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Home My WebLink About2010-00165 - addn/remodel/repair � ' CITY OF ORONO PERMIT NO.: 2010-00165 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 03/26/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1480 SIXTH AVE N PIN : 26-118-23-32-0008 LEGAL DESC : DOUGLAS ESTATES : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 28,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING, AND ELECTRICAL(STATE) BATHROOM REMODEL APPLICANT BOYER BUILDING CO ORATION pERMIT FEE SCHEDULE 445.25 3435 COUNTY ROAD � PLAN REVIEW 289.41 MINNETONKA,MN 55345 STATE SURCHARGE(VALUATION) 14.00 (612)475-2097 TOTAL 748.66 Minnesota State License#:2988 OWNER HAUSER,ROBERT&SALLY 1480 SIXTH AVE N LONG LAKE,MN 55356 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 sepazate permits. All provisions of laws and ordinances goveming 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 after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoke any �me fo;due cause. i�! 3 /� lGd � l l /C� Applicant P tee Signature Date Iss By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . . �/ �� City of Orono Building Permit Application for New Structures or Additions Mailing Address: Permit number: O l� !DO/ g+�.�\ PO Box 66 Q o\ Crystal Bay, MN 55323-0066 Date received: /O ��, 1 � ��s��,,. �.y��s-�;,,� s,� Street Address:' Received by: �c�L��;�ll'��, �� 2750 Kelley Parkway �,h� � Plan review fee: /� `�kEsxo4`' Orono, MN 55356 �� Total Fee: Yy� �� j�p 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: �w� P Job Site Address: � �{ gv CO(IrJ 'w �O Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, a special evenf permit is required wrth Police Department and City Council approva/60 days prior to the event. Shuttle bus service wrll be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �[ivP� �ui�.fi�,�lvc�y (,0►r,�U✓�t'�"Lf/►�J State License# a g� Expiration Date: Phone: �.r2 _r�7�_�, O S�7 (office) (cell) Mailing Address: ��{3,5- c� 1,0 t Cit � �vi�H- ZIP� ,��c�� Contact Person: Tp� �K,� Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: C�S2- K7� � �o� PROPERTY OWNER INFORMATION: Name: S•c��,,, -�- �Jb �}a.v�s.P r Phone (day): ��2_y�6_�,� Address: ��,�j ('�„�,y� �� ,� Cit � �� ZIP� �3 (� Email and/or Fax ARCH(TECT/ENGINEER INFORMATION: Name: Phone (day): Address: _ City� 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 detached garage ❑ Office/Commercial ❑ Private Sewer �'Other: (specify) �[�}� �p,i,,10G�f� ❑ 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) $ ;; $� O�� 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 sauare feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 15t Story = ❑ Other(please specify): e. 2"d Story= f. '/2 Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: � N ot Enclo ed A plicable ';� ❑ Permit A lication " ❑ Pro osed Buildin Plans �'''� d ❑ 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: ZZ 7i� � � -� ; Last Updated: 9/29/2009 � - 18 - � � � � �, � �� , � � �,y �_ � � � � � � � .. � _ . . • Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: l�l�C� �v n�r�j �A/� �j Description of work: �f�T1-1 � 'yv��0(:Z Septic review by: N/l� Date Approved: Zoning review by: 14 Date Approved: Building review by: ��C. Date Approved: �� -ZZ- I d Grading review by: /J�� Date Approved: Zo ing File#: Resolution#: Resolution Date: Zonin District Fire De artment Post O�ce Scho District Zoning: Lot Area: SF/AC Width: pth: Survey Submitted: � Yes � No Date of Survey: Pro osed Setbacks: Front(Lake) Rear treet) ( N S E W ) ( N S E W ) ther Buildings Wetland Side Side Building Defined Height: Building Peak Height: #of Stories Ok?: � YES FOR A BUILDING WITH A BASEMENT OR CRAWL SP E: FOR BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement or/crawl S ART the distance between the slab and the highest space floor and the highest roof peak,t top of ITH roof peak,the top of the cornice of a flat roof, the comice of a flat roof,the deck line of a the deck line of a mansard roof,or the mansard roof,or the uppermost point on a ro d uppermost point on a round or other arch-type or other arch- e roof roof SUBTRACT half the distance between the highest window an SUBTRACT half the distance between the highest window hi hest roof eak of a itched roof and hi hest roof eak of a itched roof SUBTRACT the distance between the basement floor/cr I ADD the distance between the slab and the highest space floor and the highest existing grade ithin existin rade within the foundation the foundation or 10 feet,whichever is le . E ALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: F % Shoreland District MCWD Pe it Received Avera e Lake ore Setback Bluff � Yes . No � N/A � Yes 0 No 0 Yes 0 No 0 Yes � No 0 N/A Permit N mber: Setback: Hardcover Zones Exi in Pro osed Variance Re uired CUP Re uired 0-75' 0 Yes 0 No � Yes � No 75-250' Type(s): T e(s): 250-500' 500-1000' REMARKS (in-hou ): Upd ted: 09/11/2009 z:�fo slplan review checklist.doac .- . � Fees to be Char ed YES NO :�..er��t.-�� J � : � � Plan Review � :��LI'C��@ '' � ; L.,,•�!� Investigation Fee ��4��`�rn'tie��oTYS�4C A3�its z ^ ��,; ; ' ` - - �-;�'�� .,:_ :�:�� '�` .,. , . _. . . ... .... ,. .� �: ::. Sewer Connection ��t@�'S0T�37�C�'I�L� � rt«x, .%,',a•� +,.�:' d ,� a .n �• H ;';_' r3- .�;, ,+g ,i 4�'_ ...�`. Park Fee '.�,��ns`;p�e�civora'�.,�� - , �t z3.�,,...�.:� ��s��.3�'�, . , � y��.� ;, � ,��;�-. Other(specify) �i��i�s��e�,k�'n�y�4'i�..";;'=a��Y��`�'�`��`�;�.� ,;�',t�,,'�"��R',�h"'i#."�'�'/ �k " 9 � l7 �..,'� ,��, ,.�'�.. � . � Calculated By: S uare Foota e $ er S uare Foota e Basement X = $ 1�Floor X = � 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ 2��po0 �-� Orono Inspections Required Work Requiring Separate Permits Required State Permits 0 Site Plumbing � Grading/Filling � Well 0 Hardcover Removal 0 Mechanical 0 Fire � Electrical O Footing 0 Septic 0 Water Connection � Poured Wall ❑ Fireplace � Sewer Connection � Foundation Survey 0 Masonry � Lawn Irrigation 0 Radon Rock Bed � Mfg. � Framing 0 Other(specify) Insulation � As-Built Survey Final 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: � YES � NO New: � YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.docx �� I DATE TIME " � CITY OF ORONO CALLED IN –�,�"��r�—� INSPECTION NOTICE SCHEDULED .�_ '�`� PERMIT NO. �� r�� L��S, COMPLETED ADDRESS �`�� 0� �" N OWNER �� ' " �� ELEPHONE NO. �'��`G'��y y CON��R� �: DESCRIPTIO� �� %�� ❑ 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 v ❑ 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 a � O � W � Q � 2 W � W � � d W' WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on s' : Inspector. White Copyllnspector's File Canary Copy/Site Notice DATE TIME ✓ CITY OF ORONO CALLED IN � INSPECTION�`OTICE SCHEDULED PERMIT NO.o� D DOIIo COMPLETED ADDRESS l � � OWNER TELEPHONE N0.9,2 Z �7��7 CONTRACTOR 1 �P/�� DESCRIPTION u��d�r �� ^ ��`'�'�'C � ❑ FOOTING ❑ PLUMBIN AL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y O 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 «� COMMENTS: � W a � J O � � O � W � Q � Z W � W � � s � ❑WORK SATISFACTORY:PROCEED f�PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION RE4UIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-4600 Owner/Contract s' Inspector. White Copyllnspector's File Canary CopylSite Notice