HomeMy WebLinkAbout1998 - 010177 - well house PERMIT
CITY OF ORONO PERMIT TYPE:
„ 2750 Kelley Parkway- P.O. Box 66 Rf!I LL i I tat;
Crystal Bay, Minnesota 55323 Permit Number: i s 1;'}1.f,'
(612) 473-7357 Date Issued: 06/15/98
SITE ADDRESS:
0 W OOHiILL RD
CH
P . I . N . , `_2-11 ;- _-12-0001
DESCRIPTION:
WELL HOUSP
Building Permit Type COM--cc =iTR(JC T ai
Building Work Type COMMERCIAL
UBC: Occupancy Ul
Construction Type VN
Zoning RR-18
Census Code 328 8 OTS- ER NONRFS .
REMARKS:
FEE SUMMARY:
VALUATION $10,000
Base Fee $162 . "25
Plan Review $105. 46
Surcharge S5_00
Total Fee $272 . 71
CONTRACTOR: - Applicant - OWNER:
iALZK I 1=:j-?OS CONSTRUCTION 1`5'98°iii i WOODHILL COUNTRY y C L..t,B;
16090 ELM RD j _(ii 7 WOODr- 1 LL RD
MAPLE GROVE i N 55369 6 ORONO MN S:s:91
(612) c59-J80 473-S811
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THE UNDERSIGNED HEREBY REQUESTS PERMISSION ION TO MAKE THE REAL IMPROVEMENTS
SPECIFIED AND AGREE': TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF
ORONO ORDINANCES AND STATE OF MINNESOTA OUILDING CODE REQUIREMENTS.
.1-j,APPLICANT/PE ITEE SIGNATURE / ISSUED BY:SIGNATURE
I
Total Fee: $ 7/ Date Received:- a • `JS
Entered By: cuu , Permit#: 'O/ 7
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 O ,CONTRACTOR
JOB SITE ADDRESS: OO w001 h :11 Jt� • ZIP: S Sr-3
NAME OF OWNER: ti✓i'dil li C o1 r� G/v.4 PHONE: (home)
C '�:cl; �,-, lr:�ks�� (work) 73 S. ii
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: 6,--./Lk: S• hS PHONE: S--S7' .8111?
CONTACT PERSON: �� c, MOBILE/PAGER: S
MAILING ADDRESS: ' (CO'1c^ 1 )Q/ CITY: 1174,1,_,L &,Y'- ZIP: JJ
STATE LICENSE: # 203 (
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure 1
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detail): a M ,ss 2.2 X / V
STORIES: / SQ. FEET OF EACH FLOOR: a c'° f /-
NO.
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ 0, cc 0.
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 accordanc- with the approved plan. / /
APPLICANT'S SIGNATURE: t , 7 DATE: y(.2...//U
u
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.
5
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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 nature 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�lname
is required to process this application or permit. /
gljf:I),4'. l,]:C i `.c.t : 1- ``�.' Ger("2 fes; P rl-n,�..--
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PROPOSED WELL LOCATION SKETCH FOFORDO co
• . WOODHILL COUNTRY CLUB
IN SECTION 2- 117-23
HENNEPIN COUNTY, MINNESOTA
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JUDICIAL-• —tog'
LANDMARK
CITY OF • RONO
BUILDING P R I AN REVIEW
INSPECTOR • _
DATE ' '- - ". PE:. Ili NO.
w ,@—APPROVE:: ;.I ,, .
•
• 0 APPROVED IONS AS NOTED
r) ❑ NOT AROVED--_fir. ,R?: CT&RESUBMIT
i A ��� C P°
These Cornet?ills 1?re `ora- .' ,�.- :„• ;_i in. All work shall be done
in full comp) \v, ;: i ting and zoning code.
RequiremeAts Including items not:;:e.; :ily noted in this review.
•
KEEP THIS PLAN SET ON S E AT ALL TIMES
I
1 T . L N
The Southeast quarter of the •Northeast quarter of Section 2, Town-
ship 117 North, Range 23 West of the 5th Principal Meridian, ex- -
thoseparts platted as Edgewood Place and Registered Land Survey
No. 1098. Also, that part of. the Northeast quarter of the South-
east Quarter of said Section •2 lying northerly of the Dakota Rail-
and easterly of Registered Land Survey No_ 1098 _
•
I heretic iertilc haat this sunny was prepared be me or under me direct super- DATE I-19-98
COFFIN & GRONBERG`INC.
vision,and that I ain a duly registered Civil Engineer and Land Surveyor under ray. -6„,,„11„,0,0,,,,,.LmJ5ur,\\ria,Sitertnurrr: the laws of the State of ftlinnrso1a.
n
48?ram.vad.Atonic • Lung Like:\1N ii5115t,.. SCALE I 5D'
ni
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h12473-401
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98-014-
Mark S.Cn _d
ul\re ome- to License Number 1275; 98-014-
JOB N0.
8-0I4
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- CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2 0 o iot•k (2D"4
PID:
DESCRIPTION OF WORK: e l-E-o scJ
ZONING REVIEW BY: DATE APPROVED: y-2.7-18
BUILDING REVIEW BY: /d./tAe.,4,-- DATE APPROVED: Y•2 7•FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes C/' No
PLAN REVIEW Yes Ln No SEWER CONNECTION
STATE SURCHARGE Yes t No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: A
Fire Department: W6641-2,4, Post Office: W Mislt School District: Civ01 -/At-rY4-
Lot Area: Sq.ft. -1 0 (4-at Acres 70 Width Depth
Survey Submitted: Yes c( No Date of Survey: /-1 I -' `o
Proposed Setbacks:
Front (Lake): t 00 0 4- Right Side: (000 4
Rear (Street): (000 ,f Left Side: ( lb 9
Adjacent Structures: 1000 f- Wetland: /U (f9
Building Height: Def. Hgt. Q). Peak Hgt. 0%(G
Lot Coverage: 114
Grading: Staff Approval Date: N By: Council Approval Date:
Septic: Staff Approval Date: /If(4 By:
Zoning File: # Z 3 SZ Resolution: # Resolution Date:
Shoreland District: AI (
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
7
BUILDING REVIEW CHECK LIST
UBC: U 1 CONSTRUCTION TYPE: NP-)
Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ I 00 p0042"
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical • Water Connection
04 Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
LI 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
DATE TIME
CITY OF ORONO CALLED IN /CI/5ff/
INSPECTION NOTICE SCHEDULEDl= 3d
PERMIT NO. ! O/ '7'7 COMPLETED /l /� 9�'• 7 3O
ADDRESS c:::Rd d
OWN0-e-• CONTR.
TELEPHONE NO. ,175 - 58//
DESCRIPTION -/ja.'
4, S ••TING 11 M HANICALRI 18 EXCAV/GRADING/FILLING
V, 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
H
C:1
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 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
• • BING FINAL 36 FOUNDATION/REMOVAL
- OWNER/ 9 NTRACTOR TO MEET YOU:1,, YES_NO
o - NTS:
CC
a
CC
C-15c-e e/'c: fi-f c c ( l ` 5/0e c
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W CIWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
ORRECT WORK&PROCEED
CI ISSUE CERTIFICATE OF OCCUPANCY
• ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
CISTOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner/Contractor on site:
Inspector. /"1/2
White Copy/Inspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN ,� }
INSPECTION NOTICE SCHEDULED3"Is w ' $
PERMIT NO. 0(0I 77 C MPLTED — �'•- 36
ADDRESS '2•4:5-0 �Uv cA Ft I
OWNER CONTR. Joef- .5- I
TELEPHONE NO. ({73.5311
� rn tb of J9e
DESCRIPTION F inea Din P m f�vz C/havlivi►X.G8v edict/a
W 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
• 02 FRAMING 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
• 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
• OWNER/CONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
CC
W
a
CC
O
CC
O
U-
W
CC
W
W
CC
O
ORK SATISFACTORY:PROCEED ROJECT COMPLETE
W ❑CORRECT WORK&PROCEED E ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
Cl CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
LI STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-4600
Owner/Contractor on site:
Inspectord,;fes e"-c""
White Copy/Inspector's File Canary Copy/Site Notice
ATE TIME
CITY OF ORONO CALLED IN 23/ 7.
INSPECTION NOTICE SCHEDULED - /r
PERMIT NO. /O/17 COMPLETED ®C ag? 9c
ADDRESSV5IPZ: litt
uh '
OWNER CONTR.� . • " .�� `
At
TELEPHONE NO. 64Z — 723— %/Ge
8
D : •TION
01 FOOTING 11 MECHANICAL RI V 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 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
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
H 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
-d 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES NO
• COM ;: S:
CC
O
W
Q
Z
W
W
O RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑ ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
0 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑, PHOTO TAKEN
INSPECTOR WILL RETURN
El
CI STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
1r the next inspection 24 hours in advance.473-7357
ctor on site:
C )
e Copyllnspector's File Canary Copy/Site Notice