HomeMy WebLinkAbout2011-00906 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2011-00906
2750 KELLEY PARKWAY
/ ORONO, MN 55356- DATE ISSUED: 08/23/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 2985 WATERTOWN RD
PIN : 04-117-23-21-0001
LEGAL DESC : AUDITOR'S SUBD.NO.230
: LOT 006 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 4,000.00
NOTE: SEPERATE PERMITS REQUIRED: ELECTRICAL(STATE)
ENTRY PORCH
APPLICANT PERMIT FEE SCHEDULE 103.25
BRENNAN PROPERTIES LLC PLAN REVIEW 67.11
8452 153RD PLACE
SAVAGE,MN 55378- STATE SURCHARGE(VALUATION) 2.00
(612)616-4447 TOTAL 172.36
Minnesota State License#:20381410
OWNER
GHERARDI,RICHARD&LORI
1010 WILLOW VIEW LANE
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 i r risible for assuring all required inspections are
requested i anc with the State Building Code.This permit may be
revoke t an ime du cause.
Appilutult rmitee Si ature Date Issued Siiqure D e
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address: Permit number: C2D�/-
PO Box 66
�/Q O Crystal Bay, MN 55323-0066 Date received:
Street Address:'
Received by:
2750 Kelley Parkway Plan review fee:
\ Esz;o4� Orono, MN 55356
-- Total Fee: / 7 ,3�
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:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑'No
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: r! re WX Vnci . — ,r
State License # a=C% 3 5 i'--1 16,- Expiration Date: 7 Zo ,,
Phone: („ 1 2 -40 t(0 -4 c+r7 (office) (cell)
Mailing Address: ( go F=, P4 _ 2e( City: ! '• aZIP: '5�- ; 7,(
Contact Person: J0-e 4 r,e n I Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:/
Name: CC I- 6 WP., C4 i.
Phone (day): & _ & 70 It ZZ Sr
Address: (o/0 t-, t(oma V, ,,, L City: (y'� :. , r l ZIP:
Email and/or Fax
ARCHITECT I 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
❑ New Construction [L] Single Family with ('�Residence
j�Addition attached garage ❑ Garage/Accessory Bldg.
'❑AccessoryBuilding g n' 9• Public Sewer
g ❑ 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 C
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. V"Story = ❑ Other(please specify):
e. 2nd Story=
f. '/2 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 S stem 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: Z Qi W IATC 'TO�,t��.f ri1,q�
Description of work: L/V' >NtH �oRCN
Septic review by: V/A Date Approved:
ZDning review by: /0 , 07- C . Date,Approved:
Building review by: Date Appco ed:
Grading reviewby: rr// Date Approved:
Zoning File#: Resolution#: Resolution Dater
Zoning District Fire Department Post Office School District
Zoning: tot Area: T). 2%0( SF'/AC Width: . _ Depth: ' Z(.(.
Survey Submitted: zryes M No Date of Survey: 13-
Pro osed'Setbacks: 1�
Front( Rear reef) 'N Side ( N Side, W Other',Buildings Wetland
Building Defined Height:. Building Peak Height: #of Stories Ok?: 0 YES
FOR A BUILDING 11111TH A'BASBMENT OR CRAWL SPACE: FORA BUILDING ON-A SLABFOUNDATION: '
START WITH the distance betweenthe basement floor/crawl START the distance be_ween:the slab and'the'highest
space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof,
the cornice of'a flat roof, he deck line of a the deck line of,a mansard,roof,.orthe
mansard roof,or uppermost:point on a round uppermost point on a round or other arch-type
or other arch-type roof roof
SUBTRACT half the distancebetween the highest window and SUBTRACT half the distance between the highest window
highest roof peak of a:. itched roof and highest roof peak of a�pitched.roof
SUBTRACT the distance'between the basement floor/ ADD the distance between the slab,and.the highest
space floor and the,highest texisting grade within eAsting grade within the foundation
the foundation or 10 feet,whichever is less. EQUALS :Defined building height
EQUALS Defined buildin ^hei ht
Lot Coverage: SF
Shoreland District VCWD Permit Received Average Lakeshore'Setback Bluff
0 Yes 0 No �No
,I N/A I7 Yes
� Yes 191,No D Yes �No � 'N/A
Permit Number: Setback:
Hardcover Zones Existing 'Proposed Variance:Re uir CUP Re uired
0-75' 0 `Yes +No D Yes No
75-250' Type(s): Type(s):
250-500'
500-1000'
REMARKS (in-house):
Updated: 09/11/2009
zaformslplan review checklist.dom
Fees to be Charged YES :NO
Plan Review
Investigation Fee
Sewer Connection
Park Fee
Other#.pecify)
Calculated By.;
Square.foota, a er S uare Foota` e
Basement X
1"Floor x _
2nd Floor x
_ $
Garage X
Estimated Construction Value: $ �-(_000 '26-a
Orono,Inspections Required Work Requiring Separate Permits Required'State Pennits
D Site 0 Plumbing 0 Grading/Filling 7 Well
0 Hardcover Removal 0 Mechanical 0 Fire Electrical
;Footing 'D Septic Water Connection
D Poured Wall 0 Fireplace 0 Sewer.Connection
D foundation Survey 0 'Masonry 0 Lawn Irrigation
0 Radon`Rock'Bed 0 Mfg.
Framing 0 Other(specify)
Insulation
0 s-Built Survey
Final
D .,Other(specify)
REMARKS (in-house):
Other.Review: Reviewed by: ;Date Approved:
Access.,Existing: j,D YES D NO New: <0 YES 0 NO
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
Updated: 09/11/2009
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CITY OF ORON // CALLED IN TE TIME
INSPECTION N,OjICE /SCHEDULED
PERMIT NO.
ADDRESS <a
OWNER TWE PHONE
CONTRACTOR ���� f
DESCRIPTION Mw k-
W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
h
O
El FRAMING El MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
ElFINAL ElSEWER HOOK-UP El 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
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CC
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Ujh0(ORKSATISFACTORY:PROCEED ElPROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
C1STOP ORDER POSTED.CALL INSPECTOR El 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
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D�E TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. COMPLET D
9AW
ADDRESS o?
OWNER TE HONE NO. _
1 01
CONTRACTO
DESCRIPTION
W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
W ❑ POjAfD WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
Q RAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ' ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ' ❑ WATER HOOK-UP ❑ PROGRESS
El FINAL ❑ SEWER HOOK-UP El COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES NO
COMMENTS: V c'� Lir 2A Can, C- 264it.nS
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El WORK&PROCEED F-1ISSUECERTIFICATE OF OCCUPANCY
Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP ORDER POSTED.CALL INSPECTOR 1:1 CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO 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
E � TIME V 1
CI OF�ORONO CALLED IN D
INSPECTION NQTICE SCHEDULED
PERMIT NO. —000�,7COMPLETED
ADDRESS5 '///
OWNER TELEPHONE NO."- � 454 7
CONTRACTOR
DESCRIPTION rt
❑ FOOTING ❑ PLUMBING F AL ❑ EXCAWGRADING/FILLING
Q ❑ POURED WALL ❑ MECHANIC L RI ❑ LAKESHORE/WETLANDS
h ❑ FRAMING
El MECHANIC NAL
Q [:1 TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
El FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ElSEPTIC INSTALL ElHARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ElFOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
o COMMENTS:
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OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
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/Contract In si
Inspector� :t R
1
White Copy/Inspector's File Canary Copy/Site Notice
D T / TIME
CITY OF ORONO CALLED IN 1
INSPECTION NQT�,CGE,_00 SCHEDULED
PERMIT NO. 4 ` COMPLETED
ADDRESS
ADDRESSS� W -f C�' ✓� A?k
OWNER TELEP 6NE NO.
CONTRACTOR w
DESCRIPTION
W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAWGRADING/FILLING
❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y
Q ❑ FRAMING ❑ MECHANICAL FINAL E] TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP El COMPLAINT
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMME
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SATISFACTORY:PROCEED 11PROJECT COMPLETE
W ❑ RECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 El CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
Cj BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP 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 Sit
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
ori-�o gad V/
ATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. - WCOMPLETED
ADDRESS
OWNER g NO. �-�
CONTRACTOR �PA A-,AJ
> DESCRIPTION
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL El MECHANICAL RI ❑ LAKESHORE/WETLANDS
H ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ElSEWER HOOK-UP ❑ COMPLAINT
❑ DEMO-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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0 OWdQgBECT WORK,CALL FOR REINSPECTION TEMPORARY
CJ 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
f � / AT TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO. ol017-yft 91(a COMRLETED
ADDRESS ��F z!
OWNER 00 TELEP NE NO. a—Z; ' 7
CONTRACTOR
>: DESCRIPTION e
❑ FOOTING ❑ PLUMBIN FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ElSEWER HOOK-UP El COMPLAINT
❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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0 ❑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. (J52) 249-4600
Owner/Contractor on site:
Inspector. as
White Copy/Inspector's File Canary Copy/Site Notice
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Job Number.- 7282
l hereby certify that this certificate of survey was
SCHOBORG
prepared by me or under my direct supervision and Book/Page: 73/80
that / am a duly egistered Land Surveyor under the
laws of the Sta o in esota. Survey Date: 5-03-11
LAND SERVICES
Drawing Name: gh erardi.d wg
INC.
Drawn by. KLB
Pau/ B. Schobor Revisions: 7-29-11 (prop. berms)
763-972-3221 8997 Co. Rd. 13 SE Date: X��s2a`l____ Registration No. 14700 8-05-11 (prop. grading)
www.SchoborgLand.com Delano, MN 55328
8-17-11 (prop. porch)