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Home My WebLink About2018-00029 - addn/remodel/repair CITYOFORONO * z � 18 - r� � mz9 * 2750 KELLEY PARKWAY DATE ISSUED: OU12/2018 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2780 SHADYWOOD RD PIN : 21-117-23-24-0041 LEGAL DESC : REG. LAND SURVEYNO. 1196 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR VALUATION : $ 20,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL, ELECTRICAL(STATE) KITCHEN AND BATH REMODEL APPLICANT PERMIT FEE SCHEDULE 356.22 STATE SURCHARGE(VALU?,TION) 10.00 PLEKKENPOL BUILDERS 'COTAL 366.22 470 W 78TH ST Payment(s) BLOOMINGTON,MN 55420- (952)888-2225 CREDIT CARD 6152 366.22 Minnesota State License#: BUIL-BCD01797 OWNER CARTER, RICHARD&JEANNE 2780 SHADYWOOD RD EXCELSIOR, MN 55331- 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 onty 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 shall be compied with whether or not specified 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 afrer work has commenced. The applican[is responsible for assuring all required inspections are requested in conformance with the Stat Building Code.This permit may be revoked at any ' e for due u e. i '_ ' - % � l� i l i� Appl' ant Permite gnatu Date Issu y Signature Date City of Orono Building Permit Application for Maintenance / Replacement 1 Remodel — Residential ONLY {i.� ,...:::_. ;;#erat�, r�•-�c�c�f, �tc. OA, Mailing Address: Permit number. ,�C� --��1 � f yO PO Box 66 Crystal Bay, MN 55323-0066 Date received: C—/�— Street Address: ecE�ived by: ` y�. � 2750 Kelley Park ,� Plan review fee: � �' ,, J y �� Orono, MN 5535� �� , ��pa�d !�'r�SHO� 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 retumed. (Please prrnt) GENERAL INFORMATION: Job Site Address: o�,'��(� ��j�/Gb� �c�1�� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Horne? Yes No If yes,a special event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus serv wi!!be �equired unless applicant demonstrates su�cient on-site parking is available. Non permitted events will not be allowed. CONTRACTOR/AP LICANT INFORMATION: Name: G�KK�N�aC. ��U�C.�E'�L.S � .�iVC . State License# � �pp ' Expiration Date: � � Lead Certification Number: �j/�T"- 3.�tT S s" Expiratio�n Date: S 2,0 (for work on homes that were constructed rior to 1978 ► Q Phone: (cell) (office) q r - a Mailing Address: � /q� ( 7 City: y�,T'�ja�V ZIP: �'3' p Contact Person: q 2 i �✓ L 1 Applicant is: n rac o� Homeowner (Circle One) Email and/or Fax: ( r1 b . GbN'� PROPERTY OWNER INFORMATION: Name: (Z,.�!�I�c. y- SEA�NI�' C/4-2T� Phone (day): � -,S'( 2 Address: a,�T o Sf�d`�� ¢p c�ty:C�XCEL�i��C ziP: -..S�3=3� Email andlor Fax: (��k ,��,r}�Cr' L0 1 hbra rp�GON'� PROJECT INFORMATION: Overall project description: l�'Z7Z� `f- � t;�(. Type of Project: My earth movement may also require ❑ Door(s) �emodel ❑ Fire Damage MC'WD review 8 permits: � Minnehaha C�eek Watershed District MCWD ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage � � 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑Siding ❑Other: (specify) Phone: 952�71-0590 F=ax: 952-471-0682 ❑Window(s) wwvy.minnehahacreek.orq Estimated Const�uction Valuation of Project(excluding land) � C� .�'JD APPLICANT ACKNOWL.EDGEMENT: • Agrees to provide all information required or requested by the Building Department; • 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; • Some or all of the infonnation that you are asked to provide on this application is classifieci 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 ou refuse to su I the information,the a ication ma not be issued. ApplicanYs Signature: � � r� Date: ��O Owner's Signature: Date: Last Updated:January 2016 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: � !�4 GtfC�fSt.� Permit No.: �129'' ��d�� Description of work: Date Rec'd: Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: r �� Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: �, SF/AC Width: Lot Coverage: SF % \ Survey Submitted: 0 s � No Date of Survey: Revised date ? : Landscape plan submitted. � Yes 0 No Landscaper: Proposed Setbacks: Front (Lake) Rear(St et) ( N S E W ) ( N S E W ) Other Buildings Wetland Side ide Defined Height: P ak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% = L.F. below grade Basement? � Yes � No, Stories FOR A BUILDING WITH A BASEMENT OR CR WL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distanc between the lo est proposed Slab at or above grade— floor(of the b sement or cr�vl space)and measure from hiQhest existina START WITH the highest po t of the ro . ra ade to the highest point of the START WITH roof even if fill was brought in to elevate home. If you have a... SUBTRACTION • GABLE OR I PED ROOF(no Slab below grade—measure (BASED ON windows): S tract half the distance from highest existing grade to the ROOF TYPE) between th i hest point of the roof hi hest oint of the roof. to the low oint f the corresponding If you have a... gable or pped r of SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE R HIPP ROOF(with (BASED ON (no windows): Subtract half windo s): Subtract alf the distance ROOF TYPE) the distance between the betw en the top of th highest highest point of the roof to win w and the highes oint of the the low point of the ro corresponding gable or hipped roof • L OTHER ROOF TYPE (flat, . GABLE OR HIPPED ROOF ansard,etc):No subtracti . (with windows): Subtract SUBTRACTION Sub act the distance between the half the distance between (BASED ON ba emenUcrawl space floor and the the top of the highest EXISTING h' hest existing grade adjacent to the window and the highest point of the roof GRADES) undation OR 10 feet(whichever is less . ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined building height subtraction. Defined building height EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? � Yes 0 No Permit Number: � Yes 0 No 0 N/A � Ye No � 0 N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf 0 Yes 0 No 0 Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Perm it Plan Review (� State Surcharge t/� Investigation Fee SAC—Number of SAC Units t� Other(specify) � Square Foota e $ per Square Footage Basement X = $ 1 St Floor X = $ 2nd Floo� X = $ Garage X = $ ..�jr� ,�c� BO Estimated Construction Value: $ �V U'�� Orono Inspections Required Work Requiring Separate Permits � Footing � Site `�Plumbing � Grading/Filling � Poured Wall � Silt Fence/Erosion Control �Mechanical � Fire ❑ Foundation Survey � Hardcover Removal � Septic 0 Water Connection � Foundation Waterproofing 0 Other(specify) � Fireplace � Sewer Connection Framing � Masonry � Lawn Irrigation � Insulation � Mfg. � Landscaping � As-Built Survey 0 Other(specify) Final 0 Lathe Required State Permits � Other(specify) ❑ Well Electrica► REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: 0 See Builder Acknowledgement Form � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 �•\fnrmc\nlan ravic�ni rharklict 1f1_7f11F rinrv �� f � DATE TIME CITY OF ORONO CALLED IN INSPECTION bOT� _c��SCHEDULED � PERMIT NO.ol� COM ETED ADDRESS �G OWNER ELEPHONE NO. �� CONTRACTOR � �, � DESCRIPTION ��- .� ` 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTRACTOR TO MEET YoDU:_YES_NO y COMMENTS: ' �/� 6 a� � � f NSL►/Q�:�•a ak- � 0 �. � 0 W � Q � � W aC , d W� O WORKSATISFACTORIF:PROCEED ❑PROJECT COMPLETE W ❑CORRECT Y1bRK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK�LL FOR REINSPECTION TEMPORARY V BEFORE CONERING PERMANENT �CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED �INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS. Ca�l forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector: T��/t White Copyllnspector's Filo Cenary CopylSite Notiee n � � � �.i/ DATE TIME CITY OF ORONO CALIED IN Zl INSPECTION C �, SCHEDULED ,3 � PERMIT NO. ��Z OMPLET D ADDRESS a 7 � �C- OWNER TELE E NO.��'3�g��✓� � CONTRACTO � � DESCRIPTION �'�-""� ��'�r �'V 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YiOU:_YES_1� � COMMENTS: �// /�iS�'�d nS G�wsl��',� � Sialv�'.c. e e� Lo el t�+t��v/r� t�J�. o �v__ �c✓ S�'+;r �^�; 1 o k � [2��i'�� 1 0 W � Q � � W � j � L�W'ORK SATISFACTORY:PROCEED ❑PROJECT COMPLEfE W ❑CORRECT NfORK�PFiOCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑C�RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COMERING PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS_ p pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REW IRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnedContractor on e: Inspector: WMte Copyllnspector's Flle Canary Copy/Site Notkx 6:M SM -9991S6:104 O U WOO BBJ sL � ! 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