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Home My WebLink About2010-00773 - addn/remodel/repair ! � CITY OF ORONO PERMIT NO.: 2010-00773 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEu: 08/30/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3440 SHORELINE DR PIN : 17-117-23-43-0142 LEGAL DESC : NAVARRE HEIGHTS : LOT 022 BLOCK 006 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL- BUSINESS CONSTRUCTION TYPE . ADDN/REMODEL/REPAIR ACTIVITY : ��-'� 3�1 �RFSrnFN tai .,.,,,,....�,r�v��PIN ��j� iVll VALUATION : $ 3,000.00 NOTE: FRAME DOORWAY-REPAIK SHEE'1'ROCK APPLICANT PERMIT FEE SCHEDULE 88.50 MITTELSTAEDT INC STATE SURCHARGE(VALUAT[ON) 5.00 P O BOX 454 TOTAL 93.50 WATERTOWN, MN 55388- (612)716-9595 Minnesota State License#: 20012394 OWNER BILGRER, R[CHARD 3440 SHOREL[NE DR ORONO, MN 55391- 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 this type of work shall be compied with whether or not specified herein.This permi[will expire and become null and void if construction authorized is not commenced within I 80 days of the date of issuance,or if construction is suspended for a period of 180 days at an time atter work has commenced. The applicant � le assu g all re uired inspections are requ m confor an t ,tate B g Code.This permit may be voked at any e � r v ' � '�� / �i �Ui /C� Ap cant mite ,i'gnat e Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. s � City of Orono Building Permit Application for New Structures or Additions Mailing Address: � �,L,�� PO Box 66 Permit number: � Q/(J—C �� 0 ,A � Crystal Bay, MN 55323-0066 Date received: � �A,�� -��' �, Street Address:� Received by: ��L c ��:� � �� " 2750 Kelley Parkway Plan review fee: '�kEsxo�''� 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: -' � � ,,,, �� , � ,� 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 Crty Council approval 60 days prior to the event. Shuttle bus servic will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR 1 APPLICANT INFORMATION: n Name: ��./��t-fel s ta�� 1-�elX f �v�c-, State License# ��,��? q[/ Expiration Date: _ Phone: �, - � - ys office � i - � -- cell Mailing Address: Pp, o S- Cit : t� �,� ZIP:�-S- Contact Person: --T�,.� .�il ,�..�-F� �-j-u c�.-�- Applicant is: Contractor / Homeowner (Circle One) �- Email and/or Fax: y� Z _q�S=�,� �3 PROPERTY OWNER INFORMATION: Name: �`�� ,��,-_ � Phone (day): Address: City: ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: Cit : ZIP: Email and/or Fax: ` PROJECT INFORMATION: �c�w�C ��p/' C�l� 1. Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal & Water Supply ❑ New Construction ❑ Single Family with ❑ Residence ❑ Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation « �r ��,��C detached garage ❑ Office/Commercial ❑ Other: s eci ❑ Private Sewer ( p fY) �� Multiple Family/Condo ❑Warehouse ❑ 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 - �• l� '� G�S� G'''/l/�-w�,,.� A-r�-f'� �f-��v�-L � ._,: ; ,:.. � . � � 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. '/z Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not 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. ApplicanYs Signature: Date: ��j� ,t;, Last Updated: 9/29/2009 - 18 - � ..�: ( �._ _ _ _ .. . .� :�: t.�� ._:.�,� �� L�� DAT TIME CITY OF ORONO CALLED IN � � V INSPECTION OTICE D�73 SCHEDULED PERMIT NO COMPLETED .� ADDRESS `�� J/1U l�T��- C �/V Q OWNER TELEPHONE N CONTRACTOR � � -�� ' S � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO c�., COMMENTS: � W C � ��A � .��e D� �c�o.��1 0 �. � ° ��. �, � _ en �' �us 'T' QQ W Q �— ��2 � Z � C_ S' . S � ��l✓t� S �.� �, 'D �-�c�,urS �.� �4 � _ �'�/Y' CG��`�� '� s r�C�ti� � A / �ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC01/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. � Ca11 for the next inspection 2a hours in advance. (952) 249-46�� Owner/Contractor on site: Inspector. � � �`� White Copyllnspector's File Canary CopylSite Notice