HomeMy WebLinkAbout1992-004278 - public works bldg v �
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CITY OF ORONO � '
PERMIT TYPE:
1335 Brown Rd. South • P.O. Box 66 Permit Number: �i i�.��;���'
Crystal Bay, Minnesota 55323 Date Issued: t_��/i�1/'�z
(612) 473-7357
SITE ADDRESS: I
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DESCRIPTION: I
��t tE�L I C: W��+�;��:'t� E:LE�G
E�uilF�an�� F'�rrr�it. TY�� IN'�TTTt���'Ii�N—PlEW
B��il.��i.ti� Wr���}:: TyF.� I(�i���TITUTIi��PdhL �
R.!E:�: i;�c c uF��i�c y :,_,�;�.�'!H�.
. �:�:.r���t�i'��ct•i���-� Ty��e ! Ih!
����-tiz�3 �,�;-1Es
REMARKS: PRovzDE SPECIAL INSPECTION REPORTS ON SOIL, CONCRETE, STEEL BOLTING &
WELDING. SEPARATE PERMITS REQUIRED FOR PLUMBING, MECHANICAL, FIRE (SPRINKLER) ,
WATER & SEWER CONNECTION, FUEL STORAGE TANKS & ELECTRICAL (STATE) .
-- _..._ ..__.___.M.._______.._..__. __.___�_____ _ ___.------ -- ---------________..
FEE SUMfViARY:
UALl1ATI��f�l �1 ; i��,:�.'il
E�a�e FHe �:;, 7��1 .Si� I,
F'l�a-� ��vi�w �:�, �F.�. . �.� �
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T���t•a 1 F�� ��, �;�.��, .:;q.
— �F��l i c�c�-�t. — OWNER:
�T'�r�t���+��h� C:i t��_;T�,t1�':Tt�� �:�:_;;�7��c�1 �:ITY +sF �.�R��iNi�+ �
�`'.� �- ;'�H �_;� - Ti��Wlti( HALL FiC}
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MI�li�#F�1F`+�LI_� � t�11V ��q.t:y�#. l:i�! l�.�f_i �y� ��:,��,
(F.1� �� �������--7�:1
�'. ti�� (�.�.�.r�7:�,— -S7
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�------- --_ _ __ ___ _. _ _ _ ___� __ _--__.__ _ _ _ ----_. __;------- _ _.- -__.-�
THE t_i��;�F�,':�Irl�1EC� �f�RE�Y' F;E���1C`_1''�, F'��1�1I'- - I+��N Tr�► hf�a�•::E T#�E �'E�L IMF'FiiV�MENT:,
:_�F�E i:I�'I�a �rh�4Cy '`r'i1r.?h;EE::=, Tf�i C���F �LL �E::►�;�.:: I(� :�:T�I�:T �:r�tWf�'L I AhtC:E W I 7H ALL �:I T'T i4tF ',!
�i�;�i�+�i� iihC►I�+fr�l�a�:E'� At�lJ ':,TATF ��+; ht I�lN�'=;���Tt� �:t�I LD I N�; �:+�G� �Et:�t J I FiEti�1�T:;,
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APPUCANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE 1
s �
_ ; .
CITY OF ORONO - BUILDING PSRMIT APPLICATION '
Total Fee : $ �� �� �'�� � � ! _ Date Received:
Date Approved:
�tered By: ,��':-+�� �� �� !
Permit�:
AT.T. INFORMATION MIIST BE SIIBMITTED IN FLTLL BEFORE PLAN REVZ�F1 i�7ILL BS STARTED
(See Check-off List Enclosed)�
------------------------------
THE APPLICANT IS: (circle one) OWNER or ONTRACTO C�NSi12vGT1�►a �G2
JOB S ITE ADDRRSS: 2�v5� �w N H��-L- R-OR� Z IP:
(work) y73-13�
NAHE �F �WNg.R: C�'�"� CSF' CXLO N.O PHONE: (home)
MAILING AnD�ss• 'P,O. C3oX Co(o cz�: C2y��� �3�Y zIP: 55'323
COc�IS�. MG R '72�`
CONTRACTOR: �C 21Vs �����-SOI�, Cf�(.ST PHONE: �j3Z.'
MAILING ADDRESS: r`JZS S• a� S'�' CITY: MPLS Z ZP: 55`�dy
�PE OF WORK: New X Addition Accessory Structure Move
Demo Remodel/Alteration Renovate Land Alteration
PROPOSED WORK (describe in detail) : C-�K SMv� �'`"� ���',C ���S
(�1.�l,�t�c�
STORIES: Z SQ. FEET OF EACH FLOOR: 2S �2.P� '{" `1�10
NO. OF B$DROOMS: -�- GARAGE STALLS: ATT. DET. .
ESTIMATED CONSTRIICTION VALIIATION (ezcluding land) : $ � � �s g� �
',SO� ' N� O C7 FOOTINS q�O FOJ/`���T
I hereby apply for a building permit and I acknowledg� �hat' t�ie� 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.
APPI�ICANT'S SIGNAT'DRE: ;�,�'w�`� s DATE: 3'Z3-�12
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� CITY of O ONO
Post Office Box 66•Crystal Bay,Minnesota 55323•Municipal Offices
•
� - � � On the North Shore of Lake Minn.etonka
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subj cts of
data", we would like to inform you that your request for a pe mit or
license from the City of Orono or any of its departments may r quire
you to furnish certain private or confidential information.
You are notified that:
1. The information you furnish wil.l be used to determin your
qualification for the permit or Iicense reguested.
2. You may refuse to supply data, but refusal may requir that
the City deny the permit or license.
3. The information may be shared with other local, s� te or
federal agencies to the extent necessary to process the pe it or
Iicense.
. 4. If your requested permit or 3.icense requires Council c��on
" to approve, some information may become public.
5. You have certain rights under M.S. 13.04 to review pr ' vate
data on yourself.
6. Your full name is required to process this application or
permit.
�O�-1� 1r1 � Fav �ES
First Middle Last
S2S S • Q,��. S�
Address
(�nP�.S �� SS'-�oy
City State" Zip
332-� ?281
Phone
2 understand my rights as stated above.
� �- ��_:�a .
Signatur
BUILDING&ZONING-473-7357 • ADMINISTRATION&FINANCE-473-7358 • PUBLIC WORKS 473-7359
ASSESSING
. . CS�?CX OFFFG�SOr�'�CF�IUSII p�yOF PSR�SITS
ADDRESS OR LEGAL: Z�5 o j�u�rs ��t4�t- A A PID:
DESCRSPTION OF WOR3: Pc�(3�« l�c�RkS 4c-�OC�
ZONING REVIEW BY:----------------------DA2B APPROVED:--�! -ZD -�l Z.
BIIII�DING REVIEW BY s d��.l� l�i�w.�.- DATE APPROVED: y' �-'y?�-
FEES TO BE C3ARG$D:--- ----------M=sc. rees Ca?culated By.
.rR.MIT � No
p� g�IEw Yes� No SEWER CONNECTION
STATE SIIRCRARG�, Yes—� No WA'�'y'=� C�NNECTION
INVESTIGATION FEE Yes • No�� PARK FEE
SAC Yes D� No SITE INSP�CTION
Number of S�C IInits � l� DA�D iN OT�'R (saeci�y)
---------------------------
-----NouSE ---------------------------------------
ZONING C�� LIST Zoninc Dist_�c�: �/L-1 �
Fire Deaar�..-ient s (�n�
/cC Past �r�-ce: (�nr CR�� �c::oo1 Dis�_ic�: �,eo_
.
Lot Area:(a(�,�,9��} I .l�t ' +Width:�o� � Av-2 De�th: �S s �
Survev Submi�led: Yes p( No DaLe oT Sur�ey: 3�Z3� 92
P�o�osed Se=�ac?cs : �
Front (T-.�--�e.) 77 �icnt Side : 1 2s
Rear ( S.t.�eL) : ,SS�� � �eT� s�de: �Y3. 9 7
�
Ad;acen� St�uc�sres : �SS W2=��-IC: 3�..� � ,,,,�e.Tc.,�,�.�b �ws�=
�ui?ding fie�ght: De=. figt. 2�1 � =eak fic�. 4 G
Avg. Setbac?c: N �G4 LoL Cove_age:
Exis�ing Propc ed ,
fiardcove=: 0-75 '
75-250 '
250-500 ' �
500-I000 '
�ardcover Variance Re ire : Y D te of C il Approval:
Grading: Staff Appro al D te: By: Coun il ApprovaZ Date:
Septic: Staf� Appr val Da e: Y=
Zoning Fi1e : = R olut�o ;�: Re olution Dat=:
R;�RRS (in ho e)
_ _...._. .._. . _,_._. . . • �
BUILDING REV=Ew CHECS. LIST ` _
IIBC: g3f 4=z I�-y CONSTRIICTION TYPE: �-N
Sc Footage $ P�r Sq Ftg
Base�e�t � + X _
lst Floor X =
2ad Floor X
Garage X _
x
TOTAL
Bstimated Canstruction Qalue: $ �� I�5, �`i( �
Wor3� Reqa3.ring Separate Permi.ts:
Inspectioas R�;''�= �_p 1�ing Grading/Filling
Site R,,.,K"cR
�Footing �_Mechanical Fire Sp
Septic �atsr Connection
�rraminc g_ToDlace �Sewer Connection
p�Tnsulaticn (Mason�y) pc Other . F'v��- `�''�`S
�wa?? �oasd �Mfg. � well State Pe_ t
�F-na1 �.Electrical (State Pe�it)----
___0`iie--------------------------------------------------------------------
RRMAR$$ (IN HOIISE� -
R,.,�yW BY OT�3EFtS: DATE:
Ac�ess : Exis�'_z? New
Access Annroval: Date - --------------------
.
- -----------
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,.� o2'r'S oN SC9tL�
RFMARR$ (TO B$ NOTSD ON PERM=T) = F�RUJ�� S�De G�v� 1 NSl�2�a ��
C/l�a 5 T'L�(. OC.'�l�v A�v� �1,.►6c,b 1 (�