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Home My WebLink About2011-00302 - outdoor fireplace CITY OF ORONO PERMIT NO.: 20��-00302 ` � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 05/20/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 395 SUSSEX LA PIN : 04-117-23-24-0007 LEGAL DESC : FOX BEND : LOT 006 BLOCK 001 PERMIT TYPE : ACCESSORY STRUCTURE PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : OUTDOOR FIREPLACE VALUATION : $ 44,000.00 NOTE: ADV.PLAN REVIEW FEE 20 1 1-003 0 1 OUTDOOR KITCHEN i ; APPLICANT pERMIT FEE SCHEDULE 617.25 ; MANTIS DESIGN&BUILD � STATE SURCHARGE(VALUATION) 22.00 � 465 NEWTON AVE S i MINNEAPOLIS,MN 5540� TOTAL 639.25 � (612)377-0123 PAID WITH CC# 1537 Minnesota State License#:20470400 OWNER CAMPBELL,JON&SUSAN 395 SUSSEX LA 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 j not grant permission for additional or related work which requires sepazate ;j 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 � .5uspended 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 conformance with the State Building Code.T ' permit may be re at any tim r due cause. S� 20 � // � , �� / � . App icant ermitee S r Date Iss By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. I � � , ��`, /�" V��\" ��1 City of Orono r � � . � 3 Building Permit Application � for New Structures or Additions Mailing Address: 020!/- ��,�,jV. PO Box 66 Permit number: OD3D Z._- �� Crystal Bay, MN 55323-0066 Date received: 5'$` /1 �I �� '� I Received b �� 1�,a �'�t�,�;•:� �,�, Street Address:� y� ��'�,c, � . �„':'� Gti/ 2750 Ketley Parkway Plan review fee: ,�d//-003D/ �t.�Es�og,� Orono, MN 55356 0 .2../ '-___-' 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: �:'�� S�';s�x �,�;ti P_ G�'��v�-� �� S3 S�' Will this be a Parade of Homes, Remodelers Showc ome or other`Display Home? ❑ Yes � No If yes,a special event permit is required with Pofice 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/APP ICANT INFORMATION: Name: � ',� r e<<�` -��a/f`S � ' .� t/��, �o� State License# p • p Q Expiration Date: � Phone: � � Z �Z ��%/ (ofFice) (cell) Mailing Address: Cit : � ZIP: � ;s'r�� Contact Person: ' � � � � Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: E'/ -- - _-U� PkOPERTY OWNER INFORMATION: Name: .)n.� '!- S ii S'a� �ra�'J�� Phone (day): �Z -, ��( -6�'y�� Address: �3 c[ S S'��s e�,�/�,7 C� City: CT.J/'c+,�� z�P: -�r3 s� Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & 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 �Othe�(specif�r) MCWD review&permits. ❑ Industnal �9�'�.-Jr,�,,r- (�'� �[1-tP� ❑ 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) $ � � � � ' , STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= �Z. Number of bedrooms= � (�Wood/Frame �Masonry b.Width (ft.)= �g Number of garage stalls: ❑ Metal Attached= � ❑ Pole Bldg. Areas in square feet Detached=�_ ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1St Story = ❑ Other(please specify): e. 2"d Story= f. 'h Story = g.Total Area= RtQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable � ❑ Permit Application � ❑ Pro osed Buildin Plans � ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ ❑ Surve meetin all re uirements �� ❑ Stormwater Pollution Prevention Plan k=: � ❑ Hardcover Calculation(s � ❑ Septic S stem Site Evaluation Report � ❑ Access Permit � ❑ Wetland Buffer Im rovement Plan s� � ❑ En ineered Plans for Retainin Walls 4 feet or above � ❑ Plan Review Fee ❑ ❑ Other APPLICANT 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 4� 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 k� 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 agreement to ensure completion of the as-built survey and all site improvements. �� ;� ,S'- S- l/ ApplicanYs Signature: Date: � �� Plan Review Checklist for New Structures / Additions Address/ PID/Legai: _ .> Z � .SvS�P K � � Description of work: Septic review by: Date Approved: �'' ( � � � � Zoning review by: � �� Date Approved: � `�� I Building review by: Date Approved: S � ��i ' � � Grading review by: �//�- Date Approved: Zoning File#: �---" Resolution#: Resolution Date: �� Zonin District Fire De artment Post Office School District , t Zoning: Lot Area: �-�rTZ— SF AC Width: Depth: Survey Submitted: �0'�es 0 No Date of Survey: �.�J � Pro osed Setbacks: Front (J.a�ke� Rea N et) � N S� W � � N Side W � Other Buildings Wetland i �1�� L��fJ' '�` --- �' - Building Defined Height: N/} Building Peak Height: �V� #of Stories Ok?: � YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement flood crawl START the distance between the slab and the highest space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the dec ' e of a the deck line of a mansard r�nfre�the- mansard roof,or the up st point on a round uppermost poi �I und or other arch-type or other arch-t e roof SUBTRACT half the dis e between the highest window and SUBTRACT e distance between the highest window hi he of eak of a itched roof and hi hest roof eak of a itched roof SUBTRACT t istance between the basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet,whichever is less. EQUALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: SF % Shoreland District MCWD Permit Received Avera e Lakeshore Setback � Bluff 0 Yes � No /A 0 Yes No 0 Yes �o � Yes � No N/A Permit Number: Setback: Hardcover Zones Existin Pro osed Variance Re uir CUP Re uired 0-75' � Yes No 0 Yes No 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Charged YES NO Permit.h - -� ,,.x _ . Plan Review �State��rcMarg� _ _ Investigation Fee "':574C :�I+I�rrt'b�r of�SA'G l�n°its - 3 , . . _ . _ Sewer Connection ;�;lVa�e�C,on��ction �.� , _ - = � �.. �� Park Fee "�J��I��V��G.� i-:_ F :�1,!` Other(specify) "�I�scella�eoWs Fees' � .x z , ,:' ' �' : , a:, Calculated By: S uare Foota e $ er Square Foota e Basement X = $ 1 gt Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ 35�,!t�o°`—' Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing � Grading/ Filling � Well 0 ardcover Removal 0 Mechanical � Fire � Electrical Footing 0 Septic 0 Water Connection 0 Poured Wall � Fireplace � Sewer Connection 0 Foundation Survey 0 Masonry � Lawn Irrigation � Radon Rock Bed � Mfg. � Framing � Other(specify) 0 Insulation 0 As-Built Survey 0 Final 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: � YES 0 NO New: � YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.docx �j,�� I��Q� DATE TIME ✓ t/ CITY OF ORONO CALLED IN _��L�� INSPECTION.�LQ I�E m��SCHEDULED _g'� __�� PERMIT NO. r�� '" COMPLETED ADDRESS ��` S �- -z �c c�� OWNER TELEPHONE NO. �� b�7�� CONTRACTOR ,�'�''1'�� 5��? � DESCRIPTION /"i !�1�-�` �(,��1�%C/�h-�� t� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ 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 _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL�� ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_[!NO C`�Y C�[i-�(`,� �' C�� 3 � COMMENTS: ! V1 C,' � IJ i{1C- {� ��t� W C � � O a � O � W � Q � Z W � W - � � Ldu ❑WORK SATISFACTORY:PROCEED L�ROJECT COMPCETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT flCORRECTUNSAFECONDITiONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN _O STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�0 OwnerlContractor on site: ' Inspector. � � � White Copyllnspector's File Canary CopylSite Notice