HomeMy WebLinkAbout1999-012028 - land alteration � • PERMIT
: CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway - P.O. Box 66 Permit Number: -
Crystal Bay, Minnesota 55323 Date Issued: � � �
(612) 249-4600 _. . . _
SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: -.. ;:,;:.:,�:� �� _�_,:;�. - ;. .: _. ; _; OWNER:
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APPLICANT- RMITEE SIGNATURE ISSUED BY:SIGNATURE
� 1C.�19%99 TL?E 11:16 FAY �pp�
FROM :SCHDELL 8.: h�1RD:4N 612 54F 9065 1999�Zc3-1'� 4�5:p3 #7a7 P.�'�;'D2
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Taia.l Fee: $ � `���
Date Recei��ed:
Entered By: —�?�„ Perm.it#: ��
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CTTY ��' ORONQ - $UILDING PE��"1' A.P'pLICA'i'I�N
All information mus# be submitted in full before plan review will be started.
(please print dll r.'nform�rron)
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T�-TE APPLICANT IS- {circle one} �WNER OR CpNTRA,CT�R ,-
JOB S�'I'E ADDRESS: � D �t� f`/'e�7�'"_ ZIP:
NAh� pF Q`�'�;R; �,�c an r'/aGIrI%�!�� _ 1'I�ON�: (home}
(woric} � o
MAII.ING A1�D�tESS:/�/ ,1r1���t�or�� �.a��o C1TY: s�t ZIP:ss���
C�NTRA,Cx'OR: � �u ! FI'lONE: (��o�- �T�-����-
CONTACT PERS�N:_ �,�� ��'�r' s_ ,' �- MOBILE�PAGER: �,/a--- � ..
1VIAZL ,.Tiv.G.ADDRESS: , �
STATE Z.rCENSE: #_�2(0�,� r� S� CITY: ST i�o,,,, l�c�� ZIP: 5�'�.1/G� 3S6
A�.2CHIT�CT/ENGINEER:�qp �ra�! /1G PHpNE: —���-7641
MAILIl�G ADDRE3S: CTTY: a� ZIP: i���
N.A.�LE: ,--.�.l� REGISTRA.TION�1� d
TYPE OF yVQRK; New Additian Accessory Stnie.�ure
Mo�e Remodell�lteration Land Alteratioa^�_
P`R�PaS�D WORK(describ�in detat�: � ' � � 8
�
STORIES: SQ. FEET QF F.ACH�I.�OR:
NO. OF BE�?�OOMS: GARr�.GE STALLS: ATT. D�T.
�STIMATED Cp1�STRUCTION VALUATIpN (exclucli:ng land): $ ``� , C�
I hereby applv for a building pernait anci I acknowledge r.hat the �ot��rion abvve is-complete and
accurate; that the work will b�� i7rx con�oznn�nce with the ordiaaa,nces and cades of the CityT and wirh
the State Bui,�diztg Code; that T undezstand thi ' nat a permit and work is nvt ta start wi[h,out a
petmit; and that the wc►rk will be in aC r -anc ith the approveS p1an.
4PPL�CAi�1T'S SIGNATURE: � . DATE: D
NOTE! p�_u,de of HQ„me.€ events r�eqtiire separate perrnit ccppravul by PoTice Depa�thxent and
City Caur�ciX 60 days pr�zor to the eyent. �Vox:permitted events will not be allowed,
. 9
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY • '
ADDRESS OR LEGAL: I�Z v �o� s—rct,�-Z�
PID:
DESCRIPTION OF WORK: �,a„�.1,/� ✓���cti.--c�.�r�c•—� ti �i2�v-�W�t
ZO�G REVIEW BY: DATE APPROVED: i o-zm ��.5
BUILDI�IG REVIEW BY: n� (r9 DATE APPROVED:
----------------------------------- - ------------------------------------------------------------------ I
FEES TO BE CHARGED: �' 6�'�''`jMsc Fees Calculated By•
PERMIT Yes ✓ No
PLAN REVIEW Yes No SEWER CONNECTION
STATE SURCHARGE Yes No WATERCONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC Units OTHER (specify)
ZOiVPi 1G CH�CK LIST Zoning District: (2{2.-i r3
Fire Department: (,on16�� Post O�ce:��G�L4c.e.�s School District: O��+�
Lot Area: Sq.ft. tio c a,r-,�-w�,cAcres �- Width — Depth '—
Survey Submitted: Yes � No Date of Survey: '1• t 3'��
Proposed Setbacks:
Front(Lake): Right Side:
Rear (Street): Left Side:
I'V. V-�
Adjacent Structures: Wetland:
Buildin� Height: Def. Hgt. Peal:Hgt.
Lo[Coverage: �
Grading: Staff Approval Date: �� •'1.�•�S By: 1U. Council Approval Date: /� '1�- S S
Septic: Staff Approval Date: -- By:
Zoning File: # 2 5 2�-1 Resolution: # `�,, �.7 Resolution Date: /D• �l'4�
Shoreland District: i✓v
Avg. Setback: Bluff Setback: Lot Coverage:
Ezisting Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REi�IARKS (in house): � Dv�L t�o Cv� +G V✓�-�.5 w � n-� G�� -�
r � -,5,�� ►= �:.--�
�
BUII..DING REVIEW CHECK LIST
�C� � � CONSTRUCTTON TYPE: '
Sq Footage $Per Sq Ftg
Basement R =
lst Floor x =
2nd Floor x = ,
Garage z =
R =
TOTAL
Estimated Construction Value: $
Inspections Required: `Vork Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing ` Septic Sewer Connection
Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
�Vall Board (Mfg.) Well (State Permit)
��F�� Grading/Filling Electrical (State Permit)
Other
REMARK.S(LN HOUSE): .
REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date By;
REI�IARKS (TO BE NOTED ON PERMI�:
8
, 1C�'19:'99 TL'E 11: 16 FAY _ C�003
FF..Or1 •1CHOELL & MFID50hJ 612 S46 9Qf65 199'�. 117-19 09: 15 #73C�1 F.u2;'C�c
Sec.t3.Od RIC.$TS OF SLTBJ�',CTS O��IA,TaI,
Subd. 1. '1�pe oP daka, The rights of individual on whom rhe daca is stored or to be stnred shall�as 5��forrh in chis sectioe.
5l�bd.:. Tnf'orcaaqon required to be�ven fiadferidual. Aq individual asieed tn supply �,ttirate or eunf,dential dara concccniug lumse(P shz11
be Infot'med of; (a) Che plerpo5e flud inteoded usc oE�he rt�pcsttd da�wtthin rhe cpllce�ng sffitc agcncy,poliaca]subdivisioa, or statewide sy5�cm; (b)
whclhcn c�mAy �(u9C�r lg 1cgrJly re.quitr.d to s�pply tbe aequcstUi data; (c) any known coa,eq�ence arising frvm,his supplyiuK vr refusiu� ta�upp{y
pnvare oe��ntldeacial dats; eac"(d) �ha id�nnry of ochcr p�ssons or entities autharized by sratc ar fedctat law np rceciVc tbe data. 'I'his requiram�.�c shall
not apply whea ya indivldusl is 1Sked ta supply invastigauva data, ptt�uaat tn secduu 1z.S'�, SU�1VlS106 S, [0 3 1dW cnfo�e[7;CIIC AfCICBf,
T�te comtnissioner of revewe mav plag t�c noecz ttrn�,}red u,xirr ih;�ti71LY�VLSFUq lII fbC iL•(LLVI�t13� �ncom��ar m asx rettind instnicnons
i.astead of u��as� forms.
Suht, 3. Accc�to daa by individuQl, Upon�equest ta a respoasihle authoriry, �indivlduaE shalL be uitormed whet}icc hc is thc 5ubject of
srored daa,on iadi�idusls, and whesher ic is cfass�ed as pnblic,pd•,�ate or co�dentl�il. Vpoo hic ti�rr,har r�quest, ;in ind.ividual whu is chc subjcct of swre�i
priva�e or pubLic daw en indivuluslb sbrs]].t�e shnuv ihe dara wir�oui any c&a.�'�C ta him aad,if be desltes, sball l�informed of thc copt:nt�d tueaping
of tbac data. Afrer sn iodi�iduzl h�s been sho�n the privste data and infornxed of its mean111R, fht d�ta need 6ot 6e discioxtd co him for siz months
thatr.after unlass a dispu�e or bcrioe pu:suaa[[o tktis stcrian is�nding or oddili�nal data on Ghe iodividu3!has been coLln�[cd or croatcd. '('hc resForuiblc
autboriry shai]provide copias of tha private or public d�C apon zequeat by the Indi��idual subj4ce of�tco da�. 1'he rasponsible auLho:i�v may require the
:eque�ting persou[e,,pay tL�sctu�l costa oF inabing, cerCfyiag, a�d compiling t�c copics.
1hc rr,sponsihic audloriEy shaTt cor�p]y immpd3�s1'y, if po.3�ible, with any requcs[marlc pursuwft tn �Lis subdivisiuri, or withia fr�e days nf tt�e
d��of tbe�eqqest,e;ccludi4g SaWtdays,S'uacJays and Ieg�l holidays, ]f'lInmediatc CumPll�nc�iv not possible, If hc cannot cnmp;y with the r-quest u ichin
mac dme, he shall u infom��c imiividua�, arrd may have axt addiuonaJ five days wirbin which io complV wi�h [he rtques� ex�.luding�aturdays, Sundays
and le�a1 holidays.
SUbd,�, Yra.e�dure when d�ta i�nae aaurate or compI�e, .An iudividual may con�5c thc accv�acy �r comDlctc��css of publ[c or private da�
��a�eming him�nLf. To acerciso�his righ� un iu].ividual shall aolify in wriliag We respo�sil�]e sutllnCi�y deScrlbLpq d!e u8�t�s of l6e cLi�y�reemaul. ;"i�:
respoosible authority shall within 3U'days eirher, (a)cart�st the dala found to be inaccurats or incomple�and aarmp�tu rotify p�st tecipients of in�c:urate
or in�»apl�r�e}xa�., ir�ctuding�ecipieap named 6y [he iddividua]; oc(b) notify the indiVic7uai,that he baljeves tbe data to be correcr, pati in dispute shall
`�e disclosed only if ihe individual's statsment oF disagreeme¢[is iacluded�ith the discloscd dam.
'I7u determina�nn ot thc te,�nnsiblc enibvriry may 6e xppe;�n1 pur�laYrt Eo the pmvisioo5 o1'the ad.Gllnisu'+ttive prc�cedure ac[rela[ing �contested
�ases.
, DATA PRIVACk �D'VYSORY
Tn eccordance ���ith M.S. 13:04, 5ubd. 2, "Rights of subjects of daca", We�w•ou14 like to inform you that your req�cst
for a pezlDi� oi �icen�e from the City df Orona or any.of its departmenis may'require you ro furaish cercain priv,ue or
contTdential info�mation.
You are notified rhat;
1. The iaformatio�yp� furnisll will be uscd to detei-mine your qualificarion for rhe peimi� ar license requested.
2• YQu may re.fuse �o su�ply d�.ta, but refusal may require that the City deny �he permie or license,
, 3.. The informaaon may be shar�d with other Iocal, skate o.[ federal agencxes to the e�ctent necessary to prac�ss
ihe pctm.'tt or liccnsc_
4. If yvur requestcd permit or license xtquires Councii ac[ion �o approvc, some infonnation may become puhlie,
5. You have certain rights under M.S. 13.�4 {available upon request) to review grivate data on yourself.
6. your fvl] ame is r quix� to pmc,�ss this agplication or permit.
- � .
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CLIENT LO
I SCHOELL & MADSON, INC.
ENGINEERS • SURvEY0R5 • PUWNERS
SO4 TESfiNG • EIMHONMEHf�1 SERVICES �
— — 10580 W�tt�TA BOULEVMD. SUfTE � W. D l)N C;A N M c M I I_I_A N