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Home My WebLink About2012-00609 - addn/remodel/repair CITY OF ORONO * 2 B 1 2 — 0 0 6 QJ 9 * � L 2750 KELLEY PARKWAY DATE ISSUED: 06/28/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2990 SUSSEX RD PIN : 04-117-23-31-0020 LEGAL DESC : FOX BEND : LOT 3 BLOCK 4 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RES[DENTIAL ' VALUATION : $ 275,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) APPLICANT PERMIT FEE SCHEDULE 2,106.75 WILLIAM POHLEN STATE SURCHARGE(VALUAT[ON) 137.50 15623 NORMANDY LANE TOTAL 2,244.25 MINNETONKA, MN 55345- (612)396-6728 PAID WITH CC# 4038 Minnesota State License#: 20267452 OWNER KELLY,JUSTIN& SUSAN 2990 SUSSEX RD 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 governing this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of[he date of issuance,or if construction is suspended for a penod of 180 days at any[ime atter 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. ._ ��Y_/ 1��f�l � �� - �.��--�–�� "�"�L` c � / / Applicant ermitee Si ure Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ` City of Orono ' Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: ��t —�b 5 j�/�,0\ PO Box 66 \� � Crystal Bay, MN 55323-0066 Date received: 'a�P� a ! ��,�_ � ��-- p , ��, s,� StreetAddress: ceived _ T" �'.F, ' '��`�' GtiF 2750 Kelley Parkway �� Plan review fee: � 9. � / L9kE3H��`� Orono, MN 55356 .� d /� — d,Z� �O � �_--_= Total ee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us °' � j? � , �,h This application form must be completed in full and all required information must be submitted. { n�;��j ��1� Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: ` �1 � �� ' . ��c� 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: �;l I,q vi'1 �c`��t�,l-t State License# ? ��(d'7�f�L Expiration Date: ��J"3 I I7�1 3 Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: �� J Z —�4f� — �'7"Z_� (o�ce) (cell) Mailing Address: � ��,L3 �,,,,,a,�� (,�,,.� City: ti1-n n ZIP: '�j S ` L Contact Person: ;� Applicant is: ontractor� / Homeowner (Circle One► Email and/or Fax: �rj; , ( � �� p��,�,p,y�� u��y� PROPERTY OWNER INFORMATION: ` Name: �v SC.�YI C�n.GI c�i�S�,YI ��` r-�1 Phone (day): Address: °2 Cj(� Svs�� ip� CitY: Qi�'O►�-D ZIP: �3�1p Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) �Remodel ❑ Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ❑ Re-roof, other�specify) ❑ Siding ❑Other: (specify) Fax: 952-471-0682 ❑Window(s) vwuw.minnehahacreek.orq Overall Project Description: $c�d�,•-oc��,�� Gtre�( M,�t�;�r �oSe� 12,Q,vnooCGL Estimated Construction Valuation of Project(excluding land) $ 2?5, pCx7,<`��> 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 re uired b law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: "<z-�z-��—'�"z..,� Date: 4�Z � ��Z � Last Updated: 08-09-2011 Pian Review Checkiist for �lew Structures / Ad�ditions ` Address/PID:/LegaL ��I O SuSS� � t�q„� Description of uvork: ` /1/IA S�72 f��A�{ /�A'=-yv�•��P� Septic review by: N 1 1A Date AppcDved: �Zoning-reyieyv;by: Date Appro�red: . B.uilding review by: Date:flppcoved; �, � Z.4�,`� i "Z �ratling review by: �A! / 14 :Date�pproved: oning File#: ' Resolutian#: Resolutian Date: Zonin District Fir�e De artment Past Q�ce Sch I�Districf �oning: Lot Area: SF/AC ` Va/idth:- epth: - Survey Submitte . �Yes � Mo Date of`Survey: Rro: osed Setbacks: _ Front(Lake) •:Re �Str�et) � 'v� S E x1N 1 (' �1 S E V!I Other 8uildi�,gs �Rlle�land` ;Sitle ;Sitle ' ' Building Defined Height: Building Peak Height: ' ' #of Stories Ok?: 0 1�ES �FDR A BUILDING WITH J48�EIwENT OR'CRAWL- Pi4CE: F R A BUILDING ON A SL1►B FOUNQATIDM: START W4TH `the�distance:befiiveen the basem #loor/`ccawl START the.distance'between'the slab and the highest space floor and thefiighest roof pe the top of WITH roof peak,the top of the co.rnice of a flai roof, #he cornice afi a'flat roof,.the.�ieek lir�e< a the deck line of a mansard roof,�r�he ' mansard°roof,or the uppermost.pdint on roun uppermost,;point on a round or otMerarch,type : or otMecarch-; e roof roof SUBTR}�CT half the tiistance betanreen.the highest.wind d SUBTF�ACT half the distance#�efinreen.#he highest aiVindow ~hi hest rnof eak of a itched roof and hi hest ro�f. eak Qf a itched roof SUBTRACT the distance between#he basement fl r/crawl ADD the distance belweens#he:slab and the highest ` space floor anci the highest:existin cade with�n existin rade within the foundation thefoundation:orl0#eet,�whiche ris'less. QUAL:S Definedbuildin !hei ht EQUALS Defined builtlin ,hei ht . Lot�Coverage: SF a/o �hnreland':District � . D Permit i�eceived �4►v�ra: e=La �hoce Se�ba�k BiufiF� Yes 0 No � N/A ; ,n Yes 0 No 0 Yes � 'No � �les � Nn D N/A Permit Num.ber. Setbaek: Hardcover�nnes Existin Pro osed Uar-iance Re uiced CUP Re uired ' D 75' � Yes � No ` ,0 Yes � No 75 250' TYP�(S): TYP ): 250 . 00' 0-1`:000' RE RKS (in-house): t�l/' � C /--�74/�J�j� . Updated: D9/17/2009 z:lfortnslplan review checklistdocx Fees to be Char ed ��g �p _ >., , . r_ _.._ . :� .. , . . • :..._ . �.-_ _:. Pian Review � ' _ _ Rr ,_.. _ . „�, , ; . ...� , _., . Investigation Fee � > . , ; � . _ . �. ,:,,..�. . ....,.. .o....,_ .. Sewer Connection Park fee - Other(specify) _ __„�., Calc�rlated By; _ . . . S uare Foota e $ er:S uare Foota e Basement X ` _ � 1�':Floor X _ � 2nd'.FIooT' � X = � Garage .:.::,,. X _ $ -.:: Estimated Construction'Value: � Z'7�, C�O(� °= 4rona'inspections Required ' �llork i2eqwiring Separate Permits Required:State Permits D .Site ' lumbing � Grading /Fillin� G Well '� Hardcover Removal, Mechar�ic�l � Fire `Electricai � Footing � Sepfic � YVater Connection " 0 Poured Watl � Fireplace :� Sewer�onnection � Foundation Survey � Masonry � lawn lrrigation fl Radon Roak Bed p IUlfg. �Framing D �ther(specify) Jns�lation ,� As-Built Survey �Final D Other�specify) f�EMARKS(in-house): t�ther R�eview. Reviewed bY= Date AAproyerl: Access:Existing: 0 1'ES D ND 'New: � YES � `NO REMARKS (TO BE NOTED ON PERMIT AI�ID fN1T1�1LLED BY`PERSON PULLING'P�RM1T) Updated: 09/11/2009 z:\formslplan review check(ist.docx WdLL hldNiED K'.GE56_iRAr �/ \I TUB lIJ'x348' � I �\ /I L\-----_J _ 5..q. r � MASTER TILE CU STONE TiLE SHOWER, --I BATN F�� GL ENGL.W/FLOOR -- _-"� --- . BTONE TILE GElll Cl1RB�CW Cl1RB �N =_ NEW GNITY /I I 61wC. dI1GET� BTEAYI \ / ipP � 6HMt $WOWER 'I C 9 T� // \YJ� r - � 4 / I _ a]•uiGu rl W ° 5 E -r I WdLL W/ L gwqM GBOVE 55 I ❑ 01 6uELVES I SipN BEAT I I I I I I - I I STE GEN. I � � I I I I ��I � � - b�-n iia.��I �� lug u ` I� I �� " �n 5oFclr I IT � L��I I I� I I �6PD" MIRRpRED I I CGBI ETB I I �� J �I I z � ] FIELD VERIFY I ' �� II L---- iwcirzev�ace oaoR ne rxncx� �I n — I �-- - ------_--1 I I Ranirr, �b�,� I I I Y�-im• a•-s' __ �r----------��i I � ROBE NOGK e .. PFa�v�bE F�I.T WNDPL L__-_-- I HAn R ZIP WqLL FOR g BEOT II � �I� I 1` �rz� �I ou5,PieorEcrioN �I -- I I I u�-m ie•� - I�m oF exlsru+o � - � I I� � W A D}CLLERB� BEDROO�H J I m ,, �, g , _ ; , �,J �, � -- - � W �I � MASTER -- I � � I � I r \ m I��CLO.F � � i �i �� i i �, v �I�l w000 �coR � �y I � d �� I i � I O � iL�=F� �y�0 i i u i �-��i � i � Lz, - ,;, �� , L _ � W e L_ w 0 A 4'-10 3/4'��//e� NEW v NITY O SINK, GET� � � e iOP � � BQTN S I r.� GER iILE RE�'�OVE 60FFI I y.y r , F�-OUILD Exl6i.SwpLER L �y W W/NEW LINER PGN ANO � GER iILE WdLL6 30'NK.W r � �,W'i ^ ^ � U Q � MASTER BATH PLAN OPT 2 � MASTER BATH DEMO PLAN � �"�°x � �/a•-r� � ��4''�'-0' �_�.___ __. . .. - _ _°_ � M••�w z SE�ECtAL t`��?►TE � `'��z SEE ATTACHED SHEET Q w �° � � NO F�R �-� �1V�� L�c'r°.� - CQDE REQUL��'�ENTS �SS�E . ._.........�. ._..........��, "'.. _« JUNE 1.2012 REVISIONS JOB#12812 '� : ` { '�' � �'- �y, x:.;j 4!i d:^ � F i � _ s..�33��w...��`c�.:: � 4_•�:st ��v�'�'..: O,i•'�s5�:8��.A3Giei� .� ..�. sHeeTu — –-- _ -- – – — -------- FL;�N CH�CKE� 8Yd',�,/C�� nATE �- 2 � - 0 2- 1 _ 9� _--- ___ OF1 (..��f�''�,i v�,)` f�,�.. � :i I�.L i: :7 ._.`�:J C L.�LJ :=TY GLAZIiVG tkEQUlRED r`'t`�',�JVriu� �`�J�Ji� ��/J� E-'�_�Er�Ui�`'�� H�„L,�,�':?� T�;;:�;�v+�=�i �;�i= �'��:;",UCE�TALLE MASTER ��"4� � . BATN � , N � � � � � � I I I _ � I I I n ��-ii v4• I I � I I I � � I I I � � � � — � 2'-6� I � n III'-10' 4'-5' I � � I � � I ` �'-6 I/2' � I 0 II'-0 5/8' � II � � � I I - - — `� MASTER I I � � c° CLO_ � � I I I � I � ��f0 � I �n L _ �. v '% 4'-10 3/4' �' 0 � BATN "2 'v � � N , IVI�A,STER BATH PLAN 2 1 ��4■ _ �� , � ✓ �L�- DV�D�/ ��TE lI� TIME CITY OF OR CALLED IN � INSPECTION NOTI E /- �sc EDULED _Z� �� PERMIT NO. �� tlJ��COMPLETED ADDRESS `��C/� � S S��! � OWNER TELEPHONE NQ. �� 0�-0'3�� CONTRACTOR ��/ ��u r`� �IC,tor,6 ��b ; ?/� �: DESCRIPTION � �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ PTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YO�_YES_NO � COMMENTS: � W a � J O � '/ � r.� r� �i �-� � "��C-�"�'�%,/� � � C S� � W � Q z � 4? � .� �,� � c� T-� C�c��- � � �L `�-`f ��-- l A ��,� W � j GW �WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W d ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT Cl CORRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED -! STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTfON REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours irt ad��- "� OwnerlContractor on site: If1SDP�'�"" ��-� r/ ,� .� DATE TIME , / ,� � � �vZ- v CITY OF ORONO <:'"`�V CALLED IN INSPECTION NOTICE SCHEDULED -�7�� -ti2� PERMIT NO. "? � COMPLETED ADDRESS -S OWNER TELEPHONE NO. � ��% �� ?� CONTRACTOR �� v,��__�:�YYI(d.1J �: DESCRIPTION `�=��--� �a-�\� � ��'"� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/ LRI LING '� Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS� y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL , Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION�/? �G Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP = 0 DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ S P C FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACr TOR TO MEET Y _YES_NO � COMMENTS: � W C � � O � � O � W � Q ti Z W � W � � ��ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED G ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT 0 CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �952� 249-46�0 OwnerlContractor on sit : Inspector. � � � White Copyllnspector's File Canary Copy/Site Notice