HomeMy WebLinkAbout2013-00228 - addn/remodel/repair CITY OF ORONO * 2 0 1 3 - 0 0 2 2 8 *
� . 2750 KELLEY PARKWAY DATE ISSUED: 04/17/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2050 SHORELINE DR
PIN : 10-117-23-34-0014
LEGAL DESC : HARTWOOD
: LOT 001 BLOCK 001
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVTTY : 434-RESIDENTIAL
VALUATION : $ 28,000.00
NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE)
BATHROOM REMODEL
ADV PLAN REVIEW 2013-00227 $289.41
APPLICANT pERMIT FEE SCHEDULE 445.25
TONKA MGMT 1 ST STATE SURCHARGE(VALUATION) 14.00
4573 SADDLEWOOD DRIVE
MINNETONKA, MN 55345- TOTAL 45925
(612)598-3116
Minnesota State License#: BC386358
OWNER
KVAMME TRUST(TOM BROSTROM), BERTA
2050 SHORELINE DR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved pians 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
permi[s. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permi[will
expire and become null and void if construc[ion 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 applicant is responsible for assuring all required inspections are
requested-i�-eort� ance with the State Building Code.This permit may be
revoked at any tim�r e'6 ya�
�' " / �
- s"`� -'�-'" � � � � � (� ,-' i � � .� ;,�, �' _t �` Y/ / ���i
Applicant ermiXee Signatu Date � �' �+ '- ' � �
Issued� y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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Cit of Orono '��� �,� {, .;
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: Bu�lding Permit Application for Maintenance / Replacement / Renovation #
� (No structural expansion. Only windows, doors, siding, re-roof, etc.) `'
�O� Mailing Address: Permit number. al�I 3—d�`� �� `;
O PO Box 66 _ k`�
Crystal Bay, MN 55323-0066 Date received: ' �-3 ��
�1� �
Street Address: Received by: �v S Y,
'' y �� 2750 Kelley Parkway Plan review fee: �'
`�tq � �' Orono, MN 55356 ��/ _ 00�a �
� � 7
.; kFSH° 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 f�e returned. (Please print) ;;�
GENERAL INFORMATION: �
Job Site Address: Z�,��`: j1r�-e��Z�L�t�t� �� - �J����'J� 55�� � �
S�;
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No �
If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be ,X
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. ;_�
�'�
,�,; CONTRACTOR/APPLICANT INFORMATION: �
Name: .3C`.b'�-� G �;,,ti�,�2.- `f��1��A MA-�.Il�sG �!t'��=�-�`T �;
State License# L �' �" Ex iration Date: ' -3 ZG l`5 ��
� 3��: � .�� p� t - �
` Lead Certification Number. �A i_l�-��{12 _ � Expiration Date: "�j�-c..( ^ 2,�� (o ;
(for work on homes that were constructed prior to 1978 ��
Phone: (cell) (p 12-��'- `�1�E, (office) �'
-� Mailin Address: ' ' � Cit : ZIP: �
�, 9 y�7 � S�l7��c�c::� Q� - v M�'K-� 55 3`{ S
Contact Person: �� Applicant is: Contractor / Homeowner (CircleOne) �
Emailand/orFax: �,,��,�,,��tz �' •-f-�js�- M�/+ . t=M��-r- CnM �
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�
PROPERTY OWNER INFORMATION: '.:�
Name: ���-�� ��l�l"�n-� �= � � ��
;_�
�;, Phone (day): �
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Address: 2�jS�.: �i�%� �-�-,.�� ? _ City: G�.e;r.�L; ZIP: >�j �`�j f �
r����� Email and/or Fax: ��
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PROJECT INFORMATION: Overall pro�ect description:�A-tt�l(--��n� �M���� ,�
Type of Project: Any earth movement may also require �
❑ Door s MCWD review&permits:
( ) �Remodel ❑ Fire Damage �
❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) �f
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 `�
❑ Re-roof, other(specify) ❑ Sidin Phone: 952-471-0590 �
g ❑ Other: (specify) ,�
Fax: 952-471-0682 ,,,
f.< ❑Window(s) www.minnehahacreek.org
..:�. -
� Estimated Construction Valuation of Project(excluding land) $ 2 f��c�c� '�
�:,.,
�; APPLICANT ACKNOWLEDGEMENT: `_
• 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; �:
A,
�,, • Some or all of the information that you are asked to provide on this application is classified by State law as either private or �+
j4 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 inf ion is to annually update our records and records of other governmental agencies required by law. If ;�
ou refuse to su I e in rmatio . e+a lication ma not be issued. �
K Applicant's Signature:� � ��r -- Date: � ��� � � 1�
Owner's Signature: Date: �?E
Last Updated:03/06/2013
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PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address/Permit Number: Z u S� St-�(�2-�(��VV c: t�2\V�
Description of work: 1'��S"�R- 4��� �?..'�ww�Ot�L-
Septic review by: N I/-} Date Approved:
Zoning review by: ►� Date Approved:
Building review by: Date Approved: �!-f(� - ZO�3
Grading review by: /v�A Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
Zonin • Lot Area: SF/AC Width: Lot Coverage: SF _%
Survey Su itted: �Yes � No Date of Survey: Re ' ed date ? :
Pro osed Setb ks:
Front(Lakej Rear(Street) ( N S E W ) ( N S E W ) her Buildings Wetland
Side Side
Defined Height: Peak Height: FFE: F minus 6 feet= (Existing Contour)
Perimeter(linear feet)= 50%_ # Stories Ok? 0 YES
FOR A BUILDING WITH A BASEMENT OR CRA SPACE:
The disrance between e lowest FOR A BUILDING ON A SLAB FOUNDATION:
START WITH proposed floor(of the ba ment or crawi
space)and the highest poi of the roof. START WITH The distance between the top of slab and
If you have a... the highest point of the roof.
If you have a...
• GABLE OR HIPPED ROO o . GABLE OR HIPPED ROOF(no
windows): Subtract half the windows): Subtract half the distance
distance between the highest p between the highest point of the roof
of the roof to the low point of th to the low point of the corresponding
SUBTRACTION corcesponding gable or hippe of SUBTRACTION
gable or hipped roof
(BASED ON ROOF . GABLE OR HIPPED ROOF with (BASED ON . GABLE OR HIPPED ROOF(with
T�'PE) windows): Subtract half t ROOF TYPE) windows): Subtract half the distance
distance belween the to of the between the top of the highest
highest window and highest window and the highest point of the
point of tl�e roof roof
• ALL OTHER ROOF TYPES(flffi,
• ALL OTHER RO TYPES(flat, mansard,etc:No subtraction.
mansard,etc): subtraction. ADDITION Add the distance between the top of slab
SUBTRACTION Subtract the dista e between the (BASED ON and the highest existing grade adjacent to
(BASED ON EXISTING basemenUcrawl pace floor and the EXISTING the foundation.
GRADES) highest existi grade adjacent to the GRADES
foundadon 10 feet(whichever is less). EQUALS Defined building height
EQUALS Defined uilding height
Shoreland District MCWD Permit Received Avera e Lakeshore S back Met? Bluff
0 Yes � No 0 N/A 0 Yes 0 No
0 Yes 0 o O Yes 0 No /A
Permit Number: Setback:
Stormwater uality Existing Proposed Variance Required CUP equired
Overla D' trict Tier Hardcover Hardcover
0 Yes � No 0 Y 0 No
Type(s): Type(s):
Updated: January 2013
v:\formslplan review checklist 2013.docx �'1�Q C H Iq Jv��
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REMARKS (in-house):
Fees to be Cha ed ���,�ES. � , > ,..z�4 .;:
r
�� w�. -.. ..- ,=s , : a � ,- e 7:�
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�;, .� � ,�, �:.,u �;... .�.e � _ , .., �-�
Plan Review
: .._ � � ��.,_ _ � � � ��� .
.. �-_ �e ...
Investigation Fee
r� _ � - � . _m�� a .r �- . . w T .�:
. _. . ,�� � _ _ .
Other(specify)
S uare Foota e $ er S uare Foota e
Basement X = $
1$`Floor X = $
2"�Floor X = $
Garage X = $
Estimated Construction Value: $ 2`�,l�nn��
Orono inspections Required Work Requiring Separate Permits Required State Permits
� Site Piumbing 0 Grading/Filling 0 Well
0 Hardcover Removal Mechanical � Fire Electrical
� Footing � Septic G Water Connection
0 Poured Wall � Fireplace � Sewer Connection
G Foundation Survey � Masonry � Lawn Irrigation
C Radon Rock Bed G Mfg. � �
Framing � Other(specify)
�nsulation
� As-Built Survey
Final
� Wetland Buffer
� Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: � YES � NO New: � YES 0 NO
OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED
Updated: January 2013
v:\forms�plan review checklist 2013.docx
:terior Places and Spaces, LLC ����� �j��� S�ii:.�.:•��'�l... N�TE
r'��gela L. Pazker,ASID � SE ATTACHEt� 5;-fEFT
2940 Hampshire Avenue South, . � � d ; ,n,T�/Z
Minneapolis,MN 55426 � CODE REQU1REtV1ENTS
!h�ne� 9S1_-4S 1-19fi(1
www.alparker-1pS.com
Date: September 17,2012 � g h l`'�'�
`
Client: "
T�m Rr�strnm anc�Rerta Kvamme �
2050 Shoreline Drive ---- - -
Orono,MN 55391 Q ��,��� ;��--��"'�
�hnne:952-R93-02Rh � �
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REVIE�IYEi� for CQ��� �OMPLIANCE
�p SIrl�ore.�i�t..�n�'E�,�Sr�y[a�L-{� P�N CHECKED BY DATE
C9r�rin �t� 55z9 I ��-��.,-
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-�� �'_� DATE TIME V
CITY OF ORONO CALLED IN `t"—Z —
INSPECTIOAL�V��IC� � SCHEDULED —Z�'�3 L -�L��'
PERMIT N(ID�t� CO LETED
ADDRESS OZ�J�� ���rr �Y.(L�1 ^ / �_.
OWNER TELE HONE NO. � � ����
CONTRACT
>; DESCRIPTION �-�� � �� �
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ 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
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW �11fORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED �
W ISSUE CERTIFICATE OF OCCUPANCY
O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector. 1�
�
White Copyllnspector's File Canary Copy/Site Notice
`�� �� DATE TIME "
CITY OF ORONO CALLED IN �
INSPECTION NOTICE/�j� SCHEDULED — — '
PERMIT NO.� �/���� OMPLETED
ADDRESS �
OWNER TELEPHONE NO. �� S�1` -
CONTRACTOR �
>; DESCRIPTION
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECNANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISS E CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �Q5Z� 249-4600
OwnedContractor on sit .'
Inspector. '
White Copyllnspector's File Canary CopylSite Notice