HomeMy WebLinkAbout1990-003212 - entrance monuments �'ERMIT
CITY OF ORONO PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number: ��t��L�j�!�L
Crystal Bay, Minnesota 55323 Date Issued: '•?`'='��i'�
(612) 473-7357 t�=.:'',;�=_:i'�t�)
SITE ADDRESS:
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CONTRACTOR: OWNER:
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`�,'�'1'I IGAN1 PFRMI(E�� � � �� �� ISSUEDBY:SIGNATURE
� ' CITY OF ORONO - BDILDING PERMIT APPLICATION
Total Fee: $ ��.�� �L�% Date Received:
�� Date Approved:
Entered By: "�
Permit#: ��al/ -1-
ALL INFORMATION MDST BE SIIBMITTED IN FULL BEFORE PLAN REVIS'W WILL BE STARTED
(See Check-off List Enclosed)
--------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER o CONTRACTO
JOB SITE ADDRESS: � �i�' ��Q��f ��-1� ZIP: <'��� 9
(work) ���Cy�U�J
NAME OF OWNER: � � ` ( �� L" � � ��� � PHONE: (home)
P�AILING ADDRESS: �� L���2/�f} ��= CITY: !"�i��-e ��h"Z/� ZIP: ��3 S �
CONTRACTOR: �C rZ-- '✓ L� � L��e2S PHONE: �7�--���'�
:4AILING ADDRESS : l�� ' �0/�� �J�-� ���IG'`u CITY: M��Lj�1 /� ZIP: ����
TYPE OF WORK: New � Addition Accessory Structure� Move
Demo Remodel/Alteration Renovate Land Alteration
�ROPOSED WORR (describe in detail) : �Q1,�.��c�= �"YVv"L�6'1�2��
/C,� � /�kx c_`�- � � 6t�� _
STORIES: �'/�~ SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STAI.LS: ATT. DET.
.i-
����
ESTIMATED CONSTRUCTION VAI�IIATION (egcluding land) : $ �-
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
•.�nderstand this is not a permit and work is not to start without a permit; and
that the work will be in ac dance with the approved plan.
APPLICANT'S SIGNATORE: / � � ` DATE: �'� Z`3 ! �
A y
�f � �a'tir
�4� ;i � t � C ITY of OROl�TO
, ,.
; �n , ' `' Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Officea
-r-' .
y+•l�` �
. - � g On the North Shore of Lake Minnetonka
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2 , "Rights of subjects of
data", we would 3ike to inform you that your request for a permit or
l.icense 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 3icense.
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 Iicense requires Council. action
to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pri�a��
data on yourself.
6. Your full name is required to process this application or
permit.
���,�� � ���� -
First Middle Last
7`�/ /�'�f�f ��( �,��v��
Address
�'�(�u�.�l� �'�Il�' S�� � `f
City State Zip
� ���-� � ��
Phone
I unders d my rights as stated above.
�
�� l."/� �
Signature
BUILDING&ZONING—473-7357 • ADMINISTRATION&FINANCE —473-7358 • PUBLIC WORKS —473-7359
ASSESSING
�.� �Gg� �g �gJECTS OF DATA
Subdivision 1. Z�pe of data- The rights of individuals on whom the data is
stored or to be stored shall be es set forth in this section.
Subd. 2. Information �
� to � ��� ��i�ridu8l. An.individual asked to
� su ly private or confidentiel data concernin� �BmW hin the collecti g state gency,
PP
purpose and intended use of the requeste �b� whether he ma� refuse or is legally
political subdivision, or statewide system;
required to supply the requested date; (c) any known consequence arising from his
su 1 ing or refusing to supply private or confidential data; and (d) the identity of
PP Y state or federal law to receive the data. This_
other persons or entities authorized by investi ative dats,
requirement shall not apply when en inatola law enforcementuof icer. �
pursuant to section 13.62, subdivision 5,
The commissioner of revenue mav ple�t tax re�und instructQonsunsteaah°5
subdivision in the individusl income tax or Rr�* v
on those orms. . --
tp �� by ����, Upon request to a responsible ,
Subd. 3. Access
Buthority, an individual shall be informed whetbh�c hp �a eeor confident al.e Upon his
individuals, and whether it is classified as p � ublic data on
e to him and, if he desires, shall
further request, an individua� who is the subject of stored private orvidual hes been
individu8ls shall be shown the date withou�fan�y ��g. After an indi
�e in for med of ihe content end meaning t he data need not be disclosed to
shown the private data snd informed of its tr►eaning, u�uant to this section is
him for six months thereafter unless g dispute or action p
ending or additional data on the individuel h� ateeor publi t datarupongrequest by
p require the
responsible authority shall provide copies of t e p
the individual subject of �e gc��•�as�h of mak ng,l ae8t fYingyand compiling the
requesting person to pay t -
copies. if ssible, with any request
The responsible authority shall comQly immediately, Po
macie pursuant to this subdivision, or withi lida e �f Simmediategtcompliance eisu not
excluding Saturdays, Sundays and legal ho ys�
� within which to comply with the
P
ossible. If he cannot comply with the requese within that time, he shall so inform t e
individuel, and mey 1�sve �►5��� � legal holidays.
request, excluding Saturdays,
Subd. 4. Proce�u'e �►hen data is not ecc�a
te or complete. An individual may
contest the accuracy or completeness of public oinr Writeng tthe�responslb e au hor ty
exercise this right, an individu8l shall not�fy
describing the nature of the disagreement. Tnaccura e oren omplet and att mpt to
days either: (a) correct the data found to be
notify past recipients of inaccurate or incomple t he believesdthe datalto be correcL
the individual; or (b) notify the individual tha eement is
Date in dispute shall be disclosed only if the individusl's statement of �8� to the
• included with the disclosed data. be appe�led pursuant
" The determination of the responsible authority may
provisions of the administrative procedure act relating to contested cases.
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}�' ' � ,s � MI PLAN R�ifIEW,'
:� ,.,, ��� . , , , , . �14�D1NGf �+E�,
'!�, i i 'S-6 ' G 5 6 !,� _ � .
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}', •. �, . ''�' '• � p.r0 t � TE ��Z.S �� PERMIT NO. --
�.' � �� _ ��.--r.__
��� � � � A�'PROVED AS �USMITTED
�'
�, �� AP{'ROVED WI�N CORRECTIONS AS NOTED
�� . ' ,��_] NOT APPROVED — CORRECT & RESUBMIT
� � '� These comments are for your information. All work shall De doM
• Ir},full compHa�ce wlth ��I appllCeble bullding & mning oode re•
qulrem2nts including ipems not specifically noted in this revle�L.
ti ' KEEP THIS PLAN SET Ofv SITE AT ALL TIMES.
Certificate of Survey for
Betz Builders , Inc .
�n Lot 4 , Block 2 , McCULLEY FARM
� Hennepin County, Minnesota
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LEGAL DESCRIPTION OF PREMISES :
Lot 4 , Block 2 , McCULLEY FARM
This survey is expressly to show the proposed location of
a proposed gate in relation to the Easterly line of said
Lot 4 . It does not purport to show any other improvements .
I hereby certify that this survey was prepared by me
or under my direct supervision, and that I am a duly
registerer Civil Engineer and Land Surveyor under the
laws of the State of Minnesota .
COFFIN & GRONBERG, INC.
7� ���� Scale : 1 inch = 50 feet
l��� y''--�� Date : 8-2 1 -90
Mark S . Gronberg MN. Lic . No. 12755 � . Iron marker
Engineers , Land Surveyors , Planners
Long Lake, Minnesota
_ t. . � .
_ _. . ___ ... _ .
CHECR OFF LIST FOR ISSIIANCE OF PSRMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: �S� D���2�'�'�' �11/•-t. PID:
DESCRIPTION OF WORR: GJYT2ANC.E I'ti.0/vU/n t."N'T S t fv/4"T'G
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ZONING REVIEW BY: �; (� Yw DATE APPROVED: fs — � � - �Q
BIIILDING REVIEW BY: ��p DATE APPROVED: �l ' Z S -�(c7
FEES TO BE CHARGBD: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes� No SEWER CONNECTION
STATE SURCHARGE Yes �/ No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No� SITE INSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------
ZONING CHECR LIST Zoning District: � �, -- / �-
Fire Department: Post Office: School District: J�j� �-
Lot Area: /� � . Width: � � Depth: ��
Survey Submitted: Yes ✓No Date of Survey:__� - a! - 9d
Proposed Setbacks : �
Front 5����!e� . �d� Right Side:
Rear ( Street) : Left Side:
Ad jacent Structures : J� f4--- Wetland: � f¢
Building Height: Def. Hgt. � ��� ��
,
Avg. Setback: N �'" Lot Coverage : � �-
Existing Proposed
Hardcover: 0-75 '
75-250 '
250-500 '
500-1000 '
Hardcover Variance Required: Yes No_� Date of Council Approval:
Grading: Staff Approval Date: By: `f Council Approval Date:
Septic: Staff Approval Date: �� By: '��
._---
Zoning File: # -"�� Resolution # : Resolution Date:
REMARRS (in house) :
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BIIILDING REVIEW CHECR LIST
QgC: ff� Q- 3 CONSTRUCTION TYPE: �
Sq Footage $ Per Sq Ftg
Basement X =
lst Floor X -
2nd Floor X -
Garage X -
x =
TOTAL
Estimated Construction Value: $ °). �W
�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
�Footing Mechanical Fire
Framing Septic Water Connection
Insulation Fireplace Sewer Connection
Wall Board (Masonry) Other
�Final (Mfg. ) Well State Permit
Other Electrical (State Permit)
REMARRS (IN HODSE) :
------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access : Existing New
Access Approval: Date BY=
------------------------------�(�- ----------------
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R$MARRS (TO BS NOT$D ON PERMIT) :�'��L����..� -���'�"=�
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� DATE TIME
CITY OF ORONO CALLED IN ��� .G7i� 11��
INSPECTION NOTICE 5CHEDULED �.�
PERMIT NO. �'=�� "� COMPLETED �_
ADDRESS J �� ��
OWNER CONTR. :�
TELEPHONE N0. �"� � - �" ��� � �/
� �OOTING ❑ MECHANICALRI ❑ SITEWELL
W ❑ FRAMING ❑ MECHANICALFINAL ❑WELLTESTPUMP
� ❑ INSULATION ❑ FIREPLACEIWOOD BURNER u EXCAVIGRADING/FILLING
�
Q ❑WALL BD. ❑WATER HOOK-UP C LAKESHOREIWETLANDS
Z ❑ FINAL ❑ METER SETITURN ON ❑TREE REMOVAL
Q C DEMO—SITE �SEWER HOOK-UP ❑SITE INSPECTION
_
� ❑ DEMO—FINAL �SEPTIC MAINT. ❑ PROGRESS
J
Q C PLUMBING RI ❑SEPTIC INSTALL. ❑COMPLAINT
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_ ❑ PLUMBING FINAL ❑ SEPTIC FINAL ❑ FOLLOW-UP
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� COMMENTS:
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d WORK SATISFACTORY:PROCEED G PHOTO TAKEN
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� C7 CORRECT WORK R PROCEED ❑ CITATION ISSUED
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O �; CORRECT WORK,CALL FOR REINSPECTION ❑ PROJECT COMPLETE
� BEFORE COVERING ❑ ISSUE CERTIFICATE OF OCCUPANCY
C_] CORRECT UNSAFE CONDITION WITHIN HOURS. TEMPORARY
INSPECTOR WILL RETURN
PERMANENT
f; STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContrac on ite:
Inspector.
White Copylinspector's ile Canary CopylSite Notice