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Home My WebLink About2012-01038 - addn/remodel/repair CITY OF ORONO * z 0 1 z - 0 1 0 3 8 * 2750 KELLEY PARKWAY �AT� [ssu�n: 10/17/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 � ADDI�ESS : 2080 SPATES AVE PIN : 10-117-23-31-0104 LEGAL DESC : N/A : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 30,000.00 NOTE: SEPERATE PERMITS REQUIRED:ELECTRICAL(STATE) INK[ND REPLACEMENT,NO CHANGES TO ADDITION APPWCANT pERMIT FEE SCHEDULE 466.75 DANBERRY BLDG CORP. PLAN REV[EW 303.39 5413 MANITOU RD TONKA BAY, MN STATE SURCHARGE(VALUATION) 15.00 (952)474-5990 TOTAL 785.14 Minnesota State License#: BC6389415 PAID WITH CC# 7499 OWNER MORSE,TERRY&CHRISTINE 2080 SPATES AVE WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work Yor which this permit is issued shall be performed according[o the approved plans and specitications,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 requices 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 conformanr�e th the State Building Code.This permit may be revoked at any time cause. , i� � � 7 :� �/ � /� Z `�/ (� / O ,� e Ap i e ign re Date �/`�'� ��CCL! � � �� Issued By Signature Date SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � City of Orono � - Building Permit Application for New Structures or Additions Mailing Address: Permit number: o��.�c�- C < <-�' 3�S"' O�,�,�.0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: l C.> - ��' � � Z' A J�� c��l:;��f Received by: �� . �} _ y-�J� ' � a �.�, �, Street Address:� , � �`,�, Gti`S' 2750 Kelley Parkway --- �f Plan review fee: '�j ' �� -V�`� L'�'Esxo4`� Orono, MN 55356 Total Fee: . �g -JN- . l�-/ 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: 2� �� a�� 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/APPL ANT IJaIFORMATI :/� �� Name: be,�►r State License# Expiration Date: ZO Phone: 2 7 �f v office t ZSD /d O cell fVlailing Address: /3 : � Cit : ZIP: 4 Contact Person: plicant is: Con ractor / Homeowner (Circle One) Email and/or Fax: ,e, � �,�, r� PROPERTY OWNER INFORMATION: Name: ,2/+r r S t Phone (day): ' .- .- s2+/ Address: Z�o tr0 S !� Cit : � ZIP: -�j� 3� Email and/or Fax ARCHITECT/EIVGIN R�1 FOR TIO�: Name: t ti ✓' Phone (day): .- `t�j a- Z Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal 8� Water Supply ❑ New Construction []�Single Family with esidence �dition attached garage ❑ Garage/Accessory Bldg. [�ublic 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 O� Estimated Construction Valuation (excluding land) $ ?j0, /4�/ Packet Last Updated: 03-06-2012 -21 - � STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= �Z Number of bedrooms= Q�ood/Frame ; ' b.Width(ft.)= 2� Number of garage stalls: ❑ Masonry Areas in spuare 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 application to be processed: Not Enclosed A licable ❑ ❑ Permit A lication ❑ ❑ Pro osed Buildin Plans ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ ❑ Surve meetin all re uirements ❑ � p Stormwater Pollution Prevention Plan � " � ❑ Hardcove�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 ❑ ❑ 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 exces&of$500; ' • Certifies that the information supplied is true and coRect to the best of his/her knawledge. 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 govemmental 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 temporary 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. Applicant's Signature: Date: � � Z Owner's Signature: Date: Packet Last Updated: 03-06-2012 -22- DA'1'A PRIVACY ADVISORY � tn accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd. 2, "Tennessen warning", we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under Minnesota State Statute 13.04 (see following page) to . review private data on yourself. 6. Your full name is required to process this application or permit. �l�I''e Jn�^ H.��'r' First Middle Last � � 3 r1'?��.: �+� �� Address � �3 � � C� 12 ZSa '1 �d o � City State Zip Phone I understand rights as st above. Signa ure Packet Last Updated: 03-06-2012 - 19- Plan I��uiew +�heckiist for New Structures / Additions Address/PIDJ LegaL Z C� 4J� SQI� TCS /��:- Descri,ption of work: �.C��h c_.�: t'o2C,f-4- �v�' �I •'� � , Septic review by: �V/!f Date Approved: Zoning revieanr by: �J�� Date Approved: ` Building re�iew'by: Date Appraved; /0-/�'�°� Z Grading review by: /�J �0'�' Date Approved: Zoning:File#: 'Resolution#: Resolution Date: � Zonin :District Fire'De artment Post O�ce Scho District ;Zoning: Lot Area: SF/AC V1lidth: Depth: Survey Submitt : .� Yes � No Date of`Sunrey: _ _ Pro osed Setbacks: Front:{L�ake) •Re (Street) ( N S E '��i11 ) ( N S E 'Vl1 Other'Buildin,gs Wetland Sitle Side Building Defined Height: Building Peak Height; #of Stories Ok?: � YES FOR A BUILQING WITH 11`B�ISEMENT OR CRAWL:SP : �R A BUILDING DN A SLl►B FOUNDATION: START�Ial1�H the distance between the basement' r/crawl START the distance`befinreen'the slab and the highest space`floor and#he highest roafi peak;#h op of WITH roof peak,the top of the cornice of a flat coofi, `the c�rnice of a flat roof,.the.deck Iine Df a the.deck line of a mansard roof,or.the mansard roof,or the up�ermost point oh a ro uppermost point on a round or other arch-type or other arch= e roof roof SUBTRACT half#he distance between:thefiighest:wi oaw and SUB'TRACT halfthe distance:between#he h'rghest window `fii hest roofi eak ofa itched roof and hi hsst roof: eak of:a itch.ed roof SUBTRACT the distance betweert the basemenf or/crawl DD #he distance between the.slab and'the highest space floor and the highest ex'rsti geade-within e�cistin rade�vithinthe`foundation `the fioundation or 10 feet,which er isiess. EQU 'S Defined buildin hei ht EQUALS Defin�d:buildin hei ht Lot Coverage: SF % Sh�rsland:Distcict �111D f�ermit Received -aAv$ra e,Lakesho Setback Blu�f Yes � No � N/A � Yes � ;No � Yes G No � Yes ;� No °N/A ; Permit Number. Setback: Hardcover;Zone Existin Pro osed Variance Required CUP Re uired D-75' � Yes ❑ No � , es � tVo 75 25 TYPe(S)� TYpefs): 25 -500' 00-1000° ;REM,�RKS (in-house):�L�1_L��r�� /�-��°f/�C� ✓Y�l�' .'✓0 C�o'i-,-�' •/ Updated: 09/17/2009 . z:\formslplan review checklist.docx Fees to be Char ed 'YfS : �10 : .„�,. _ _ . , __ . , � Plan Review _. �. -�.�,»�r _...___ ,�_ _. ,..,,. _ . s _ __ .. .. . . ; . ... - . . _ , Investigation Fee ' :,.,4.: _ . . _ . . .....: ,_ _ Sewer�onr�ection . ... . _ ,... -.. . , _ . "Park f.ee - Other'(speci#y) Calcu�ated.By; _ S uare Foata e $ er uare Foota e Basement � _ $ 1�Fioor X = � �nd_FIooT � :�: _ ,$ Gacage �( _ � Estimatetl Constr��tion Value; � 30,O(Ya�-- Orono'tnspec#�or�s Required #llark Requiring Separate P�rmits Required State Permits O :Site - � Plumbing D Grading!Filling G WeU Q Hardcover Remo�ral � G 'Mechanical � Fire Electrical Footing � Septic � Water Connection � Poured VVall � Fireplace D Sewer.Connection 0 Fonndation Survey � Masonry n Lawn lrrigation ` �;Rarinn;Rock Bed ' p Mfg. <Framing D Dther(specify) `. `ins�aiation � ' s-Built Survey Final : G Other(specify) REIVIA�KS (in-��use): Other�Feview: 1�eyiewed:by: Date.�lpproyed: Access:Existing: ,� YES L7 NO New: �� YES G ND REMARKS(TU BE NOTED"ON PEFtMIT Ai+�1D I�VITI�ALLED 8Y:PERSDN PULLING PERMIT) Updated:-09/11/2009 z'\formslplan review chedclist.doac �� DATE TIME � CITY OF ORONO CALLED IN �b -�7 INSPECTION NOTIC SCHEDULED ��Z �a� PERMIT NO.ad -'D D3gCOMPLETED ADDRESS ��D �� OWNER TELEPHONE NO. ��Z Z�D 7/U75 CONTRACTOR � DESCRIPTION �O6 ��n '�1 � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAI Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FO�LOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO ��., COMMENTS: � W C J O �. � O � W � Q � 2 W � W � � O W� �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPEC710N TEMPORARY V BEFORECWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-4600 OwnedContractor on site: Inspector. � ►i< White Copyllnspector's File Canary CopylSfte Notice �� D TIME V CITY OF ORONO CALLED IN �� INSPECTION NOTICE SCHEDULED —��— O• � PERMIT NO.�Q102—Dl D3g COMPLEfED ADDRESS a-�BO S� �,lJ�� _ OWNER TELEPHONE NO. ��2 z�7 2�7 ZS� � CONTRACTOR � DESCRIPTION Fr - a� � � FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q � POURED WALL ❑ MECHANICAL RI ❑ IAKESHORFJWETLANDS y FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z Lj] INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � �FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑IDEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ pLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OW�:ER/CONTRACTOR TO MEET YOU:_YES_NO � CO�VIMENTS: W I a � � O � � O � W � Q � Z W � W � � � '�14fQRK TISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRE T WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORREC WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE OVERING PERMANENT ❑CORREC UNSAFECONDITION WiTHIN HOURS. p pHOTOTAKEN iNS CTOR WlLL RETURN ❑STOP ORD R POSTED.CAIL INSPECTOR ❑CITATION ISSUED ❑ INSPECTIO REQUIREO.CALLTOARRANGEACCESS. , Ca1 for the next inspection 24 hours in advance. (952) 249-4600 OwnedCon actor on ite: Inspector. � Wqite Copyllnspector's File Canary CopylSite Notice � �� (_ I�� DATE TIME �,/ CITY OF ORONO CALLED IN I I ��I `l�� ERM TTNON �C � �� C'/U�S SCHEDULED !l- L��v� (.T 7 COMPLETED ADDRESS % �� S ' �C.r� ��'�. OWNER TELEPHONE NO. �� '7�7y �� CONTRACTOR �t�'1��.r/'L/ ��" • �: DESCRIPTION �7 S �z /�z r� �:rt �'�G�rc`� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q p POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINA ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES�NO � COMMENTS: � W a 0 5 j �6�- `-� �i� M �. � 0 � W � Q ti Z W � W � j � WO KSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN �STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �95Z� Z49-46�� OwnerlContractor on si Inspector. � � ;,Z _- � White Copyllnspector's File Canary CopylSite Notice