HomeMy WebLinkAbout2003-P06069 - fire systems PERMIT
CITY �F ORONO Permit ►vumber:
275�j Kelley Parkway - PO Box 66 Po6o69
Crystal Bay, Minnesota 55323 Permit Type: Fire syste�Pe�t
(952) 249-4600 Date Issued: 2�2gi2oo3
SITE ADDRESS: 177 Glendale Dr
Long Lake,MN 55356
PID: 34-118-23-33-0001
DESCRI PTION:
Proposed Use: Institutional
Permit Class: General
Permit Type: Fire Systems Permit Permit Sub-type(s): Alarm System
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
Fire Alarm
FEE SUMMARY: Permit Fee: $ 83.25 Valuation: $ 2,800.00
Plan Review Fee: $ 54.08
State Surcharge Fee: $ 1.40
TOTAL FEE: $ 138J3
APPLICANT: Diversified Security Inc. OWNER: Calvin Presbyterian Church
219 Lakeview Avenue 177 Glendale Dr
Long Lake,MN 55356 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGN TURE 1SSUED BY SIGNAI URE
Copies: 1-File(Sienitures Required), 1-Applicant. 1-Monthlv Reports, 1-Assessine, 1-Finance Page 1
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e: � � '-' � � � e Received: i� i �.% �� C'� /
Total Fe $ ( Dat
� Entered By: ;� Pernut#: � / �� �i J�.,�
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CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOI�
__.___. .
_ _..__.
JOB SIT'E ADDRESS: � � � � r���� !� �V f . ZIP: ,�,5 J f v
NAI�ZE OF OWNER: c_Cx �v��•. �i�E=S/j c..?�C n ��� PHONE: (home)
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. (work) '
MAILING ADDRESS: / � -7 C(�,,,.�,�(e /�:�_ CITY: [ �.. ZIP: �fI ��,
CO\�TRACTOR: ��,r�rc".!I c�,� ,JC'c u�t�-, 1�t PHONE: `�.�� --���-� {� �� �1
COti�TACT PERSON: /va.���,G,,, ,fn�., ,w.� 1VIOBILE/PAGER: ( �,1 - �'`1 � - ;l�'
M.AII.I�i 1G ADDRESS: �-! "l L.,k� i,�t,��'ti.e CITY: �, � ZIP: J J �
ST�iTE LICENSE: # � < <� ��`� P .�
1
ARCHITECT/ENGINEER: �„�e � �n ' ,.,� .^ � PH0�1E: ��7�.1 ' .�`�-r.� � ��I l � 3
NIAII..�'�ADDRESS: ��i/ ,c�', /.,..�r 1,� CITY: r-��,/S. ZIP: .s�J �
NA.IIE: REGISTRATION#
TYPE OF WORK: New Addition� Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: �•1,r 1`H ( � �,,r- N lGr� - _
STORIES: �_ SQ. FEET OF EACH F'LOOR:
NO. OF BEDROOMS: -� GARAGE STALLS: ATT. DET.
ESTLI�IATED CONSTRUCTION VALUATION (excluding land): $ ��� d P �N
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 Buildin' Code; that I understand this is not a permit and work is not to start without a
permit; and that the work wiR be in accordance with the approved plan.
' I NA -z� - DATE: ���'� � .
APPLICANT S S G TURE: ``1 /
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.
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
' FOR OFFICE USE ONLY
f A.DDRESS OR LEGAL: ��� ��o�u: /]2.
PID:
DESCRIPTION OF WORK: F�it,� r9l-c-�•1 �.,sT�-- ,
ZO.�i IG $EVIEW BY: DATE APPROVED:
BUII�D�1G REV�W BY: ,/� �� DATEAPPROVID; _Z-Zf�-�3
FEES TO BE CHARGED: Misc. Fees Calculated By:
PER�I�IIT Yes � No
PLAl�t REVIEW Yes � No SEWER CONNEC"TION
STATE SURCHARGE Yes No � WATER CONNECITON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No STTEINSPECTION
Number of SAC�Units OTHER (specify)
ZONING CH�CK LIST Zoning District: /U U C����
Fire Deparcment: Post Office: School District: �
Lot Area: Sq.ft. Acres idth Depth
Survey Submitted: Yes No ate of Survey:
Proposed Setbacks:
Front(La.tie): Right Side:
Rear (Street): Left Side: +
Adjacent Structures: �Vetland!
Buildin HeiQ t: Def. H t. Peak H tl
g � g g ��
I
L,ot Covera�e:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # R�solution Date:
Shoreland District:
Avg. Setback: Bluff Setback: L.ot Coverage:
Eusting � Proposed
Hazdcover: 0-7�' I
75-250'
250-500'
500-1000'
i
Hardcover Variance Required: Yes No 'j Date of Council Approval:
I
REI�IARKS (in house): I
7
i
BUII,DING REVIl;yy CI�CK LIST
�C' - �� � CONSTRUCTTON TYPE: � "
, Sq Footage $Per Sq Ftg
Basement x _
lst Floor x _
2nd Floor x _
Garage x _
z =
TOTAL
F.stimated Construction Value: $ Z� QC' °`�
Inspections Required: `Vork Requiring Separate Permits:
S ite Plumbing Fire
Hazdcover Removal Mechanical Water Connection
Footing ' Se tic
� Framing P Sewer Connection
Insulation Fireplace Lawn Irrigation
�Board ��0�'� Other
. (r'Ifg•) Well(State Permit)
Grading/Filling Electrical (State Permit)
Other
RENLARKS(�1 HOUSE):
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REVIEW BY OTHERS: DATE:
Access: Ezisting New
Access Approval: Date By.
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REMARKS (TO BE NOTED ON PERivIIT�:
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