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Home My WebLink About2012-00791 - addn/remodel/repair CITY OF ORONO 2750 KELLEY PARKWAY * 2 1 2 - 0 PJ 7 1 DAT0 E ISSUED: 08/29/22 012 ORONO, MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS 3940 WATERTOWN RD PIN 32-118-23-32-0001 LEGAL DESC UNPLATTED 32 118 23 LOT 000 BLOCK 000 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDN/REMODEL/REPAIR ACTIVITY 434-RESIDENTIAL VALUATION $ 81,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(ELECTRICAL) BASEMENT FINISH ADV.PLAN REVIEW PD BY CREDIT CARD 8/14/12$594.26 APPLICANT PERMIT FEE SCHEDULE 914.25 BOYER BUILDING CORPORATION STATE SURCHARGE(VALUATION) 40.50 3435 COUNTY ROAD 101 MINNETONKA,MN 55345 TOTAL 954.75 (612)475-2097 Minnesota State License#:2988 OWNER HEDBERG,CHRISTOPHER&HEIDI 3940 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 ys of the date of issuance,or if construction is suspended for a perio of 80 days at any time after work has commenced. The ap 'cant iseresns' le for assuring all required inspections are re sted r conw' the State Building Code.This permit may be r oked at y t Appli t Petrnitee SignatuK Date i W14 Issue(03y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono 7 Building Permit Application g,,a� for New Structures or Additions —=- Mailing Address: Permit number: O•g,�,�0 Cr Box 66 Cry _ stal Bay, MN 55323-0066 Date received: T. Received by: t P_-111Orono, StreetAddrE.2750 Kelley Parkway Plan review fee: gMN 55356 _ d�/_ �-_ ' 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: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o 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/APPL CANT INFORMATI N; , Name: io 'L�i v Oh State License# Expiration Date: Phone: oL. c 7 5- 2,019office L S- o cell Mailing Address: 3 +" _ /o/ Cit i y ZIP: 3 5l Contact Person: 4Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: h ,' PROPERTY OWNER INFORMATION' Name: kv Phone(day): 3'2G� Address: City: ZIP:9,� 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 ❑ New Construction ❑ Single Family with ❑ Residence ❑Addition 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) STRUCTURE INFORMATION: 1. Structure Dimensions 1.Structure Dimensions (continued) 2. Type of Construction a. Length ft)= Number of bedrooms = ❑Wood/Frame b.Width ft)= Number of garage stalls: ❑ Masonry Areas in square feet Attached = ❑ Metal ❑ Pole Bldg. c. Basement= Detached = ❑ ICF d. 151 Story = ❑ On-site Prefab e. 2"d Story= ❑ Off-site Prefab f. '/2 Story = ❑ Other (please specify): 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 Bui ding Plans ❑ ❑ MN State Energy Code Calculations and Mechanical Code Requirements Form ❑ ❑ Survey(meeting all requirements) ❑ ❑ Stormwater Pollution Prevention Plan ❑ ❑ Hardcover Calculation(s) ❑ ❑ Se tic 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/OWNER 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 to ensure completio f the as-built survey and all site improvements. Applicant's Signature: Date: (�_ / 31/ L� Owner's Signature: Date: Plan Review Checklist for New Structures / Additions Address/ PID/Legal: -3140 tn11r�-rt I/L�-o w N Description of work: (-aw-e& - e L '00;'�-4ec Septic review by: Date Approved: Zoning review by: / Date Approved: Building review by: ✓�( Date Approved: Grading review by: Date Approved: Zoning File#: Resolution#: Resolution Date: Zoning District Fire Department Post Office School DisW&t Zoning: Lot Area: SF/AC Width: De Survey Sub ' ed: 0 Yes 0 No Date of Survey: Proposed Setbac Front(Lake) ear(Street) ( N S E W ) ( N S E W ) her Buildings Wetland Side Side Building Defined Height: Building Peak Height: #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR C L SPACE: FORUILDING ON A SLAB FOUNDATION: IkS START WITH the distance between the ba ment floor/crawlS4ART the distance between the slab and the highest space floor and the highest roo eak,the top of ITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the dec ine of a the deck line of a mansard roof, or the mansard roof, or the uppermost poi t 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 w do nd 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 baseme/isaleses.�\ cr I ADD the distance between the slab and the highest space floor and the highest existiwitexistingrade within the foundation the foundation or 10 feet,whichev EQUALS Defined building height EQUALS Defined building height Lot Coverage: SF Shoreland District WD Permit Received Ave ge Lakeshore Setback Bluff Yes 0 No 0 N/A 0 Yes 0 No 0 Yes 0 No 0 Yes 0 No 0 N/A Permit Number: Setback: Hardcover Zon Existing Proposed Variance Re fired CUP Required 0-75' 0 Yes 0 0 0 Yes 0 No 75-2 Type(s): Type(s): 250-600- 500-1000' 50- 00'500-1000' REMARKS (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx 1 Fees to be Charged YES NO Permif . Plan Review .`State`Surcharge. � ,/ Investigation Fee QAC'C44Nu of'SAC+Units Sewer Connection ater-I vection Park Fee :`S�te'�nspection:, Other(specify) 'Miscellaneous:Fees Calculated By: Square Footage $ per Square Footagi Basement X = $ 1st Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ 0 d 0 Orono Inspections Required Work Requiring Separat Permits Required State Permits • Site Plumbing 0 Grading/ Filling 0 Well O Hardcover Removal ,Mechanical 0 Fire 00p, Electrical 0 Footing 0 Septic 0 Water Connection 0 Poured Wall 0 Fireplace 0 Sewer Connection 0 Foundation Survey 0 Masonry 0 Lawh Irrigation 0 Radon Rock Bed 0 Mfg. Framing 0 Other(specify) Insulation 0 s-Built Survey Final 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date �pproved: 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 zAforms\plan review checklist.docx 61 '�O/a1 —'60 g 4 y /t7o TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED —/7-7z— % PERMIT NO.-202 - O 07 9/ COMPLETED nn rr ADDRESS 39VO CcJa �- ,�� L OWNER TELEPHONE N CONTRACTOR DESCRIPTION �r ¢ FP El FOOTING El PLUMBING FINAL ❑ E RA ILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ 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 OWNER/CONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: W a J O W W Q 2 W W QC J Z4� K SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W 0(QR 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 2 ours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. White Copyllnspectoes File Canary Copy/Site Notice DATE TIME v CITY OF ORONO CALLED IN INSPECTION NOTICESCHEDULED PERMIT NO. o?G!a -bD 71 COMPLETED ADDRESS OWNER TELEPHONE NO. 5 r�f CONTRACTOR DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO cam., COMMENTS: W a e C co ° St f W Q Q 2 W W cc j d L .'WORK SATISFACTORY:PROCEED AeROJECT COMPLETE 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 ❑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. S White CopylInspector's File Canary Copy/Site Notice