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HomeMy WebLinkAbout2013-00366 - addn/remodel/repair NEMNUMIMM w CITY OF ORONO * 2013 - 00366 * 2750 KELLEY PARKWAY DATE ISSUED: 05/29/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS 3760 WATERTOWN RD PIN : 32-118-23-31-0005 LEGAL DESC HILLAWAY FARM LOT 002 BLOCK 001 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDN/REMODEL/REPAIR ACTIVITY 434-RESIDENTIAL VALUATION $ 80,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) APPLICANT PERMIT FEE SCHEDULE 906.75 CONSTRUCTION RESOURCE STATE SURCHARGE(VALUATION) 40.00 15724 115TH AVENUE LITTLE FALLS,MN TOTAL 946.75 (763)360-6486 PAID WITH CC# 3963 Minnesota State License#: BC447049 OWNER STEPHENSON,REVIS 3760 WATERTOWN RD MAPLE PLAIN, MN 55359- 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 &responsibl assuring all required inspections are request n 6 anc with ilding Code.This permit may be rev ed me for e c / APO p ite i at Date 41SBy Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono q 4� Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: /3 — b-D 3 40 �0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: a� 2750 Kelley Parkway Plan review fee: / .3 Orono, MN 55356 �kFSHC�� Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.rn.us This application form must be completed in full and all required information must be submitted. Incom lete applications will be returned. (Please print) GENERAL INFORMATION: 23_7� Job Site Address: ,✓ 95�-_) WA-rv_- r ti RJ SZ Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes OV 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/A"LICANT INFORMATION: Name: o.l ?,,e3s State License# ZE4,1.1 C,-A q Expiration Date: 3 -fit 6`-f Lead Certification Number: �4 ACT- -- jy'e>aq p - k Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) 3(oc> (OLJ%(,p (office) IGA_VW is Mailing Address: 15.7 a—) 1( S -r H A--v E City: L;fj�e, P=,L IIs ZIP: Contact Person: ,dk-x{C_ Applicant is: 111ontractor Homeowner (Circle One) Email and/or Fax: (�,19, ,y 3 S 6)0-11 ��� �,rv�n�J�—�oN r�S�u r-C2 PROPERTY OWNER INFORMATION: t Name: �.y.S Co`rL tL `Sori\ Phone (day): Lek (.F Address: —� ,� p ZZI-� City: C9LC_,t.4c, ZIP: C453S(,, Email and/or Fax: PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) emodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof,asphalt �CJR pair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof,other(specify) ❑Siding ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.org Estimated Construction Valuation of Project(excluding land) $ ©off APPLICANT 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 cengLally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information i our cords and records of other governmental agencies required by law. If you refuse to supply th ti the l ation may n t be issued. Applicant's Signature: Date: +O Owner's Signature: Date: Last Updated:03/06/2013 FLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address/Permit Number: Description of work: 1 � �— Septic review by: Date Approved: Zoning review by: i I�� Date Approved: Building review by: Date Approved: ' S` e Grading review by: ori Date Approved: Z ning District: Zoning File#: Reso#: 7e/sDate, Zoni : Lot Area: SF/AC Width: Lot Coverage: SF _% Survey bmitted: ❑ Yes ❑ No Date of Survey: Re4ed date(?): Prol ed S backs: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) er Buildings Wetland S. Side Side Defined Height: Peak Height: FFE: FFE inus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% _ #of S ories Ok? ❑ YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: The distance betty n the lowest F A BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the asement or crawl space)and the highest int of the roof. START WITH The distance between the top of slab and If you have a... the highest point of the roof. If you have a... • GABLE OR HIPPED RO F(no • GABLE OR HIPPED ROOF(no windows): Subtract half th windows): Subtract half the distance distance between the highes oint between the highest point of the roof of the roof to the low point of th to the low point of the corresponding SUBTRACTION corresponding gable or hipped r SUBTRACTION gable or hipped roof (BASED ON ROOF GABLE OR HIPPED ROOF th (BASED ON GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half th ROOF TYPE) windows): Subtract half the distance distance between the top f the between the top of the highest highest window and th ighest window and the highest point of the point of the roof roof • ALL OTHER RO TYPES(flat, ALL OTHER ROOF TYPES(flat, mansard,etc): o subtraction. mansard,etc):No subtraction. ADDITION Add the distance between the top of slab SUBTRACTION Subtract the distap6e between the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemen pace floor and the EXISTING the foundation. GRADES) highest existi grade adjacent to the GRADES foundation R 10 feet(whichever is less). EQUALS Defined building height EQUALS Define uilding height Shoreland District MCWD Permit Received Average Lakeshore Se ack Met? Bluff ❑ Yes ❑ No C3 N/A E3 Yes 13No E3 Yes No C3 Yes C3 No ❑ Permit Number: Setback: Stormwa r Quality Existing Proposed Variance Required CUP Re uired Overlay,6istrict Tier Hardcover Hardcover ❑ Yes ❑ No ❑ Yes ❑ No Type(s): Type(s): Updated: January 2013 v:\forms\plan review checklist 2013.docx a REMARKS (in-house): Fees to be Charged YES NO Permit . a.. ✓ Plan Review State Surcharge i Investigation Fee SAC—Number of SAC Units Other(specify) Square Footage $ per Square Footage Basement X = $ 1St Floor X = $ 2nd Floor X = $ Garage X = $ 0 Estimated Construction Value: $ Orono Inspections Required Work Requiring Separate Permits Required State Permits 0 Site eErPlumbing 0 Grading / Filling 0 Well 0 Hardcover Removal Mechanical 0 Fire Electrical 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) ,,M Insulation 0 As-Built Survey Final 0 Wetland Buffer 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES 0 NO New: 0 YES 0 NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\forms\plan review checklist 2013.docx DATE TIME CITY OF ORONO CALLED IN �3 INSPECTION N TILE SCHEDULED40�73 -13 PERMIT NO. 'fid COMPLETED ADDRESS .�7wO .� OWNER TELEP ONE N07 - "/�il/fC CONTRACTOR � > DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ 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 QJ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ElSEPTIC FINAL ElFOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: LU a. cc 0 cc 0 W CC Q ti 2 W Z LU C W —C RK SATISFACTORY:PROCEED 1-1PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR E)CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cali for the next ins ion 24 hours in advance. (952) 249-4600 Owner/Contrac ' e: Inspector. White Copylinspector's File Canary Copy/Site Notice 2) 5z—,3LDATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED — PERMIT N 05_ c/o4fLETED ADDRESS OWNER ELEPH E N07K& CONTRACTOR DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ti ❑ FRAMING ❑ 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 ElPLUMBING RI ElSEPTIC FINAL ElFOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc W a O O Cr O U_ W Q Z W z W cc O GW ^ORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE W/❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 00 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V 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 OwnerlContractor o Inspector. White Copylinspector's File Canary Copy/Site Notice 54-t- TIME L/ CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO.a o 13-006&& COMPLETED ADDRESS 3780 W OWNER � TELEPHONE N0.70 3 � CONTRACTOR i - n DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAWGRADING/FILLING y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/wETLANDS Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ 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 v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: a 'o� , ,f^ gr I-e%z - o 44V VSo W -De A) Q 2 W W cc LAJ j ❑WORK SATISFACTORY:PROCEED APROJECT COMPLETE QC W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTOTAKEN INSPECTOR WILL RETURN EI 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 sit Inspector. White Copyfinspectoes File Canary Copy/Site Notice