HomeMy WebLinkAboutPermit Record STREET FILE 2705- ii..)A( $�fi-IN1
PERMIT RECORD
PERMIT NO. DATE TYPE OF PERMIT
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PERMIT
,r;ITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Permit Number:Crystal Bay,Bay, Minnesota 55323
Date Issued:
(612) 473-7357
SITE ADDRESS:
-•
DESCRIPTION:
--
• —2
REMARKS:
•;
• — • • • • -• • • •
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FEE SUMMARY:
7';t
CONTRACTOR: OWNER:
THE UNOEFC:::“GW:D HE:REBY REQUEST PERMISBION TO MAK::: THE Ri=7.AL I!'--POVEMENTS
SPECJFIED AND Ac3REES TO DO ALL f...-.1)RK IN STRICT COMPLIANCE WITH n'LL CITY
OR.ONO OF.DINANCe3 AND STATE OFBUILDING COOE REUTRMENIB .
L _
APPLICANT'PERMITEE SIGNATURE( I ISSUED BY:SIGNATURE „2/4"14-CW
4
CITY OF ORONO APPLICATION FOR DEMOLITION PERMIT
F.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, MN 55323
SPECIAL CONDITIONS & HOLD HARMLESS AGREEMENT
General Instructions
1. You may be required to obtain other permits, i.e. burning, well abandonmment, etc.
2. Work must not begin unless the permit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call 473-7357.
JOB SITE ADDRESS:a s 010,4'«'",
Occupancy Type: A Residential ' Commercial
OWNER'S NAME: APO t`d /4✓ `' Phone:q(i7 ?G 0)
Mailing Address 70 Cce .� (41--310 City:
drig kv,1111.1111'1 S 3,
CONTRACTOR'S NAME: Bus. No.:
Mailing Address: City:
Demolition if planned by means of: manual disassembly
Jr heavy equipment
burning (by fire department)
Permits Issued:
# Burning Fire Department
Well Abandonment
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as
follows:
1. The structure(s) shall be kept enclosed and/or secured until such time as demolition is
complete.
2. Demolition debris will be kept off adjoining property and/or the public rights-of-way
unless specific prior approval is obtained in writing for temporary use thereof.
3. Foundations shall be completely removed from the ground.
4. All demolition debris shall be completely disposed of off site in accordance with all
applicable PCA requirements.
5. Water wells must be abandoned in accordance with State Health Department regulations.
6. Inspection required when all debris has been removed, before backfilling.
4
4
7. Within 5 working days of superstructure removal, a final inspection shall be requested.
The site shall be left clean and clear of all debris, with any excavation filled with earth
level with the adjacent ground elevation (except when such excavation is to be used as
part of a new building and such new building is actually under construction).
8. The undersigned owner shall and hereby does indemnify and hold harmless the City of
Orono, its agents, employees and assigns from and against all claims, damages, losses
or expenses, including attorney fees, against the City, its agents, employees and assigns
arising out of or resulting from the demolition described herein as performed by the
property owner, his employees, agents, subcontractors or assigns.
PERMIT TYPE AND FEE CALCULATION
$50.00 - Principal Structure
3 $30.00 - Accessory Structure
1. Subtotal of above permit requested $
2. State Surcharge $ .50
3. TOTAL PERMIT FEE (add lines 1-2 above) $ PC-'53—n
The undersigned hereby applies to the City of Orono for issuance of a Demolition Permit, agrees
to do all work in strict accordance with the ordinances of the City and the regulations of the
State of Minnesota, and certifies;that all statem-nt m e on this application are complete, true
and correct.
0101
A lit Hv t1Date:
APPLICANT'S SIGN ' �
OWNER'S SIGNATURE: „ , uJ Anil Date: Yii41
APPROVED BY: Cfge
0 Date: -3- 14 -9S>
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,, DHS-2722 (9-85) - '
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STATS OF MINN<ZSOTA@ «� Q v �,
DEPARTMENT OF HUMAN SERVICES
444 LAIAYETTE ROAD 1
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F — f u ST. PAUL. MINNESOTA 11101 I;il� f >Y
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s 3/3110 '11
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Date
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,'v,' Zoning Authority
'N,:'7'. �..),_) l 0,-)LA„;Y1 :
�, Street Address '' .*',X
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1: City State Zip Codes
RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
b,,; Subjects Sala E',/\t L rc, v\
`"` Name of Day Care Home Applicant
tType of License:
`r j .,970sLOLI•erielvn kcl Family Day Care
s Street Address Group Family Day Care '-
Y >
2 o,l c� (c�(<<� �1/.� Licensed Capacity /�,% ..
1f City J State Zip Code Phone No. ? a — / (, --
",t, This is to inform you that we are in receipt of an application for ::::` '`-
5' licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly
r , Rule 2) , Family Day Care and Group Family Day Care Standards. Issuance of
this license is subject to compliance with the provisions of Minnesota
Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known .as
'# the Public Welfare Licensing Act and the rules of the Department„.ot:-Human
Services. ,,-
"-t.'"
�
You should note 'that under Minnesota Statutes, Section 245.812, Subvision i!
�_ - 3, a licensed day care facility serving 12 or fewer persons shall be ; »
considered a permitted single family residential use of property for the .
purposes of zoning. '
Subdivision 4 of the same section indicates that a --
44:,'4''.-
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, '
w licensed day care facility serving from 13 through 16 persona shall be =. F�' '
`,4 - considered a permitted multi-family residential use of property fors
purposes of zoning.
It we do not hear from you within 30 days after receipt of -this letter�'we i . " �:
r ':'
will consider the above-mentioned day care home to bt--inyeomplianof with
your local zoning code. 5-
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_ L • SERVICES OGIwEji4 �` • � hfri'�.< /' i%(/ Y f _. HEAL hi SERVICES .• .4 . `'POHtu.p AVENUE SOUTH
,Lictnainq Worker ams O
i MINNEAPOLIS.SAN 55415.2001
Street Address CC try ZIGR1OA KRAKE ',3w,�r te"
_� SI Social Wash 2 .-w. . '
+t# o ca,.Um1 1
34 20'A °
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DATE TIME
CITY OF ORONO CALLED IN +�
INSPECTION NOT CE SCHEDULED
PERMIT NO. //�'7 OMP TED /7 h _
ADDRESS 4,2271— L �"--44'
OWNER CONTR. PAP-422/del
TELEPHONE NO.
• DESCRIPTION / 'L"`""� Jiz9'
1U 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
h 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 Fl 14 SEWER HOOK-UP 06 PROGRESS
EMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v L 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO ME YOll YES_N!
• COMMENTS: 7 ccj
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LU ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. n PHOTO TAKEN
INSPECTOR WILL RETURN
H CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on •
Inspector. /'„!
White Copy/Inspector's File Canary Copy/Site Notice
Minnesota Well and Boring
MINNESOTA DEPARTMENT OF HEALTH Sealing No H 7 0P,O
WELL OR BORING LOCATION 1
County Name WELL AND BORING SEALING RECORD Minnesota Unique No.
�f Minnesota Statutes. Chapter 103/ or W-senes No
1.1.:.-.11.1 ICI'1 11 p (Leave blank A nol known)
Township Name Township No Range No Section No Fraction Ism •Ig I Date Sealed Approximate Date Well
,._.r..;-.t
r .f.t 1
i e't4. , 71C ''d or Boring Constructed
Numerical Street Address or Fire Number and City of Well or Boring Location / //y�f
r_.. :1 =..J'r. t.,r(.t',,f ,ti i. Depth Before Sealing
14/7–‘;.7 ft Original Depth • ! ft.
Show exact location of well or boring _ Sketch map of well or boring Static Water Level .Accurate
in section grid with..X... location.showing property lines.
r and buildings ❑Approximate
N wa►}V* 7P" .
*Single Yl Single Aquifer ❑Multiaquifer // Zri ftX below above land surface
A _i - Jam,' CASING TYPE
W ; E
1-, - - j4 Steel ❑Plastic ❑Tile ❑Other .
I .
'f
S Screen from (/88 10 /�` ft. Open Hole from to h a
/
HI-- i r''''— * t, - OBSTRUCTION/DEBRIS/FILL
{{
\ xObslruclion ❑Debris ❑Fill
PROPERTY OWNER'S NAME - - rY
eater Althea CaKvany � y *•.
Type //LYItf./r! 1 j i ' Q /--^ O //
T e of debris/obstruction ->:'
Mailing Address if different than properly address indicated above
Obstruction/Debris/Fill removed? ❑No
14140 .78th,-$t.
Ifttit, . PUMP ii
' d Prairie"'**.5534',
Removed ❑Not Present ❑ Other 56PL)/ ?P
CASING
GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO '
FORMATION
P.
Diameter - - Depth Set in oversize hole? Annular space initially grouted? -,
If not known indicate estimated formation log from nearby well or boring. : ,
infrom �toLea' ft ❑Yes �No ❑Yes ❑No 111 Unknown "1
-) <» Si
infrom to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown ..
• in.from to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown ;--
METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE:
No Annular Space Exists '1
❑Annular space grouted with tremie pipe '?
❑Casing Perforation/Removal
,a
infrom to ft. ❑Perforated ❑Removed
infrom to ft. ❑Perforated ❑Removed ,!..4:
:i';3
Type of perforator '
`r
❑Other
GROUTING MATERIAL
.6'0- .
Grouting material from _el_to ft. yards 162f•-
bags
,
50
.41
from to ft yards bags
REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING
from to ftyards bags `'-',
from to ftyards bags `'i
UNSEALED WELLS AND BORINGS
Other unsealed well or boring on property? ❑YesJo
.'S
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
This well or boring was sealed in accordance with Minnesota Rules,Chapter 4725 The information contained in this report is
true to the best of my knowledge. 13
.v;
„PM- i`}iV A WELL DR1 T.mG CO..,.{:C. 27172
Contractor Business Name License or Registration No 1 fd'
4resen alive Sig Date a
HName of Person Sealing Well or Boring
HE-01434-01 al
CITY OF ORONO Date
ADDRESS Connected to
CODE SEPTIC SYSTEM INVENTORY CARD Municipal Sewer
Address 2-705 air/0 Tdcc'n/ Property I.D. 04--/t7- .2 3 /2 6O65 WELL i DATA
O Standard trench 1 I
❑ MoundI) ,
System type O Other Legal Description L\ C) m`
Permit No. 2 34& M1l2 Date of permit Installer W ov Iii O
No. Bedrooms Garbage = m I
Building type /ZCSiDC--7v &—( or GPD .un• b r co o Disposal Q
E a ..d
SEPTIC TANKS: Material -• y 1 2) cc ,� c
- — a
Proper outlet and inlet Baffles ow Li A'• •epth to RO level
..
m
Height of tank bottom above water table a to ,e t• -arest building ' co
N E O
0
DRAINFIELD: Total length of line Nu Ines Trench width
N . 7
Y L
Total treatment area(sq.ft.) Hei•• 'drain eld above water table �' >.
-iJ
Type of filter material
a „-
N N
E t 47
Distance from nearest bldg. .
Perc rate min/in 2 n m c
p v
Depth of fill over drainfield `b•pth of rock over tile under tile c a
E c
a a U i
LOCATION
INSPECTION RECORD • PUMPOUT RECORD SKETCH
DATE COMPLIANCE DATE GALLONS
6' Ak 3 ?O-Ki /0O2
8-A9OS 4/c
-?9/ I'1Co .SWAa�:f o?
640,g
iniz
7
'6
1 4nstalled 19f
44/s71 .TZc✓.V
Include: 1) Well location
2) Distance from house to
septic tanks,dist.box,
and drainfield
C— CONFORMING S—SUBSTANDARD N —NONCONFORMING 3) North arrow and road
g„,
CITY OF ORONO 0
Municipal Offices O Z O
Post Office Box 66
Crystal Bay, MN 55323-0066 a '4a 1
� ON—SITE SEWAGE TREATMENT
S,111 ' INSPECTION REPORT
kESii&
Owner:, bin !/Qi\ Address: 27t3 2d
Permit #'s: n/9/'16 Dates: Contractors:_
City ordinance number 100 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.
The on-site sewage treatment system at the above address has been inspected and appears to fall into the category
checked below.
(This is [< an existing system [ I new construction)
SYSTEM CONFORMITY (1-3): g
1 "CODE SYSTEM"-A system which meets all the location, design, and construction standards of the current City
Codes, and which is operating satisfactorily by treating and disposing of the entire current sewage input
without discharging any pollutants into ground or surface waters.
"CONFORMING SYSTEM"-A system which does not meet all the location, design, and construction standards of the
current City Codes, but was installed according to the code in effect at the time of installation, and which
is operating satisfactorily by treating and disposing of the entire current sewage input without discharging
any pollutants into ground or surface waters.
3 "NON-CONFORMING SYSTEM"-A prohibited system; a system located within a designated 100-year floodplain; any
system which may or may not meet all the location, design, and construction standards of the current City
Codes and which is failing for any reason; and any system with less than 3 feet of unsaturated soil or sand
between the distribution device and the limiting soil characteristics.
(The limiting soil characteristic [ 7 has or }-has not been identified at this time. If the limiting soil
characteristic has not been identified, this classification may be subject to revision.)
TANK CONDITION (5-10): Cp
Tank inspection indicates:/
5 Pumpout not needed at this time.
6 Solids accumulation in tanks indicates they should be pumped out this year to help prevent future problems.
7 Solids accumulation in tanks is at a critical level. Tanks should be pumped out as soon as possible.
System is discharging to the surface. Tanks must be pumped out within 48 hours to eliminate surface discharge.
Inspection risers missing-tanks could not be inspected. Inspection ' ers 4" dia. .i.e u . -,ch
tank at next umpout. If tanks have not been pump-. .1 wi in t e as ree years, they should be pumpe.
o -
10 Inspenton pipe is located directly over tank baffle (does not give accurate measurement of solids accumulation).
If tanks have not been pumped out within the last three years, they should be pumped out now.
DRAINFIELD CONDITION (11-14): L
Dr field inspection indicates:
7ki_AE 1 Drainfield is dry, no surfacing evident.
7������ Some evidence of surfacing, not critical yet.
13 Drainfield is saturated and visibly discharging untreated effluent to the surface. Contact the City Inspector
immediately. Repairs must be completed within 90 days.
14 Drainfield extent and condition unknown.
LIMITING SITE FACTORS (slope,setbacks,etc.):
POTENTIAL FOR SYSTEM FAILURE (depends on soils,water table,etc.):
C9MMENTS: A / i i (.i • l�f� J IS-- ))'Yrt-73‘, 7 >
ff,YIN"?plOPY-11,,.
Date of Inspection Se'tic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of
property, be advised that this report does not guarantee or certify that an existing system will continue to function
properly( but is merely an opinion of the adequacy of the system under current conditions based on the available
information.
This report must be kept on the premises with the system location and pumping records.
WHITE COPY/Inspectors File YELLOW COPY/Homeowner
�\
.� On the North Shore of
Lake Minnetonka
ON-SITE SEWAGE TREATMENT CITY
INSPECTION REPORTOF POST OFFICE BOX 66
ORONO 1335 S. Brown Rd.
Crystal Bay, MN 55323
473-7357
OWNER Q17 L/14n ADDRESS 27) .-- lit-b/64wl'\
PERMIT NO.'S. 0239 Rr'a r DATES CONTRACTORS
City Ordinance No. 210 requires that each on-site sewage treatment system in Orono be inspected on a regular basis.The on-site sewage
treatment system at the above address has been inspected and appears to fall into the category checked below.
(This is jk.an existing system ❑ new construction)
1 Meets or exceeds current City standards in all respects relating to design,construction,and location.Appears to be operating
properly.
��1 54 2 Does not meet all current City standards for new construction (1978 Code) but in most respects appears to be designed,
located, and constructed generally in accordance with previous codes.System appears to be functioning properly;no major
upgrading of the system is required at this time.
3 Does not meet current City standards in many respects relating to design, construction,or location.Appears to be operating
adequately at this time, but has a relatively high potential for future problems. No major upgrading of system is required at
this time.
4 System may or may not meet current City standards for design, construction or location, but is failing to properly treat and
dispose of the current input,and is endangering a water supply, or is a source of pollution to surface or groundwaters,or is
creating a safety hazard,or is otherwise creating a public nuisance.Please contact the City Inspector to discuss system repair/
replacement procedures. If drainfield replacement is necessary,soil testing will usually be required,and a design and site plan
must be submitted for review.Your contractor must obtain a permit before work is started.
SYSTEM CONDITION ( m Checked items may require your action)
Tank inspection indicates: ' - Inspection pipe is located directly over tank baffle.(Does not
❑ Pumpout not needed at this time. giveyaccura e s ement o so i s accumulation.) If tanks
❑ Solids accumulation in tanks indicates they should be pump- ha,: • +`' .r pe• out within the last three years,they
ed out this year to help prevent future problems. sou
❑ Solids accumulation in tanks is at a critical level. Tanks Drainfield inspection indicates:
should be pumped out as soon as possible. 0 Drainfield is dry,no surfacing evident.
❑ System is discharging to surface. Tanks must be pumped 0 Some evidence of surfacing,not critical yet.
within 48 hours to eliminate surface discharge. 0 Drainfield is saturated and visibly discharging untreated
❑ Inspection risers missing—tanks could not be inspected, effluent to the surface. This condition may require replace-
Inspection risers (4" dia. pipe)must be installed in each tank ment or additions to drainfield. Contact the City Inspector
at next pumpout. If tanks have not been pumped out within immediately.Repairs must be completed within 90 days.
the last three years,they should be pumped out now. -5Py Drainfield Ytentanrl condition unknown.
SITE CHARACTERISTICS:
Limiting Site Factors Potential for System Failure Site Capabilities for
❑ Slope (depends on soil types,water Future Expansion
❑ Soil table,and system condition) 0 Adequate
❑ High water table 0 Low tFair
❑ Lot size Medium Poor
❑ Lake,wetland,or stream 0 High 0 Inadequate
❑ Drainage 0 System is causing visible
surface discha_rg_e.--� 1 J
COMMENNTS: A - an S r� P" bS7L d����i'ai 5—�/ Q �/ // �� rt�Y1(
rn �o - prW8n 47/-e-tar
Date of Inspection Septic System Inspector
Note: In the event that this inspection report is used to satisfy the requirements for a mortgage or other transfer of property,be advised that
this report does not guarantee or certify that an existing system will continue to function properly,but is merely an opinion of the adequacy
of the system under current conditions based on the available information.
This report must be kept on the premises with system location and pumping records.
WHITE COPY/Inspector's File GOLD COPY/Homeowner
0
„,„ CITY of ORONO
,.a Nth Offices
Post Office Box 66
Crystal Bay,Minnesota 55323-0066
Date: P-e ,2 ! �--
Hennepin County Government Center
Department of Property Tax & Public Records
Attn: Don Deutsch, ID Controller
A 607
Minneapolis, MN 55487
Dear Mr. Deutsch:
I (we) hereby make request for a combined assessment on the
following described land:
Legal Descriptions :
Outlot A, Countryside Manor - 04-117-23 12 0005
2705 Watertown Road
RLS 1089 , Tract A - 04-117-23-12 0002
2645 Watertown Road
Address: 2645 Watertown Road
Municipal Code: 38 For 1992 Tax Year
qLQ % r
6)aff4/C .-4 ( _ AP
Signature of Fee Own ( s ) Signature of Tax Payer( s )
44 V
Tax Payer' s ress
i/�� mss' 3 6
TELEPHONE-473-7357•FAX-473-0510
CN.,. . •
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