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Home My WebLink About2013-01248 - addn/remodel/repair ' CITY OF ORONO � 2750 KELLEY PARKWAY * � 0 1 3 - PJ 1 2 4 B * DATE ISSUED: 12/03/2013 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-RESIDENTIAL VALUATION : $ 50,000.00 NOTE: SEPARATE PERMITS REQUIRED: FIREPLACE,ELECTRICAL(STATE) ADD GAS FIREPLACE MAIN FLOOR LIVING ROOM CONVERT MASTER FP TO GAS FP APPLICANT pERMIT FEE SCHEDULE 681.75 WIPO HOMES STATE SURCHARGE(VALUATION) 25.00 15623 NORMANDY LANE MINNETONKA, MN 55345- TOTAL 706.75 (612)396-6728 PAID WITH CC# 4038 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 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 l SO 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 conformance with the State Building Code.This permit may be revoked at any time for due cause. � !Z� 3 � /3 pplicant Permitee Signature Date Issued By Si ature /ate / SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED E. � G��3 � ., � City of Orono 'a �b� .�� Building Permit Application for Maintenance / Repiacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �OA,O Mailing Address: Permit number: 1Q0 3 ` D�2 $ �V PO Box 66 Crystal Bay, MN 55323-0066 Date received: t �'Z7-�.3 ,� � Street Address: Received by: �6J 5 � 2750 Kelley Parkway Plan review fee: 6� �lqkESN��G Orono, MN 55356 �,��3_ Q)Z, �: �3, ,� P d .� Main: 952-249-4600 Fax: 952-249-4616 v✓v:�.N,ci�rono,mn us This application form must be completed in full and all required information must be submitted. Incomplete applications will be retumed. (Please print) GENERAL INFORMATION: - .� C - �� , f Job Site Address: �<_l��C� � �i S 5 c_�C 1��>�� -� , j.��.�� _��. �--� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If yes,a special event permit is required wRh Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be r�quired unless applicant demonstrates sufficient on-site parking is available. Non-permitted ev�ents will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: UJ i 1� c �G.�-• �� State License# �G z�,,7��Z Expiration Date: 3 3 i i S Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) lQ lZ. - 3`((�" (;;7 Z S3 (office) Mailing Address: i�-� L 3 f�{�.��^-�-��-� �-::.�� C�tY� lti��nn�-��-F-��. ZIP: ��3y 5- Contact Person: � � �, ��i,��„� Applicant is: �Contractor�`� Homeowner (Circle One) Email and/or Fax: �,',�� w �� ,,,,�� , � � L..� PROPERTY OWNER INFORMATION: Name: � �:S��-� ��,,.,.( _�__�c s 1 � � lLc t l� �.. Phone(day): � �Z - y�� - 3 g 5�� Address: 2`l`1� 5�s s-2 x Z.:S. City: L��...1e--� ZIP: `a 5 3 .S �., Email and/or Fax: ;�;��,� , c o r�-� ;l�:�; �il �;.�.�i� I � r�.��. PROJECT INFORMATION: Overall ro'ect descri tion: ��•c; c;,^ �,,<�'w ,�w.:,n-C��_-- i��;�^� r%-� � �.;ucc�'� i��.?�:r -� Type of Project: Any earth movement may also require j"��''��'� ❑ Door(s) �Remodel ❑ Fire Damage MCWD review 8�permits: Minnehaha Creek Watershed District(MCWD) ❑Re-roof,asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑Re-roof, other(specify) ❑Siding ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) ,� ��_ �, ;�- � ,�,;;� or:- Estimated Construction Valuation of Project(excluding land) � ��, �� 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 altemative but to reject it until it is complete; • Some or all of the information that you are asked to provide on this application is Gassified 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 annualty update our records and records of other govemmental agencies required by law. If ou refuse to su I the information,the a lication ma not be issued. Applicant'sSignature: ��-��- t"-�'��'=��`-`�---- Date: �� 7 /3 Owner's Signature: Date: �� 3 Last Updated:03/06/2013 PLAN REVIEW CHECF(LIST FOR NEW STRUCTURES / ADDITIONS Address/Permit Number: 2.`1�� Sv f^s t x (Zont/� Description of work: ��.a,c e.. �, n��l o�,; Septic review by: N �f� Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: �t • 2� Zo�3 Grading review by: A Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF _% Survey Submitted: �Yes � No Date of Survey: _ Revised date(?): Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% _ #of Stories Ok? �YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the basement or crawl space)and the highest point 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 ROOF(no . GABLE OR HIPPED ROOF(no windows): Subtract half the windows): Subtract haif the distance distance belween the highest point between 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 . GqBLE OR HIPPED ROOF(with (BASED ON . GABLE OR HIPPED ROOF(with TYPE) 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 TYPES(flat, • ALL OTHER ROOF TYPES(flat, • mansard,etc):No subtrac6on. mansard,etc:No subtredion. ADDITION Add the distance between the top of slab SUBTRACTION Subtract the diatance between the (BASED ON and the highest existing grade adJacent to (BASED ON EXISTING basemenUcrawl space floor and the EXISTING the foundation. GRADES) highest existing grede adjacent to the GRADES foundation OR 10 feet(whichever is less). EQUALS Deflned buliding height EQUALS Defined buiidfng height Shoreland District MCWD Permit Received Avera e Lakeshore Setback Met? Bluff � Yes � No 0 N/A 0 Yes C No � Yes 0 No � Yes � No � N/A Permit Number: Setback: Stormwater Quality Existing Proposed Overla District Tier Hardcover Hardcover Variance Required CUP Required � Yes � No � Yes 0 No Type(s): Type(s): Updated: January 2013 v:\forms�plan review checklist 2013.docx /� /D� /� ��/)�'��C 1[� ��— / V ��/v ��. REMARKS (in-house): Fees to be Char ed YES , NO ` ��'�'' „�i/ b4?�S"k,.." .:C° ST�a'��'a� ,. q� �„, .�, ��.'k,.a°��Yn"P,1�k..w.a;=A�i` .,�'i.:t.'t,`M^s.�: �?�ca..,'�s��": i? .i sR";N ''A.'�. . Plan Review r� C^ ' % r P.�v aAa "a�A R. {- g �..�:Y y��'�{?.. Y `�� :. "� .� @ � tn, 4u.�. � x �_ � w.,Fv��. a.' ...r,�i,'"��'�, e�`. "d^�t:�[' �#"as�,' Yr _ �;`s�.� .2,�.�- Investigation Fee .. .... ; . .... ._ . ..r._W . . ��a —1 �'by�",' Yy ' �� +7�, �� ' � :1-.m r�' �9.v�. �1��,M1� ,.:.�fA�'"nn-Y�.. � _Js'- <.v� �. x.}. s#. _ Other(specify) S uare Foota e $ er S uare Foota e Basement X = � 1$`Floor X = � 2nd Floo� X = $ Garage X = $ on Estimated Construction Value: $ �� Oa Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site � Ptumbing 0 Grading/Filling 0 Well � Hardcover Removal 0 Mechanical 0 Fire � Electrical 0 Septic 0 Water Connection � Poured Wall �Fireplace � Sewer Connection � Foundation Survey 0 Masonry 0 Lawn Irrigation 0 Radon Rock Bed �Mfg. Framing 0 Other(specify) �Insulation G ys-Built Survey 1o�Final � Wetland Buffer 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES 0 NO New: � YES 0 NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\forms\ptan review checklist 2013.docx �—S �—"" DATE TIME � CITY OF ORONO CALLED IN I 'I '" INSPECTION NOTICE SCHEDULED /-��! ./' PERMIT NO,oZ�/3-�� COMPLETED ADDRESS � � OWNER TELEPHONE NO�S " '�7 CONTRACTOR - �; DESCRIPTION " � /� �77? � � ❑ FOOTING ❑ PLUMBING FIN ❑ EXCAV/GRADING/FIWNG y ❑ POURED WALL ❑ MECHANICAL R ❑ IAKESHORE/WETLANDS ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 COVEH REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbAT10N/REMOVAL 2 OWNERfCONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: o� � j O � O W � Q � � �� a ` J O � WORK TISFACTOFlY:PROCEED O PRW ECT COMPLETE W ❑ RRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PEHMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. ❑pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Call br the next inspection 24 hours in advance. (952) 249-46�� OwnedContractor on site: Inspector: White CopyAnspector's File C CopylSife Notke c<�C/� TE ,/ TIME ✓ CITY OF ORONO ALLED IN /- -�7` INSPECTION TICE SCHEDULED /- - •� PERMR N COMPLEfED ADDRESS � �/ OWNER TELEPHONE NO. � '� CONTRACTOR �{�� / � DESCRIPTION � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILUNG � ❑ PO ED WALL 0 MECHANICAL RI ❑ LAKESHORE/WEfLANDS O ❑ AMING p MECHANICAL FINAL ❑ TREE REMOVAL Z INSULATION ❑ WOOD BURNERIFIREPLACE ❑ SITE INSPECTION Q ADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � � FINAL ❑ SEWER HOOK-UP p COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: a� � � J O ). o� O W � Q � � W � � J d W RK SATISFACTORY:PROCEED ❑PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEEO O ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CAIL FOR REtNSPECTION TEMPORARY V BEFORECOWERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advaru:e. (g52 2 9-4600 OwnerlContraator on site: Inspector: VYhite Copyllnspector's Ffk ��Canary CopylSite Notiee DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. a�113-��SrY COMPLEfED ,!e-19/S� ADDRESS �`1' /�O �S S� �� OWNER TELEPHONE NO. CONTRACTOR ��d ��s � DESCRIPTION � s �' � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILIING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING p MECHANICAL FINAL ❑ 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. OLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERfCONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W � o T�l�s �,.��L �� ! 3- a�-/4� �. � d y rJo�� s . Q�o•r� w oe%�,t ° �- �o�� - o�o�� W � Q � W � w � J � ❑YVORKSATISFACTOR�PROCEED PROJECTCOMPLEfE w ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECO'VERING PERMANENT �CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR Wlll RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-460� OwnerlContractor on site: Inspector. ��^�� WAite CopyAnspector's Ffle Canary CopylSite Notice