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Home My WebLink About2014-00748 - addn/remodel/repair ' � �� CITY OF ORONO * z 0 1 4 - 0 0 7 4 8 * � 2750 KELLEY PARKWAY DATE ISSUED: 07/15/2014 ORONO, MN 55356- (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/REPAIK PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 25,000.00 NOTE: SEPARATE PERMITS REQUIRED: I;I,F.C�I�RICAL(S�I�A"1�I?) INTF,R[OR BATHROOM RF,MODEL APPLICANT PERMIT �GE SCHEDULE 413.00 PLAN REVIEW 268.45 D.R. SIMON CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 12.50 I5118 WILLISTON LANE TOTAL 693.95 MINNETONKA, MN 55343- (612)597-2386 Payment(s) Minnesota State License#: BUIL-BC004316 CREDIT CARD 0352 693.95 OWNER GULBRANDSON, DAN & ERICKA 1480 SIXTH AVE N LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd shall bc performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. 'I�his permit is for only the work described and docs 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 specitied 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 timc after work has commenced. "I�he applicant is responsible for assuring all required inspections are requested in conformance with the State Bui �ng Codc.This permit may be revoked at any time for due cause. �� ..-� + rr�t ' �iW�''. (��,/.' f "'' ,J �',{ ��_ L��.��..�'�.�-• l l p�y'cant Permitee Signature Date [ssued y Signature Date I ' � City of Orono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) /�� , Mailing Address: Permit number: �O/ —D� 7 � �0�1%� Po BoX 66 —�— � Crystal Bay, MN 55323-0066 Date received: �� J�� ( ' Received by: V L� ` � Sfreet Address: `y � �% 2750 Kelley Parkway Plan review fee: �`�t �`�'� Orono, MN 55356 �Kf.SHUQ'.� � ��. /� _ _� 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 City Council approval 60 days prior to the event. Shuttle bus service will be required unless applrcant demonstrates sufficient on-site parking is available. Non-permifted events wi�l not be allowed. CONTRACTOR/APPLICANT INFORMATION: ` L Name: : � . vne.�� T � v� �o �� L L- State License# � G b C� �3/e Expiration Date: � �� Lead Certification Number: � � �-- j� � � � Z — / �jj�jd u�/Expiration Date: (for woik on homes that were consfrucfed prior to 1978 Phone: (cell) �j( 2. ��/7 Z'3��; (office) Mailing Address: / " , / ` ,� �,,�� City: l,�y `�N P�,��r ZIP: �� r�,- 3�S` Contact Person: � �u,�� S�',,,��, �2 Applicant is: Contracto / Homeowner (Ci►cleOne) Email and/or Fax: cl r s s��c�.� ![�:.-�'� r�.��•�5/L. �C7` Fq,c �S�Z `%�3 �" oo �� PROPERTY OWNER INFORMATION: Name: � �,'k y f- � a� �v��,��s a:� Phone (day): ��Z 3p c� !�C � y Address: �{ �p Cn � City: ..�� ,,��, ZIP: -� 3 S 6 Email and/or Fax: e, ��t u L b �^�hrf5o" �;;J G;,�,,"/ , �,� PROJECT INFORMATION: Overall pro�ect descri tion: Type of Project: Any earth movement may also require ❑ Door(s) (�.Remodel ❑ Fire Damage MCWD review 8�permits: Minnehaha Creek Watershed District(MCWD) ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Siding ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.ora Estimated Construction Valuation of Project(excluding land) $ 2 c, �p0. 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; • 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 ou refuse to su I the information,the a licati ma not-�e issued. ApplicanYs Signature: �`�.. Date: Z � �G � ; Owner's Signature: / Date: Last Updated:03/O6/2013 ' � �� PLAN REVIEW CHEC�(LIST FOR NEW STRUCTURES / ADDITIONS Address/Permit Number: �� v D � 1 y-"� I`1V� �� , Description of work: �h^^��D�=2 Septic review by: �✓//� Date Approved: Zoning review by: N /a Date Approved: Building review by: Date Approved: �7'> >�'��`{ Grading review by: N�� Date Approved: Zoning District: Zoning File#: Reso#: Reso D e: Zonin : Lot Area: SF/AC Width: Lot Coverage: SF _% Survey bmitted: 0 Yes � No Date of Survey: R ised date ? : Pro osed S acks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak Height: FFE: FE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50%= of Stories Ok? �YES FOR A BUILDING WITH A BASEMENT OR C L SPACE: • The distance be n the lowest FOR A BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of th asement or crawl space)and the highest int 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 HIPPEDRO o . GABLE OR HIPPED ROOF(no windows): Subtract half windows): Subtract half the distance distance between the h' est int between the highest point of the roof af the roof to the low oint of the to the low point of the corresponding SUBTRACTION corcesponding ga or hipped roo SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR HI ED ROOF(with (BASED ON . GABLE OR HIPPED ROOF(with T�'PE) windows): tract half the ROOF TYPE) windows): Subtract half the distance distance en the top of the between the top of the highest highest indow and the highest window and the highest point of the point the roof roof • ALL OTHER ROOF TYPES(flat, • A OTHER ROOF TYPES(flat, mansard,etc:No subtraction. ansard,etc):No subtraotion. ADDITION Add the distance between the top of slab SUBTRACTION S tract the distance between the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING asemenUcrawl space floor and the EXISTING the foundation. GRADES) highest existing grade adjacent to the GRADES foundation OR 10 feet(whichever is less). QUALS Deflned building height EQUALS Defined building height Shorela District MCWD Permit Received Avera e Lakeshore Se ack Met? Bluff � Yes G No O N/A 0 Yes 0 No � Y s � No � Yes � No 0 /A Permit Number: Setback: Stormwater Quality Existing Proposed Variance Required CUP equired Overla District Tier Hardcover Hardcover � Yes � No � Y � No Type(s): Type(s): Updated: January 2013 v:\formslplan review checklist 2013.docx REMARKS (in-house): Fees to be Cha ed YES NO *� p t� ,. ��_ x .: `�` aq'� � F ��G x'" P�mtit �`� � > � ,t. r,� � `f � , Plan Review ./ ;'��8t8 S1l1'C�A�B�. : .F �,, :, �T� „°��r� Investigation Fee �S�irC=�t�nm�er:�f 5�►C Un�ts ��;� � '°�,� �r°� h� ; ,.;°` � ,. . ,.. : ; Other(specify) S uare Foota e $ er S uare Foota e Basement X = $ 18�Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ Z5,o o'0 `�- Orono Inspections Required Work Requiring Separate Permits Required State Permits 0 Site � Plumbing � Grading/Filling 0 Well 0 Hardcover Removal � Mechanical � Fire �Electrical 0 Footing 0 Septic � Water Connection 0 Poured Wall G Fireplace � Sewer Connection 0 Foundation Survey 0 Masonry 0 Lawn Irrigation G Radon Rock Bed O Mfg. �Framing � Other(specify) �nsulation O Qs-Built Survey ��Final G Wetland Buffer � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES G NO New: 0 YES G NO OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\forms�plan review checklist 2013.docx .—J '��`�`� �� ""`� REVlEWED fo� C�DE CCfMPl�I�,NC� - � �r„�.��:c ��r��f%°� 4--n��5 —' � '� �"�'"`� �°�'"` � `"� pLAN CHECKED BY Q��DATE �-1S-1�{ - — p�,e �e«,�� j�v i�c r�� ti+a��S 1LJ '�!'y �,a�,.. b).-�a�/ ' �. -- r�, s�iu�f� �-u��;�sQ�- ;�-� l�s ,��..�., ,�,� (�v�i`�1�R�+c f=e��-�,��yJ�•,�Pf �3(Q:.,.�� --- 5�a� � — C�r� �s�w, r.-k1�� -- c'��1,`u� < v BEQ �tO�M V1IiND4WS � �'� � - ____._---__��_._ �IF2� F_XIT REQJlR�D a� � �p�� ;��, �'°._�� /ViDTH -�-- �— , 2�" :�l��. 5:.;��i�,� ��1GNT - 5.7 SQ. F��.-�. ��l� �TG �1 4.i'n �yR t`l.°'� v�L� n1 `1 N� �� , ,._,._._....._.._.._._.._._ _A__._.-.-....,�_.,._..-__" _ � �/ 7 a��J� .. . �s-��__...._ .. � ��. _, � �.. ..., -......,.� : �Q _ � � � � � � � �/ '9" P,<„'Y --'`�"'...^z^.-,.•� �'!r�4"r,y-7 �.Z f� .4,- � ��y�/� �� / • �u�/�b� �/, I i? Q "�.�/�/ �/�e�G' �,•�-�1�/ � � "I SPECIAL N ��"'�; � �j 9J� 5�� ATTAC�-IE� �ET FQ R _"�_.-- CC?�E REC�U��E� - � „ �' ��.��,��, ,-�,,�� s �� ; ��lc q �-- �� b � � a� . 3/8=1'-0" , NEW WALL ��!�� ` � � � REMOVE EXISTW(3 WALL �� r� ��, a� , ,��r�r ,�v ; � 3 s� ' . , J J a 3 3 3 � w ? z � � x � w w > 0 � W _ � �..��' ua�„��'�r , y � i O . ; � M �� DAT�` TIME CITY OF ORONO cnLLED IN �' 7 . INSPECTION NOT CE SCHEDULED — � • � PERMR NO. COMPLETED ADDRESS L�gD �'�� '� OWNER TELEPHONE NO.��a S9?a�� CONTRACTOR �� S� � ��f � DESCRIPTION rGZ�I.C'r�- � ❑ FOOTING ❑ PLUMBING FINAL p EXCAV/GRADING/FIWNG � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS O '�FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q p RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � � FINAL O SEWER HOOK-UP ❑ COMPLAINT � O DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ � DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDA710N/REMOVAL 2 01AlNERI'CONTRACTOR TO MEET Y�OU:_YES_NO y COMMENTS: � �� Q� a� � -�r�...,.„,� �'s✓ h'��St.�./ ��as.�..� Ll-L , f � �4 �tk o • �. � � 1��Sfo�C'�S�s -�r ,��v��rt ic�._c � b�eL�w�on ��ua�� QS �iS�45S� � W � Q 2 �'�<<�-+� d� -�' c'o�.+�✓ � W � j W ❑�WOHKSATISFACTORY:PROCEED O PROJECTCOMPLEfE ��CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILI RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR �INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca�l for the next inspection 24 hours in advance. (952) 249-4600 OwnedCor�tractor on site: Inspector: lGl/M- �� White Copyllnspector's File Canary CopylSite Notke �� .�� ✓ DATE TIME CITY OF ORONO /_ CALLED IN � INSPECTION OTIC '/,� SCHEDULED St-�—L� al.:,� PERMIT NO. '�7T� COMPLETED ADDRESS � � �,rL. OWNER TELEPHONE NO.��'Sy7�s�g� CONTRACTOR 'D �� ✓�� , U� � DESCRIPTION ��s�� ❑ FO ING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG ❑ P RED WALL ❑ MECHANICAL HI O LAKESHORENVEfLANDS Q ❑ AMING O MECHANICAL FINAL ❑ TREE REMOVAL Z INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ ADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v 0 DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERfCONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W a j O � o� O W � Q � W � W 2 � W O WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERINfi PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN INSPECTOR WFLLRETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hou in adv . (95 249-4600 OwnedContractor on site: Inspector: White CopyAnspector's Ffle Canary CopylSke Notice V� � �`•� I�A E TIME CITY OF ORONO CALLED IN � INSPECTION I�QTICE SCHEDULED � PERMIT NO.�C�I��O��I Y�COMPLETED ADDRESS t�I� � `�� h OWNER TELEPHONE NO. CONTRACTOR�K c„ �� ; DESCRIPTION ��—' �e-m� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ IAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ EMO-SITE ❑ SEPTIC MAINT. O FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTFiACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a OC ^ ' J O �. � O � W � Q � 2 W � w � J GW ❑WOR ATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑C RECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY w O RRECT WORK,CALL FOR REINSPECTION TEMPORARY V EFORECOVERINCa PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hou ' advance 249-46�0 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSfte Notice