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Home My WebLink About2009-00546 - addn/remodel/repair �' t ` CITY OF ORONO PERMIT NO.: 20o�-oos46 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 09/14/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 1980 SIXTH AVE N PIN : 27-118-23-42-0004 LEGAL DESC : UNPLATTED 27 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 100,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,SEPTIC,ELECTRICAL(STATE) NEW KITCHEN,FINISH LOWER LEVEL,REMODEL MAIN BATH APPLICANT pERMIT FEE SCHEDULE 1,056.�5 BRIAN STEPHANSON CONST.INC. PLAN REVIEW 686.89 2025 PAWNEE RD MEDINA,MN STATE SURCHARGE(VALUATION) 50.00 (612)889-0477 TOTAL 1,793.64 Minnesota State License#:20222459 OWNER PIERPONT,JUDY 1980 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 dces 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 consGvction 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 fo assuring all required inspections are requested in n ance w' the State Building Code.This permit may be revo ause. � � � � /� /Q pplicant Permit Signature Date Is ed By Si ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � � ;� . . a � � (�.�'� � I � �� ;�� ; a1� � City of Orono := �� : Building Permit Application for Internal Work � �{� �� (windows, doors, siding, re-roof, etc.) �= �� Mailing Address: Permit number: �d� �� ' PO Box 66 � ��Q� �� Crystal Bay, MN 55323-0066 Date received: �� I•� �`�'i��_,mm. s,�� Sfreet Address: Received by: � ��n %. °�� 2750 Kelley Parkway Plan revie fee: '� L9kESK�g�'j Orono, MN 55356 � � / 7g , C� � -� Total Fe � � � 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) f`:; � ; GENERAL INFORMATION: � �= Job Site Address: � �U�� j ;� �,� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes •, No lf yes, a specia!event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service wil/be � ` �' requrred unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed �° i �; CONTRACTOR/AP LICANT INFORMATION: �; � ` Name: R�.A� �S�«��nsc�ti �9nS�� 'C , � State License# t20��2 �3 y Expiration Date: 3-3��- �ai0 � ��- Phone: �- �� 7 office cell ¢� Mailing Address: ,� F ,� Cit : ,-,�,� ZIP: r - � Contact Person: 2�,�,,, f�p P„s,�,,J Applicant is: ontracto / Homeowner �c��ie o�e� Email and/or Fax: �Y PROPERTY OWNER INFORMATION: �' Name: ��'�Z o,1� � -TiTm P $� Phone (daY)� �.5 ` - �7,3�` ` / � : � �,., ^ddress: ��SUI L�?�S � � .�' � �itv��r�sL�,�r� ZIP� �� Email and/or Fax � �" F '-: PROJECT INFORMATION: Type of Project: I Any earth movement may require � MCWD review&permits ❑ Door(s) �Remodel ❑Water Damage �, i Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd f, Deephaven, MN 55391 '^ z s ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 � . Fax: 952-471-0682 �� ❑ Re-roof ❑ Fire Damage � www.minnehahacreek.orq ,, 4 � Overall Project Description: /f/�t�> �i ��c;� ; ��,,�� ,w��, L��l - /��l,�c/` i%t�,� ,(�.�f-h � �. ' Estimated Construction Valuation of Project(exc uding land) $ /QD Un�7 � � �� ': 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; � �� '?x� • 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 � re uired b law. If ou refuse to su I the information,the a lication ma not be issued. � �: � ApplicanYs Signature: ' �v��- � �L� Date: �-j-(� � �". �:; Last Updated: 05-04-2009 � � �" 4 . . . ._. ... .��i r:�'�. ��e Y,��'.T.�...{��. ... .. �.��, . ..�a"4� .l ,�.b �..s / f , Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: 1 °1 `�v �c��.r-rH 120.�✓� (, Description of work: Q-�V�"�/�tr� Septic review by: �' Date Approved: Zoning review by: �' Date Approved: Building review by: ��X�--- Date Approved: 6 -L–aS Grading review by: — Date Approved: Zoning File#: Resolution#: Resolution Date: Zonin District Fire De artment Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Submitte � � Yes 0 No Date of Survey: Pro osed Setbacks: Front(Lake) Rea Street) ( N S E W ) ( N S E W ) Other Bui mgs Wetland Side Side Building Defined Height: Building Peak Height: _ FOR A BUILDING WITH A BASEMENT OR CRAWL S CE: FOR A BUI ING ON A SLAB FOUNDATION: START the distance befinreen the basem t floor/ ST the distance between the slab and the WITH crawl space floor and the highest ro peak, H highest roof peak, the top of the cornice the top of the cornice of a flat roof, the eck of a flat roof, the deck line of a mansard line of a mansard roof, or the uppermost roof, or the uppermost point on a round or oint on a round or other arch-t e roof other arch-t e roof SUBTRACT half the distance between the highest SUBTRACT half the distance between the highest window and highest roof peak of a pi ed window and highest roof peak of a roof itched roof SUBTRACT the distance between the base nt floor/ AD the distance between the slab and the crawl space floor and the hi est existing highest existing grade within the grade within the foundati or 10 feet, foundation whichever is less. EQUALS efined buildin hei ht EQUALS Defined buildin he� t Lot Coverage: SF % Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff 0 Yes p o � Yes 0 No 0 N/A p Yes 0 No � N/A Yes 0 No Permit Number: S ack: , Hardcov ones Existin Pro osed Variance Re uired CUP Re ' ed 5' � Yes � No � Yes � No 5-250' Type(s): Type(s): 250-500' 500-1000' � REMARKS (in-house): o Updated: 07/01/2009 z:\forms\plan review checklist.docx � , . Fees to be Char ed YES NO -Penrr�it _ Plan Review �/�' �#at+e��c�tar �/ Investi ation Fee S�#`C--Tiut�ber af S;IAC i�r�i�s Sewer Connection t�at��nr��ect�on Park Fee Site�n ect��n � Other s eci I�I�s�e'l�a�eaus.Fees Calculated B : UBC: � Construction Type: �/ S uare Foota e $ er S uare Foota e Basement X = $ 1 Floor X = $ 2" FIOOr X = $ Gara e X = $ Estimated Construction Value: $ f��000 °� Orono Inspections Required Work Requirinq Seaarate Permits Required State Permits � Site ,�Plumbing � Grading/ Filling 0 ell � Hardcover Removal ,0 Mechanical � Fire Electrical 0 Footing ,O�Septic � Water Connection � Foundation Survey 0 Fireplace � Sewer Connection �Framing 0 Masonry � Lawn Irrigation ,�(Insulation � Mfg. � � Wall Board � Other(specify) �/As-Built Survey ,� Final � Other s eci 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: 07/01/2009 z:\forms�plan review checklist.docac �/� /� `� ' / AT TIME CITY OF ORON CALLED IN `�`��D A�, INSPECTION T�C SCHEDULED ` --G� PERMIT NO. ��OS COMPLETED ADDRESS g� vl ��G � OWN ER CONTR S TELEPHONE NO. — "' D � DESCRIPTION � ` � t� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING �FRGMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS Q�❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT Q ❑ DEMO-FiNAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDAT�ON/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � � d � ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CAL�INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site Inspector. White Copy/inspector's File Canary Copy/Site Notice