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Home My WebLink About2010-00056 - addn/remodel/repair • � CITY OF ORONO PERMIT NO.: 2010-00056 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 02/OS/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1910 SHADYWOOD RD PIN : 17-117-23-24-0020 LEGAL DESC : SHADY-WOOD : LOT 031 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RES[DENT[AL VALUATION : $ 50,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMB[NG, MECI�ANICAL, ELECTRICAL(STATE) BASEMENT REMODEL ADVANCE PLAN REVIEW PAID 2/3/10 2010-00055 $443.14 OWNER MUST SIGN CONTRACTOR LICENCING ACKNOWLEDGEMENT FORM APPLICANT PERMIT FEE SCHEDULE 681.75 MCMANUS, JAMES& MEGAN STATE SURCHARGE(VALUAT[ON) 25.00 1910 SHADYWOOD RD TOTAL 706.75 WAYZATA, MN 55391- PA[D WITH CC# 1501 OWNER MCMANUS,JAMES& MEGAN 1910 SHADYWOOD RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this pennit is issued shall be performed according to the approved plans and specitications,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 this type of work shail be compied with whether or not specified herein.This permit will expire and become null and void iY 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 applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any ti for due cause. - �� ;? --� �� _ , - � ��/ �'- ,� � �/� Z ` �i i /� ��, �,_� ��'�'�r'c �" i i Applica ermitee Signature Date [ssued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) MailingAddress: Permitnumber: �0��—�OSb O.¢,�,�.0 PO Box 66 Crystal Bay,MN 55323-0066 Date received: .2'3"�� a �,, StreetAddress: Received by: �C-'*' ti 2750 Kelley Parkway Plan review fee: �O O— � G lqxEB�a�*d Orono,MN 55356 ;� 5/ ��aj/ d {J� al Fee: r� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �� 7��(�.' 7�j This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: � ;� ��y�� S S J l � Job Site Address: 1�� Will this be a Parade of Homes, Remodelers Show se Home or other Display Home? Yes No If yes,a special event permit is required with Police Department and City Counci!approva!60 days prior to the event. Shuttle bus servi il e required unless applicant demonst2tes su�cient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICA�INFOR ATI N:CDI,(�N��-��n vS Name: ir� /�t� State License# Expiration Date: Maii ng Address: office Cit~: ZIP: �fl /Z ��d��s� Contact Person: S Applic nt is: Contractor / Homeowner �c��a,a� Email and/or Fax: C S� b . PROPERTY OWNER INFORMATION: ��v '3 5 g0 �'�� Name: SQ�'Y1�. ,$ �l V Phone(day): Address: City: ZI P: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑Door(s) emodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑Repair ❑Storm Damage 18202 Minnetonka Blvd Deephaven,MN 55391 . ❑Siding ❑Restoration ❑Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Re-roof ❑Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) S �"j�,bO a APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Departrnent; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they i 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; • Some or all of the infortnation that you are asked to provide on this application is classified by State law as either pr'Nate 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 eRher 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 govemmental agencies r uired b law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: � Date: a��/b Last Updated: 05-04-2009 . Plan Review Checklist for New Structures / Additions Address/PID/ Legal: 1�'S 1 O S I�r°s�Q�f�.�9oc�� LpA.,O Description of work: _ �(}��.��t�-- {�,-�,�,o�p� Septic review by: "'— Date Approved: Zoning review by: '— Date Approved: Building review by: Date Approved: Z—`-1 — I o Grading review by: � Date Approved: — Zoning File#: Resolution#: Resolution ate: Zonin District Fire De artment Post Office School District Zoning: Lo rea: SF/AC Width: Depth: Survey Submitted: Yes � No Date of rvey: Pro osed Setbacks: Front(Lake) Rear(Stree ( N S E W ) ( S E W ) Other Buildings Wetland Side Side Building Defined Height: B ' in eak Height: #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement oor/crawl START the distance between the slab and the highest space floor and the highest roof p k,the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the de line of a the deck line of a mansard roof,or the mansard roof,or the uppermo point on a round uppermost point on a round or other arch-type or other arch-t e roof roof SUBTRACT half the distance between e highest window and SUBTRAC half the distance between the highest window hi hest roof eak of a i hed roof hi hest roof eak of a itched roof SUBTRACT the distance between e basement floor/crawl ADD the ' ance between the slab and the highest space floor and the 'ghest existing grade within existin de within the foundation the foundation or 1 feet, whichever is less. EQUALS Defined buil ' hei ht EQUALS Defined buildin ei ht Lot Coverage: SF % Shoreland Distric MCWD Permit Received Avera e Lakeshore Setback uff 0 Yes � No � N/A 0 Yes 0 No � Yes No 0 Yes 0 No � N/A Permit Number: Setback: Hardcov Zones Existin Pro osed Variance Re uired CUP Re uired -75' � Yes � No � Yes 0 No 75-250' Type(s): Type(s): 250-500' 500-1000' EMARKS (in-house): /I/tJ �/-�iq.,�,r� ,(� � Updated: 09111l2009 z:\forms�plan review checklist.docx Fees to be Charged YES NO Permit ` , . f Plan Review � "State°Surcha[ge � : investigation Fee SAG–.Number.of.SAC:Units - - ,�.. Sewer Connection 'Water Connection ; . :. -. _ , .;: , . Park Fee , _ .. Site Inspecfion r: Other (specify) , .. .; . Miscellaneous Fees;: � � , . , Calculated By: Square Foota e ! $ per Square Footage Basement X = � 15t Floor X = $ 2nd FIOo� X = $ Garage X = � Estimated Construction Value: �C�,�k� a� Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site ,�'Plumbing ❑ Grading / Filling ❑ Well ❑ Hardcover Removal �Mechanical ❑ Fire �'Electrical 0 Footing ❑ Septic ❑ Water Connection ❑ Poured Wall ❑ Fireplace ❑ Sewer Connection ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigation ❑ Radon Rock Bed ❑ Mfg. ja'Framing ❑ Other(specify) �'Insufation ❑ As-Built Survey �Final ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) �W 'Z I I b/J C G�v Tl'l�4(>J-C+�L L� C�L.=NC/ CxIVD;,�/(�=Y,coC m�✓1� )�z}��— Updated: 09/11/2009 z:lforms\plan review checklist.docx BUILDING PERMIT APPLICANT: PROPERTY OWNER I, l�C�q�Le� l�� ✓1(�-�� , understand that the State of Minnesota requires that all r sidential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. This license requirement applies to owners of residential real estate who build ar improve such property for purposes of speculation or resale. By signing this document, I attest�o the fact that I am improving this house far my own use and am not building or improving this house for the purpose of reselling it. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building or remodeling on speculation or for resale and that the house for which I am applying for this permit, located at � `%%�'' ��;!��.�� ; �r��c��, � tx,�, Orono, is the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic's lien rights to which I may otherwise have been entitled under Minn. Stat. §514.01. - Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minn. Stat. §326B.082, subd. 16 and can also result in a fine of up to $10,000. I further state that I understand that the filing of a false statement with the City of Orono may also result in criminal prosecution and/or civil penalties pursuant to applicable city ordinances and/or state statutes. I have also been informed and acknowledge�hat by listing myself as the contractor for this project, I alone will be responsible to the City of Orono for compliance with all applicable building codes and city ordinances in connection with the work being performed on this property. � :� � ��-G� Name �l5l/U Date For questions or information on contractor licensing, or to check the licensing status and enforcement history of a particular contractor, call the Minnesota Department of Labor and Industry, Construction Codes and Licensing Division, at (651) 284-5069. The Web site is: www.doli.state.mn.us/contractor � "�E �y , i �;.� � �i d�ry 4 �=� � � � . M � ��`' � C� ��': (l �9 .� � . �� J� � "� � Y �.7 n", �'� �i t�'�' � � � Jp :" . 1` r.� ��l �1 `^ ~I Y �.y 1r 4�!1 . '��...'� .'. ,)"n ; �I j 1 �l�Y _ �y � ,.+ f'� , {°;;r � � a 1� ( t� :-„�... 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O \ � _- - � -_� II il ° (I �� I I I �o �' II I � _ _ , I � e � iii_ ;- . _ _ , ,, :; il ; � _ _ _ f ' _ _ . �; i l � � --J � � � --__ _ _----� i -� ;� � .o ; ' ;� � � .___.. � I � : �, ,�o --------------- --------------- � \ .. . � � � � s � — � � R �I X � � � � C� � TIME � CITY OF ORONO � CALLED IN � //� INSPECTION NOTICE a� �� SCHEDULED � PERMIT NO o- COMPLETED ADDRESS � ld ��d� OWNER ELEPHONE NO��a` �`"7� -7OZ� CONTRACT � DESCRIPTION �' , - ��ti%�� ❑ FOOTING ❑ PLUMBING FINAL ❑ XCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMB�NG RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO ��., COMMENTS: � W a � J O � � O � W � Q � Z W � W � � WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑ ECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOHERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUiRED.CALLTOARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-46�� OwnertContractor on site: Inspector. , �_ � White Copyllnspector's File Canary Copy/Site Notice