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Home My WebLink About2014-00643 - addn/remodel/repair ' CITY OF ORONO * Z 0 1 4 - 0 0 6 4 3 * � 2750 KELLEY PARKWAY DATE ISSUED: 06/25/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRES : 31 15 SUSSEX RD PIN : 04-117-23-32-0015 LEGAL ESC : FOX BEND : LOT 004 BLOCK 002 PERMIT XP : ADDITION/REMODEL/REPAIR PROPER Y T E : RESIDENTIAL CONSTR �TI N TYPE : ADDN/REMODEL/REPAIR ACTIVIT : 434-RESIDENTIAL VALUAT ON : $ 1I5,000.00 NOTE: S �RA PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) KITCHEN M EL APPLICANT PERMIT FEE SCHEDULE 1,146.75 STATE SURCHARGE(VALUATION) 57.50 M. A. PE S DESIGNBUILD 6161 WO D A AVE. S TOTAL 1,204.25 EDINA, 'S5 4 Payment(s) (952)925- 455 CREDIT CARD 7738 1,204.25 Minnesota tate 'cense#: BUIL-BC006704 OWNER MARY SKO DANIEL DELMORE& • 3115 SUS EX LONG LA �, 55356- AG �E NT AND SWORN STATEMENT The work fo which is permit is issued shall be performed according to the approve pians specifications,applicable City approvals,and the State Buildi g Code This permit is for only the work described and does not grant pe issio r additional or related work which requires separate permits. All rpvisi s of laws and ordinances governing this type of work shall be com iad wi whether or not specified herein.This permit will expire and b come I and void if construction authorized is not commenced ithin 0 days of the date of issuance,or if construction is suspended f a peri of 180 days at any time after work has commenced. The applic is res sible for assuring all required inspections aze requested in omfo nce with the State Building Code.This permit may be revoked at y time r due cause. / / Applicant ertnit Signature Date Issued By Signature Date ti � � . �� o� �. City of Orono B iild g Permit Application for Maintenance / Replacement / Renovation o structural expansion. Only windows, doors, siding, re-roof, etc.) Mailing Address: Pertnit number: f —� O PO Box 66 Crystal Bay, MN 55323-0066 Date received: "� Street Address: Received by: T'" � �` 2750 Kelle Parkwa �j y�. G Y Y • Plan review fee: � 4 Orono,MN 55356 a��_ fs �' � 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) GEN � NFORMATION: Job i e dress: 31 �5 SUSSe,x Road�� O�ono �rv1N 5535` Will h�s b a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If es,a cial event permit is required with Police Department and City Council approval 60 days prior to fhe event. Shuttle bus seMce will be required unless applicant demonstrates sulficient on-site parking is available. Non-permitted events will not be allowed. CON RA OR I APPLICANT INFORMATION: Nam : , WI A Pt�tu'son 'i�c.s�qr� '(3u,il�k State L�ce # �C 0067�`� Expiration Date: 03/�i/2oi� Lead rti tion Number: N qT_232 i7-� Expiration Date: �H/o$/zo i 5 (fo �or n homes that were consbucted prfor to 1978 Phon .� (cell) (office) as2-q25-q�is4 Maili iAd ss: (,I G 1 Wo aa�t l�vtnu�c. S oc�wa. City: E��+d ZIP: 55H2M Cont ct Pe on: �o�Y�F3irw.�a.+�9- Applicant is: ontracto / Homeowner (CircleOne) Email and/ Fax: ��. y;�ksla�i rr�o,.Pt,he.rs.n. c,or+�, PRO ER OWNER INFORMATION: Nam pV�0.f� �r �aw+ l�elmo�t Phon (�iay G�y2 ��3- u&t S Addre si: 3115 SuSStX '2oarR City: Oron�o ZIP: 553'f� Email rid/o Fax: PRO EICT FORMATION: Overall ro'ect descri tion: Type roj t: Any earth movement may also require ❑Do (s) � Remodel ❑ Fire Damage MCWD review 8 permits: ❑Re-�of,a halt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑Re- qf,c ar ❑ Restoration ❑Water Damage Deephaven,MN 55391 ❑Re- of,o er(specify) ❑Siding ❑Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.ora Estim ted nstruction Valuation of Project(excluding land) a 1 l 5 .ooe APPLI N ACKNOWLEDGEMENT: • A r�es provide all information required or requested by the Building Department; • C r�ifie hat the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are s lely r ponsible for submitting a complete application being aware that upon failure to do so,the staff has no altemative but to r e�t it til it is complete; • S rrle o all of the information that you are asked to provide on this application is classified by State law as either private or c nfide I. Private data is information which generally cannot be given to the public but can be given to the subject of the data. C nfide al data is information which generally cannot be given to either the public or the subject of the data. Our purpose and in nde se of this information is to annually update our records and records of other governmental agencies required by law. If efu to su I the information,the a lication ma not be issued. Applica Y Si ature: �� y��Q Date: OG�?'j�2o/�( Owner' Slign ure: Date: Last Upda ed:03 /2013 LAN REVIEW CHECF(LIST FOR NEW STRUCTURES / ADDITIONS Addr s�/P mit Number: '7l(� ,5.>;5�x (t.t�A-✓� Desc iptio of work: 1� ��t.�l,� 1 c.t;vrvo,�-Q�- 6e ic review by: t�tf J �1 Date Approved: Zo g review by: //? Date Approved: Bui ing review by: w�,�— Date Approved: � - 2S -- !C� Gr ing review by: /V /,� Date Approved: Zonin ict: Zoning File#: Reso#: o Date: Zonin : Lo rea: SF/AC Width: Lot Coverage: SF _% Surve $u itted: Yes 0 No Date of Survey: Revised date � : Pro o eid tbacks: Fro tl(L e) Rear( eet) ( N S E W ) ( N S E W Other Buildings Wetland Side Side Define Hei t: Peak eight: FFE: FFE minus 6 feet= (Existing Contour) Perim ter(I ear feet) = 5 0 = #of Stories Ok? � YES FOR A UILDI WITH A BASEMENT OR CRAWL SPA E: The distance between the lo st FOR A BUILDING ON A SLAB FOUNDATION: ST T WITH proposed floor(of the baseme or crawl space)and the highest point of t roof. START WITH The distance between the top of slab and If you have a... the highest point of the roof. GABLE OR HIPPED ROOF o If you have a... ' • GABLE OR HIPPED ROOF(no windows): Subtract half th windows): Subtract half the distance distance between the hig st point befween the highest point of the roof of the roof to the low po of the to the low point of the corresponding �SU RACTION corresponding gable o hipped roof SUBTRACTION gable or hipped roof '�(gq D ON ROOF . GABLE OR HIPPE ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with TY windows): Subtr half the ROOF TYPE) windows): Subtract half the distance distance betwe the top of the between the top of the highest highest windo and the highest window and the highest point of the point of the of roof • ALL OTH R ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat, mansa ,etc):No subtraction. mansard,etc:No subtrection. ADDITION Add the distance between the top of slab SUB CTION Subtract distance between the (BASED ON and the highest exis6ng grade adjacent to (BA D ON EXISTING baseme crawl space floor and the EXISTING the foundation. G ES) highe existing grade adjacent to the GRADES foun ation OR 10 feet(whichever is less). EQUALS Defined building height EQU S D med building hefght S otei d Distri MCWD Permit Received Avera e Lakeshore Se ack Met? Bfuff 0 Yes 0 No � N/A 0 Yes � No � es No 0 Yes � No 0 Permit Number: Setback: - Stor �r Quality Existing Proposed Variance Required CUP Re ired Over Di rict Tier Hardcover Hardcover � Yes � No � Yes 0 No Type(s): Type(s): Updated: a ua 013 � F�'�� v:\forms�pl n evi checklist 2013.docx �(� � i REMARKS (in-house): Fees to be Char ed YES NO Perrr�it �' � �''' Plan Review ; Stite:�Surct�a�s . Investigation Fee ��1C ;�.�Ir�ra�er;:+c�f.S�"C°.�n9t� LL k � l�,,��,. . , Other(specify) S uare Foota e $ er S uare Foota e Basement X - $ I 1 S�Floor X = $ 2nd Floo� X _ � i Garage X - � O� Estimated Construction Value: S � ��, l�� Orono Inspections Required Work Requiring Separate Permits Required State Permits ' G Site Plumbing 0 Grading/Filling 0 Well � Hardcover Removal �llechanical � Fire Electrical � Footing � Septic 0 Water Connection � Poured Wall 0 Fireplace O Sewer Connection 0 Foundation Survey 0 Masonry � Lawn Irrigation 0 Radon Rock Bed 0 Mfg. �Framing � Other(specify) � Insulation � /4s-Built Survey �Final � Wettand 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:lforms�plan review checklist 2013.docx Jv� D TE TIME V CITY OF ORONO CALLED IN �`�� INSPECTION TIC SCHEDULED 7-� � PERMIT NO. "� COMPLETED ADDRESS 3�/5 SG4�� OWNER TELEPHONE NO.d�Z �� I��-- CONTRACTOR ��PE�� DESCRIPTION r � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI 0 IAKESHORENVETLANDS O �RAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q p RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FO�LOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: ��. Q Z " �k a - n e w �oc. �N �xt- i,.��, c r— 0 `� �0 ttt 1 5 t 2 s �i�a �Ap d '�6 1..�r K��c,,J ^ � � /f C tJ q�/' � .a�c� e�✓'�, � � 0 � --- � . W � OK �� h Str�� Q � 2 W � W � � d � SATlSFACTORY:PROCEED ❑ PROJECTCOMPLEfE W CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE CONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED �INSPECTIONREQUIRED.CALLTOARRANGEACCESS. C or the next m ion 24 hours in advance. (g52) 249-46�� Ownerl tractor on site: � Inspector. � White Copyllnspector's File Canary Copy/Site Notice �� TIME v CITY OF ORONO CALLED IN �� INSPECTION NO I SCHEDULED " �'� �� PERMIT NO. d�� COMPLETED ADDRESS 3/!5 S�-aa-Q� 6� OWNER TELEPHONE NO��Z 3�Z �� CONTRACTOR �� >; DESCRIPTION /�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ P RED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS y ❑ RAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z SULATION ❑ 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 FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � O � W � Q � Z W � W � � d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ IPiSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advanc,e: 2� 249-46QQ OwnerlContractor on site: f � Inspector. �l _ r. White Copyllnspector's File ;:,Canary Copy/Site Notice ATE � CITY OF ORONO CALLED IN CI � � INSPECTION OTICE SCHEDULED % PERMIT NO. � COMPLETED ADDRESS OWNER TELEPHONE NO. CONTRACT�R ��--�P..T r3� � ��r1�«�-�-� � DESCRIPTION • '�' C tu ❑ FOOTING ❑ PLUMBIN AL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS h Q O FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNERlFIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL � SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL � FOUNDATION/REMOVAL 2 OWNERICONTHACTOR TO MEET YOU:_YES_NO c�n COMMENTS: � a S � � O a � 0 � W � Q � 2 W � W � � J W ❑WORK SATISFACTORY:PROCEED ROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALI INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours i advance. (g52) 2 9-460� OwnerlContractor on site: � Inspector. White Copyllnspector's File Canary CopylSite Notice