HomeMy WebLinkAbout1996-008191 (grading for driveway) � PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 �:°=��� �_��=?i��r�)
Crystal Bay, Minnesota 55323 Permit Number: ;_;��~;�:�;�
(612) 473-7357 Date Issued: _�;r;�i�;s�:,
SITE ADDRESS: ' '" ' �''
i`i K
_�? t_�H T���I C� E`'•:U
{_�.j
�` . T . �t� , , ti�:—ii;- __—j,:;—i}i.3 ;
DESCRIPTION:
{;�';�i�._#��`�� �i_,!�i ��iF�i Y��(,�1 c=�Y
�_�=:y 1' f��9�EIf 1�• I :��'�' �Fi�al� i�����'.����_��;
REMARKS:
FEE SUMMARY:
��=�=� ��=�*� _______ ��t? E�i?
T���{.�}. F�_�= �:.�t_,�:_r���
CONTRACTOR: OWNER: — �;,=�;�=l i���it. —
�',�=�t_���=��_��� �i���I C�a "i
� _. _:_� .��;�:c� �,F 4���=:r�.i� F;r�
i�i;;i;ij�i i ;•���} �S�_:!;i�,
ri— _.C�s�_i
. . — - - -'.�.
- j-= (�!� �` �} i—`t;i-E� `.t;t—4,�t�3—'.—� �— z I 1 �;■ jyl •i' �t- ,_ '-�'�;•'=j r •��—'y`�„{4:}�:�"i�-i••,'�:_:
f. �+� _ �i:���°°=�i�.3t�� i—i._, _—��r __ _-`�T°:; �_'._.!�`i° I'y�'=;I'�. a T_ i i��r�..� i�J. 4.. .,.._ .�i ��.._:
_._,�:..� �--. __._._.__ _ _ �, , :
� • 3 � �'•i'::'�`. i:... .� . . --�� r. � ��� iEj �t! E '3 F�V
._.F'R..l:t� .I.�.11 4-)�wi.,r h€h�;r t::-� l�:..i e_fi_� r•Si..i... �.c;3_f�l�T�•. J.!� W� � �?�i.:� i.:!_,tf43i-`; i �•,�'iff:f�-. :;J j. !f� :�il_e... �_.��. : . !,E�
i,i�i;i_ij;#f�! i 1?Z`�1 1�`�H�'a�..���= Fi'�i1.J -; � c°?i c.. `..�i` s'i��ilVt='=�l�!I�1 �,r—„�����J��`� t'�f f�.t;� 1�;;';,'�_%.f.!�'.�.='§i;!`i'`= .
L —�
. ^ ,�----� �.
APPUCANT PERMITEE SIGNAT ISSUED BY:SIGNATURE fi1L.
Total Fee: � �C.�I1.� DateReceived: �7�,:7�/��
DateApproved:
Entered By: ,.�� Permit#: �/�/
CITY OF ORONO - BUILDING PER1tiIIT APPLICATION
AI.L TiV`FORMATION�IUST BE SUBv1TTTED IN FULL BEFORE PLAN REVIEW WII.L
BE STARTED
-------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) WN OR CONTRACTOR
JOB SITE ADDRESS: ���j G �CZ ►i �'i�lE? �`GI ZIP: J�S.����
" / -____-
N�VIE OF O`�i ER: �L��iV �,�ct��'c4c� r c� PHON�: (home)j��J�fC�/
(work)
MAILIl�TGADDRESS: J��/ at . ��e 1 CITY: D�-���� fdli> ZIP: ��3��a
CONTRACTOR: S� �� PHONE:
I�IOBILE PH0�1E/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: #
ARCHIT'ECT/ENGI�i]EER: PHO�]E:
MAII,ING ADDRESS: CITY: ZIP:
�;��,�: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move �_ Remodel/Alteration Larxl Alteration
PROPOSEDWORK(describeindetail): � y j �y vz�c� v
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROONIS: GARAGE STAI.LS: ATT. DET.
EST�1aTED CONSTRUCTION VALUATION(escludingland): $ N��'�'
I hereby apply for a buildin� 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 Buildin� 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.
, -�
APPLIC�ti'T'S SIGNATLTRE: � �� :�� DATE: �o�y y`!
NOTE! Parade of Homes events require separate permit approval by Police Deparhnent and
City Council 60 days prior to the event. Non permitted events will not be allowed.
r . �
Sec.13.04 RIGHTS OF SLJB.TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom[he data is scored or to be stored shall be as set forth in this secaon.
Subd.2. Information required to be given individual. r1n individual asked to supply private or co�denaal data conceming himself shall
be informed of: (a)the purpose and intended use of the requested data within the coliecring'state agency, polidcal subdivision,or statewide system;
(b)whether he may refuse or is legally required to supply the requested data;(c)any lmown consequence arising fi-om his supplying or refusing to supply
private or co�denaal data;and(d)the iden[iry 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 investigarive data, pursuant to secaon 13.82, subdivision 5, to a law enforcement o�cer.
The commissioner of revenue mav place the notice required under this subdivision in the individua] income tax or propertv tax refund
instrucrions instead of on those forms.
Subd.3. Access to data by individual. Upon reques[to a responsible auchoriry,an individual shall be informed whe[her he is the subject
of stored data on individuals,and whether it is classified as public, priva[e or confidendal. Upon his further request, an individual who is the subject
of stored private or pubtic data on individuals shall be shown the data wichout any charge to him and, if he desires, shall be informed of the content
and meaning of[hat data. After an individual has been shown the privace data and informed of its meaning,the data need not be disclosed[o him for
six months thereafrer unless a dispute or action pursuant to this secnon is pending or addidonal data on the individual has been collected or created.
The responsible authority shall provide copies of the privace or public data upon request by the individual subject of the data. The responsible authoriry
may require the requescing person to pay the actual costs of making, cerrifying, and compiling the copies.
The responsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days oi
the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the reques[
within that time,he shall so inform the individual,and may have an addiaonal five days wi[hin 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 nature of the disagreement.
The responsible authoriry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipieots of
inaccurate or incomplete data, including recipiencs named by the individual; or(b) notify the individual that he belizves the data to be correct. Data
in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed dara.
The determinacion of the responsibfe authoriry may be appealed pursuant to the provisions of the administraeive 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 pernut 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. T'he information you furnish will be used to determine your qualification for the pemut or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the pemut 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 pernut 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 perm.it.
� ���C � G�c:c �./
l//% /
First 1 �e1 Last
,�5��j /��v s:�/� ��
Address �� �/J�
�r�>�t�'G �� N � �,� i ��U.� l
C�n, State Zip Phone
I understand my rights as stated above.
��s�fi'Y�c � �.��,f�/
Signature � ✓
�
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 3 c.Se L3 A�`t S c�J c` �--c�(
PID:
DESCRIPTION OF WORK: �lt��/�!� �=0 2 Q 2(J,� w�,, �{�c,=
-------------------------------------------------- -----------------------------------------------�------_-----y`---
ZONING REVIE� BY: DATE APPROVED• � z Y-
BUILDING REVIEW BY: N (►'d- DATE APPROVED:
---------------------------------------------------------- --
- -----------------------------
FEES TO BE CHARGED: Misc. Fees alculated y:
PERMIT Yes No
PLAN REVIEW Yes No �- SEWER CONNECTION
STATE SURCHARGE Yes No � WATER CONNECTION
INVESTIGATION FEE Yes No � PARK FEE
SAC Yes No « SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District:
Fire Department: Post Offce: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
� �
Front (Lake): Right Side: � S
��}' Rear (Street): Left Side: ��d� �
1
G► Adjacent Structures: Wetland:
�� ��.
� Building Height: Def. Hgt. Peak Hgt.
a
Lot Coverage:
Grading: Staff Approval Date: ��Z`{- °Lco By: d •�• Council Approval Date:
Septic: Staff Approval Date: By�
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback:
Existing Proposed
Hardcover: 0-75'
75-250'
� 250-500'
SOO-IOOO'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS (in house):
10
_ n�,
�
BUII..DING REVIEW CHECK LIST
usc: /��✓'- co�vs�uc�o�r z-YrE: ���
Sq Foota�e � Per Sq Ft�
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ � ��
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Pemut)
_� Final Grading/Filling Electrical (State Permit)
Other
REMARKS (N HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By�
REVIARKS(TO BE NOTED ON PERt'�IIT):
27
. �
��� � ��
� ^Y� �
�I
�_
- � _
• . •�/ _�_
Y
� � � p, l.,�r�''T`�* �
� ,� r ��►..Ir
s ' ad,, �� !
� �
.
+ * �'�
� �
e' •
' 1
s��
'.'
� •
�� _
•�• `p ^��
O "\'
• �
• � ���N
Z � �°�'�
. ; g � � �
. � �
�� Z �
�Q� � � �
CLr 9 --- �1,.
� F� w 9 S
� � � � � �
7 � �
T � � � = p r � r
` r' z , � _, ' � � �
� �� � � � � �
d eL �� '-'� r
� � � �� � � �
� t
�- ,� � .� g � �
^ C1? CS.. �'.�- Ct'a W �-
��� ��� � � O._
Lc� ��[] [�J m C] 1
�
i
��
i
��
�
��
���
1�
�7 ��,�
i��� r ��/�
�
,. ,.... .....m., . . . . . . .. . . . _,. . _ .:.,.u�,R�•,�-, -. . .. • ,.
H(;5330(F/93?, �"
HENNEPIN COUNTY PUBLIC WORKS
320 Washington Avenue South �i ` t �
Permit Na
Hopkins,Minnesota 55343 E�,�.;,
.9<���
DRIVEWAY OR STREET ENTRANCE PERMIT ANCA�CIA�P�OVISIONS
Field inspected by Date
Location Speed zone A.D.T.
Nearest Cross Street(if rural)
Sight distance: Actual-Left Right
Minimum-Left Right
Curb to be removed to: O Construction Joint ❑Sawed Joint
Recommended drainage: ❑ Surface ❑ Culvert Culvert length Culvert diameter
1.CONSTRUCTION SPECIFICATIONS(Within Right-of-Way)
BASE SURFACE CURB SIDEWALK SHOULDER BLVD-DITCH
Type Type Type Type Type Topsoil
Depth Depth Design Depth Depth Depth
2.TRAFFIC CONTROL REQUIREMENTS
;
3.SPECIAL PROVISIONS )!+� l�i� M�ZIKI„TM� �Z� 1�4AXIMtJk W�DTH SEC013D DAIVEWAY
:�co�s�ucr�o� ���z-rEn ns �sc�u�s�n.
DO NOT PLACE CONCRETE ON COUNTY RIGHT-OF-WAY WITHOUT WRITTEN
PERMISSION. IF YOU HAVE ANY (�UESTIONS, CALL 930-2548.
IDiagram A I Diagram B I
p� IMPORTANT: TYPE"a"CONSTRUCT ROUNDED BERM TO C�� IMPORTANT: CONSTRUCT SWALE TO DIVERT WATER FROM R�
PREVENT WATER FROM RUNNING DOWN SHOULDER.
DRI VE. I
�b••
2"Gutter 6"Swale
+ priveY+aY
..a�p�ivewaY . , ._.� . .ic� •r_sn. . ..... t.V+:.... :•t,..,
�'t Existing Roadway }�''' '��"••�
��
Shoulder Shoulder f
�`" I I I � I(� � Place culvert in existing ditch
_�
, . � -';
_ �� ' ;� :i�,
Final inspection date
Driveway was found to be ❑ Satisfactory
APPROVEDlDENIED:
❑ Unsatisfactory HENNEPIN COUNTY PUBLIC WORKS
Inspected by By
Date
..._ ._.. . ..—^7+�sYr��-�'�qs11p6i*•ny17'�'.�'�a•y;,�o�p'�wIR�f5+7�F*+►..--�ler�-- , .. . . . . �•+'I�r-�"----'�'aI.R4'���---�+5r+i*...S.we+w.�Iw�.�.r�--•-----•---
Curb Gutter ` '
� DRIVEWAY y,'Expansion Jt.�.
1/2••
Ex ansion � , Expans�o�Joints at 60'IApproxl
%z'Expansion Jt.� �o��ts i i �maximum interval.
�
w '. ,
...c�•.,.�. J �.::�. �. .. . - . . .. ,�.�... '. ,:.....,:._
4••Walk� Q 1/2' � �6'Walk� '� '/z'Expansion Jt
Expansion 4"Walk
�w Joints Square Panels Contraction Jts
>
Q `',
a Private Walkr :':`� •.�'.'
..., �.':�;�;�i��..r'':.'.': ►
Curb and Guttet
8" Pav't. 6" Pav't.
; ivate �
� Oriveway ;
.�}.- ��. .
�aved A I ley
4'�Walk 4"Walk 4"Walk
Contraction Joincs
Prov ide intermed iate jo int at
:/4" R. 1/4" per ft. slope tovrard roadway squared end in sidewalk, v,hen � .� � �
sidewalk fs adjacent to curb � ; '
� and gutter. E ' �
:e•::.:•• a :.'•. � .:.:; :.:'.'a:,:.�: '•:!': o C` c0
U
� 4%6"
+ Variable Width -..{
SECTION THRU WALK
COW��ETE WALK 4""''"` �
,/ �,
�,. ,
,- .' �;' ,`� �
���`�\Ja• � ,' �' ,.•� '�
�`ae 10�� ; ,/ r/
/a�� '� q
'� �' 45° �
C & G '`�, .;..,.,. .. ...
- 60° to 90�
` ���
. �.a
; _ ,a
�
� 3 �°Ae
::,: . .:1/4" R. Drivev+�y Pavement 1/4"R.
Variable � ` Length rks
q. S�OAe � a. o, .p,e—, --- a..
�./ e
� :�:.
5-10�L dts in�le,
1516 wx. diff.
HC 5330 badc(3/93)
,��' f
Hcss2e s�ss HENNEPIN COUNTY PUBLIC WORKS Permit No. �'' �`
� E�ITRANCE 320 Washington Avenue South
PERMIT FEES Hopkins, Minnesota 55343
PRIVATE 550.
TEMPORARY $50. APPLICATION FOR DRIVEWAY OR STREET ENTRANCE PERMIT
COMMERCIAL $100.
STREET $�oo. (Read "General Requirements" reverse side)
Name of applicant Phone
Address
(city) (state) (zip code)
Name of Property Owner Address
1. Contractor performing work (If Known) Phone
2. Application is hereby made for permission to construct and thereafter maintain: Driveway(s) Public Street(s)
3. Building to be constructed: � Yes � No � Residence � Commercial (Specify Type)
4. Driveway or street will be: � Temporary � Permanent Date proposed entrance will be needed:
(Permit expires one year from date)
5. Is the property: � Platted � Unplatted Number of present driveways or entrances to property:
6. Building Permit acquired: � Yes � No City Permit No.
7. Type of proposed entrance surface. � Bituminous � Concrete o Rock � Other
8. Location
(Address) (Co. Road) (City)
4
9. Location, if rural: Miles of
(N.,S.,E.,or W.) (Road or Street)
Dated Applicant's Signature
Printed Name
TO HELP THE INSPECTOR, PLACE A STAKE WITH A CLOTH ATTACHED IN THE CENTER OF THE PROPOSED ENTRANCE,HIGHER THAN
ANY SURROUNDING VEGETATION.
APPLICANT'S DIAGRAM - (If plot or construction plan is not submitted)
�
(Complete this form and send all copies to: Hennepin
County Public Works Permit Office,320 Washington Avenue
South,Hopkins,Minnesota 55343. Phone:930-2548.
After approval,one copy will be returned to applicant.)
� r
HC,329 bzirk i....,.,.
1. Applications for commercial and industriai driveways or driveways servicing parking lots or garages with five or
more vehicular parking spaces must be accompanied by two (2) separate layouts, Such layouts must meet the
requirements of the Rules and Regulations Establishing Design Specifications for Driveways along the Highway
Systems of Hennepin County, Minnesota. Gopies available at the Hennepin County Pubiic Works, 320
Washington Avenue South,Nopkins,Minnesota 55343.
2. Applications for entrances serving private residence, farm or parking lots of less than five vehicular
parking spaces need not submit a site plan, but shall make an appropriate sketch in the space
provided on the front of this sheet. Such sketch shall generally locate the entrance, indicate its
dimensions,and relate to property li�es.
3. No work shall be started untii application is approved and permit issued.
4. If the installation of this driveway makes it necessary to work on the roadway,traffic must be protected;lights,signs
and proper barricades must be in place.
5. It is expressly understood and agreed that this permit is conditioned upon not placing any materiais
on traveled portion of the County roadway and that restoration of all disturbed area becomes the
responsibility of the applicant. The area disturbed must be restored to its original or to a satisfactory
condition.
6- After driveway construction is completed; persons requesting installation must notify the permit office that such
work has been compieted and ready for finai inspection and acceptance by Hennepin Couniy.
7. No changes or alterations in entrances may be made at any time without written permission from the County
Engineer or Representative.
$. Approval of this permit does not deny ihe Gounty Engineer the future right to revise, relocate or
close any entrance to expedite the movements of vehicuiar or pedestrian traffic.The Caunty retains
the right to close said entrance(s► at its discretion, based upon the necessity for traffic regulation and
control.
9. Existing driveways are not automatically perpetuated. In the event of a change in land use or a major
change in the traffic pattern of the existing facility, new driveway appiications may be required by
the County.
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI r q SCHEDULED '�
PERMIT NO. 6� ` ` COMPLETED
ADDRESS S �
OWNER ONTR.
TELEPHONE NO.
� DESCRIPTION
LL 01 FOOTING 11 MECHANICAL I 18 EXCAV/GR NG/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHOR /WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVA�
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
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTHACTOR TO MEET YOU:_YES_NO
Z
D COMMENTS:
�
W
a
�
J
O
�
�
O
�
�u
�
Q
�
2
W
�
W
�
�
d [_l WORK SATISFACTORY:PROCEED PROJECT COMPLETE
W
� ❑ CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �, PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next' c 4 hours in advance.473- 357
Owner/Contr tor n ite•
Inspector.
White Copylinspector's e Copy/Site Notice