HomeMy WebLinkAbout2005-application/monuments/no permit on file Total Fee: $ Date Received: �`� I�� � �J��
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Entered By: Permit#: .�1 j,7, �(�
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTO I�b��� I�SSO .
JOB SITE ADDRESS: �7?� C� �0�' � W ' ZIP:
�� �- y w��
Will this be a Parade of Homes, Remodelers Showcase Home or b�Yher Display Home?
❑ YCS �NO If yes, a special event pe�-rnit is required with Police Department and City Council approval
60 days prior to the event. Shzrttle bars service tivill be reqaiired unless applicnnt demo�tstrates
sufficien on-site pa�-king is availahle. Non pennitted events will not be allowed.
�,�r•Q.o c�r�► �Y s i�,..�',
NAME OF6'�LR: ��h,Q ��/(/ PHONE: (home) (o/a�7�7�g��
(work)
MAILINGADDRESS: � ,.'� �, �1� �1 ��.;_; l�.`=r � CITY: �I�l7Yl0 ZIP:
CONTRACTOR: ��{'1 f'1 SUYt �ULC�-C PHONE: ���'�73-�a 9/
CONTACT PERSON: MOBILE/P ER:
MAILING ADDRESS: p 7 S'� CIT�': �l,�,V ZIP: ��"
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Addition Accessory Structure
Move Home Remodel/Alteration
PROPOSED WORK(describe in detai�: ,�j Gu,�G� � �Gh
STORIES: SQ.FEET OF ��n�� ��+ w X ��f-I-i x �g ��dee�
NO. OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ ���U ��'1 C�
. . . /a.�-�d Sc �,
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.
APPLICAl�iT'S SIGNATURE: DATE: b 'IC� '��
31
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or ro be stored shall be as set foRh in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data conceming 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 or is legally required to supply the requested data;(c)any known consequence arising from his supplying or refusing to supply
private or confidential data;and(d)the identity of other persons or entities authorized by state or federal law to receive the data.This requirement shall
not apply when an individual is asked to supply investigative data,pursuant to section 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue may_p11ce the notice required under this subdivision in the individual income tax or property tax refimd
ins[ructions instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individttal shall be informed whether he is the subject of
stored data on individuals,and whether it is classi5ed as public,private or confidential. Upon his fiirther request,an individual who is the subject of
stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be infonned of the content and
meaning of that data. After an individual has been shown the private data and informed of its meaning the data need not be disclosed to him for six
months[hereafter unless a dispute or action pursuant to this section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authority
may require the requesting person to pay the actual costs of making certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant to this subdivision,or within five days of
the date of the reques[,excluding Saturdays,Sundays and legal ho(idays,if immediate compliance is not possible. If he cannot comply with the requesc
within that time,he shall so inform the individual,and may have an additional 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 con[es[the accuracy or completeness ofpublic or private data
conceming himsel£ To exercise this right,an individual shall notify in wiiting the responsible authority describing the nature of the disagreement.The
responsible authority shall within 30 days either. (a)con�ect the data found to be inaccurate or incomplete and attempt to notify past recipients 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 individuaPs statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the ptrovisions of[he administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to infoim you that your request
for a permit or license from the City of Orono or any of its departments may require you to fumish 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 license
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 local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit 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. Your full name is required to process this application or permit.
First Middle Last
Address
City State Zip Phone
I understand my rights as stated above.
Signature
32
I''
F� � �
� ��, I6�Yu�aic9g�ai Offices
Street Address: PNailing Address:
��`�� ��'�� 2750 Kelley Parkway P.O. Box 66
E�H
Orono, MN 55356 Crystal Bay, MN 55323-0066
Au�ust 24, 200�
Geri Jorgenson
2650 Countryside Drive W
Long Lake, iVIN 55356
Re: 2775 Countryside Drive
Building Permit Application for 1Vlonument Sign
The City is in receipt of your building permit application which was received by this office
on August 22, 2005. Per our telephone conversation the following items must be submitted
or revised in order for your application to be considered complete and tor the pian revie�v
to continue:
Certificate of Survey. Please provide a revised copy of the survey indicating the location
of the proposed sign with respect to the public right-of-���ay, the edge of the traveled
roadway, the City bike path and property lines.
Development Name. The nameplate as proposed indicates that "Thorougllbred Meadows"
is the name of your development. The name of your development according to the plat
document is "Old Crystal Bay Road Addition". In order for the City to allow a nameplate
sign stating a subdivision name other than Old Crystal Bay Road Addition you must
provide legal documentation indicatinQ the name of your development has been chan�ed to
Thorou�hbred Meadows.
�'errni�, The property owner of the lot where the sign construction is proposed must be the
applicant listed on the building permit application. �lease have the property o«-ner
complete and sign the attached building permit application for subinittal.
�Pg� �.�c�����a, The proposed monument si�n may not be locatecl bet�veen the bike path
and Jld Cr`�stal �3ay road as indicated in the letter dated Au�t�st 16, ?OC�� from Irene Levv,
Countrvside �rive �4'est Homecw.�ers Association. �iease I�evise the sian location east of
the bike path o?Z the subject property and indicate this location on the revised survev (see
above).
;?���'��nF (i�%i ;� �'>����� � -r�::. JS:a� �'� .,,:n
Page 2
2775 Countryside Dive
Sign Standards. Staff has the following comments regarding the sign design:
1. The pillars are each proposed at 12" x 18" and 5' in height. The pillars meet tlze
standard as p��oposed.
2. The nameplate area appears to be approximately 4' x 2' according to the slcetch
provided. The nameplate marst be �-evised not to exceed six (6) sqz�are feet.
3. The piece connecting the two pillars shall not be taller than 42" above grade. The
connecting piece mzest be revised to not exceed 42"in 1�eiglTt.
Please feel free to contact me at 952.249.4627 or by email at mcurtisn.ci.orono.nul.us if
you have any questions.
Sincerely,
City of Orono .
���������
Melanie Curtis
City Planner
c: Lyle Oman, Building Official
Irene Levy, 2655 Countryside Drive
Todd & Mary Murley, 2775 Countryside Drive
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August 16,2005 � � � � (� ��� �� ��� �,�
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Melanie Curtis , , '�`
City of Orono � ,����
2750 Kelley Parkway �J � �
Orono,MN 55356 y�;1 r` ��
Re: Building Permit Application for Monument
The Homeowners Association of Countryside Drive West has approved the building of a
monument at the entrance of Countryside Drive West. The Homeowners Associations
requests a building permit from the City of Orono to begin construction of the monument in
September.
Attached is the building permit application. Due to the unique nature of this request and
some of the quesNons you addressed with Geri Jorgenson awhile ago,we are providing the
following information to help assist in the approval of the permit.
• The location of the monument would be on the corner of the property address of
2775 Countryside Drive West between the bike path and the road.
• Todd and Mary Murley have granted permission to the association for the use of
their property for the purpose of building a monument.
• The monument would be built in the area that meets all of the setback rules
including a minimum of 5' from all property boundaries and never fewer than 10'
from the edge of the paved,traveled roadway.
• The Homeowners Association will be the owners of the monument taking full
responsibility for the maintenance and upkeep of the monument. Any access needed
to maintain or repair the monument will be provided by t6e homeowner at 2775
Countryside Drive West.
• Johnson Concrete will be the builder of the monument.
• Attached is a drawing of the monument and t6e proposed site.The monument will
be approximately7 feet wide by 5 feet high and 18"deep.The monument will be
made of concrete with a brick facing. The nameplate will be made of engraved
limestone with the name of"Thoroughbred Meadows",which is our development
name.
• The total cost of the project is$9000 including landscaping.
We look forward to hearing from you with regard to this application. Please contact Geri
Jorgenson at 952-475-1368 if you have any questions.
Sincerely,
ene Levy
President
Countryside Dr.West Homeowners Association
612-747-8265
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