HomeMy WebLinkAbout2010-00186 - land alteration , ' CITY OF ORONO PERMIT NO.: 2010-00186
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 04/14/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 4245 CHIPPEWA LA
PIN : 31-118-23-42-0001
LEGAL DESC : UNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : USER DEFINED
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS)
NOTE: TEMPORARY TRENCH FOR GEO-THERMAL HEATING
APPLICANT LAND ALTERATION 50.00
SOUTH METRO PLUMBING& HEATING INC.
612 N BROADWAY TOTAL 50.00
JORDAN, MN 55352 PAID W[TH CASH 50.00
�)
Minnesota State License#: 65625
OWNER
ADAMS,JOHN&CLEA
4245 CHIPPEWA LA
MAPLE PLAIN, MN 55359-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additiona]or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced wi[hin 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
- l /�lo2.D/�
/ /
AP��� , 4 r.y1- Ye Issue By gnature
EPARATE PERMITS REQUIRED FOR WORK OTHE THAN DESCRBED ABOV
� ,���` City of Orono FO�USE ONLY
t '�Y p�
O{, O P.O.Box 66 Date Received: / /� Nermi[# 02��0 -� �0
�,, 2750 Kelley Park��ay
a ,;11���,<<���� � Crystal Bay,MN 55323 Amount: $ � C.U.P Filed:
��',1I���'P�V'�,�� (95'_l 249-4600
a
��x� Approved By;-���_ Site Plan:
l
Recommends: A rova� Denial ❑
CITY OF ORONO - USER DEFINED/GENERAL PERMIT
(All pennits must be approved by the Building Official and/or Zoning Department)
Job Site/Owner Inforniation:
Site Address: �� � � ����;� P�� �, � o.� • �� � �'`� �
✓
Owner: ,..—.C��� � 4 � � � Mailing Address: G/�-y� �/�' �'t�� L�--�
� �-..
City: % � � v Zip: �.�.� 3.� �
Home Phone: �� .�� �� ����� ���Alternate Phone: ��� � ��� C� - t��(��
7
Contractor/Applicant�Information: � ��r �;��,_ ;
,,�c. -� l� i.. v'�'Jef�v
Contractor/App.: � -n_S;�..�� � ,��,,.�� Contact Person: �o ^� � r 7�.-��-.c,.�
�
Address: �v �� N. a�� v `��v�°� State License #:
City: �^JO r'��� Zip: _S.S�.�� Expiration Date:
Phone: (p/�'02 �� "" �/O.S Alternate Phone: y�� � �y� �� / �
����`; � �; ..,, .�°"�:�'T`YpES`UF I7SER�:DEFINED PERMITS •' ' . � ;�':#' � "°��; ,
❑ Stairway to Lake ❑ Retainin Walls ❑ Temporarv Trailer
General-User Defined Surcharge General-User Defined Surcharge General-User Defined
* (Per UBC) * (Per UBC) * �30.00
*Estimated Cost: $ *Estimated Cost: $
❑ Docks-One Time(tvon-Lake Mtka� ❑ Land Alteration ❑ Zoning Review
General-User Defined Surcharge General-User Defined General-User Defined
❑ Commercial-(Per UBC) � 0-500 Cubic Yards *For 0-75'Zone-$30.00
*Estimated Cost: $ $50.00 (Needs Site Plan)
General-User Defined ❑ 501+Cub1C Ya1'ds �
❑ Residential- $30.00 $50.00 (Needs C.U.P.) ` Z'�"'�/��r`�
� v
❑ Tree Removal � /`r� c � �r'
General-User Defined /
*Within 0-75' -$30.00 �� �} �'�_�� �--� �., ''_ � ,�
✓�
SL" -r t2 f-,,{� c � .-K �-ti- T,;
I herby apply for a User Defined 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 pernlit;and that the wark
will be in accordance with the approved plan.
-------
� - / �2 � �� �
Applican _�� ___ Date ' �
�Lt/'''..� �� Nser DeSned Pemvt OS/O8/49)
, �
Proposal #1 CERTIFICATE OF SURVEY FOR ����-� C�� av
� �{a �f 5� CN r PP�.r,✓A l�nl� C� � 1
tN THE SE 1/4 OF SECTIDN 31-118-23 � %A�,
HENNEPW COUNTY� MINNESOTA �/� ,����`'—
�
- 1 , _
� CHtPPE41lA � �NE � '!`'' �` ,
-- + � , ..... � �..e c ii�c� ��
y .. ` S. �� ���M�M'�M
�•M ' -
` �i . .� ,.,, �': . . . !`� �'� t ��* �.
�
� + �� _...� � � - .
.` , � I . ,
_��.
� ` j�\ � `amc i • /
' '�� � �,�',`�1+
� �� '� �
f ', ��. =- „� �
_`�,s- '" .
_ � ; .
.
; `��:J I:�tin�� 5e��tic �
� �� r .�'
17 to � '
.' -' .-
20 ft. %� '�
• � •�.
t�«� :r" }���� /' ►
•Bann ar} �- ,
� , .
.
. .•
� rench East Edge ppro�. 40 to -��
� from `'�est Edge of isting Septic. �
. 151Tlr'c
� � �5►
� Pro osed ther ' al Trench
o p .
� . 16 feet ��Vid � 00 �et Long, 8 feet Deep.
. �..M . .�.
. �..� ��
,.r.. �A,� • .
Y� V� • .��. �. �' i . �
ff���rt4�rM�w��{Mk�iM twwr.rt Q�Nr M��w+II�M C
4 st:TwrMl'w-t 1+l MrR Ar'���nt dw�►i1�AM�wI iyrMr
. /J��a�OM M�Mt�F�11/���U�t1
�wf��p/f 1v��A��?�,l��M��IINI��i��
., ��• • , :�.
:�'�M/11�M1/11����1�N1�����'���w�'�
i�/wri41q1�1rMq�A����1����11�r
t+Mw+M�wA�1a r+.w.�►�r.rf�a��rw�yw b
M�Mi!�1��w*Ir�ali�M�t . ,
•: �..+rr�•�.11/.• ` . ' . ',: . • • . . .
2� to 2� ft. o o t .� "`�'r� .. . , . .. ', . .
H ' . . . ;:
Boundar,y ��p � � ' � '
�
w.i��
w�n`�'w+�w..'i��u,� .
�VC �'�' . '4f^`'�
_.�. -�.�i�R ,c ��„ w
J . r
PLUMBING • HEATING • AIR CONDITIONING
FIREPLACES �N�RSBO
/��NT FLOOR HEATING
L'r I/ !o/L'•Z��--
s
Phone: 952-492-3399
612 NORTH BROADWAY Fax: 952-492-3392
JORDAN, MN 55352 DON HARTMAN
♦