HomeMy WebLinkAbout1995-007091 - berms PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Permit Number:
Crystal Bay, Minnesota 55323
Date Issued: I
(612) 473-7357
SITE ADDRESS:
DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: L I
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JHE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE -R,�L -I MPROVEMitENTS,
SPECIFIED AND AGREE$ JO DO ALL :WORK IN STRICT COMP' L I AN(E.,VJ TH ALL C 17Y OF
'ORONO ORDINANCES AND 'STATE OF MINNESOTA BC J I LD'I NG CODE` RE6 I
4:1 REMENTS
APPLIC+/PERMITEE SIGNAfURE ISSUED BY:SIGNATURE
CITY OF ORONO - BUILDING PERMIT APPLICATION
. V
Total Fee: $ ®� � Date Received:
Date Approved:
Entered By: '
Permit#: ?W
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
(See Check-off List Enclosed)
---- ---------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OP7NER or ONTRACTOR
ZIP: s ?L�
JOB SITE ADDRESS: /
(work)
NAME OF OWNER:,///�/J/ ��-�� PHONE: (home)
MAILING ADDRESS: �.Sl �` �' '� CITY: J/ ��I _ ZIP:
CONTRACTOR: Zx- PHONE:
i
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: � � ,- �� PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Struc --
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) :
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. 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 accordance with the approved plan.
DATE:
APPLICANT'S SIGNATURE:
J
CITY Of ORONO
Post Office Box 66•Crystal Bay,Minnesota 55323•MuniciPal Offices
•
On the North Shore of Lake Minnetonka
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
mit or license requested.
qualification for the per
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 to review private
data on yourself.
6 . Your full name is required to process this application or
permit.
First
MiddleLast
a� D Zia a�v�2
Address /
City State Z3.p
W-3-S�� w Sys- of l
Phone
I understand my ri hts as stated above.
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE—473-7358
• PUBLIC WORKS—473-7359
ASSESSING
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
90 (,v/}it'rLT��/`� PID:
ADDRESS OR LEGAL: Z
fI-c7z12 _�n/
DESCRIPTION OF WORK: -------------______------ g ---------
---- --- -----------
------------------ -2--4
ZONING
S
ZONING REVIEW BY:
_ DATE APPROVED:
/z �/� DATE APPROVED:
BUILDING REVIEW BY: -------------------------------
_ -------------------
Misc. Fees Calculated By:
FEES TO BE CHARGED: C,O�� ae-i
PERMIT Yes No
PLAN REVIEW Yes � No SEWER CONNECTION
NNECTION
No WATER CO
STATE SURCHARGE Yes No PARR FEE
INVESTIGATION FEE Yes
SAC Yes No SITE INSPECTION
OTHER (specify)
Number of SAC Units _ _ _ __ ___ __ ------------
-------------LIST ----------------Z_ning District:
-----�I----------
ZONING CHECK
Fire Department:
Post Office: Scho 1 District:
Lot Area :
Width: Depth:
S_ No Date f Survey:
Survey Submitted: �
Proposed Setbacks:
Front (Lake) : Rig�it Side: L
11 I
Rear (Street Le t Side:
i
Adjacent St u tures: Wetland: _
Building Height ef• H t.
Peak Hg •
Avg. Setback: Lot Coverage:
Existing Proposed
Hardcover: 0- 5 '
75-250 '
250-500 '
500-1000 '
Hardcover Variand Required: es No
Date of Council Approval :__
Grading: Staff A proval Date: BY:
Council Approval Date :
Septic: Staff Approval Date: By:
Zoning
y=Zoning File•# Resolution # : Resolution Date:__
REMARKS (in house) :
BUILDING REVIEW CHECK LIST
UBC: CONSTRUCTION TYPE:
Sq Foot ge $ Per Sq Ftg - -
Basement --- ---- - . -_x
�-
lst Floor x
2nd Floor x
Garage x
x -
TOTAL
Estimated Co#struction valne: / $
Inspections Required] Work Req'niring Separate P rmits:
Site Plumbing Grading/Filling
Footing Mechanical. Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Lawn Irrigation
Final (Mfg.) Other
Other Well (State Permit)
Electrical (State Permit)
------------------------------------------------------------------------------
REMARKS (IN HOUSE) :
------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
------------------------------------------------------------------------------
REMARKS (TO BE NOTED ON PERMIT) :
Its
CERTIFICATE OF SURVEY
Prepared for ; ROBERT SUFSS
LOCA`T'ION SURVEY OF: The West 1 /4 of the Southeast 1 /4 of
the Southeast 1 /4 of. Sect i-ori 33 ,
Township 118 , Range 23 , Ilenriepin County . Q.
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CITY OF ORONO
V r. ¢SING PIAN , .,, [.;f,, 3z-11 R-- 23
'/1f'1'i1(.i�!z:l% r'Llci`tih. 0 44-- 0001
1.14111fiEV IONS
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North Y19111 of way line of Wafertown R044
n,
m
--- __ WATERTOWN - ROAD I -
GENERAL NOTES
1;','
nt Proposed top of foundation lavation
o Denotes iron monume P
-Z�
++" Denotes cross chiseled in concrete Proposed basement floor elevdtion _ _-.--
x 939,7 Denotes existing spot elevation Proposed garage floor elevation
939 Denotes proposed spot elevation
E - Denotes surface drainage BENCHMARK:
Dashed contour lines denotes proposed features
Solid contour lines donotes existing features
I hereby certify that this survey, plan or report SCALE
ALL -METRO TRO LAND was prepared by me or under my direct supervision I �Or
and that I am a duly Registered Land Surveyor
SURVEYORSunder the laws of the Stale of Minnesota. BOOK PAGE
. �
2340 Daniels Street - — -
Long Lake, Minnesota 55356 4/fig / ( �0Z5 FILE NO.
Ph: 475-1433 DATE REG. NO.
___ —_I-___ SpO^S�A