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Home My WebLink About1997-008970 (land alteration) � PERMIT CIT1( OF ORONO PERMIT TYPE: _ _ _ . _ _. ` �750 Kelley Parkway- P.O. Box 66 _-�: �'_.r��;`a�:�� Crystal Bay, Minnesota 55323 Permit Number: �;;_:;�,:,;..,.,' � (612) 473-7357 Date Issued: _ SITE ADDRESS: _ ._ . . . -��=Ti,; F . ... _ .. � _ - - - �..: : ,>:: ...:�:_. . : �_ �- � �, DESCRIPTION: _ ;.� _'a*.=-t' f';'�"•'.._ _ _ ....�.... 's._t-i`��I1 ,'-?E�`i�:�� [ 1��'�.� REMARKS: . _ _ . _ _ ; : ,� .. t_ _ ..._ , , . , ,v. _ : :._. � . , �.�:� ; ., , .. .� �,: . „� L._.�... _ _. _ ,. . . _. .. .. .. FEE SUMMARY: <��€__�.�:�i i�_��3 __ , :�:,�_3 N;r,: -s;�; ��..�.,'::: �}.�.3•?^� . .� • t.: � : 's,":'�'c'.r�.1 �:7�-�,'�;,.3 t�i;! .__�_____ {..j'a � a=:��,y-�;7 "F:,}} �•�.-i��Tf;'_�' CONTRACTOR: OWNER: - _ _ __,-. _ - _ - . _ _ r;'t____�,r•`� ___ . _ _:'t:='_�_E _�.1�`v� `'`� _ .._ � -_'_` , .._. _ ; ._ ;i _.j , ; - ; � ; { � ;�; '.:�`,�':_ -. _.,.. _. . . ._ . __ ._. = ,`_ ;«; ; _ . _ . �_ ._. .:_ _ __.� . _... .._.. . _ _:�� ..._ .; :=W _ _ _. _ , . __ .._ ...._ � � ,�� . _,_ ,_...._ _ . .. _ ,W�_ ._ , ,_:�: :�:�,:,�: r : - ��r -- r.: �..; { s:_ . . ;, _,. W. . . , . . ., ... . ,. ,. . . , , . ,_,,w�_� . _ P.�_ ... , ;r- ,.:, x:i . .. _ . . . _ . _ . . ... _ . _ _ . ___ . . . ._.. . _ . _._ _ i ;";ti.�:',s,>:_ , � _ ;�<. - - - r _ .� � .. , �,.:'��.,;.' ;, �' :=t � .... .,;, , �• : : : .; _� : : _ �__ _. . . ._ _ ,�.__. ,. . _ ._ ._ _ ..._ , _ .._ . .-- L _. ._ _. . . r I _J _ i .i' APPLICANT ERMITEE SIGNAT RE �� ISSUED BY:SIGNATURE � .1�� , � �! 1 � Total Fee: $ I��•� Date Received: �/� /��, Entered By: Pernut#: ��17 D CITY OF ORONO - BUILDING PERNIIT APPLICATION All information must be submitted in full before plan review will be started. (please print all information) ---------------------------------------------------------------------------------------------------------------------- _ THE APPLICANT IS: (circle one) �NE R CONTRACTOR JOB SITE ADDRE�S: �;�G �Gt S CC� p0 i n� ��t ZIP: �� NAME OF OWNER: ��I� 'I <E- �U t� S�h c� ��'S PHONE: (home) �`7I- (�Q(o O /� (work) MAILING ADDRESS: 0��0 �Gi S'Co 1'Q�`��1�ITY: � c:� ZIP: �;S_3 q/ CONTRAC�OR: PHONE: CONTACT PERSON: MOBILE/PAGER: MAILING ADDRESS: CITY: ZIP: STATE LICENSE: # ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: rJAME; REGISTRATION# TYPE OF WORK: New Addition Accessory Structure Move Remodel/Alteration Land Alteration PROPOSED WORK(describe in detain: ��L� �� STORIES: �_ SQ.FEET OF EACH FLOOR: � ��/C/` NO. OF BEDROOMS: � GARAGE STALLS: ATT. c/ DET. ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �� v 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 woxk is not to start without a permit; and that the work will be in,accQrdance with the approved plan. APPLICANT'S SIGNATURE: �- "��ATE: .� — � � `�`� NOTE! Parade o�Homes events require s`eparate permit approval by Police Department and City Council 60 days prior to the event. Non permitted events will not be allowed. a� � r Sec.13.04 RIGHTS OF S[JB.TECTS 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 fonh in this section. Subd.2. Information reqirired to be given individual. An individual asked to supply private or co�denrial dara 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 oY is legally required to supply the requested data;(c)any irnown consequence arising from his supplying or refusing to supply priva[e or confidential data;and(d)the identiry of o[her persons or enriries authorized by state or federai law to receive the data. T'his requirement shall not app(y when an individual is asked to supply invesrieadve daca, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer. The commissioner of re�enue mav place the nodce reauired under this subdivision in the individual income tax or propertv tax refund instructions instead of on those forms. Subd. 3. Access to data by individual. Upon requesc to a responsible authoriry,an individual shall be informed whether he is the subject of stored data on individuals,and whether it is classified as public, privace 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 con[ent and meaning of that data. After an individual has been shown the private data and informed of iu meaning,the data need not be disclosed to hun for six months thezeafter unless a dispute or action pursuant to this secdon is pending or additional data on the individual has been collected or created. The responsible authoriry shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the requesting person to pay the ac[ual cosu of making, cenifying, and compiling the copies. The cesponsible authoriry shall compiy 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 immedia�e compliance is no[possible. If he cannot comply with the request within that time,he shall so inform the individual,and may have an addiaonal 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 conceming himself. To exercise this right,an individual shall norify in wriang the responsible authoriry describing the nature of the disagreeme�t. The responsible au[horiry shall within 30 days either. (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipienu 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 authoriry may be appealed pursuant to the provisions of the administrative procedure act reladng 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. The 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 pernut 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, our full name is required to process this application or permit. , � , S�, ��rs� � u � First Middle Last .�� s�� P� ; hfi �a Addre � ��7 j�� • �/� , a � f� YI/I . �.53�1/ � City 3tate Zip Phone ��I unders and my rights as s ed ve. �� gnature � CHECK OFF LIST FOR ISSUANCE OF PERMITS � FOR OFFICE USE ONLY ADDRESS OR LEGAL: � ��i�s �'✓!5<_.,, � ;,,�, ;_ /- ,.,��, PID: DESCRIP'TION OF WORK: ��,1�.�:� ------------------------------------------------------------------------------------------------------------------- ZO�TING RE'VIEW BY: ��(, (��:., DATE APPROVED: s� `� -`�7 BLTILDING REV�W BY: � �; i�^; DATE APPROVED: ----------------------------------------------------------------------------------------------------------------------- FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes ✓ �"�rNo�`"' . PLAN REVIEW Yes No � SEWER CONNEC"I'ION STATE SUR:HARG� Yes No WATERCONNECTION INVESTIGA'I'ION-FEE Yes �� No PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER (specify) ----------------------------------------------------------------------------------------------------------------------- ZONI�i tG CHECK LIST zoning Districc: �—�- � `L- � Fire Deparcment: Post Office: School District: �v" � Lot Area: Sq.ft. Acres Width Depth Survey Submitted: Yes No Date of Survey: Proposed Setbacks: , � Front (Lake): . Z =��` �- Right Side: I 3 � � � &ear(Street): �� ' "-`= Left Side: I��`� Adjacent Structures: y�' = Wetland: /"f s� Building Height: Def. Hgt. !^�� Peak Hgt. �,�/.�"'� Lot Coverage: 1"�' ��'" Grading: Staff Approval Date: �-� �' -`� ' By: ,� '� Council Approval Date: Septic: Staff Approval Date: r''� � �' By� Zoning File: # �' �o-�� Resolution: # Resolution Date: y- �� `+ � Shoreland Dist:ict: '�� .� i Avg. Setback: Bluff Setback: Lot Coverage: ; Existing Proposed v�-� ' -,'Hardcover: 0-75' ' 75-250' � 250`500' 500-1000' � Hardcover Variance Required: Yes No Date of Council Approval: REMARKS (in house): __ . 26 . BUII.,DING REVIEW CHECK LIST �C� _ �!(�!' CONSTRUCTION TYPE: /'t.'�-'� � Sq Footage $ Per Sq F[g Basement R = lst Floor x = 2nd Floor R = Garage R = x = TOTAL Estimated Construction Value: $ ��.,-,,;,,�,;� 'r�',,,,� � /� , ; Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection Footing Sep[ic Sewer Connection Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well (State Permit) � Final Grading/Filling Electrical (State Permit) Other - ----------------------------------------------------------- REMARKS (IN HOUSE): ------------------------------------------------------------------------------------------------------------------------ REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By; ------------------------------------------------------------------------------------------------------------------------ REMARKS(TO BE I�TOTED ON PERI�IIT): q np,�ie�,,,P.9 2p„ � t,,,�� ,r,� nti� c�,.F �5 v(.c� n o,v �- ---T� 27 SU8484 CERTIFICATE OF SUf�VE-Y FOR ALL��.�N SCHEF'Ei�� OF LOl.. 2, BLOCK G, TOWN�IT� OF LANGDON (�;��RK f HENNEPIN COUNTY, h✓11�1NESOTA � �, �'�� C��Y ��, l`�� . . ,�. ' , �� ,,. � , O�.• -(93�.0) . . oP �, CITY O�F ORfl�O . � `��`�� S1TE PLAN � GRADING PI,AN � �� ' , l:.�APF'��1,'�;� P ,� n - z.nn,c�� t�te (9?7•°) ° Q� . � Q A{�F��tOV�U WiTH f�EVISIONS#Z2r,s / Q ''' r ❑ D�SAF�P�+ V�D O �� BY �G '�`�� UATE s-�2 -�7 nGQ' �, . .. �9��.2� , � � •(940.0) p�`L� � �� . O� � �` ,,� �.� �! � '` ` `�: (q39,i) � ; ��,.,\ �.fO+'o�� f'D / � . �c O ✓o � �* � n�� K\ �� ` �V� � ` e `�� 1 \p� `. �'�, `�/ ., 'o �K '• �18r �� S y `� � R�O � \ � � � '� X. . !� `(936.4� \ � 4.5` fC��f�N�� ,.� �, ,,o ,1 o Cq3 J .a � / �� g° . �0 9 0�•5 � � �Ql.icfwr p t \ 4 . ' S � �934• �, �A,fAGF�[OOA -j� �. i � I� ��1r'� '.� � l �,� /..�'.fi� "'?. ,�� .� �-i19.C6� YV � ,95-'�� ,\,,-'' / , `��1" '►.� �'�'�s � � � s :�� q s� ,�� '9 � � � �. � � � . l� �''� �' �5 � ' l r ' S E . � �O, / � yo�� q,�s��`q3��t�S �'.�s �� o.' oQ `9�y�. . ��, r 1.° gp .6St S'�0 10 �� o.o �` .`. 1A' rAO�j OPO • ,• s.�6o .oq Sr, . � '• � � �,"�, , �� P� 6� +� �iD��F f er�j �q3j.3) , � �6,p 40� �'�. , �1• �l/lq,�9� �S4�q3i � � LEGAL DESCRIPTION OF PREMISES : "��'j �� '• 5 stE�' .dya c� / � J" '. .. p0 ' ,a� , . Lot 2, Block 6, TOWNSITE OF LANGDON PARK ��.� q�5, � ---� `, � . , . � ' , ' . / . • o : denotes iron marker �'�� . . �� . � ' . •% (s37.$) : denotes existing spot elevation, mear� sea level datum � � �3�' o �, / � 945.9 : denotes proposed spot elevation, mean sea level datum ro •.�,.,�' o,�`O� 1`�'/ •o ��, Bearings� shown are based upon an assumed datum. • �'�� /� ��1 � / �O This survey intends to show the boundaries of the above �� / . e described property, and the proposed location of a proposed 6'�p • � , ��`/ �,`� house thereon. It does not purport to show any other '�Q �"5��`�e oJ� ��. improvements or encroachments. � `'��''e� Go��` � / � �� . .. , '•, '"/ .��'� � � iro,00r��! E/rvwt.'anf �s, �� l oRl�,��„ � _ q.�s.s �M � �� Z� Fii✓'� F/ovi- s 94�.S �) Gqra9 e � 9 9S.S c/PiF�t 1 935.S �ou�E� . .�,r,t r: . � �� '�-' 1 hereby c��rli�� that ►!�is survey was prepared hv me ur under my dirrct su�er- DnTE ,�-J6-96 , �s , � � � �1 � � � �' � �'�., , vision, anci tlint I��ni n c��ih�regi�t��rt��l(�i�,�il Ens•,in��er,incl l,�nd Surveyor iinder 1�--8'' � �� k�,�y�t�_'� the la„��- n( t!�� Sl.�ic n( !�linncsc�t�. ` '„'�, scn�r: � k � �. � �� .. Mark S. Grc�nbcr�; Minnrsota Liccnsc Numbcr 12755 ��'��N�� 96- 170 ,_„ v t�o