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Home My WebLink About2016-01476 - addn/remodel/repair �- •. CITY OF ORONO * Z 0 1 6 — 0 1 4 7 6 * 2750 KELLEY PARKWAY DATE ISSUED: 1ll30/2016 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRE S : 3115 SUSSEX RD PIN : 04-117-23-32-0015 LEGAL ESC : FOX BEND : LOT 004 BLOCK 002 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPE Y TYPE : RESIDENTIAL CONST UCTION TYPE : ADDN/REMODEL/REPAIR ACTIVI Y : 434-RESIDENTIAL VALUA ION : $ 50,000.00 NOTE: S PARA,TE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) REMODE BATH APPLICAI�TT PERMIT FEE SCHEDULE 715.92 PLAN REVIEW 465.35 M A PET SON DESIGN BUILD INC. STATE SURCHARGE(VALUATION) 25.00 6161 WO AL�AVE S EDINA, 55424- TOTAL 1,206.27 (952)925- 455 Payment(s) Minnesota tate License#: BUIL-6704 CHECK 65122 1,206.27 OWNER MARY RA KOB, DANIEL DELMORE& 3115 SUSS X RD LONG LA E, M�1 55356- AG EM�NT AND SWORN STATEMENT The work for hich tnis permit is issued shall be performed according to the approved lans and speci6cations,applicable City approvals,and the State Buildin Code. This permit is for only the work described and does not grant pe ission fer additional or related work which requires separate permits. All ovisions of laws and ordinances governing this type of work shall be comp d with whether or not specified herein.This permit will expire and be me null and void if construction authorized is not commenced 'thin 18p days of the date of issuance,or if construction is suspended for period of I80 days at any time after work has commenced. The applicant s respopsible for assuring all required inspections are requested in c nformance with the State Building Code.This permit may be revoked at an time fot due cause. J � ll/30�G � '� �r� /l l�l�.� Applicant �e itee � ature Date [ssued Signature Date I� i �� . � City of Orono B ilding Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) OA, Mailing Address: Permit number: -;/ � C� `� ! d. � !y PO Box 66 � � Crystal Bay, MN 55323-OOC6� �� Date received: � � � z� "/� �� Street Address: �� lo Received by: �� 2750 Kelley Parkway ��`� Plan review fee: ��E?Lf.e�� L � Orono, MN 55356 �' !1 kFs H�� ,�/ Total Fee: �p �a� . � 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. (P/ease print) GE ERAL INFORMATtON: Jo Site Address: "51 ►5 SusS�.�c ►�oa.dt. �o.+ l.�nc,.� , mrv K 5�5 V Wil this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No yes,a special event permit is required with Police Department and City Council approva/60 days prior to the event. Shuttle bus service wil/be required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. CO TRACTOR/APPLICANT INFORMATION: Na e: �'Y1q 'Pi.t-cr�Son Sta License# �}Lou�,-� o N Expiration Date: 3�3 i/Zo� g Lea Certification Number: N�yT- 232 i�- 2 Expiration Date: 4/ 22/2ozo ( r work on homes that were constructed prior to 1978 Pho e: (cell) (office) (952)�125 -��ts s MaiingAddress: Gi � � v�loodZd-.�..ic /�..w.wc City: �a2,�-.a. ZIP: ss�l2�i Con act Person: �or��;r�.,�� Applicant is: ontrac or / Homeowner �c�►�b o�B► Em il and✓or Fax: PR PERTY OWNER INFORMATION: Na e: T�,,,,. �- m o�,rh �r,I mo rc. Pho e(day): (q52�y73- 0$t S Add ess: 3tiS Swss<% 2oa.�- City: Lon� Laic.c ZIP: 5535� Em il and/or Fax: PR JECT INFORMATION: Overall project description: �� w�'f ��+ Typ of Project: Any earth movement may also require ❑ D or(s) �Remodel ❑ Fire Damage MCWD review 8�permits: ❑R -roof,asphalt ❑Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑R -roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ R -roof,other(speclfy) ❑Siding ❑Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 (�(Window(s) www.minnehahacreek.orq Esti ated Construction Valuation of Project(excluding land) a_ �O,Ooo APP ICANT 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 required by law. If ou refuse to su I the information,the a lication ma not be issued. �-��r^�— Date: � t �2 i�2 o i� Applic nt's Signature: � Owner' Signature: Date: Last Up ted:January 2016 I: • � . LAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS -, ^/ � / Addr ss: � l� � �ll SS�X 'd�(J Permit No.: ��1��`" �� Desc iption of work: Date Rec'd: �� Septi rev�ew by: /V Date Approved: Zoni g re�liew by: Date Approved: Build ng r view by: '� —Ct'i � Date Approved: � 5� � � Gradi g re�view by: Date Approved: Zoni g District: Zoning File#: Reso#: Reso Date: Zoni : Lat Area: SF/AC Width: Lot Coverage: SF % Surv y Sulbmitted: � Yes�\ � No Date of Survey: Revised date ? : , Land cape plan submitted? 0 Y�s � No Landscaper: Prop sed etbacks: % Fro t(L�ke) Rear(Street) `�, N S E W ) ( N�' S E W ) Other Buildings Wetland `� Side i' Side 1 � Defin d He ght: Peak Heig �FE: FFE minus 6 feet= (Existing Contour) � Perim ter( inear feet) = 50%T L.F. below grade Base ent?� � Yes 0 No, St ie�' � � FOR A UILD G WITH A BASEMENT OR CRAWL SPACE:� FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lo�vest proposed Slab at or above grade— START WITH floor(of the basement or cra�l space)and measure from hiphest existinp the highest point of the roof. `\ ra ade to the highest point of the START WITH roof even if fill was brought in to elevate home. If you have a... SUBTRACTION • GABLE OR HIPPED ROOF(�o Slab below grade—measure (BASED ON windows): Subtract half the distance from highest existing grade to the ROOF TYPE) between the highest point of the roof hi hest oint of the roof. tothe low point of the corresponding If you have a... gable or hipped roof �'�,\ SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE OR HIPPED ROOF(with � (BASED ON (no windows): Subtract half windows): Subtract half the distance ROOF TYPE) the distance between the between the top of the highest highest point of the roof to window and the highest point of the the low point of the roof corresponding gable or hipped roof • ALL OTHER ROOF TYPES(flat, . GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract the distance between the half the distance between � (BASED ON basemenUcrawl space floor and the the top of the highest EXISTING highest existing grade adjacent to the window and the highest GRADES) foundation OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES ; (flat,mansard,etc):No EQU/� S Defined building height subtraction. , Defined building height EQUALS 1 � Updated: Octo r 2015 z:\forms\ lan re iBw checklist 10-2015.docx � , , . Shoreland District MCWD Permit Average Lakeshore Setback g�uff Met? 0 Yes 0 No Permit Number: � Yes � No ❑ N/A � Ye No � � N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf � Yes � No 0 Yes 0 No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit � Plan Review State Surcharge !/` Investigation Fee SAC— Number of SAC Units Other(specify) Square Footage $ per Square Footage Basement X = $ 1 St Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ �-� �� Orono Inspections Required Work Requiring Separate Permits 0 Footing 0 Site Plumbing � Grading/Filling � Poured Wall � Silt Fence/Erosion Control Mechanical � Fire � Foundation Survey � Hardcover Removal � Septic 0 Water Connection � Foundation Waterproofing � Other(specify) � Fireplace � Sewer Connection raming ❑ Masonry 0 Lawn Irrigation Insulation 0 Mfg. 0 Landscaping � As-Built Survey ❑ Other(specify) Final 0 Lathe Required State Permits � Other(specify) 0 Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: 0 See Builder Acknowledgement Form 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 �•\fnrmc\nlan rcvia�ei rhorklict 1f1_7h1F rinrv i� � � D TIME � CITY O R O / CALLEDIN ��_ _� INSPE O CE ,1, SCHEDULED /- PERM O. � 7 COMP ED ADDR `� �IYNE LEPHONE NO � �o a� CONT AICT � '' DESC pTl ` �� D � ❑ FOOTI G. ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POUR D WAL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUN A710N ATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADO SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMI Q ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSU TION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑AS BU T-SU EY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO 91TE ❑ SEPTIC INSTALL i OMfN RTOMEETYW:_YES_NO � COMM N � - � � O � o � �- - � � � �Q/�� ° � �- Q �, ��- �� z � J �'-�.�-� [�✓ �` . � �� W � j tdt� SATiS TORY:PROCEED ❑PROJECT COMPLETE W ❑ RR CT K d�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORR Cfi K�LL FOR REINSPECTION TEMPORARY V BEF �O�V ING PERMANENT ❑CORR U FECONDITIONWRHIN HOURS. ❑pHOTOTAKEN I � WILLRETURN ❑CITATION ISSUED ❑STOP ER TED.CALLINSPECTOR ❑INS ON QUIRED.CALL TO ARRANGE ACCESS. cxaN r u�e next inspection 2a hours in advance. (952) 249-4600 ctor on sit�: In � ' CopyAnspecMr's FlN C�nary Copyl3Ms Notk:e �� DATE TIME CITY O R O CALLED IN �� -►7 �I$P O E HEDULED �'la-�—I 7 � _ p� �M a PERM O. i�� ADOR OMIN LEP ONE NO��' 3��-�� C � DESC IRTI ty ❑ FOOTI C ❑ DEMO-FINAL ❑ SEPT�C FINAL � ❑ POUR D,',WA ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLINO Q ❑ FOUN AtION ATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z � RADO $LAB ❑ MECHANICAL RI ❑ SITE INSPECTION � ❑ FRAM ❑ MECHANICAL FINAL ❑ RATED WALLS J �INSU T�ON ❑ WOOD BURNERIFIREPLACE ❑ COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑AS B Lr-S VEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ ❑ DEM -$ITE ❑ SEPTIC INSTALL r i dINN TO MEET YOU:_YE8_MO � COMM � 4 ✓Io�' l( - G G 0 a Dat/Vl aG ` � ' � ��E.�"i �6 T s k i¢ Se.c(e� — � � � �tl CD y� � — � � ' W � � � 4d1 SA CTORY:PROCEED ❑PFWJECT COMPLETE � ❑00 8 PROCEED O ISSUE CERTIFlCATE OF OOCURANCY W O ❑COR RK,CALL FOR REtNSPECTION TEMPORARY V BEF NO PERINANENT O CT FE CONDITION WITHIN HOURS. ❑pHpTO TAKEN WILL RETURN O dTAT10N ISSUED o PosrEn.c�►u i�croR p 1 IRED.C/1LL TO ARRAN(iE ACCESS. � u��u�s h�►�ce. (952) 249-4600 on sit� /�- po�np�c�or.Fa. Canap Covl�•Notla � i � � IDATE TIM ITY O OR NO CALLED IN INSPE TIO NOTICE SCHEDULED __^'�.",�.�7 PERM NO. �� ' �".�- COMPLETED � � ` �. ADDR �� L � S��_ � OWNE TELEPHONE NO.�k 1�- '� �� - (��j� CONT ACT R �}': � DESC IPTI�N �� C�- � �� 4~j ❑ FOOTI G I ❑ DEMO-FINAL ❑ SEPTIC FINAL ��(,(�%.� Q ❑ POUR D WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUN ATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADO SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMI G ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSU TION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J�FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BU LT-S VEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ � ❑ DEMO-SITE ❑ �/P�IC INSTALL 2 OWN HTiiAICTOR TO MEET YiOU:�YES_NO r• � c�.� COMM NTSk �:�. ',�i6�7G'G � 3"G`�7 � W � J r��tc��G _ o _ � s- � .� C•O ��r:��ors r �/ � ° �a/,� �a� l � •�- �s D� W � Q � 2 � � � ,,o/�vlJ </IC,AQi J � ❑WOR SATIS ACTORY:PROCEED OJECT COMPLEfE W ❑CORR CT NfaIRK d.PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � ❑CORR CT WQIRK CALL FOR REINSPECTION TEMPORARY V BEFO ECOV�RING PERMANENT ❑CORR CT U FE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN 1 SPE R WILL RETURN ❑CITATION ISSUED ❑STOP RDER�POSTED.CALL INSPECTOR ❑INSP TION FIEQUIRED.CALL TO ARRANGE ACCESS. Cal1�For the next inspection 2a hours in advance. (952) 249-4600 Q ctor on site: --, Ins or. ite Copyllnspector's File Canary CopylSite Notke I