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Home My WebLink About2012-00222 - addn/remodel/repair CITY OF ORONO * 2012 00222 * 2750 KELLEY PARKWAY DATE ISSUED: 04/09/2012 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS 1075 TONKAWA RD PIN 08-117-23-13-0002 LEGAL DESC AUDITOR'S SUBD.NO.217 LOT 006 BLOCK 000 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 40,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) INTERIOR REMODEL-REFINISH 1/3 OF LOWER LEVEL AND ADD BATHROOM ON 2ND FLOOR APPLICANT PERMIT FEE SCHEDULE 574.25 REVISION LLC 10985 OAK SHORE TRAIL STATE SURCHARGE(VALUATION) 20.00 DELANO,MN 55328- TOTAL 594.25 (952)540-7150 Minnesota State License#: BC639027 OWNER SANFT& SARENA LIN,CHRISTIAN 1075 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 requested in confor with the State Building Code.This permit may be revoked at any t' fo due caus / / 1Z Applic e rtee hte Issued By S#nature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ` City of Orono Building pp Permit Application for New Structures or Additions Mailing Address: Permit number: 0PO Box 66 Crystal Bay, MN 55323-0066 Date received: 0-46-13 Received b 1�6s Street Address:' y �cn rt xv o` 2750 Kelley Parkway Plan review fee: 373. 2L Orono, MN 55356 ESKo, c;2 o 0 -o o a a i 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) GENERAL INFORMATION: Job Site Address: S T0ty t,0WA Qa Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No !f 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: State License# Z Expiration Date: 3/3t Phone: q lZ 7 SLID -7150 (office) �7- (cegl) Mailing Address: 7o1,1-7 )6u-7-e—+1 Rl\)A City: Qq 011'S ZIP: SS�12 Contact Person: `�_ g-l� Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: o\rIAAI- (z-,)a U 1 ;j AJ , G onn PROPERTY OWNER INFORMATION: Name: G[ArI's Phone (day): Address: �c��S �i,n�y4�c� ��] City: (kQ8z6 ZIP: 5631 Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: �/,F?Kvl.��e� L!iA) Orbv>° Phone(day): Address: G Ie,- S771 City: Z.4, ZIP: 3� Email and/or Fax: PROJECT INFORMATION: A,,00M On �yJd r/oo IF- 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal& Water Supply ElNew Construction ElSingle Family with 'S Residence ❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial Other: (specify) P.NUo(-,e_I ❑ Multiple Family/Condo El Private Sewer p y ❑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) 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. 151 Story = ❑ Other(please specify): e.2nd Story= f. 'h 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 ❑ 1IS1 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: Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: "7 �`,'� ,` �`/4 Description of work: onI Septic review by: Date Approved: Zoning review by: N--"/ Date Approved: Building review by: ^^ Date Approved: 3 1 Z Grading review by: N fy t Date Approved: Zoning File#: Resolution#: Resolution Date: Zoning District Fire Department Post Office School District L.R.-V6 Zoning: Lot Area: •SY SF(Fq Width: � � Depth: 270 Survey Submitted: G Yes TKN o Date of Survey: Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Building Defined Height: N Building Peak Height: N #of Stories Ok?: YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl START the distance be the and the highest space floor and the highest roo eak,the top of WITH roof peak,the top of cornice of a flat roof, the cornice of a flat roof,th eck line of a the deck line of ansard roof, or the mansard roof,or the up rmost point on a round uppermost nt on a round or other arch-type or other arch-type r roof SUBTRACT half the distanceetween the highest window and SUBTRACT h e distance between the highest window hi hest roof ak of a pitched roof 4nd highest roof peak of a pitched roof SUBTRACT the dista a between the basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existing rade within the foundation the foundation or 10 feet,whichever is less. EQUALS Defined building height EQUALS Defined building height Lot Coverage: SF % Shoreland District MCWD Permit Received Average Lakeshore Setback Bluff 0 Yes 0 NoN/A 0 Yes 0 No Yes 0 No 0 Yes 0 No N/A Permit Number: Setback: Hardcover Zones Existing Proposed Variance Re uir CUP Required,/ 0-75' 0 Yes No 17 Yes No 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Charged YES NO Permit Plan Review State Surcharge ' Investigation Fee SAC-Number of SAC Units Sewer Connection MlaterConnection Park Fee 'Site.4fispection. Other(specify) MiseeIlaneous fees Calculated By: Square Footage $ er S are Footage Basement X = $ 15'Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ tin,nob Orono Inspections Required Work Requiring Separate Permits Required State Permits 0 SitePlumbing 0 Grading/Filling 0 ell 0 Hardcover Removal Mechanical 0 Fire JarElectrical 0 Footing 0 Septic 0 Water Connection 0 Poured Wall 0 Fireplace 0 Sewer Connection 0 Foundation Survey 0 Masonry 0 Lawn Irrigation 0 Radon Rock Bed 0 Mfg. Framing 0 Other(specify) Insulation 0 As-Built Survey Final 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES 0 NO New: 0 YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.dom SC' AATTE� TIME CITY OF ORONO CALLED IN - -�-r INSPECTION NOTICE SCHEDULED PERMIT NO.,Q COMPLETED ADDRESS OWNER TELE O. CONTRACTORC�l SC�� LLG ^ j DESCRIPTION W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS Q El FRAMING El 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 COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc W V,► cc cc / T �V �CJ O W CC Q f2 Z W Z W CC Lai K SATISFACTORY:PROCEED ❑ PROJECT COMPLETE cc W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ElSTOP ORDER POSTED.CALL INSPECTOR EJ CITATION ISSUED D INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on ite: ,& 00 =� .. Inspector. White CopylInspector's File Canary Copy/Site Notice C ' AT TIME V CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO.O�lD�-� � coMPLETED ADDRESS I D OWNER TELEPHONE NO. X07 71, CONTRACTOR 3Z DESCRIPTION ❑ FOOTING El PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS H ❑ FRAMING ❑ MECHANICAL FINAL Q [I 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 COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: W a o i::� A Cc LL S W Cc Q 2 W Z W Cc Z) d � W2 RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN El CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑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