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Home My WebLink About2013-00778 - addn/remodel/repair CITY OF ORONO �2 0 1 3 - 0 a 7 7 B * < - 2750 KELLEY PARKWAY DATE ISSUED: 08/09/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4225 SIXTH AVE N PIN : 31-118-23-12-0012 LEGAL DESC : LJNPLATTED 31 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 2,000.00 NOTE: DECK REPAIR APPLICANT pERMIT FEE SCHEDULE 73.75 DATTILO,GRANT PLAN REVIEW 47.94 4225 SIXTH AVE N STATE SURCHARGE(VALUATION) 1.00 LONG LAKE, MN 55356- TOTAL 122.69 PAID WITH CC# 3531 OWNER DATTILO,GRANT 4225 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 separate 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 conform with the State 'Iding Code.This permit may be -� revoked at any ti due cause. - ^ �� g� � �13 A 'cant Permitee Si atu Date Issu 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: �� _�77 .��0 PO Box 66 Permit number: _ Crystal Bay, MN 55323-0066 Date received: '� StreetAddress:' Received by: y � 2750 Kelley Parkway Plan review fee: F �` Orono, MN 55356 l�kESHO�� Main: 952-259-4600 Total Fee: �O� p�. �p 9 FaX: 952-249-4616 ��rw�v c� ��ion�� iiii� u� This application forrr� must be completed in full and all reyuired information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: � 2� C� �0 �, 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/APPLICANT INFORMATION: Name: v-;�--,�- n��.\� State License# Expiration Date: Phone: cell � 2 � 't s�� office Mailing Address: '?�Z � , a �N Cit : ro._...� SJ 3(, Contact Person: 5�,�,�� Applicant is: Contractor / omeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: SS-�, z Phone (day): Address: City: ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: F'hone (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 8 Water Supply �New Construction j�Single Family with ❑ Residence ❑ Addition attached garage �Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building ❑ Single Family with Deck ❑ Relocation detached garage ❑ Office/Commercial `�Private Sewer ❑ Other: (specify) ❑ 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) $ l�U � , 0 v Packet Last Updated: 04/19/2013 Page 22 of 23 , . . STRUCTURE INFORMATION: ! 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= � G Number of bedrooms= �(Wood/Frame b.Width (ft.)= � +�l,G Number of garage stalls: ❑ Masonry Areas hn spuare feet Attached = ❑ Metal ❑ Pole Bldg. c. Basement= Detached = ❑ ICF d. 15t Story = ❑ On-site Prefab e. 2nd StOry= ❑ Off-site Prefab f. YZ Story = ❑ Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Ap licable ❑ ❑ Permit A lication ❑ ❑ Pro osed Buildin Plans ❑ ❑ 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 ❑ ❑ Minnehaha Creek Watershed District Permit s ❑ ❑ Plan Review Fee ❑ ❑ Other: APPLICANT/OWNER 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; • 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 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. • 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 iemporary Certificate of Occupancy may be issued upon receipt of a �10,000 escrow to ensure completion of the as-built survey and all site improvements. ApplicanYs Signature: Date: �[ �� Owner's Signature: Date: Packet Last Updated: 04/19/2013 Page 23 of 23 PLAN REVIEW CHEC�CLIST FOR NEW STRUCTURES / ADDITIONS , Address/Permit Number: 1"'� ZZ�J �1 �l-+-1-� /gV l► /v 0�� Description of work: �C C+k �c��i 2 Septic review by: I'�1 I � Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: � "' � ' �� 6 Grading review by: N//�' Date Approved: ning District: Zoning File#: Reso#: Reso Date: Zoni : Lot Area: SF/AC Width: Lot Coverage: SF o Survey S mitted: 0 Yes � No Date of Survey: Revised date ? : Pro osed Se acks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildin � Wetland Side Side Defined Height: Peak Height: FFE: FFE minus 6 fe = (Existing Contour) Perimeter(linear feet) = 50%_ #of Stories k? 0 YES � FOR A BUILDING WITH A BASEMENT OR CRA L SPACE: The distance betwe the lowest FOR A BUILD G ON A SLAB FOUNDATION: START WITH proposed floor(of the sement or crawl space)and the highest p t 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 HIPPED R00 (no . GABLE OR HIPPED ROOF(no windows): Subtract half the windows): Subtract half the distance distance between the highest p 'nt belween the highest point of the roof of the roof to the low point of the to the low point of the corresponding SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR HIPPED ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with T�'PE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance distance between the top of the between the top of the highest highest window and the highest window and the highest point of the point of the roof roof • ALL OTHER ROOF TYP (flat, • ALL OTHER ROOF TYPES(flat, mansard,etc):No sub ction. mansard,etc:No subtraction. ADDITION Add the distance between the top of slab SUBTRACTION Subtract the distance b een the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenUcrawl spa oor and the EXISTING the foundation. GRADES) highest existing gr e adjacent to the GRADES foundation OR feet(whichever is less). qUALS Defined building height EQUALS Defined b ding height Shoreland District MCWD Permit Received Avera e Lakeshore Set ck Met? Bfuff � Yes 0 No � N/A � Yes � No � Yes No 0 Yes 0 No � N Permit Number: Setback: Stormw er Quality Existing Proposed Variance Required CUP Req 'red Overl District Tier Hardcover Hardcover � Yes � No 0 Yes 0 No Type(s): Type(s): Updated: January 2013 v:\forms�plan review checklist 2013.docx � ' REMARKS (in-house): Fees to be Charged YES NO Permit X" Plan Review � �State Surchar e �� ' �� ,s � 9 � �� .�� .�� Investigation Fee SAC—Number of SAC Units =�� rv ,; , Other(specify) S uare Foota e $per S uare Foota e Basement X = $ 1 S`Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ Z,�� fLs� Orono Inspections Required Work Requiring Separate Permits Required State Permits 0 Site 0 Plumbing � Grading/ Filling � Well � Hardcover Removal � Mechanical � Fire 0 Electrical � Footing 0 Septic � Water Connection � Poured Wall 0 Fireplace 0 Sewer Connection 0 Foundation Survey � Masonry � Lawn Irrigation 0 Radon Rock Bed 0 Mfg. 0 Framing 0 Other(specify) � Insulation 0 As-Built Survey Final 0 Wetland Buffer � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES 0 NO New: � YES � NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\forms�plan review checklist 2013.docx �' , - - � � � -�- F-----------__------- � � ; �� Z i�� '1 , ' I � - _ _ __—_ _-- __ _. ___ .._... _ _ �.— �. — —� � � � I i ? c ; � - _ _____ ; _ __ _.___ � �--� _ __ .__ _ _ __-- -- - _ � ____ _--___ t� ______ I '�� __ ____ __ _ -_ ! _ _ _ _ _ _-- _--_ �, � � �-r� _. �_ �� g� � � sM-'C' � ' s � �'= ,� ` � �- � �'% " G(�� (""'�` � r� .� �y �' `� ' � � ; � �" � � � � �� ----- --- - � �._,-__- _ . . __ ._..___ ... _.._�__ .,. ..._._.. 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""'s►' C� � '' y ` 4 - I � � r - C"� � � � I I � ,� , y a �' ' `�, ° � _ _ _ _ _ - _..� __ -- - "'� -_ . .__ _ �:-_ � -� .,,,� � c. � ��c, 3 � - S m �� N � Z . __ __ � = 6 � � _ �_w_ C�m m __ __ __ .___.___� __ ._��. _._.____. o Q Q ��° � �- � -� n� � � m " � � � N �? _ ; ,.. y' c�- a R' t' ; � � a � o � o Q I— ,__ — _ _ v � � �- ° � Jl fA rt i .-� .� �s�'��- ��o � 'r' c�� t m � � : � � ti � � �A fD ro � � �.� , � c. � � 5 �• g � � D �-'� d � i _ _ _ _ � s" ^, � a ro c° � �r (�'. ___._ . . _ _ � �_�-��,. �� (� -' S � � �' v � cz �' � '� ID � i ui �. ��' :�7 � ' � �p �- �' iCJ m 'a�i � � N, ------- �i o, e� � �y � � I -- _—._—_ __ ___.. � �, � � _�� -- i k _ _ o � � U_�,� � c� � �� ;I N � ` � � o � � �,C � �j �� p.� �. t�qr � � ;�? � � p t.� ^ ♦/ � ` ; tT �� '. �. �� rn � ..�W __ ----_ _ ___ _.._.__ �. � __. _�_.___�_ �, _ __�.� - � u> �� _ _-- -� � ---- __ _------------�- � , t �' a. �t c%� " AT TIME � CITY OF ORONO CALLED IN Z� INSPECTION OTI HEDULED .� PERMIT NO l��77�g PLEfED ADDRESS `�`�a S �`�'�� OWNE � !��`-S��ELEPHONE NO. CONTRACTOR � DESCRIPTION �� 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT ��FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERlCONTRACTOR T MEET YOU:_YES_NO y COMMENTS: C�� r � I'�� J�/ � ne bt� � '�/"iG�i�� G�C �✓�S 0 ove r �lqr�� 1� ��t /'r.1O{- ' a � ° � ,�iov�i-✓e l�I�CX. y " O.dvKs• �a� I'�se�S W °� On Si%.e.rS — Q � z � ��= � d'r� ' °G �'h�v'��-�- .Oerv�� •�c.d�erJP j � ❑VYORKSATISFACTOFlIF PROCEED ' PROJECT COMPLETE RRECT WORK a PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORR CT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. all for the next inspection 24 hours in advance. (g52) 249-4600 ctor on site: J �S S Inspector: White Copyllnspector's File Canary CopylSfte Notics