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Home My WebLink About2018-00222 - addn/remodel/repair � ' CITY OF ORONO * z p� 1 8 - 0 0 z 2 z * 2750 KELLEY PARKWAY DATE ISSUED: 03/12/2018 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-RESIDENT(AL VALUATION : $ 30,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) MASTER BATH REMODEL � APPLICANT PERMIT FEE SCHEDULE 490.12 PLAN REVIEW 318.58 BUILDERS BY DESIGN STATE SURCHARGE(VALUATION) 15.00 21185 VIKING BLVD. WYOMING,MN 55092- TOTAL 823.70 Minnesota State License#: BUIL-20026555 Payment(s) CHECK 8453 823.70 OWNER GULBRANDSON, DAN&ER[CKA 1480 SIXTH AVE N LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perfornied according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permi[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 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 are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. .. . ��___------ -�- ,Z �� r@� .3 � ra � �� Applicant,P�ermitee Signature Date Issued Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel — Residentia! ONLY ��.ex �ir�d��s, �a�r�, �iding, r�-r�af. e��. — fl S�"� �TUR�L. EXP� �1 N� ��A tO Mailing Address: Permit number: a��'��`� �y PO Box 66 Crystal Bay, MN 55323-0066 Date received:- � �� /� , � � Street Address: Received by: ` y�, �1 2750 Kelley Parkway�� Plan review f : tqk�s��,� �\ Orono, MN 55356 �� ` ' � Total Fee: ��3 ,�v 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: y�(� t� , Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If yes,a special event permit is requi�ed with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonst�ates su�cient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: {�jU►� r5 b V ��S1Alrl State License# '�C �p Expiration Date: 3 -3 � - )q Lead Certification Number: NAT ��-L��d�� - o? Expiration Date: G'� -aq -�O (for work on homes that were constructed prior to 1978 Phone: (cell) a-�-35 - 5 ,c� (office) �(�3y3y-�1.P31 Mailing Address: � ��; City: (J� �� ZIP: Contact Person: "�� Applicant is: Contrac / H eowner (Cfrcle One) Email and/or Fax: ' PROPERTY OWNER INFORMATION: Name: �Gfl d' �<'� C�S�l�C1�C1�1�1 Phone (day): a - a�� Address: S�m� City: ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project description: I ' tGS�� ba�l �e-+(1�lOC�P� Type of Project: Any earth movement may also require ❑ Door(s) �emodel ❑ Fire Damage MCWD review 8 permits: ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ 3�,O�p 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 e information,the a lication ma not be issued. .�, � ; Applicant's Signa r. Date Owner's Signature: Date: ( Last Updated:January 2016 � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS , r� � / "� �nl�� , � Address: � % �� '- ( Permit No.: `-(/ (�z�C Description of work: Date Rec'd: � � l Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: � Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: Sffi(AC Width: Lo Coverage: SF % Survey Submitted: 0 Yes ` � No Date of Survey: Revised date(?l: Landscape plan submitted? � Yes 0 No Landscaper: Proposed Setbacks: `'�,� Front(Lake) Rear(Street) ( N S`�, E W ) ( S E W ) Other Buildings Wetland Sid�e Side Defined Height: Peak Height: FF : FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50%= L.F. below grade Basement? � Yes � No, Stories � FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: OR A BUILDING ON A SLAB FOUNDATION: The distance between the low t proposed Slab at or above grade— START W ITH Floor(of the basement or cra space)and measure from hiqhest existina the highest point of the roof. START W ITH rQ ade to the highest point of the roof even if fill was brought in to If you have a... elevate home. SUBTRACTION • GABLE OR HIPP D ROOF(no Slab below grede—measure (BASED ON windows): Subtr ct half the distance from highest existing grade to the ROOF TYPE) between the hi est point of the roof hi hest oint of the roof. to the low poi of the corresponding If you have a... gable or hipp d roof • GABLE OR HIPPED ROOF SUBTRACTION (no windows): Subtract half • GABLE OR IPPED ROOF(with (BASED ON the distance between the windows): ubtract half the distance ROOF TYPE) highest point of the roof to between e top of the highest the low point of the window nd the highest point of the roof corresponding gable or hipped roof • ALL HER ROOF TYPES(flat, . GABLE OR HIPPED ROOF man ard,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract e distance between the haif the distance between (BASED ON baseme Ucrawl space floor and the the top of the highest EXISTING highes existing grade adjacent to the window and the highest GRADES) found tion OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS De ned building height subtraction. Defined buitding height % EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? Permit Number: 0 Yes 0 No � N/A � Yes 0 � Yes 0 No No � N/A–see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf � Yes � No 0 Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit t/� Plan Review (�'' State Surcharge v— Investigation Fee ;/-- SAC–Number of SAC Units ?/� Other(specify) S uare Foota e � er S uare Foota e Basement X = $ 1s1 Floor -X = $ 2nd FIOo� X = $ Garage X = $ Estimated Construction Value: $ �vi vv� Orono Inspections Required Work Requiring Separate Permits � Footing 0 Site � Plumbing � Grading/Filling 0 Poured Wall � Silt Fence/Erosion Control �Mechanical 0 Fire 0 Foundation Survey � Hardcover Removal � Septic � Water Connection � Foundation Waterproofing 0 Other(specify) � Fireplace 0 Sewer Connection Framing � Masonry 0 Lawn Irrigation Insulation � Mfg. � Landscaping 0 As-Built Survey � Other(specify) Final � Lathe Required State Permits 0 Other(specify) � Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: ❑ See Builder Acknowledgement Form 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 �•\fnrtnc\nlan raviow rhor4lict'I(1_9f11ri rinrv 1�-+ t�D � - — - - - - - r' �►q �i cr - �n ►-�- o 0 0 cD � � , m a � b. � ° Oo � N• c� w rr y, � N� - - - - - - - - - - - - - - - - - - - - - - - o° � 2 � o � � rn • M fD � / \ fi n O r't � — " � � rt, � .� � � ' DD � � -� cn ___ � - � _ � __ -� - ° � m �;, o - - - - -� O � m ' � � �o o � � � � a � ; � � � , m � i 00 � . 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I � Feb. 22� 1480 Counly Road 6 21185 Viking Blvd. 20�I Q 'I Orono,MN 55356 Wyoming,MN 55092 � I V MN Lic#BCO26555 I /` � � DATE TIME CITY OF ORONO CALLED IN � INSPECTIO OT E SCHEDULED PERMIT NO - �� COMPLETED ADDRESS <<-L.�� C �l,(SL l, OWNER T LEPHONE NO. CONTRACTOR �1�,� ��S � �� DESCRIPTION �r 4~j ❑ FOOTING ❑ DEMO-FINA ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑1�THE ❑ MECHANICAL RI ❑ SITE INSPECTION Q �RAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO ,�,/ � COMMENTS: E`� �� 3`� ��`6 a or�»+�T�,�.,- .�•�2 � /'GY/i G s/qrQ < F �w � � /' ^ �¢ i1s��i s , .�d/ � �/� „?.�e Lt.7�t�/ �� — , � 2 � .�� •c��Qsrs rJ�_- - � j �p/'✓'�'� � d� �`—�'oA7�ivtlL�_ W ❑WORKSATISFACTORY:PROCEED ❑PRWECTCOMPLEfE a �RRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECTNfORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOMERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL RETURN O STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnedContractor on site: Inspector.�i vc�• `�'— White CopyMnapector's Flle Canary CopylSite Notke �� DATE TIME � CITY OF ORONO CAILED IN �� INSPECTION�OTI��Y�2Z2 SCHEDULED � �" �`'"' PERMR NO. �� ' COMPLETED ADDRESS I �-E v �eC,-�-� G V e� OWNER TE HONE NO��' �'31 CONTRACTOR 'r � DESCRIPTION �� 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION _ ❑ RAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � �INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 4� ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL Z J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET Y�OU:_YES_1� y COMMENTS: �" �i�N�J'G�- ' �� /nsc.L• W �/►-� • 6r� � oeoc�s��3 k�a,��s � � � �P�.O'�iYla.�cO � ' JG�6l� � Q � .s�� ol�. p�n��o�. � -��y �� - � a w Gor r e�E q �s!L � �o v�.i � 3 W ❑WORK SATISFACTORY`.PROCEED ❑PROJECT COMPLETE W �RRECT WORK 3 PF�CEED ❑ISSUE CERTIFICATE OF OCCUPANCY O O CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECOMERING PERMANENT O CORRECT UNSAFE CONDITION WITHIN H��• O PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: ��-�� Whits Copy/InspectoPs File Cenary CopyfSke Nodce