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Home My WebLink About2010-00173 - addn/remodel/repair � �. CITY OF ORONO PERMIT NO.: 2010-00173 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE Iss[1En: 03/25/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1795 SHADYWOOD RD PIN : 17-117-23-21-0008 LEGAL DESC : REG. LAND SURVEY NO. 0702 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : .3�9=�TF�'ffRES.B'�R�N B�HtDTNGS1-I�'�� ` `'<<� `� ��t "� � VALUATION : $ 5,000.00 NOTE: INSPECTION PRIOR TO POURING GARAGE FLOOR IS REQUIRED. APPLICANT PERMIT FEE SCHEDULE 118.00 BETZ BUILDERS INC. STATE SURCHARGE(VALUATION) 2.50 300 CRESTVIEW AVE. TOTAL 120.50 LONG LAKE,MN 55356 (612)221-2963 OWNER SUNNARBORG&ALIC[A KRASEN, MICHEAL 1795 SHADYWOOD RD P.O. BOX 81(NAVARRE WAYZATA, MN 5392) AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing[his type orwork shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The appl t is responsible for assuring all required inspections are reque ed i conformance with the State Building Code.This permit may be rev ed at ny time for�lu/�}cau �. � � � � l� Applicant Permitee Signature Date Iss By Signa ure Date SE TE PERMITS REQUIRED FOR WORK HER THAN DESCRIBED ABOVE. . . / gO� 1 � City of Orono Building Permit Application for New Structures or Additions �Q,O� Mailing Address: Permit number: ��0"�d�� PO Box 66 Q �\ 0 Crystal Bay, MN 55323-0066 Date received: ,� �� 'Af?i�4�T� � �� t�§'��-4-��.'� s, Street Address:' Received by: �� N'pe�� G�F 2750 Kelley Parkway Plan review fee: t�, � / `9IfESKp4�'�' Orono, MN 55356 Total Fee: ��, �.� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: ,_ Job Site Address: �� h,�� '/2. /� Will this be a Parade of Homes, Remodelers Showcas Home or other �splay Home? ❑ Yes o lf yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service wil/b required unless applicant demonstrates sufficienf on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: � � .��C State License# Expiration Date: Q, �b/� Phone: — 7 j office (cell Mailing Address: � Cit : ZIP: 3S Contact Person: Applicant is: Contra or / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION:. ,� Name: �(/��_�p� J��'�� Phone (day): Address: City� ZIP� Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: _ Cit � ZIP� Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal & ❑ New Construction Water Supply ❑ Single Family with ❑ Residence ❑ Addition attached garage ❑ Gara e/Accesso Bld ❑ Accessory Building /� ��— ❑ Single Family with ❑ Deck9 ry g' � Public Sewer ❑ Relocation rl `� detached garage ❑ Office/Commercial f��s�� ❑ Private Sewer �Other: (specify) ❑ Multiple Family/Condo ❑Warehouse �tq�/� ❑ Public ❑ Storage ❑ Public Water *'Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (speCify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ -��---- Last Updated: 9/29/2009 - 17 - � � STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame ❑ Masonry b. Width (ft.)= Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1 S`Story = ❑ Other(please specify): e. 2"d Story= f. 'h Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: N ot Enclosed Applicable � ❑ Permit A lication � ❑ Pro osed Buildin Plans � ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form � ❑ Surve meetin all re uirements � ❑ Stormwater Pollution Prevention Plan � ❑ Hardcover Calculation(s � ❑ Se tic S stem Site Evaluation Re ort � ❑ Access Permit � ❑ Wetland Buffer Im rovement Plan � ❑ En ineered Plans for Retainin Walls 4 feet or above � ❑ Plan Review Fee � ❑ Other APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the information, the application may not be issued. � � �/D ApplicanYs Signature: Date: � Last Updated: 9/29/2009 - 18 - � - S O ,j � D TE TIME CITY OF ORONO CALLED IN -3 � O INSPECTION NOTICE SCHEDULED � _ 02��, PERMIT NO.��io-Dar73 COMPLETED 7 p.,�,�� ADDRESS � .� �� /t�� OWNER TELEPHONE NO. CONTRACTOR —_ D�Y� �� — ��""��i''"�� : DESCRIPTION ��c� �/�� ' � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION O WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGFESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o � �� G �.� a � 0 � W � Q � Z W � W � � GW�10RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. � �o f�/�/ �, White Copy/lnspector's File Canary CopylSite Notice