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Home My WebLink About1995-006964 - grading/fill � - ° � PERMIT �ITIf OF ORONO PERMIT TYPE: 2750 Kelley Parkway- P.O. Box 66 ; -:. _ Crystal Bay, Minnesota 55323 Permit Number: F �_ -- -- (612)473-7357 Date Issued: ; _ SITE ADDRESS: _. ..: . . --� - - - - .... ;. , : �., ; ; . -:= � DESCRIPTION: �.��- .-. --�: -. .. .�f i.s�:.�.`i _.__... ' ' 7�i[ _ _ .�.._ . . .?`s�=€i`. .. i r;=�= ,._:—�la�.J `��._� i?��? � i.�_=,`•� -� — REMARKS: FEE SUMMARY: - ------_.___--- - - _. __... = .._�`: ��:t; . _;i CONTRACTOR: OWNER: ..- '- - ' .; -:; - .- �" .-: �_._. .":�:: �. _ . ..��?-{1 }:�. ``{ _=. ': �:.: '.'�.:'"� { M' . �� .1 '-.; ' .�._.;..�.._ . ... � .,.f �+ f� .. _.. ... .�# ; . _ � .. .. _ . �. . ._._. .._ ...��1. . .. _ . . � ...._ _ � .;. Y :; .. t T ;j=} : � r._�. ._.___ s_: ., _»c.. ��: .. . . � . . _< . ._. _• • _ _ _._ . .. _., s � ,. . ._. .1 .�. �,..� : " ' , t , t;t �, ' • i.� _ � { .. .� . .,. .. � , .. .- ..�. : r.` ._ .. . _ _ .. . . . ,.. _ . . ... .. .. ....-�__� '.. ._ _ . , . ,_ _. . .. .... ... . � . ' ' ''.� � ' ��._ ' . ._. . L _ ... _ . _ --' 1'� � APPUCANT'PERMITEE I NATURE � ISSUED BY:SIGNATURE � - CITY OF ORONO — BIIIZDING PERMIT APPLICATION Date Received: Total Fee: $ Da�e ADproved: intered By: � permitr: �L INFORMATSON MIIST BS SIIBMITTF.D IN FIJ�L 8�0� P�N REVIEW WII`L B$ STARTP� (See Check-off List Enclosed} ------------------------- ---------- � AppLICANT IS: { circle cne) OWNER or CONTRACTOR JOB SITE ADDRESS: � V' � � �- � ZIP: � �/G Cl (work) ~� l )O V, � �,G PHONE: (home) CI 7�OZ� ?,IAM�: O� awN�: �i� � C� 1 MATI,ING ADDRESS: / �l � I�IC�_1'f-�� /rt�� CITY: � � k Q ZIP: s � J �i CONTRACTOR: S �=� � I PHONS: ?dASI�ING ADDRESS: CITY: ZIP: STAZ'S LICENSE: ,� ARCHITECT/ENGINEER: PHONE: MATZING ADDP.BSS: CIZ*ys ZSP: N�: RBGISTRATION ,� TYPE OF WORR: New Addition Accessory Structure Move Demo Remodel/Alteration Renovate Land Alteration PROPOSED WORR (describe in detail) : � r � �► �� STORIES: SQ. FEBT OF EACH FLOOR: NO. OF BEDROOMS: GARAGE STALLS: ATT. DET. - � oc� �� ESTIMA�ID CONSTHIICTION VALUATION (eaclnding Iand) : $ � hereby apply for a building permit and I acknowledge that the infor�atio: above is coutplete and accurate; that the wor3c will be in conformance wi.��h �h� u ordinances and codes of the City and with the State Building Code; understand this is not a rmit and work is not to start without a permit; anc �zat the wvrk will be i ac dance with the approved plan. • ,/� '`• DAZTE- �� r 9� p,ppI,ICANT'S SIGNATDRE: �1 � � . � , �� . � �� (�I'�'�' O� ��►��T(� �,� y �,. �. ��i rJ��A��.�5'��' �L' t�``. w`{��r� t� +-�"� Post O�ce Box 66•Crystal Bay, Minnesota a5323•Municipal Offices .�¢-� �.. .r��,. ,: • � _ � � On the North Shore of Lake Minnetonka DATA PRNACY ADVISORY In accordance with M.S. 13.04 , Subd. 2 , "Rights of subjects oF data" , we wou3d 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 Iicense requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or Iicense. 3. The information may be shared with other local , state or federal agencies to the extent necessary to grocess the permit or license. 4. If your reauested permit or Iicense requires Councii action to approve, some information may become public. 5. You have certain rights under M.S. 13.04 �o review pri�a�� data on yourself. E. Your full name is required to process this applica�icn or permit. ��or � ��-�K- �`��-- First Middle Last � � [ � � � ��W � �� Address � � �� I�� s S� � City State Zip C� � i - c� Z� � Phone I un erstand my rights as stated above. r, � Si ature BUILDING&ZONING—473-7357 • ADMINISTRATIOI�1&FINANCE —473-7358 • PUBLIC WORKS —��3-�359 ASSESSIN G �.p4 RIGHTS OF SIIB.TECTS OF DATA ' ision L Type of da�e- The rights of individuals on whom the data is Subdiv stored or to be stored shell be es set forth in this Section:�� An.individual asked to Subd. 2. Information requ�'�d to be given in�vi 'vate or confidential data concerning himWi hin the collecti g state agency, supply pri purpose and intended use o f t he r e q�m;d �b� aj,yhether he ma� re f u s e o r lfrom his political subdivision, or statewide sys �o,,,�n �onsequence arising required to supoly the requeste� dat8; (�) �Y �d (d) the identity of supplying or ref�sing to suoply private or confidential data; s or entities authorized by state or federal law to recenvest gative da a other pe:�son When gn individual is asked to supply requirement shall not epply to a law enforcement officer. pursuant to section 13.8?, subdivision �, The commissioner of revenue mav Dlace tgX re°una i�tau�teonsu nsteadhot subdivision in the individu�l income tax or D:'oDertV on those orms. � � �� by ��yi�. IIpon request to a responsible Subd. 3. Access to it an individual shall be informed whet�c h r vateeor confident al.e UP°n his author y, ified as pub � P ublic data on individuals, and whether it is � AtS e to him and, if he desires, shall further request, an indi��u� �t8 without any chsrgtored private �vldual h�s been individu$ls shall be shown the of that data• After an in �e informed of the content and mearung the data need not be �isclosed to shown the private data and iT�f ormed of i�s u��o�ac�on pursuant to this secti�n is him for six months 2hereafter unless a P n request by " or additional data on the in��u� h�8 e or public datarupoeated. T � , pending rovide copies of the pri uire the responsible authority shall p The responsible authority may re4�in the the individual subject oft�e actusl.costs of makirig, c8rtifying, and comp g requesting person to pay - re uest copies. ssible, with any 9 The responsible authori�o� �°w t�n f ve�daysyof th date mf ii�?cQ e�u not made pursuant to thzs subdi � if immediate co p excluding Saturda��s, Sundays and legal holidays, If he cannot comply with the request within that Lime, he shall siln�°rth tihe possible. �Ve � additional five da}'S within which to comp y individual, and mey and le al holidays. request, excluding Saturdays, SundaYS g te or complete. An individual maY Subd. 4. Proce�u'e �►hen �ata is not $��ivate data concerning himself. To contest the accuracY or completeness of public oin �it� the responsible authority ht an individual shall notify �ible euthority shall within 30 exercise this flg � lete and attempt to describing the nature of the disagreement. The respo days either: ($) �aj'i'ect the data found to be inaccurate or inc�mPeci ients named by notify past recipients °not f �the endiv dual Phat he belie esdthe data to be correct. the individusl� °r {b� y eement is Data in dispute shall be disclosed only if the individual's statement of disag�' • included with the �sclosed data. � aQPe�e� pursuant to the � The determination of the responsible authority to contested cases• provisions of the administrative procedure act relating . ' . CgECR OFF LIST FOR ISSIIANCE OF P�RMITS - � FOR OFFICE USE ONLY ADDRESS OR LEGt'�L: /,$-�O /��2�f �' PID: 0/^� �//� ISL�S'r��'`'3-J �dC� ��!G DSSCRIPTION OF WORK- �� ____ � _____ ' --------------------- - - DATE APPROVED: �I12��1� ZONING REVIEW BY: �l/f. DATS APPROVED s BIIII�DING REVIEW BY: W --------------- ------------------ --------------------- FEES TO BE CHARGED� Misc. Fees Calculate By: PERMIT Yes �No ��L�-►�� -��"``_ PLAN REVIEW Yes ��` a SEWER CO ECTION STATE SURCAA�GE �es Y/No WATER CONNECTION pARK FEE IWESTIGATION FEE Yes NO gITE INSPECTION SAC Yes No specif 1 Number of SAC Units OTHER ( Y ------------- ------------ ZONING CHECR LIST Zoning District: Post Office• School District: Fire Department: , Lot Area : Width: Depth: � No Date of Sur ey: Survey Submitted: Y S � Proposed Setbac}s� : Front (Lak �/Right Side: � / Rear (Str t) : Left Sid : � es : Wetland: Adjacent tructu � Peak Hgt. BuiJ.ding Heig t: Def . Hgt. ' r ' ot Coverage: Avg. Setback proposed xi stin,� r j_ Hardcover: 0-75 ' �' � i 5 250 ' -I i i �Sq-500 ' , � �00-1000 ' �� Ye / No Date of Council ApprovaJ�: Hardco er Variance equ red: � � g Co�.ncil Approval Date : Gradin : Staf f Appr vaJ. Date: Y= Septi : Staff Appro al Date: By� Zoning File- # Resol ion # : �Resolution Date: gEMp,ggS (in house) : � BQILDING REVIEW CHLCK LZST . : IIgC: ( CONSTRIICTION TYPE: /" '!� Sq Footage $ Per Sq Ftg Basement X lst FZoor X 2nd Floor X Garage X x - TOTAL Estimated Construction Value= $ �^� ��'�"^( r Inspections Required- Work Requiring Separate Permits: Site � Pl.umbing Grading/Fil�ing Footing Mechanical Fire Framing Septic Water Connection Insulation Fireplace Sewer Connection Wa�l Board (Masonry) Lawn Irrigation Other _�Final �Mf g�� rae11 (State Permit) Other Electrical (State Permit) ---------------------------------------- F�F.MARKS (IN HOIISE) : ----------------------------------------- REVIEW BY OT�ZS: DATE: Access : Existing New Access Approval : Date BY= --------------------------------------- F;F.MARRS (TO BE NO�ED ON PERMIT) : CERTIF'ICATE OF SURVEY ClTY 0�� , `' �'� - -- - - " �`�I�j� �?.'�� vL i��' �u�N G p!A N �_ ,�-:,� - �—�--�; --- ��p,�. - -- , .C�iyy? — -- �� /1i ' ,;i i I� YI��J��.�;..Y? ;� D: . � �Y`� I � Y�• �� ,NA dY . .�.� � - a 7 S l�.t: i w+�� —�2 1=ill �N (..ow �p ��,G t�-�'�s 1��1T�_ __._ �__ /vo ___ ____ . ��r�� c�s 5/� ��v x ._.�__-_ ____ .�_.._ __... _�._...__( M` r� v`� r ¢-c� Z !�� t'�/% J'i�t.� _, �9 J r �1 .! .Jr'� � � � f 9 � �" --- — � �� R y /0� , � � � ,�t , $� �. � ZZ.i � w S� �A'� � � � - � ,, zo.i / � � / ' � i F� � � � � _,� _: --- � _ --__-___ __ -� ,�,Z �� " �- � �//EO ^�__ _ � 9. __ -- � Q � /6 Z - - .. � � � � N � �X�rT 2 GI Q' Q � ; � .\;:r IZZZ NO ttz —�-�� t�l x� o � �� V � �� 1� Q (4� t� , �s0 �� 'h Vl �� 3 B �---- -- ��n �` �^ � .J �S,L'O.✓MO�/NPl. `v'. V /S.L3 y� � S ,_..-`�tti------------� ,(�,,� �6z��``_._..__. VG/Q41 N P�•.,,( a 7RACT A: That part of Lot 21 lying East of the West line of Section 8, Township 117, North Range 23, West of the 5th Principal Meridian, except the Easter]y 10 feet as measured along the South line thereof and that part of Lot 20 lying East of the t�lest line of said . Section 8, all in Hickory Hill , according to the plat thereof on file and of record in ' the office of the Register of Deeds, in and for Hennepin County, Minnesota. TRACT B: All those part of Lots 20 and 21 in Hickory Hill lying between the Easterly line of � Government Lot 5, Section 7, Township 117, Range 23, said Hennepin County, Minnesota and the center line of the County Road as now opened and traveled near the East line ' of said Section 7, according to the plat thereof on file and of record in the office � of the Registrar of Titles, in and for Hennepin County, Minnesota. � r. I I�ereby certify that this plan, survey or J08 � � SCNOBORG £ePort was prepared by me or under my direct 358� � supervision and �hat I ain a duly Registered ND SURVEYiNG Land Surveyor under tt�e laws of' the State or 800k — Pag� (NC. Minnesota. ZQ —79 s�a�� A,. ,.eox zae � „_3� , „2.,Z2, o�u,•o. MN ss3za, Date: o% / 9 Reaistration ��o. 14700