HomeMy WebLinkAbout2012-request for fire inspection ��������
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;� INTERAGENCY REQUEST FOR FIRE INSPECTION
CHILD CARE CENTERS
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To: ��I/y1Z5 vQn �y �� �t�`Nc1`C � ❑ State Fire Marshal
(�� O�� �„pn �� 1� Local Fire Inspector
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�a V��a�riN 55 3� Date: 0"o�-I�
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From: KC��l�170.�1`,� 1A71r1C VIQr'1K (Licensor) PhoneNumber:�'/ '�3I-6$30 �/I��j�-b,s28
A fire inspection under the Minnesota State Fire Code is required for all new child care facilities, and for a
proposed change of occupancy The facility must be inspected within 12 months before initial licensure. The
Commissi�ner of DHS must not grant a license untii written approval of compliance with the state fire code
nas been received from the fire marshal with jurisdiction.
Name of Program: W � ��4� �Mu,r1�.{'� .S�C�O I License Number:_ �C'��-IO�D�
Name of Facility: �YI w �(�Ol.t� �,pmMLt.n.t..�Z� .X�o D '
Address: �� 7 ��u wtQ�'°t�. �r11/"Pi �pn . �A.�.� �/\} SS �S�o
Street City Zip Code
Program Contact Person:��� a �-�/'�,1'1 ��5�1 Phone Number: (��,- ��'-j 8 g
Areas to be used Z ssrooms to be used Number/Aqe Ranges of Children
�; Basement ❑ ntire Facillty 6 weeks to 16 months:
-7. ' r; First Floor ❑ pecific rooms listed below: 1� mos. to 33 monihs:
! - Seccr�d Floor 33 mos to kindergarten _�_
�� ^ Oth�r _ _ Kindergarter to 12 years
- Specify Total: �_
Fire Inspection Results:
r Facility meets requirements of the fire c �`v�� ���
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Note: If entire facility meets �-4 � �dicate by
checking this box ❑ �� Q.ei1�.
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� Facility does not meet requirements of 1 are met.
❑ Facility does not meet requirements; bu � � � — � _(date),
pending completion of orders. ,r /G� ��
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Comments: �/
l�on �I. I
T'�X�y �ls�'V`., �'SZ��Z3 —
Signature of Fire Inspector: ��
Agency Name , uate.
When inspection is complete, mail or fax this form and any additional orders to:
Minnesota Department of Human Services, Division of Licensing
P.O. Box 64242 DNS Use:Only _
St.Paul, MN 55164-0242 oate: �� � � ;
Fax Niimhar• R�1���_���'t
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Christine Mattson
From: Christine Mattson
Sent: Tuesday, August 28, 2012 7:52 AM
To: 'terrolson@gmail.com'
Cc: Melanie Curtis
Subject: 177 Glendale Drive
Attachments: CUP Application -2012.pdf
Terry
Per our conversation today, Calvin Presbyterian Church is located in the RR-1 B zoning district. If the church is
interested in starting a school or davcare center a Conditional Use Permit is required according to City Code
Section 78-418(11).
Attached is the application for a Conditional Use Permit. The application fee is $700 and an escrow of$700 is
also required. The appfication fee is non-refundable, but the escrow is refunded after the process is complete
and all, if any, pass-through engineering and legal review costs are paid.
Please call to set up a meeting with Staff to discuss your future plans.
Thank you.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelly Parkway Orono MN 55356(physical address)
PO Box 66 Crystal Bay MN 55323-0066 (mailing addressJ
� 952.249.4620 � 952.249.4616
�� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Summer Office Hours: (Monday, May 21 through Friday,Auqust 31,2012)
Monday-Thursday: 7:30 am to 5 pm
Friday: 7:30 am to 11:30 am
OUR OFF/CE WILL BE CLOSED: Monday, September 3, 2012
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Minnesota Department of Human Services
August 20, 2012
Zoning Administrator
City of Long Lake
PO Box 606
Long Lake, MN 55356
Re: Zoning Notification of Application for
Department of Humasi Services Program Liceiise
License Number: 1064064
This is to inform you that the Department of Human Services, Division of Licensing has
an application for a program to be licensed under Minnesota Rules, parts 9503.0005 to
9503.0170 from The Willow Community School, 177 Glendale Dr, Long Lake, MN
55356 to provide day care for 18 children.
Issuance of this license is subject to compliance with the provisions of Minnesota
Statutes, Chapter 245A.
If you do not contact the Division of Licensing within 30 days of receipt of this letter, we
will consider this facility to be in compliance with your local zoning code.
If you have questions regarding the facility or its location,please contact Pamela
Hendrickson (contact person) at 612-226-1788.
If you have any questions regarding this letter, contact Kelly Gans at 651-431-6530 or
fax information to (651) 431-7673.
Sincerely,
TQ ��
�
Peggy Cunningham, Unit Manager
Division of Licensing
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DHS USE ONLY
Date:
PO Boz 64242 *Saint Paul, Minnesota *55164-0242 *An Equal Opportuniry Employer
http://www.dhs.state.mn.us/licensing