HomeMy WebLinkAbout2011-00821 - deck attached CITY OF ORONO PERMIT NO.: 2011-00821
* ~- 2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 08/08/2011
952 249-4600 FAX: 952 249-4616
ADDRESS 525 TONKAWA RD
PIN 06-117-23-41-0098
LEGAL DESC MINNETONKA SUMMIT PARK
LOT 000 BLOCK 008
PERMIT TYPE ADDITION/REMODEL/REPAIR
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE DECK ATTACHED
ACTIVITY 434-RESIDENTIAL
VALUATION $ 3,500.00
NOTE:
REPLACE DECKING AND RAIL
APPLICANT PERMIT FEE SCHEDULE 103.25
HOLM,MR.&MRS. STATE SURCHARGE(VALUATION) 1.75
525 TONKAWA RD
LONG LAKE,MN 55356 TOTAL 105.00
PAID WITH CC# 6427
OWNER
HOLM,MR.&MRS.
525 TONKAWA 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 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
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requein nformance with the State Building Code.This permit may be
rev ed at y time for
A licant ermitee Signature Date Issu&By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address: Permit number:
PO Box 66
10 Crystal Bay, MN 55323-0066 Date received:
1J Received by:
Street Address:'
Kelley 2750
Y Parkwa Y Plan review fee:
Orono, MN 55356
Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.omno.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:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes gKo
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: A-J-�E- 1±.2�1 A
State License# Expiration Date:
Phone: - S . (office) (cell)
Mailing Address: TQ City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
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
[LNew Construction [ ,tingle Family with ❑ Residence
❑ Addition D.ec Lc_N , (— 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 ❑ Other(specify)
MCWD review &permits. ❑ Industrial ❑ 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) $ Soo
STRUCTURE INFORMATION:
1. Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction
a. Length (ft.)= Number of bedrooms= ❑ Wood/Frame
❑ Masonry
b.Width (ft.)= 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. 2nd Story=
f. '/z Story =
g.Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed Applicable
❑ ❑ Permit Application
❑ ❑ Proposed Building Plans
❑ ❑ MN State Energy Code Calculations and Mechanical Code Requirements Form
❑ ❑ Survey(meeting all requirements)
❑ ❑ Stormwater Pollution Prevention Plan
❑ ❑ Hardcover Calculation(s)
❑ ❑ Septic System Site Evaluation Report
❑ ❑ Access Permit
❑ ❑ Wetland Buffer Improvement Plan
❑ ❑ Engineered Plans for Retaining 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
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
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.
Applicant's Signature: Date: l
Of E TIME
CITY OF ORONO GALLED IN —
INSPECTION OT CE SCHEDULED
PERMIT NO
INSPECTION 4D9 Z/ COMPLETED
ADDRESS 52-5
OWNERI—IrAII(f elm TELEPHONE NO. M- X73 7515
CONTRACTOR
>; DESCRIPTION
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El FINAL ❑ SEWER HOOK-UP El COMPLAINT
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
LJJ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector .��
White Copy/inspector's File Canary Copy/Site Notice]