR -/C. .
Fire Departmenr. m ov+v /� Post Office:.. w�tiv�r� School District: w e STc��N K.� -
Lot Area: Sq.fr. '�.`�b3 Z Acres . �, t � Widch Depch
Surve;Subritted: Yes_� No Date of Survey: ,1u-�t�'no
Propvsed Setbacks: � �
Frnnt(La.ke): 9S Right Side: �Z� +
I�eer(Screet): 1�s Left Side: 1�3�(o
Adjacent Structures: 14�c:'►'� �Vetland: N�A � •
Buildin� Height: Def. H�t. /� //� Peal:Hgt.
Loc Covera�e: O• ��
Gradin�: Stafi Approval Date: /✓/A gy: — Council Approval Date: —
Septic: Staff Approval Dace: N /R By:
Zoaing File: � 2 6� 3 Resolution: n Resolution Date: /Z-I l-v d .
Shoreland Disuict: �,es
Av;. Setback: _�iq/Z� r4w,c,c Blufi Setback: N /� Lot Cocera�e: _
E���a Proposed
Hardcover: 0?5' _� �� .
75-250' �o•t
?SO-500'
500-1000'
Hardcover Variance Required: Yes_� No Da�e of Couacil Approval: 12- 11-OD
gE1�iARb',S(in house):
7
BUII.DING RE'VIEW CHECK LIST
usc: �-3 - co�rs�ucTTov�E: Vn}
Sq Footage $ Per Sq Ftg
Basement z =
lst F1oor z =
2nd Floor x =
Garage z =
z =
TOTAL
o�
Estimated Construction Value: $ (s, SOO
InspectiorLs Required: �Vorl:Requiring Separate Permits:
Site Plumbing ' Fire
Hardcover RemovaI Mechanical Water Connection
o� Footing Septic Sewer Coenection
oC Framin� Fireplace Lawn Irri;ation
Insulation (Masonry) Other
�Vall Board (Mfg.) Wel( (Stat�Permit)
� Final Grading/Filling Electrical(State Perm.it)
Other
REti�1ARKS(1N HOUSE): �
REVIEW BY OTHERS: � DATE:
Access: Ezisting New
Access Approval: Date By:
RE`�IA RK.S (TO BE NOTED ON PERMI'1�: I�/�(L,D c��-e-` (L�T�•�✓-�1 s f?.c���ll.�.'�
�� �v i= �-
L9�1� r�Jr+�
8
i � ' L��uE ♦o-fa-oo
. SE'I'BA��;K'LUNE: (CilZCLE UNEi 0-7�' 7�-2�U' 2�0-SUU' SUU-1000'
"� b� EXISTING HARDCOVER IN ZON� �
� A. House x _ = S.F.
Ixngth W idth
x = S.F.
x = S.F.
._._._ h = S.F.
B: Garage x = S.F.
- - - ' C. Driveway x = S.F.
x = S.F.
- , D. Sidewalk x = S.F.
�c = S.F.
E. Patio/Deck � = S.F.
_, K
.._.... .. _ - , = S.F:__.
F. Landscape x = S.F.
� Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other-�����,�. .� __S��W�pl� = S.F.
TOTAL HARDC:OVER IN ZONE - 7 S.F. A
, TOTAL PROPERTY AREA IN ZONE - 668 I S.F. B
A = B �x 100 = O, l %
p�tOPOSED�iARDCOVER IN ZONE'
- r' � A: House x = S.F.
- Length 14�idth
� x = S.F.
- x • = S.F.
_. _ . �; = S.F. ...
B. Garage x = S.F. �
'C. Driveway x = S.F. V
.�:.. . . � _ _ S.F.._ _.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Landscape x = S.F.
Unde;lain x = S.F.
By Plastic _ x = S.F.
Or Fabric
G. Other • � = S.F.
TOTAL HARDCOVER IN ZON� - S.F. A
TOTAL PROPERTY AREA IN ZONE - S.F. B
A = B x 100 = %
_ i; _ ..
' � ' 5ETBACI�ZONL: ((;11iCL� ONL) U-7i' 7>-2�U' �2�S�U' S00-100U' �d �Q���
� " EXISTI�NG HARDCOVER IN ZONE
� A. House x = 2q33 S,F. — ��t
Length W iddi
► �,6 � s,2 = a s s.F. -s�+��
X = S.F.
. x = 24L} S.F.-CoNC.R�TE
B. Garage x = S.F.
314f C. Dri�eway x = 2830 S.F.
�►Su-n x = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck � = S47 S.F.�'p�O�
..._..... . .. � _ _ _ _..
, - S.F:
F. Landscape x = Z37S S.F.-1�4��N �'
Underlain x = 3 S�j S.F.-W�0 4++PS�A�S�
By Plascic x = 3�1, S.F�!-��`+ °M'�9�'c
Or Fabric
G. Other x = 7r� S.F.-1n/NLLrj
� TOTAL HARDCOVER IN ZONE - 97�?S S.F. A
� �, TOTAL PROPERTY AREA IN ZONE - I 6�S0 S.F. B
A 47 9S - s /� Ss� x too = s9. �B °io
PROPOSED HARDCOVER i1V ZONE'
� A. House x = S.F.
Length W idth
x = S.F.
x = S.F.
_.. ._ .. � = S.F.
B. Garage x = S.F. '
C. Driveway x = S.F.
—
_.._.._ . . ,� _; . S F... _
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Landscape x = S.F.
Underlain � = S.F.
By Plastic x = � S,p.
Or Fabric
G. Other � x = S.F.
TOTAL HAI2DCOVER IN ZOM: - S.F. A
TOT�I.PROPERTY AREA IN ZONE - S.F. B
A - B x l00 = %
.�.__ . l� - -
' ` � � SETBACK'LONE: (C11tCL� UN�:) U-7�' 75-2�U' 250-SUU' `�r' UO-lODU' �G �� �d�
, ' EXISTING HARDCOVER IN ZONE
'� A. House x _ _ _ S.F.
L,ength W idU�
`� = S.F.
�---�. x = S.F.
. � - S.F.
B. Garage _ x = S.F.
C. Dmeway x = 302 S.F.—E�'^�+�roP
_ x = S.F.
D. Sidewalk x = S.F.
.� � S.F.
E. Patio/Deck x � S.F.
..�.�.. . .. _ � _ _ S.F.��
F. LandscaPe X = � S.F.— L
Underlain x _ P�T�G
S.F.
By Plastic x = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HAI2DCOVER 1N ZONE - Sq/ S.F. A
TOTAL PROPERTY AREA IN ZONE - � 3�'j� S.F. B
._ A = B x 100 = 17,3F3 . %
PROPOSED HARDCOVER IN ZONE'
�} A. House x = S.F.
Length W idth
� — S.F.
x = S.F.
_. ._. .. _ _ x = S.F. ...
B. GaraSe � = S.F.
_.
C. Driveway x = S.F. ..
.._._. . . . _ �
_ .. _ S.F..__
D. Sidewulk x = S.F.
X = S.F.
- E. Patio/Deck x = S.F.
X = S.F.
F. Landscape x = S.F.
Underlain x = S.F,
By Plastic x = S.F.
Or Faoric �
G. Ocher � �c = S.F.
TOTAL HAIZDCOVER IN ZON� - S.F. A
TOTAL PROPER"I'Y AREA IN ZONE - S.F. B
A = B x 100 = %
.�.. . �3 _ .
x 60 main house foot rint ����� #� �� �
40 p
�4TY OF� G�R�NO .
�i;, ,,,, �;�.—.r � � i
8�.::.-�;;i4.;� . _�;;��M- �'�F1I�� REVIGW !
M!SnE<'TGi� I
- ,
C;". >-_(.2'2 2' � _•,�';:T i�,n, i
,�_
7., .�__ _�.�
L_ _. . t I
�,_ . _ � ..' , ,�.i" ��`'i:�:_.��� .=-..
f:_ . , . _ ': � , .. � . .,`.�;'i
PROPOSED DECK REPLACEMENT ��• - � � . � L � > �� � r.;� � ,.� `� .
i .: � ,: •; ' �..?� �:r,�3. �'., �.,.
JEROME J. LAGUE RESIDENCE ►+ � .: . .. . z; ;. ��,:�;. - .��N
2138 SHADYWOOD RD. ��u'���;�s�`�,',�Y :�_'-�o���; si��<,;,���.�„�c-�
�Q e c.� vw-�s� co�,,,�(� w �rt{ (L�=r�u��:��
U c; p�.r�T14 C�t-��e � (-F�-rJ�o cJ r _ .
--- �
RAMP ?
��/j,�Q(.�,v.2,� �=.�vt/a v f9-t-�j
��%� vr�=J 14 ., �
� �
,�,
� � 36' � _ �t� �
1�' '`s",,
existing sliding glass doors '
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�� Ji 1 ' '1i�� i ��� � � � �"',Il i I��li�" i n_ �,�
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� I I I I' � � � iii'�� �I �il�� I I�T�'i ii
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concrete ---- ----- -
, .—_- -
,
I J
footing ;
12" dia x 48" '
�.
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L� � __.__._______ _.________.__ __._..__.____---_ __.______ - -_.
, / '/DA� TIME
CITY OF ORONO �� CALLED IN �7 ��U
INSPECTION NO, CF,� SCHEDULED �-/P %/- 3C��
PERMIT NO. �����'1� COMPLETED �� �' �
ADDRESS ���� SI'��l✓U�J� ��.
OWNER��i Lc'�qvc� CONTR. C�c7�'�i�- �-������'�
TELEPHONE NO. �S-o�^ � 7� �lY3 �
� DE TION �E L � /��%c�%/ /VG S\
lL 1 FOOT G 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� G 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
= 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
J
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
Z
� COMMENTS:
�
w
�
�
�
O
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�
O
�
W
�
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Z
W
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W
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�WORK SATISFACTORY:PROCEED -1 PROJECT COMPLETE
W
W [7 CORRECT WORK R PROCEED �I ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
C: CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next ins tion 24 hours in advance. 249-46�0
OwnerlContra or si e
Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT E `! SCHEDULED .S�/ ¢� O�
PERMIT NO. O �7o�.S�COMPLETED _�'L�
ADDRESS� � �o��w�'�
OWNER�� CONTR.�t�-�- i'�,N��I
TELEPHONE NO. '"� �` -d .7 �7 �
� DESCRIPTION ""� G���
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 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 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTiC FINAL 35 HARD COVER REMOVAL
J 10 PIUMBING FINAL 36 FOUNDATION/REMOVAL
� OW NERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
W
a
�
�
O
�
�
O
�
W
�
Q
�
Z
W
�
W
�
�
� ,�1 NORKSATISFACTORY:PROCEED �PROJECTCOMPLETE
W ��CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING
PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR
❑CITATION ISSUED
❑ INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlConUactor on site:
Inspector.�� Ct��
�
White Copy/lnspector's File Canary CopylSite Notice
uLm I ir llui-\ Lt. ur Sum V E T ESR
JERONIE
LA UE
IN LOTS 22 & 23, WILEY' S PARK, LAKE MINNETONKA "S\
HENNEPIN COUNTY, MINNESOTA
SURVEY
LINE ...
75' SETBACK LW
A+
ROCK NW' LY LINE OF
WALLS f -LOT 2Z. WILEY'S
A PARK, LAKE MINK.ToWA
40 J L
tilCONK
AV ET
" MV P ER /
PATIO /\
EXISTING
004
HOUS�,
WALL
SE'LY LIE OF
LOT 22. WILEY'S
PARK, LAKE M04WTONKA
�� ,/' ORONO COPY
ekv
NO
MY OF ORO
7 'AN — GRADING "N
V_ SrTE PL
P4- A P P R GO V;,,D
M -H �j-,7VjSl0-NS
..250' SETBACK LNE..' �
0
jj �V 1
A
BLACKTOP
DRVEWAY
BY
D
17. - Z2- -0 ATE 0
.0 a evt
ov F &tj1zP C
01
A
%
C;)
V
N
it
01
'J-1
.4Xk"
MOST S' LY CORNER
--OF LAKE LOMMET 22,TSPARK.
ONKA
M, A-21ff
LEGAL DESCRIPTION OF PREMISES
Lot 23, and that part of Lot 22, Block 1, "Wiley's Park", Lake Minnetonka lying
Northwesterly of a line drawn Northeasterly from a point on the Southwesterly line
of said lot distant 14.25 feet Northwesterly of the most Southerly corner of said
lot, through a point distant 12.5 feet Northwesterly of the Southeasterly line of
said lot measured along a line drawn from a point on said Southeasterly line distant
273.5 feet Northeasterly of said Southerly corner to a point on the Northwesterly
line of said lot distant 271.8 feet Northeasterly of the most Westerly corner of said lot.
o i denotes iron marker found)
Bearings shown are based upon an assumed datum.
This survey intends to show the boundaries of the above described property,
the location of on existing house and shed, and the location of all visible "hardcover"
thereon. It does not purport to show any other improvements or encroachments.
D
REVISION
DATE E
DESCRIPTION
BERG,
G` RIJN NC4
I HEREBY CERTIFY THAT THIS PLAN, SPECIFICATION, OR REPORT
WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION AND
THAT I AM A DULY LICENSED PPOFESSIONAL ENC4WER AND LAND
5CALF
1 " =20'
DATE
BRAWaV
SIWEYOR UtUR TI -E LAWS OF THE STATE OF WKSOTA.
ECD
EWOERS, LAW1 SLIRVEYORS, SITE PI RS
10-10-00
C K
482 TAMARAC� AVENUE, LONG LAKE, MWN. 55356
JOB NO-
I
MSG
612-473-4141
'76�z
LICENSE NUMBER � 7 J�F
£0M -435
M, A-21ff