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Home My WebLink About2010-00360 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2010-00360 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 05/21/2010 952 249-4600 FAX: 952 249-4616 ADDRESS 4115 WATERTOWN RD PIN 31-118-23-41-0014 LEGAL DESC MAPLE PLACE 2ND ADDN LOT 002 BLOCK 001 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDN/REMODEL/REPAIR ACTIVITY 434-RESIDENTIAL VALUATION $ 57,500.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,AND ELECTRICAL(STATE) APPLICANT PERMIT FEE SCHEDULE 741.75 SAWHORSE INC. STATE SURCHARGE(VALUATION) 28.75 4740 42ND AVE N. ROBBINSDALE,MN 55422 TOTAL 770.50 (763)533-0352 Minnesota State License#:2382 OWNER DYER,MICHEAL&JILL 4115 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 is respojilible for assuring all required inspections are request d in con a with the State Building Code.This permit may be revo d t due cause. d 5 / t( / 1d 5 O A p icant V""IbEe'Agnature Date Iss y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 5(o p 1� City of Orono Building Permit Application7 for New Structures or Additions Mailing Address. Permit number: / O.¢O,�O PO Box 66 Crystal Bay,MN 55323-0066 Date received: J�� /a Street Address:' Received by: 0 t, a 2750 Kelley Parkway Plan review fee: 1� 0 °0./,V- Orono, 7� Orono,MN 55356 0635 191 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: 4W5 W#1vtTOWN ktt 10 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No H yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus servke All be required unless applicant demonstrates sutilcient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 'd AW&(Lst (14c, State License# `L3 52 Expiration Date: 1-41" ZPi Phone: -763- -6352 office cell Mailing Address: 1 4Z" Ave, Nwy Cit : rlSlNSVALt ZIP: 5 iZZ Contact Person: "P—icy, Ro-r-( Applicant is: Contractor / Homeowner (circ.one) Email and/or Fax: r ' l le @ 5aw VIo r 5r;u5 co PROPERTY OWNER INFORMATION: Name: M i " pit d. -Ai Lk- Phone(day): elS2-A3('Aeol,0 Address: ��— City: MMfU � g ZIP: Email and/or Fax Nff & t, 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 ❑ New Con truction El Single Family with Residence Addition �� 0m, attached garage Garage/Accessory Bldg. ❑Public Sewer Access Building ❑ Single Family with ❑Deck ❑Relocation detached garage ❑Office/Commercial WPrivate Sewer ❑Other:(specify) ❑Multiple Family/Condo ❑Warehouse ❑Public ❑Storage ❑Public Water "'Any earth movement may require ❑Commercial ❑Other(specify) MCWD review&permits. ❑IndustrialPrivate Well Minnehaha Creek Watershed District(MCWD) ❑Other:(specify) 18202 Minnetonka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minn Estimated Construction Valuation(excluding land) $ r71,500 Last Updated: 9/29/2009 - 17- k STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a.Length(ft.)= _ t� _ Number of bedrooms=—�Ll`f�W& Wood Frame �t 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 ❑Other(please specify): d. 1 Sc Story = e.2nd Story= f. '/z Story = g.Total Area= i REQUIRED SUBMITTALS: Vbfl-N(&R- �X(�NNSion1 All of the information must be submitted in order for your application to beprocessed: Not Enclosed Applicable ❑ Permit Application ❑ Proposed uilding 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 ❑ Wetiand Buffer Improvement Plan ❑ Engineered Plans for RetainingWalls 4 feet or above 13 ❑ 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 altemative but to reject it until it is complete; Acknowledges the Escrow Agreement is completed and signed; 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. Applicant's Signature: Date: Last Updated: 9/29/2009 - 18- Plan-Review-Checklist for New--Structures / Additions Address/ PID/ Legal: ' ( ,� 1 � �A) Description of work: Gv'- l!�✓C�� dj-yy�Q� Septic review by: ` Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: S-- 00 Grading review by: N [ A Date Approved: Zoning File#: Resolution#: Resolution Date: F-Zoning District Fire Department Post Office School District R - /A Zoning: Lot Area: 11�2 f R</AC Width: Depth: Survey Submitted: 19'�es ❑ No Date of Survey: 2005- '.4S b', Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N < W ) Other Buildings Wetland Side Ch_5Q�S Building Defined Height: Building Peak Height: #of Stories Ok?: SES 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 between 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,the deck line of a the deck line of a mansard roof,or the mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type or other arch-type roof roof SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest window— highest roof peak of a pitched roof and highest roof peak of a pitched roof SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existinq qrade 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 ❑ Yes ❑ No ❑ N/A ❑ Yes ❑ No ❑ Yes No ❑ Yes ❑ No ❑ N/A Permit Number: Setback: Hardcover Zones Existing Proposed Variance Required CUP Required 0-75' ❑ Yes ❑ No ❑ Yes ❑ No 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house):__ 5 it�vc-f ` ryn I�c" b A-�d, �x�m t I�tp,-{�C' d c b trc�s -eye v(ei-O " , 4w5e- Updated: 2009 z:\forms\plan an review checklist.docx QA V7. Fees to be Charged - YES NO . �eranrt;jar ` Plan Review V1, tate. urcharge rf" Investigation Fee S"imbe � .S ',C-_UMts Sewer Connection �11ater-�onne�xion , 4 Park Fee Arte Inspection Other(specify) �Illllsce�la�neovs�ees' ', _ Calculated By: Square Footage $ per Square Footage Basement X = $ 1s' Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ 57.500 Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site Plumbing ❑ Grading / Filling ❑ Well ❑ Hardcover Removal Mechanical ❑ Fire Electrical ❑ Footing ❑ Septic ❑ Water Connection ❑ Poured Wall ❑ Fireplace ❑ Sewer Connection ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigation ❑ Radon Rock Bed ❑ Mfg. Framing ❑ Other(specify) ,f3 Insulation ❑ As-Built Survey Final ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 zAforms\plan review checklist.docx !/ TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED �D -- PERMIT NO.Q2Q —4Z.3/40 COMPLETED aZ ADDRESS 41115 OWNER TELEPHONE NO. &/Z ZZr meq/-Tsa CONTRACTOR d044--<01 y i� a DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q El 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 OWNER/CONTRACTOR TO MEET YOU:_YES_NO v0, COMMENTS: cc W a J O cc O W W cc Q 2 W Z W O W� 1M1tORK SATISFACTORY:PROCEED ElPROJECT COMPLETE W ❑C RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTOTAKEN INSPECTOR WILL RETURN El CITATION ISSUED ElSTOP 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 sjte: Inspector. o White Copy/Inspector's File Canary CopylSite Notice �3� ae0TIMECITY OF ORONO CALLEDIN T INSPECTION WTICE SCHEDULED PERMIT NO - D COMPLETED ADDRESS OWNER TELEPHONE N � CONTRACTOR DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL ZINSULATION ElWOOD 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 E] SEPTIC INSTALL EI HARD COVER REMOVAL J ElPLUMBING RI ❑ SEPTIC FINAL ElFOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc W a cc J O QZ O U_ W CC Q 2 W z W OWE WORK SATISFACTORY:PROCEED El PROJECTCOMPLETE W ❑ ORRECT 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 ❑STOP 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 si Inspector. White Copy/Inspector's File Canary Copy/Site Notice