HomeMy WebLinkAbout2005-P08881 - intalling antennas on existing wireless towers ' ' PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: p08881
Crystal Bay, Minnesota 55323 Pel'mlt Type: Addition/RemodeURepair
(952) 249-4600 Date Issued: 7/12/2005
SITE ADDRESS: 2345 Blaine Avenue(Well No. 3 Pumphous Unit#
Wayzata,MN 553)1
PID: 17-117-23-34-0011
DESCRIPTION:
Proposed Use: Other
Census Code 437
Permit Class: Building
Permit Type: Addition/RemodeURepair Permit Sub-type(s): Building Undefined
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Installing Antennas On Existing Wireless Towers
FEE SUMMARY: Permit Fee: $ 321.25 Valuation: $ 20,000.00
Plan Review Fee: $ 208.81
State Surcharge Fee: $ 10.00
TOTAL FEE: $ 540.06
APPLICANT: American Tower OWNER: Village of Orono(Well No. 3 Pumphouse)
11225 90th Avenue N-#202 P.O. Box 66
Maple Grove,MN Crystal Bay,MN 55323
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THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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PPLICANT P RMITEE S[GNAT �� ISSUED BY SIGNATURE
Copies: 1-File(Signatures Required), 1-Applicant, 1-Monthly Reports, 1-Assessing,(if Septic, 1-Septic) Page 1
�t�c�iv��
JUN 2 3 2005 ��
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Total Fee: $ �.��{� � DateReceived: �
' R"; -- � ��, _�� '� � % - . � Permit#: In(2�1
0
� ,, ONO - BUILDING PERMIT APPLICATION
,
� ust be submrtted in full before plan review will be started.
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_ (please print all information)
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THr, h._ (circle one) OWNER OR ONTRACTOR�
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JOB S�TE�D�Ss: ���-�s �i���.�.� A�� Z�: �s3��
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ YeS �NO If yes, a specia!event permit is reguired with Police Department and City Council approval
60 days prior to the event. Shuttle bus service will be rega�ired unless applicant demonstrates
sufficient on-site parking is available. Non permitted events wiA not be allowed.
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NAME OF OWNER: � �'�J �- �)�'�!�('�� PHONE: (home)
(work)
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: ��(���(�� � PHONE: - �
CONTACT PERSON: S MOBILE/PAGER: ?(,3 - ��.=3-t��2�
MAILINGADDRESS: /(.��„� ���'`� �/,� /�'''�,�.U� CITY: j� � �� ZIP: �
STATE LICENSE: # EXPIRATION ATE:
ARCHITECT/ENGINEER: � �� � `, PHONE: ���"�:7�I-���
MAILING ADDRESS: S�k;��, Q�u.:'` �1 CITY: /l7-',1,1��p..i,�7 ZIP: 5�;5�
NAME: REGISTRATION: #
TYPE OF WORK: New Addition � Accessory Structure �
Move Home Remodel/Alteration
PROPOSED WORK(describe in detai�: ��5�f�.�� r`��1,��f,1G�S (�/1 �X�=�''�'1�/l�
W�^e SS ' tij�'S
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �� G' �',
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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 work is not to start without a permit;and that the work will be
in accordance with the approved plan.
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APPLICANT'S SIGNATURE: /� DATE: ��r�
31
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 2 3�S Q c.4���
PID:
DESCRIPTION OF WORK: �}NTCNNAS o.f w��-n-rn,..��z
ZO�P1G REVIE`V BY: 6lL�6 �'�-pPA a��v/lfoo�.s�• DATE APPROVED: 6-3�-o s
BUII�DING REVIE`V BY: ,t,�� DATE APPROVED:
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes �/ No
PLAN REVIEW Yes � No SEWER C0�INECTION
STATE SURCHARGE Yes � No WATERCONNECT'ION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
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ZONI�IG CHECK LIST Zoning District: n, o c!�
Fire Deparcmen[: Post O ce: School District: _
Lot Area: Sq.ft. Acres Width Depch
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
Adiacent Structures: Wetl d:
Building HeiGht: Def. Hgt. Pe Hgt.
Lot Covera�e:
Grading: Staff Approval Date: y: Council Approval Date:
Septic: Staff Approval Date: y:
Zoning F:le: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: I.ot Coverage:
Eusting Proposed
Hardcover: 0-7�'
7�-2�0'
2�Q-�00'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
RE�L4RKS (in house): 0 ZS -- /1/'J 5� ��
�
BUILDING REVIEtiV CHECK LIST
�C� �— CONSTRUCTTON TYPE: �—
Sq Footage $ Per Sq Ftg
Basement x _
lst Floor z _
2nd Floor R _
Gazage z =
R -
TOTAL
Estimated Construction Value: $_2o�D pv �`�
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 Permit)
—�F�� Grading/Filling Electrical (State Permit)
Other
RENIARKS(IN HOUSE): - -�-----
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REVIE�V BY OTHERS: DAT'E:
Access: Existing New
Access Approval: Date gy;
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REI�IARKS (TO BE NOTED ON PERitiII'1�:
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