HomeMy WebLinkAboutdenied permit � � � �
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��� City roe�t�'p no ��I_ ,�� FOR CITY'USE ONLY
P.O.Boz 66 ��� � D7 � 17p3
O O Date Receivcd. / —Z� Pe;mit# �
1 � 11 2750 I�elley Parkway ( �(^,�.�
,� �I y ur=. �� Crys:al Bay,MN 55323 ���
��° �"'� ��`y�, (953)249-4600
e,��oa n� /' �� Amount: $ C.U.P Filed:
' i l.
11� 1`eS�byvi� T APProvedBy: SitePlan:
� V C;d/N*i��I-
L`�^( I�- �� I Recommends: A rova! ❑ Denial ❑
CITY OF ORONO - USER DEFINED/GENERAL PER.IVIIT
(A1I penniu must be approved'oy the Building Offic;al and/or Zoning DepaRment;
:7ob S:ite/ Owner Information:
Site Address: (� �
Owner: ���� uUG�����5�"' Mailina Address: � � �� �
Cli �:��L�'� r�'
y� Zlp: "�.L.—���
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Home Phone: ��� ��?j'��� Alternate Phone:
Contractor/Applicant Inforrnation: �
Contractor/App.: LA'�l S�l�,,� ���- Contact Person: l�e ��
Address: �I�.t ����� �S State License #: ZGY7 �(o�((o l
City: � Zip: J`��Zc� Expiration Date: ,�j_/3��O g
Phone: �' ����'°>��1.–7. � Alternate Phone: ��� �+�'��O Z.
TYPES:OF tiSER DEFINED PEI2tVIITS ''-
❑ Stairwav to Lake ❑ Retainir,a Walls ❑ Teinporar Trailer
General—User Defined 5urcharee General—User Defined Surcnarge General—User Defined
* (Per UBC) * (Per UBC) "530.00
*Estimated Cost: � '� Estimated Cost: $
❑ Docl:s—42" or Greater ❑ Land Alteration ❑ ZoninQ Review
Generaf—User Defined Surcharge General—liser Defined General—User Defined
❑ Commercial—(Per UBC) ❑ 0-�00 Cubic Yards *ForO-7�'Zone-530.00
* Estimated Cost: $ ��0.00(NeedsSitePlan)
General-Use;Denned 501 T CubiC Z'ards
❑ Residential - �30.00 ��0.00 (Needs C.li.P.)
❑ Tree Removal
G:ne;al—Clser Defncd
* Within 0-7�' -�30.00
I herby apoiy for a User Defined Permit and I acl:no�vledQe that the infonnation aoove is complete and
accurate;that th�work will be in conformarce �vith the Ordinances and Codes of the Ciry ar.d with the State
Buildin�Code; that� unders nd ti�is is not a permit and work is not to start �vithout a pennit; and that the
��ork ��-i1] e �n acco Cance � ith the appro`�ed pian.
1 �_ ,. � w��
Appiicant _. �� �
Reset Form c�sz,�_:,=dt:�,,;�;;�a,�1� .
• �.,�
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE ZIS'E ONLY
ADDRESS OR LEGAL: � ; �(� ���
PID:
DESCRIPTIDN OF WORK:
ZONING REi�IEW BY.• DATEAPPROYED:� �
BUILDING�Ei�IEW BY.• DATEAPPROi�ED:
FEES TO BE CHARGED: y 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 SITEINSPECTION
Number of SAC Units OTHER (spec�)
ZONING CHECIC LIST Zoning District: i� '�
Fire Department: Post Off ce: School District:
Lot A�•ea: Sg.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
F�-ont(Lake): Right Side:
Rear(Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def Hgt. Peak Hgt.
Lot Coverage:
Grading: StaffApproval Date: By: Council Approval Date:
Septic: Staf�Approvcrl Date: - -(�,� gy. j� (�,�
L.�c.L—�t-
Zoning File: # Resolution: # Resolution Date:
Shoreland District.• MCWD Permit:
Avg. Setback.• Bluff Setback.• Lot Coverage:
Fxisting Proposed
Hardcover: 0-75'
75-250'
250-500'
�00-1000'
Hardcover i�ariance Required: Yes No Date of Council App��oval.•
REMARKS(in house):
33
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B UILDING REVIEW CHECK LIST
UBC: CONSTRUCTION TYPE:
Sg Footage �Per Sq F!g
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Flardcover Removal ,. . Mechanical Water Connection
Footing Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well(State Permit)
Final Grading/Filling Electrical(State Permit)
Oiher
REMARKS(�NHOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval.• Date By:
REMARKS(TO BE NOTED ON PERMIT):
34