HomeMy WebLinkAboutPaperwork from this old PID PERMIT
GI��"`OF ORONO PERMIT TYPE: -
2750 Kelley Parkway- P.O. Box 66 '=- =�= �-
Permit Number: W..:.����_��','_:V:�
Crystal Bay, Minnesota 55323 - - __
(612) 473-7357 Date Issued: _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE ��
CITY OF ORONO APPLICATIO�' FOR DEMOLITION PERl�iIT
P.O. Box 66 (2750 Kelley Parkway)
Crystal Bay, �SN 5�323
SPECL�I. COti�ITIOVS & HOLD HARiti�LESS AGREE�iENT
General Instructions
1. You may be required to obtain other permits, i.e. burnina, well abandonmment, etc.
2. Work must no� be�in unless the permit card is available on the job site.
3. A 24 hour notice is required for all inspections. Call 473-7357.
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JOE SITE ADIRESS: / � �
Occupancy Type: �_Residential Commercial
O`Vti�R'S N��IE��� � /���Oc.c+ T/1 Q.S� Phone: �7� - /721�
Mailin� Address:/p,�S i�[l �'_/N�c�-/2 •P� Ciry: pQo^/o
COr"TRACTOR'S NAi�: � y .���,.;t/,L_�5.:,�, ';� Bus. No.: ���' - %�U 7
c'f rr"::� !,:' C1�: t^/�/<:' i _,i.•..i C'_L
Nlailing Address: �� -��=, � ��%, >� _ �
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Demolition if planned by means of: �( manual disassembly
�_ heavy equipment
burnin; (by fire department)
Permits Issued:
# Burnin� Fire Department
# Well Abandonment
In return for issuance of said Demolition Permit, the undersigned owner hereby agrees as
follows:
l. The structure(s) shall be kept enclosed and/or secured until such time as demolition is
complete.
2. Demolition debris will be kep[ off adjoinin� property and/or the public ri�hts-of-way
unless specific prior approval is obtained in writing for temporary use thereof.
3. Foundations shall be completely removed from the ground.
4. All demolition debris shall be completely disposed of off site in accordance with all
applicable PCA requirements.
^ $. Water wells must be abandoned in accordance with State Health Deparnnent re�ulations.
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6. Inspection required when all debris has been removed, before backfilling.
7. Within � workin� days of superstructure removal, a final inspection shall be requested.
The site shall be left clean and clear of all debris, with any excavation filled with earth
level with the adjacent ground elevation (except when such excavation is to be used as
part of a new buildin� and such new building is actually under construction).
8. The undersi�ned owner shall and hereby does indemnify and hold harrnless the Ciry of
Orono, its a�ents, employees and assigns from and aaainst all claims, damages, losses
or eYpenses, includin� attorney fees, aQainst the Ciry, its aaents, employees and assiQns
arisin� out of or resultinj from the demolition described herein as performed by the
property owner, his employees, a�en[s, subcontractors or assians.
PERti1IT TYPE AND FEE CALCULATION
� �50.00 =�Principal Structure
$30.00 - Accessory Structure
1. Subtotal of above permit requested � `•�o , o c�
2. State SurcharQe $ .50
3. TOTAL PERiv�IT FEE (add lines 1-2 above) $ ,��, �'v
The undersigned hereby applies to the City of Orono for issuance of a Demolition Permit, agrees
to do all work in strict accordance with the ordinances of the City and the regulations of the
State of Minnesota, and certifies that all statements made on this application are complete, true
and correct.
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APPLICANT'S SIGNATURE: :� Date: `i •.� "�7
O`VNER'S SICNA'I'URE: -;'�' Date: �r .�'`��
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APPROVED BY: Date:
DATE TIME
CITY OF ORONO CALLED IN �7
INSPECTION NOTICE SCHEDULED � '� � �G' �• ��'
PERMIT NO. ��/�7L COMPLETED
ADDRESS �C ? j ' ��C.%��-a-� �-c�,`-Lyz4Lec..�-E�
OWNER � ' �, CONTR.
TELEPHONENO. `'�� �- � � �U
� DESCRIPTION _�/1�-�'-�<�J
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GFWDING/PILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHORE/WETLANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
2 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
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07 DEMO—FINA 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBIN(�a FINAL 28 CEDAR SHINGLES 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� (_' CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
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O �l CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
C7 CORRECT UNSAFE CONDITION WITHIN HOURS. - pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP OHDER POSTED.CALL INSPECTOR �: GTATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n xt inspection 24 hours in advance.473-7357
OwnerfContrac r ite:
Inspector. �
White Copyllnspector's Fil Canary CopylSite Notice
, PERMIT
`��ITY`OF ORONO PERMIT TYPE: _ _ : � .. _.
2750 Kelley Parkway- P.O. Box 66 - - _ �-=-� �?���=
Crystal �vay, Minnesota 55323 Permit Number: �:��`�;
(612) 473-7357 Date Issued: :;�,:�3 ,�,,�-�;;�
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: OWNER: " ' ° - � - �
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APPLICANT%PERMITEE SIGNATURE ISSUED BY:SIGNATURE /U'`� '�•
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Total Fee: $ Date Received:
Entered By: Permit#: >: f 9
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
----------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
i ' � ZIP: , � _>`�
JOB SITE ADDRESS: ���:.7"� �,� � �_� -���������_ ,�; t � � - , �
NAME OF OWNER � >�:����;�' j�<� /%.,:, �� %- PHONE: (home) � %�- � �i z c:
(work) —
MAILING ADDRESS• _,�-�✓�•���'��,� „' �- CITY: " _ ZIP: � � �
CONTRACTOR: <- _ � - � �., � - PHONE: ��' � `=� - ��= ,'
CONTACT PERSON: %%�� -� � �'=-�-��%�� ' � � MOBILE/PAGER:
MAILING ADDRESS: CITY: -� > � �� --''�,.�� ZIP:
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration u
PROPOSED WORK(describe in detain: –'>��� c7 .�=��=%��,�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding 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 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.
APPLICANT'S SIGNATURE: ; �,' f:;, , i ;/� . DATE: %�/� %'`��
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
Sec.13.04 RIGHTS OF SUBJECTS OF DaTA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this secaon.
Subd.2. Information reqtrired to be given individual. �+n individual asked to supply private or confidenrial data conceming himself shall
be informed of: (a)the purpose and intended use of the requesred data within the collecting'state agency, poliacal subdivision,or sratewide system;
(b)whether he may refuse oY is legally required to supply the requested data;(c)any Irnown consequence arising from his suppiying or refusing to supply
privace or confidenaal data;and(d)the identiry of other persons or enades authorized by state or federal law to receive the data. This requiremenc shall
not apply when an individua] is asked to supply invesdearive dara, pursuant to secdon 13.82, subdivision 5, to a law enforcement officer.
The commissioner of re�enue mav place the noace reauired under this subdivision in the individual income tax or propertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon requesc to a responsible authority,an individual shall be informed whether he is the subject
of stored data on individuals,and wherher it is classified as public, private or confidendal. Upon his further 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 informed 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 hirn for
six months thereafter unless a dispute or acrion pursuanc to this secrion is pending or addidonal data on the individual has been collected or creaced.
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 coscs of making,certifying,and compiling the copies.
The responsible authoriry shali comply immediately, if possible, with any request made pursuant to this subdivision,or within five days of
the date of the request,exciuding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannot comply with the request
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 contest the accuracy or completeness of pubiic or private
data conceming himself. To exercise this right,an individual shall noafy in writing the responsible authoriry describing the nature of the disagreemen[.
The responsible authoriry shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past recipienu of
inaccurate or incomplete data, including recipients named by the individual; or(b)notify the individual tha[he believes the data to be correct. Data
in dispute shall be disclosed oniy if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible au[hority may be appealed pursuant to the provisions of the admirustraave procedure act reladng to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your request
for a pernut 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 license requested.
2. You may refuse to supply data, but refusal may require that the City deny the pemut or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to process
the pernut 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
Ciry State Zip Phone
I understand my rights as stated above.
� . — ` G //, �i i c .��� C !'�—
Signature
� r '�
City of Orono
PO Box 66
Crystal Bay, Mn. 55323
ATTN: Bruce Vang
7-16-97
Re: Request to remove trees/removal permit
Dear Bruce,
The following is as we discussed during our on-site meeting at 1045 West Ferndale Road. I am requesting
approval to remove or relocate most of the trees currently on the property. These removals are a function of
razing the eacisting house, foundation removal, locating and removing a septic tank and removal of a
concrete/block retaining wall and concrete steps. Several other trees are dead,wind/storm damaged, old
and overgrown or affected by prior years' ice damage. A couple of the healthy trees will be relocated on the
property.
The property will be replanted with 20-30 arborvitae T-9' tall; 3-4 clump river birch 2"-4"diameter,in the
low area close to the lake shore;3-6 ash,maple or oak 2-4" diameter and a selection of evergreens.
The demolition process will necessarily include some leveling and moving of dirt,however this will be
minimized and a silt fence will be in place.
Upon completion of this first phase a more compiete landscaping plan will be submitted.
Thank you for your assistance,
a �' ����'
(/.���L /��C: c1t"�-CG c 2 _
�erry Mc�rtney �
1055 W Ferndale Road
Oronq Mn. 55391
476-1720
� OR02i0 ADMI3I=S�RAT=VE OFFSCES •
1�`T'r'ORMATION D=SQ'DATA PR CTSCES �►CT
• � Ii�l`+Zv�SOTA GO ,
• ggQUES�EEZ NOZ`E=
A. ge�uest Freque�c� - Private Data oa individuals. ��e= t°�o
have been supolied the aata and uf fo esixf non'r.nset�rea.fte,- .
aata aeed not be discl.osed to Z'ending or additional aata '°n
. � . .unless :•a. c3ispute or ac�ion is �p . . . . . � ' .
� you .has� hee� col.lected. .
you may be reauired to pay��zCtual �os�s in �akinQ.
B. zhe conies o� in=oraztio�
certifying and/or co�ailing
=eauested. l Z � '
es�: � � �
Date of Req� � ��
� � �� �� � i
gequester Name- .
� � ��� City: n 't ' � -�
p,.r3dsess: �� �/ ����1'11�11�
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Z z�: ��a ���-��r �
Busin.ess:
H�e Phane=
Descript-ion of 2nformation Requested:.
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, � ,.,
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� Recruester' s Signa�:�e:
BE,yOW �gpRMATION TO BE FII�LED IH BY DEPARTN�''N� O�'Y
- Hanc"t.led. BY= ��y'�`
�_t �����
D epar�.eIIt� Phone
. In peYsor_ Mail —
R�uest �'ype= — � —
7 0� Data Not Subject o= Dz.ta
Sub 'ec�
g�es�ed By= Private
`� �u:ol.ic —
=�o�a�.on Reqaested is Classified: —
4ublic
Non-?uDlic ="rotected Nan-- .
Con=idential. — . . � . . _ . P��
-- � Denied � pnproved n_
Anoroved — � •
ge�ues-t is: —
ge�arks/Ca�m
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�n�ori.ze3 Signa��re:
_ $
Fees:• ., X er Page Total Due ..
No. of Pages Rate p .
To: Interested Person
From: Liz Van Zomeren, City Planner/Zoning Administrator
Date: May 14, 1997
RE: 1045 Ferndale Road West
P.I.D.: 02-1 17-23 43 0024
02-117-23 43 0005
"Lot 12 and that part of Lot 11 lying east of R.L.S. No. 1372
Zoning District: LR-lA
This property is currently for sale. There has been a lot of interest in determining what can
happen to the property.
The current residence was constructed in 1903 and does not meet the current Zoning Code
requirements regarding setbacks from the property lines and the shoreline.
The property may also not meet lot area, average lakeshore setback and hardcover requirements.
A current survey would be necessary to determine conformance with current regulations.
There are also wetlands and possible flood fringe or floodway district restrictions. A current
survey would determine the existing elevations of the ground level.
The current residence may be remodeled without variances if the existing building footprint ,
envelope and height are not modified.
If the structure or any portion of the structure including the foundation is removed, any new
structure shall be subject to all current Zoning regulations. Variances and other City approvals
shall be required.
This property is allowed a private dock per City regulations.
This information is not a guarantee that any City approvals will be granted. It is intended to
provide basic information about a property that is generating public interest.
LR-1A One Family Residential District
I,ot Area Lot Width Front Yard Side Yard Rear
2 acres 200 ft. 50 ft 30 ft. 50 ft
Lakeshore Setback
75 feet from shoreline
Average Lakeshore Setback
Line drawn between two adjacent structures across subject properties.
word\I in\1045f'ern.doc
� .
RUN DATE 02/26/97 HENNEPIN COUNTY PROPERTY INFORMATION SYSTEM REPORT N0. PI433401 "
�
1997 TAX BOOK
38 ORONO
B C & KATHERINE M FOX 000.00 278 3 1095 FERNDALE RD W
1095 W FERNDALE RD STATUS: CURRENT �
� ' WAYZATA MN 55391 CONSTRUCTION YEAR 1930 ��
; THAT PART OF LOT 9 NORTH SNORE COTTAGE ACRE LAKE MTKA LYING NWLY OF
RLS NO 1372 AND LYING SELY OF RLS NO 441 AND RLS NO 902
� TAXABLE MARKET 678,000
GROSS TAX CAPACITY 16,410 QUALIFYING APtT .00 DIVISION NO �;.
NET TAX CAPACITY 16,410 FD SHARED TC DIVISION DATE
RENTAL TAX FD AREA RATE 00000000 SEE ID S
IF PROJ AMT IF PROJECT NG.
� �
TAX LEVY/DESCRIPTION HMSTDPRTYP RATE AMOUNT LAND BLDG MACH OWN% BASE1 BASE2 NHBASE NON—HMST
hON—HOPfESTEAD GROSS TX N S 120.2320 22�103.94 596,500 81,500 1,260 15�150
STATE PAID AID 14.4660 � 2,373.87CR
� SOLID WASTE FEE 128.95 �.
TOTAL TAX 19,859.02 �
TOTAL PAID .00 ' , AMT UNPAID 19,859.02
'� � �
OWNER � MORT CODE/LOAN # ADDITION NAt4E LOT BLK PLAT PARCEL PROPERTY I'.D.
� TAXPAYER NAME/ADDRESS ESCROW NAME/ADDRESS ACREAGE SCH WTR SEW PROPERTY ADDRESS SN TWP RG QQ SUFX �
METES AND BOUNDS DST SHD DST �
HENRY M SKARP NORTH SHORE COTTAGE ACRES LAKE 42760 02-117-23 43 0024 ,
.�,,.�' H[NRY M SKARP 000.00 278 3 1045 FERNDALE RD W � �y
1045 FERNDALE RD W STATUS: CURREN7
WAYZATA MN 55391 PRI—HMSTD REF ID 02-117-23 43 0005 CONSTRUCTION YEAR 1903
� LOT 12 AND THAT PART OF LOT 11 LYING ELY.OF R L S NO 1372
,,, TAXABLE MARKET 186,600 .,dJ�r,
GROSS TAX CAPACITY 3,854 QUALIFYING AMT 3,621.37 DIVISION NO 81005
NET TAX CAPACITY 3,012 FD SHARE� TC DIVISION DATE O1/81
� RENTAL TAX FD AREA RATE 00000000 SEE ID S 02-117-23 43 0012
IF PROJ AMT IF PROJECT N0. 02-117-23 43 0013 �►;
TAX LEVY/DESCRIPTION HMSTDPRTYP RATE AMOUNT LAND BLDG MACH OWN% BASE1 BASE2 NH6ASE NON—HMST
GROSS TAX H RL 120.2320 5,059.44 185,600 1,000 1 00 720 860 1,432
� STATE PAID AID 14.4660 435.71CR Al1�;
HACA 1,012.36CR
SOLID WASTE FEE 35.49
� 07990 SAN SWR W FERNDALE 80-1 DEFERRED
,,. TOTAL TAX 3,656.86 �!A►:
�
TOTAL PAID .00 AMT UNPAID' 3,656.86
"'1�' �1.
OWNER MORT CODE/LOAN # ADDITION NAME LOT BLK PLAT PARCEL PROPERTY I.D.
TAXPAYER NAME/ADDRESS ESCROW NAME/ADDRESS ACREAGE SCH WTR SEW PROPERTY ADDRESS S'sV TWP RG QQ SUFX �
�' METES AND [iOUNDS ' DST SHD DST
�HENRY S KINGMAN JR ET AL 402 0041282922 REGISTER�D LAND SURVEY N0. 03.97 43082 02-117-23 43 0025 a
� HENRY 8 MARILYN KINGMAN JR 000.00 278 3 1185 FERNDALE RD W
1185 W FERNDALE RD STATUS: CURRENT �
s}. �.�71aTA MN 55391 COPtSTRUCTION YEAR 1983 `,,�� ,� K.
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NEMfEPZN COUNTY PROPERTY INFORMATION SYSTEM RLPOQT ►q, Il�f�wpi � ' 7���� ���
/�t►1 pATC 02/24/�7 1997 TAX BOOK _
ORONO ADMINISTRATIVE OFFICES
INFORMP.TION DISCLOSDRE RE4IIEST
MINNESOTA Ga DATA PRACTICES ACT
REQIIESTER NOTE:
A, Request Frequency - Private Data on individuals. Af ter the
have been supplied the data and informed of its meaning,
data need not be disclosed to yendinq or add tional edatat�on
unless a dispute or action is p
you has been coilected.
g, You may be required to pay actual costs in making,
certifying and/or cornpiling the copies or information
requested.
Date of Request: �� �� � �� �
: r' U �'
Requester Name:
Address: 33
fxa �t�n-+���Gu. `�'.�.t '� 2 I ( city: �t��IL
Zip: �� �"�•�`'1
gome Phone: ���-' �.���� Business :
�°i "'1 - �� �� � :'.
Description of Inf ormation Requested: ����'�-� ���� i
��V� � �� -�'
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Requester' s Signature:
BELOW INFORMATION TO B FI ED IN BY DEPARZ'MENT ONLY
Handled By s
Department:
gequest Type= In persan
Mai1 Phone
ested B Subject or Data Not Subject of Data
Re�qu Y=
Information Re�uested is Classified:
�ublic Private
Confidential
Non-?ublic -rotected Non-Public
gequest is: Approved Denied Approved in Part
Remarks/Camments:
Authorized Signature:
_ $
Fees: x er page Total Due
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