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HomeMy WebLinkAbout1993-005 - shed R PEI�MIT � � CITY OF ORONO PE�RMIT TYPE: �_; ;� � ���,�=�t� 2750 Kelley Parkway • P.O. Box 815 Permit Number: �:�t�"=:�"_`; Orono, Minnesota 55356-0815 �-;-,�_�;_;;���:�; (612) 473-7357 Date Issued: SITE ADDRESS: � ;v��=t �;�_f;,��r`•; {�-i'_� �'� �,'--! �' , ? , t•�� . . ;�.—�. f�_—.L;-1 '�—i�i,�_y•�� DESCRIPTION: �_-rf•. i : Tf•,.._.! t-,! � _�X_�, _�.�L=' ''=!�!I #s.�,`It1'� 1='E't't:?i;. ..;.`r�__ '�t--(-;�_�..� _:�'�'!_�ti;'T�.,'s;'•'� +�,t.�1 �:=i�f t=.�; t:,?���:'.,: !�;`�:�+�_ '_��-1 T L7 !��':�: li��.za��til"1Cy = _ !�—J. � �:+_��:'t_t.l���rt._t��t 3;��t� ���`� ._�_'�?I:t°� Li�'.•-1('} � �•,f��•f� L�2 !t. Vlr L.'151'�fL! .jl��.^1Tl-L Vt!1!:l... � i yi�i j,::� � jL'lt�.`-yi� i�i L!a!V 1 ! ''i`�i �� REMARKS: 1`.`:`��_��L����L- �,..L` -�F t j,•j, V L!7 .... 1 7+ . . ::}i'.';:i�} .li_ii._.!!i.'VY�! r " .. . .�;�.� •U+-' V_ L'L�� FEE SUMMARY: _ _ _ �:,-- {:}�t=,_}rE-� i �,{r{�'v A� , i t:i� "'��.:1 '`=' �. _. i� s ._._ =Y.i��. '_�'_' `-`S.c�t� ��t:�4'i :�Fs� �:z'c . ;�; =+d.:]`'_�'"t:�;'��c_ `'h , =��i {t_�f.d 1 �Y�v —._.._.----•--_�—��j CONTRACTOR: Q�III�VE.� - ``'�_�. ';�f:.�`-'�-. -� ' jt•"L'�J.� i f ! j�:; �:��;i_�W�y �_.`:i�t�[ �T��.�yt{\,�� � �*Ii4t ��.l�'.� � ��"f���f�'' �`-�= �'tSt��'--�:��* _`..i;�;j '..i�:";:�� -•,� ,�-�_ - r-:;•6d E '.- -,T.�Ii`•t !I�`• ?'t�-;:,`�.!- ��'-#r- i` # � _.� '>'i`'`'_ �•- i : ,__ _, .._..__< .._ _ �l ..__ 1 ;._: --- . '`.L•�_. ._.._ . _ Y'i_+.':. . _ _ _. _ . . ._ . . _ �''.�;?�_ '�f'�;i_. __. .__i�: � .._.... . _,i.. ._.._: .. _ .. ' ' ' ' "e t.. _ � ...�_�c.r"::?7 ;"i'.?.ii"•�' i.�._ ' T _ ' r +-`i�; -�i i F'.'•�,t�F �.;5;1-.'���-- �i! ;}! I _ i ifil�": z;l , , �; , i- :;.� � i I-: €-`;! i : i E �. _. _._a. _.. _..�. t^.i i.. . .... .__ __. _. � ... . ."'._ .. _. . .t. _. . . .. _•^} _. ... .. ""__!"'11`!i:._ . _ . . _ ... . _'f y i�t,:S_�j.�:� �#_;i'•':.�e t'*!,'-��;��.#�_�.�� i�i�';t_� �� 1 H i "�"_ }_��` . �x`��`;1���.=j��'� � r. ._.`•-} t�;��j``,t_' i..•6_`'`'_�t�'_.. i'.�:'�.�+_�y;'`;it=��4 i �_ . L ,. _ , _ � � � �i APPLICANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE .!/ , �53�� h J "'! _.. . _ .ITY OF ORONO �P�I�TI�N FOR DEMOLITIO� �'�2MIT 3,0. Box 66 (1335 So Brown Rd) Crystal Bay, MN 55323 SPECIAI, CONDITIONS & HOLD HARMLESS AGREEMENT r�**#f*********�*****�******��**�********t:*�**�f********t****�t**t�r:r:t�t*** General Instructions 1. You may be required to obtain other permits,V'i.e. burning, well --- _.....__�t.____ ..�..._z_.._� ._.� _ _ ...,_... .. -� abandonmment, etc. -- - - �12 .�� 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. �**��*�****************:*******f*t*tt*******f*t*ttt*tt*��**f*�*�**t***�**** JOB SITS ADDRESS: �� 1 � ""�'�'�"r � � �ccupancy Type: �- Residential Commercial �WN$R`S NAME- �Y����t � 4i- l F � �, �.. � � l��<<�r ,�,H� Phone: ��")C- _�,s, ��� ,.� �7 3 �� �a z�� City: Mai l ing Addres s: � �� -�° Bus. No. : ":ONTRACTOR'S NAME s ' -�� f Ci ty: -;ailing Address: < « t= .�:�rittf'�r�cic�tit�t�:�t�t*t�t�tsir7t�tft�t�t*sff�t�t*7t*�tir�elt�tir*�*�t�t�t*�t�tyt*t!r**�t�tflt�t*ytit�tiryt�t*�tirir*t �emolition if planned by means of: burning (bysfireldepartment) eauipment ?ermits Issued: � Burning Fire Department � Well Abandonment In return for issuance of said Demolition Permit, the undersigned owner :�ereby agrees as follows: l. The structure(s) shall be kept enclosed and/or secured until such time as demolition is complete. 2. Demo I ition debris wi 11 be kept of f adj oining rova 1 i s ob z inedtin public rights-of-way unless specific prior app writing f or 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. 7. Within 5 working days of ss P�e sh 11 be left clean andaclearpof tall shall be requested. The debris, with any excavation filled with earth level with the ada=�eof ground elevation (except when such excavation is under constru c ion). � a new building and such new building is actually r -�---- - _ _ ___..._- - L� _._. -- -- - - - _ ._ _ . �.. 8 . The undersigned owner shall and hereby does indemnify and holc harmless the City of Orono, its agents, employees and assigns from anc against aIl claims, damages, losses or expenses, including attorne� fees, against the City; its agents, employees and assigns arising out of or resulting from the demolition described herein as performed b� the property owner, his employees, agents, subcontractors or assigns. ********�*****�**f**f*f*�*t:t�#****�*t*�**�*t*�***f��*#�*t��r*t*t*t�t�*tt�*^ � .. , -- PF•RKITf TYPS AND FE$- CAI.CULATION--. ' $50. 00 Principal Structure $30. 00 Accessory Structure �� _`���c�� , 1. Subtotal of above permit requested $ �l" � C:'c: 2. State Surcharge $ • 5d 3 � TOTAL PERMIT FEE (add lines 1-2 above) $ �l� � � � **�**********t******�****�*f*�***f**�**�*�f**�*******#**t*t************�*** 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 statements made on this application are complete, true and correct. � SIGNATURL OF APPLICANT: C'� Date: '��.�3�i �3 ' CITY OF ORONO - BIIILDING PER�LZT APPLIC�TION ^otal r ee: $ ��i`� -Z �= _ Date P.eceived: Date P.��rove8: Er.tered By: ��/ • Pe*�it� r �j �� AT.T• INFORMATION MIIST BE SIIBMITT� IN FULL B�FOR.E PZ,AN REVIEW WII�L B8 STARTE� (See Check-off List Encl.osed) -------------------------------------------------------------------------- Tgg p,ppLICANT IS: (circle one) OWNER r CONTRACTOR Jos sz� �Dxsss: � �6 /Y OQ�T�.� �"1 �c- }ur�.� � Z1P: S'S3S� (work) �7�3 --S�-a,�-- *7� • F oWNER- v 'S' PHONE: (home) �7(0 '6S'7� :�AILING ADDRESS: � C9-yr�� CI�: ZIP: CONTRACTOR: C�r�._� P$��" �AII�ING ADDRESS: �� CITY: ZIP: STATS LICENSE: � ARCHSTECT/ENGIIJEER: � fy-� PHONE: !dAIZ1ZIG ADDRBSS: CITY: ZIP: ���: R.SGISTRATION a ':'YPE OF WORR: New ✓ Addition Accessory Strnc�ure� Move DemoJ� Remodel/Alteration Renovate Land Alteration �ROPOSED WORR (describe i.n detail) : K o.� � Q�sQ� � � � � � � �� �� � O +�..s �.,�0 /�` �. /�o � ,�.,�.Q�.( - �'�TORSBS:�_ SQ. FEBT OF EACS FLOOR: /7� � �30. OF B$DROOMS: GARAGE STALLS: ATT. DET. " CJ D 'STIMATED CONSTRIICTION VALIIATION (eacludinq Iand) : $ l 7 G C� ' hereby apply for a building permit and I acknowledge that the information bove is complete and accurate; that the work will be in conformance with the =dinances and codes of the City and with the State Building Code; that I �derstand this is not a permit and work is not to start without a permit; and zat the work will be in accordance with the approved plan. . .PPLICANT'S SIGNATURE: DATE: `7^ �3 �'y3 .., .>'9' ,.Y.h� �^t�'�.�:s`� ` r%3�... ,. Y�.:�sr �����#���� y�� � ��.��.��- CI'I`7�' O� OI$O�TO ��;�.I,..�,�-��, � .s-�; - .w ,zj,�,�,�,� �'��'�::r�. -`,.�"�.�:�' �. " ��,,�� ;;`..�,;� o-i ,:�,��:: Post Office Box 66•Crystal Bay,Minnesota 5�323•MuniciPal�� .�-.�- -,� -�Y ,`�� . � J�za�: � _ � � ;" 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 Iike 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 Iicense 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 iocal , state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or Iicense requires Councii action to approve, some information may become public. 5. You have certain rights ander M.S. 13.04 to review pri�at� data on yourself. 6, Yaur full name is required to process this applicatian or permit. Fi st iddle Last / ��d � ����rfL� Address G-L_._. �, �.� SS 3 s,� City State Z1p �7 6 - a � ��- Phone I understand my rights as stated above. Signa re BUILDING&ZONING—473-7357 • ADMINISTFtATIO`1&FINANCE—�73-7358 � PUBLIC WORKS—473-7359 ASSESSI;VG i '�► 513.04 RIGHTS OF SIIBJECTS OF DATA � . gubdivision L TYPe of data. The rights of individuals on whom the data is r stored or to be stored shell be ss set forth in this section. Subd, 2. Information res�uired to be given u'���1" An.individuel esked to � � supply private or confidentiel c3ata concer a a BmWit�h�in the collecting state agency, purpose and intended use of the requeste (b) whether he may refuse or from his political subdivision, or statewide system; �own consequence arising required to supply the requested dat8; ��) �Y su plying or refusing to supply private or confidential data; and (d) the identity of P other persons or entities authorized by siVadual iseeskedlto supplyein est gative da a requirement shall not apply when an ind pursuant to section 13.8?, subdivision �, to a law enforcement office:. The commissioner of revenue mav ole�tv tgx re�und inst�ucte°s�nsLeBahoi subdivision in the individual income tax •r �r � on those orms. . - -— - " . Subd. 3. Access to �aYa bY ����L UPon request to e responsible authorit , an individual shall be informed whether h=�gteeor confident al.e Upon his Y ubl�c individuals, and whether it is classified as p � P ublic data on further request, an individual who is the subject of e to himrlandeif he desires, shall individuels shall be shown the data witho ofan�y ��g. �ter an individual h�s been 6e informed of the content and meaning the data need not be �isclosed to shown the private data snd informed of itg meaning� ��uant to this section is him foc six months thereafter unless a dispute or action p � ending or additional data on the individ�h h�gte or p blic datarupongrequest by . P responsible authority shall provide copies o P the individual subject of the �ta. Th of making,la�rtl Yingys�d c mpiling the requesting person to pay the actual costs copies. ssible, with any request The responsible s�thority shall comply immediatelYof th date of the request, made pursuant to this subdivision, or with.in five days Sundays and lega.l holidays, if immediate compliance is not excluding Saturdays, with the request within that time, he shall so inform the possible. If he cannot comply within which to comply with the individual, and maY ha�e an additio� i v�daY��n. request, excluding Saturdeys, SundaYS g Subd. 4. Proced�e when �ata is not ac�urate or complete. An indivi�uel maY - ublic or private data concerning himself. To contest the accuracY or comgleteness of p in yy�i� the res�onsible authority exercise this right, an individual shall notify �ible authority shall within 30 describing the nature of the disagreementi �e r�p° lete and atLempt to days either: (a) correcf inaccurate vrdincomplete a taeinclu�ngpecipients named by notify past recipients o the individuel; or (b) notify the indi��� ��au�,�statementof disagreement is Data in dispute shall be disclosed only • included with the disclosed data• � appealed pursuant to the ' The determination of the responsible authority may provisions of the administrative procedure act relating to contested cases. , . �'� � CHECR OFF I,IST FOR ISSIIANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR I�EGAI,: �4� C���� . �O� PID: DESC�IPTION OF WORR: w E-��O / ��-r^'✓"' ���'� - ----------------Q---------------•------ ZONING REVIEW BY- �Q�ww-- DATE APPROVED: �-2�''�i-3 BIIILDING RL�7IEW BY: DATS APPROVF.D: � '�-5 3 --------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes +� No PLAN REVIEW Yes � No SEWER CONNECTION STATE SURCHARGE Yes� No WATER CONNECTION INVESTIGATION FEE Yes No J' PARR FEE SAC � Yes No G''" SITE INSPECTION Number of SAC IInits OTHER (specify) ------------------------------- ------------------------------ . ZONING CHE(� LIST Zoning District: �.�`�� Fire Department: r Post Office• LvN L11-dG� School District: O�ND Lot Area: �3��•$'�- Width: Y�f `t• �l Depth: 3 � �•S� Survey Submitted: YesrC No Date of Survey: Proposed Setbacks: Front (�) - �S� I '�' W Right Side: 3(O � Rear (�r�"j : ��{.S� "�' � Left Side: ! 2.0 N Adjacent Structures: 3 S � Wetland: ��/� Building Height: Def. Hgt. � • �L Peak Hgt. Avg. Setback: Lot C erage: Existing Pro osed Hardcover: 0-75 ' 75-250 ' 250-500 ' 500-i000 ' Hardcover Varianc Requir d: Ye No D te of Coun ' 1 Approval:__ Grading: Staff Ap roval Da e: By� Counci oval. Date: Septic: Staff App ova7� Date y' Zoning File:# 3 2 Res lu ion � : ResoJ.ut� on Date:��� �FHtARKS (1II t10L1S � : � � . BQILDING REVIEW CHECK LIST � 4 • -. . IIgC: � $ � - � CONSTRIICTION TYPE: �- Sq Footage $ Per Sq Ftg Basement X - . lst Fl.00r X - 2nd Floor X � Garage X - x = TOTAL Esti_mated Construction Value: � � 7 4O�`� Inspections Reqnired: Work Reqniring Separate Permi.ts: Site � Plumbing Grading/Fi1J.ing Footing Mechanical. Fire —"Framing Septic Water Connection Insulation Fireplace Sewer Connection Wall Board (Masonry) Lawn Irrigation �FinaJ. (Mfg.) Other Other , Well (State Permit) Electrical (Stat,e. Permit) ----------------------0----------------------- REMARKS (IN HOIISE) : (v ,/�ci,AcYVS �lL�.� — `�''�'►'LL1 C�R�✓l.�z ""� 1� ?` V� � � �� �������������������������'������������'��������������������� REVIEW BY OTffiT'RS: DATE: Access: Existing New Access Approval: Date BY= ------------------------------------------------------- RF.JKARR$ (Tp BE NOTED ON PERMIT) : , � i . Y�„`� .�I,`� r,t Y� ,. ' ;.., . .��� ��I'���'��a'+ '����s..�Y �. ^�..,���4+1���J1! 7V tf�-",�11 � �S��� h� �� � h�.{'s`.,�V++�tA ,yf',*917�:1�p�,::+y1r t1`tl'W;;��+�U�1f}VY���d��. .��y .��r�' .e � � �t� ry. �+ �.ai..J..� - �.:�1'.�.; � � �. ;�.•I��i� �i ,��c ��K�M�'b.,�h4�,•9.` 7''' �`t�+�. ^",! i ',�.'• �;�i �tlR';�'f `�`�"�����l:Ai��r�;;e y � ��::�1 ^-��� ei.'.ti�����}.{���T}�5. 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"` � ,���: ,i i �` ' '` � ..i t i,..` rw � : r y ���. ti�C D '�.�.ire g�., � r , .�, 5 1 �. }v � . ��•� iV .1„�,+.� .� .St � .�,•,,.. , . .i. 1r �'E . .i DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTIC SCHEDULED � � PERMIT NO. COMPLETED ADDRESS G � r `2d �v � '"'� OWNER CONTR. 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