The URL can be used to link to this page

Home My WebLink About2014-01397 - addn/remodel/repair . CITY OF ORONO * z 0 1 4 - 0 1 3 9 7 * f 2750 KELLEY PARKWAY DATE ISSUED: 12/OS/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; REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN /REMODEL/ REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 25,000.00 NOTE: INTERIOR REMODEL SEPARA"TE� PERMITS REQUfRED: PLUM[31NG. MECFIANICAI.. FIRI�.PLACI��:, I;I.I;CI�RICAL (S"I�ATf:) APPLICANT PERMIT FEE SCHEDULE 413.00 PLAN REVIEW 268.45 WOODCRAFT DESIGN BUILD, INC. STATE SURCHARGE(VALUATION) 12.50 414 LEWIS AVE#102 WATERTOWN, MN 55388- TOTAL 693.95 (612)290-0895 Payment(s) Minnesota State License#: BUIL-629265 CREDIT CARD 8749 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 issued shall be performed according to the approved plans and specifications.applicable City appmvals,and the State[3uilding Code. This permit is for only the��rork described and does not grant permission for additional or related work which requires separate permits. All provisions of la��s and ordinances governing this type of�vork shall be compied with whether or not specitied herein.This permit�vill expire and become null and void if construction authorized is not conunenced within 180 davs ofthe date of issuance,or ifconstruction is suspended for a period of I AO da��s at Tm�time alter work has commenced_ The applicant is responsible for assuring all required inspections are requested in conformance with the State Quilding Code.�l�his permit may be revoked at anv time for due cause. � '��' � � ��`�.,�..c �.E,-�-��-c.�y , � , � � � y� Applicant Permitee Signature Date Issued B. Signature Date . . CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS O Mailing Address: Permit number: �- �TO PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address:' Received by: y� � 2750 Kelley Parkway Plan review fee: � �� Orono, MN 55356 �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 be returned. (Please print) GENERAL INFORMATION: Job Site Address: �� '� �� I �1{� ��- LG�l1ol � �� ' �/� 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 applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR 1 APPLICANT INFORMATION: I Name: 1l�ic�Jcen�'-� U�s��c�✓� Y i�; d�l l n�t State License# ��Z�j Z�� Expiration Date: Z�� /s��1�z< <-�- Phone: (cell)�17_�c�� ;u:t� S (office) Mailing Address: �p �;>x I�S City: �,y�rf�r,-:,,�,v ZIP: c�3r�,� Contact Person: " � � Applicant is: Co�tr2�r / Homeowner (Circle One) Email and/or Fax: ��J�� ,,..�cv�c,� ' - )� �51 C, i v; �r� a�Z -Z�S= `�%"�y Z. PROPERTY OWNER INFORMATION: ,�/fT lI 7=3C� 7- I ��7f� � �-1�-T� Name: L��'k-r'� C�cJ�la��;��j .�,��.� Phone (day): lrr%�- ,�;�LI - l��/T_ Address: ��' a ��r s'�J�r..�,�"� �v;�s'.�rr•�- City��,�;; L�`1� ZIP: S�3S � Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): � Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal & � Water Supply ❑ New Construction �Single Family with [$F�esidence ' ❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer �$Other: (specify) �1�7��av+� ��i;�./�;ln.'_ ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water ""Any earth movement may also require ❑ Commercial ❑ Other(specify) MCWD review 8�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) $ �-'� �P� , � , {a . STRUCTURE INFORMATfON: • 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= �Wood/Frame b.Width (ft.)= Number of garage stalls: ❑ Masonry Areas in square feet Attached= ❑ Metal ❑ Pole Bldg. c. Basement= Detached= ❑ ICF d. 1�`Story = ❑ On-site Prefab e. 2"d Story= ❑ Off-site Prefab f. '/:Story = ❑Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your appfication to be processed: Not Enclosed A licable � ❑ Permit A fication 6� ❑ Pro osed Buildin Ptans ❑ I� MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ Surve meefin all re uirements ❑ Stormwater Pollution Prevention Plan p Hardcover Calculation s ❑ C,�; Se tic S stem Site Evaluation Re ort ❑ C� Access Permit ❑ f� Wetland Buffer Im rovement Plan ❑ @� En ineered Plans for Retainin Walls 4 feet or above ❑ p: Plan Review Fee ❑ � Application Escrow&Agreement ❑ Other. APPLICANT/OWNER ACKNOWLEDGEMENT: . Agrees to provide ali 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 informafion supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsibfe 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 compfete; • Acknowledges the Escrow Agreement is completed and signed; • Understands 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 generalfy cannot be given to the public but can be given to the subject of the data. Confidential data is informafion 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 app(ication may not be issued. . Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure compfetion of the as-built survey and all site improvements. Applicant's Signature: I Date: I y ��l`� Owner's Signature: Date: 1 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address/Permit Number: �� 1� A� �1� . Description of work: \.�I�5�/��`�T� �'1 N t5(� Septic review by: IV ( iDr Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: 1 Z'S � 7—�l�( Grading review by: ��(A Date Approved: Z ning District: Zoning File#: Reso#: Reso Date: Zonin • Lot Area: SF/AC Width: Lot Coverage: SF % Survey S mitted: �Yes � No Date of Survey: Revised date ? . Pro osed Se acks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Build' gs Wetland Side Side Defined Height: Peak Height: FFE: FFE minus 6 eet= (Existing Contour) Perimeter(linear feet)= 50% _ #of Stories Ok? � YES FOR A BUILDING WITH A BASEMENT OR C WL SPACE: The distanca be een the lowest FOR A B DING ON A SLAB FOUNDATION: START WITH proposed floor(of e basement or crawl space)and the high t point of the roof. The distance between the top of slab and START WITH �e highest point of the roof. If you have a... If you have a... • GABLE OR HIPPE OOF(no . GABLE OR HIPPED ROOF(no windows): Subtract h the windows): Subtract half the distance distance between the hi est point between the highest point of the roof of the roof to the low point f the to the low point of the corresponding SUBTRACTION corresponding gable or hipp roof SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR HIPPED ROOF(w (BASED ON . GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half the ROOF TYPE) windows): SubVact half the distance distance between the top of th between the top of the highest highest window and the high t window and the highest point of the point of the roof roof . ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TY S(flat, mansard,etc:No subtraction. mansard,etc):No s raction. ADDITION Add the distance belween the top of slab SUBTRACTION SubVact the distance b een the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenUcrawl spa floor and the EXISTING the foundation. GRADES) highest existing gr e adjacent to the GRADES foundation OR 1 feet(whichever is less). EQUALS Deflned building height E�UALS D�ned buii ng height Shoreland District MCWD Permit Received Avera e Lakeshore etback Met? Bluff 0 Yes 0 No 0 N/A 0 Yes 0 No 0 Yes � N � Yes O No N/A Permit Number: Setback: Stormwater ality Existing Proposed Variance Required C Required Overla Dis ict Tier Hardcover Hardcover 0 Yes 0 No � es 0 No Type(s): Type(s): Updated: January 2013 v:\forms�plan review checklist 2013.docx REMARKS (in-house): Fees to be Cha ed YE NO �Permit ;� .. .. Plan Review "Sta`te Surchat�g�► � �i"'. _ ., . ..: ._ Investigation Fee "$�4�.. N�mber�o�SAC Units �. ' Other(specify) � � S uare Foota e $ er S uare Foota e Basement X = $ 1 S�Floor X = $ 2nd FIoo1' X = $ Garage X = $ Estimated Construction Value: $ Z 5�,(�00� Orono inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing 0 Grading/Filling 0 Well � Hardcover Removal � Mechanical � Fire � Electrical G Footing O Septic 0 Water Connection 0 Poured Wall � Fireplace � Sewer Connection � Foundation Survey � Masonry 0 Lawn Irrigation � Radon Rock Bed 0 Mfg. �Framing 0 Other(specify) nsulation G pjs-Built Survey ��Final 0 Wetland Buffer � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Ezisting: O YES G NO New: G YES � NO OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\fortns�plan review chedclist 2013.docx ��(/ ' �� DAT J TIME � CITY OF ORONO��r�j CALLED IN � � �-3�\� \��o��„J INSPECTION NOTIC�� }r�R�SCHEDULED �� I � S �o co 2� PERMIT NO - � `��M��rEo ADDRESS �� ' �� OWNER�µ�G-��-�� TELEPHONE NO. CONTRACTOR C.<�c��tc�L'� ��:..�ti — �rj�— %3�� =� — Cc��_�� DESCRIPTION ` � �ti' � � ❑ FOOTING ❑ PLUMBING FINAL �(' EXCAV/GRADING/FILLING Q � POURED WALL / ❑ MECHANICAL RI �� ❑ LAKESHORE/WEfLANDS QFRAMING �� ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z �F�MG�Y�10N� � WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE O SEPTIC MAINT. ❑ FOLLOW-UP ? 0 DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: W �' � � � / .1r J O � � Ot, ` W � Q � 2 W � W � J W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection hou ' n . (952) 249-4600 OwnerfContractor on site: � Inspector. White Copyllnspector's Ffle Canary CopylSite Notice �� D TE TIME CITY OF ORONO G� � 7CALLED IN /-I -�S ' INSPECTION NOTICE SCHEDULED /eZC� �( S �i'.' !� PERMIT NO. � COMPCETED ADDRE � � OWNER �EPHONE NO. ��a- a� CONTRA OR >; DESCRIPTION � � � FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FI�LING Q 0 POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z�C1pI,SULATION ❑ 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 � OWNERICONTFiACTOR TO MEET YOU:_YES_NO � COMMENTS: a �/1 J`G�.�• - J`D�� d re vtiC C)vC � P�r.�e r�o r- �o c�ti�l%��, 1�.� l�,S �� -•� - , ° --�-_L/r c�,-Ffs rSa.o 4n S�� -��4.6src� W � v{�l oc/.��,�c.s L �oa t� -��o�- re5� o � Q WL. C._ ., � �7 �� v �� '4��dD,�.s �r ✓l-a-� ��S � G'ou,�.�? ,tot� s�.o.o%.o} �e� 17�� t' o G�r •o c��E- .- � �--� C6 v2�/ W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � �E6�WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0�O CORRECT WORK,CALL FOR RE�NSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR�VILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS. C 6fe�rttre-�eic�-i ection 24 hours in advance. (952) 249-4600 Owne ontractor on s' • ��"� � Inspector. '• ` '� White Copyllnspector's File Canary CopylSite Notice �I ��./'�� DATE TIME y CITY OF ORO CALLED IN '�Y INSPECTION NOTIC SCHEDULED - — � PERMIT N a 3 7C LETED ' ADDRESS � ' V OWNER TE O E N ��-°29� CONTRACTOR � DESCRIPTION ty ❑ FOOTING ❑ DE - INAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PL B G RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF ❑ PLU ING FINAL ❑ TREE REMOVAL 2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULAT�ON ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J (�EINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTFiACTOR TO MEET YiOU:_YES_NO � COMMENTS: ��. ��f ' �-�_�� a �jj rv v�ti s.. GocQe Ce Ty,� �.�r`�% � or�e�c��,�,..�� .� — � � ° S 1�vro�lQS.�- Cb .l ��;s — � W � Q � U�e�� a-� OJa.�/L �'�.�,rol�s�� W � jW/Y�GG�i "E li�i�l �/ /'G ' 1 h d1�Js�� d � ❑WORKSATISFACTORY:PROCEED ❑ PRWECTCOMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR �TION REW IRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: � . Inspector: � White CopyAnspector's Fils Canary CopylSfte Notice C��" TIN►�/ CITY OF ORONO CALLED IN � INSPECTION��i�_ n�X,�� SCHEDULED � PERMIT NO. � �� .�" / COMPLETED ADDRESS ��8� �-�= OWNER � � TELEP,�iONE ��°3' CONTRACTOR �� DESCRIPTION �,G�Z��U GOyI � %rLI�LG�� 41 ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT v �FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL � ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � a �art�4.L5 rJrDvhd-�CJ ,�� ✓ ,�revcocrs �••�L —o�— O %I-1 t�,CG�i(C�I1, ' �. � � �� cJ�r K �vrs,o%�� d- W � C��.��!a✓�l 1�.L� _ Q 2 � � ./.�P.✓�.s�� W � j GW ❑WORKSATISFACTORY:PROCEED PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISS ERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pf{OTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. r " spection 24 hours in advance. (952� 249-4600 Own Contractor on sit • �� Inspector. White Copylinspector's File Canary CopyiSite Notiee