HomeMy WebLinkAbout2013 - 01280 - addn/remodel/repair CITY OF ORONO III I III1III gI1iIIJ II II
* 202750 KELLEY PARKWAY DATE ISSUED: 12/17/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2120 WAYZATA BLVD W
PIN : 34-118-23-24-0001
LEGAL DESC : UNPLATTED 34 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN
VALUATION : $ 3,000.00
NOTE: REPAIR INTERIOR OF BUILDING-WALLS,CEILING,FLOORING&WINDOWS
APPLICANT PERMIT FEE SCHEDULE 88.50
STATE SURCHARGE(VALUATION) 1.50
ERICKSON, BRAD TOTAL 90.00
2486 BOBOLINK RD
Payment(s)
MEDINA, MN 55356-
(612)490-2371 CASH 90.00
OWNER
ERICKSON,BRAD
2486 BOBOLINK RD
MEDINA, 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 conformance with the State Building Code.This permit may be
revoked at any ti e for e cause. /
/2/77.73 f r E---/7/5
plicant Permitee Signature Date Issued ignature Date
City of Orono
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
�O1 V Mailing Address: Permit number: <JO/3 - D/2 S--O
PO Box 66
Crystal Bay, MN 55323-0066 4) Date received: /2 -/O- /5
Street Address: �O Received by: 46
yt<,` 2750 Kelley Parkway "t- Plan review fee: 57. 53
L Orono, MN 55356
"IkES H o4`" Total Fee: (370 13 /27q
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: ) /OL9 ,��
Job Site Address: -d O (Jc ?�Jc. ✓.�7(-1r
Will this be a Parade of Homes, Remodelers Shbwcase 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 s rvice will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICAN FORMATION: -
Name: f c,� '/r L/CScr?'-)
State License# V 3 2-2, (E „ /' - Expiration Date: /26 20 •
Lead Certification Number: Expiration Date:
(for work on homes that w re constructed prior to 1978 /
Phone: (cell) /2. y o 3 J (office) 76 3 LI73 2 7//
Q 9
Mailing Address: a , ;do ._ _ ®rm• i/ City: e /„ _ ZIP: 5 S3 ,
Contact Person: racQ E Applicant is: Contractor Homeowne circie One)
Email and/or Fax: 76 3 c(73 O `t (
PROPERTY OWNER INF RMATION:
Name: 110br& ce EcrY)
Phone (day): 6/2_ of 9c 233 )
Address: _ 2-i-(8(0 :66/(4 - / c/ City: /I yr c_ ZIP: S-3-3 S 6
Email and/or Fax: 763 N 73 0'46
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑ Door(s) emodel El Fire Damage MCWD review&permits:
❑ Re-roof,asphalt //❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑ Re-roof, other(specify) IDSiding 1=1Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project (excluding land) $ '3OOO
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 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 a••['cation ma not be issued. //
0/(J
Applicant's Signature: �� f� Date: /Z(//
Owner's Signature: / % Date: lZ` ���/ / j
Last Updated: 03/06/2013
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address/Permit Number: 2 1 Z0 W A`'fZA 1Ajt--V 6
Description of work: t` :::: \A Y •eL.
Septic review by: N(4 Date Approved:
Zoning review by: A.//A Date Approved:
Building review by: At Date Approved: / Z'/ b /3
Grading review by: /t'l4 Date Approved:
oning District: Zoning File#: Reso#: Reso Dat=.
Zon •g: Lot Area: _ SF/AC Width: Lot Coverage: SF _%
Survey bmitted: D Yes Cl No Date of Survey: Revi d date(?):
Proposed S• •acks: ,
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) 0 er Buildings Wetland
Side Side
Defined Height: Peak Height: FFE: FFE inus 6 feet= (Existing Contour)
Perimeter(linear feet)__ 50% = #of S •ries Ok? Cl YES
FOR A BUILDING WITH A BASEMENT OR CRA SPACE:
The distance betwee he lowest F• A BUILDING ON A SLAB FOUNDATION:
START WITH proposed floor(of the ba ement or crawl
space)and the highest poi of the roof. START WITH The distance between the top of slab and
the highest point of the roof,
If you have a... I
GABLE OR HIPPED ROOF •o •you Gave a...
• windows): Subtract half the windHIPPED ROOF
windows): dis(ntance
half the distance
distance between the highest poin between the highest point of the roof
of the roof to the low point of the to the low point of the corresponding
SUBTRACTION corresponding gable or hipped r..f SUBTRACTION gable or hipped roof
(BASED ON ROOF • GABLE OR HIPPED ROOF ,ith (BASED ON • GABLE OR HIPPED ROOF(with
TYPE) windows): Subtract half th> ROOF TYPE) windows): Subtract half the distance
distance between the to. •f the between the top of the highest
highest window and t highest window and the highest point of the
point of the roof roof
• ALL OTHER RO,.F 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 dis ce between the :ASED ON and the highest existing grade adjacent to
(BASED ON EXISTING basement/cra space floor and the E' TING the foundation.
GRADES) highest exi ng grade adjacent to the GRA► 5)
foundati. OR 10 feet(whichever is less). EQUAL Defined building height
EQUALS Defi d building height
Shoreland Distri MCWD Permit Received Average Lakeshore Setback Me Bluff
Cl Yes Cl No Cl N/A • Yes Cl No
Cl Yes • No Cl Yes Cl No Cl N/A
Permit Number: Setback:
Stormw er Quality Existing Proposed Variance Required CUP Required
Overl- District Tier Hardcover Hardcover
D Yes D No D Yes D No
Type(s): Type(s):
Updated: January 2013 4 V D C / /' ,
v:\forms\plan review checklist 2013.docx Alfit/ C� (��
REMARKS (in-house):
Fees to be Charged YES NO
-Permit
Plan Review
:State°Surcharge
Investigation Fee
SAC—Numb'er of SAC Units
Other(specify)
Square Footage $per Square Footage
Basement X = $
1St Floor X = $
2nd Floor X = $
Garage X = $
Estimated Construction Value: $ �. O 00
D�
Orono Inspections Required Work Requiring Separate Permits Required State Permits
O Site 0 Plumbing 0 Grading/Filling D Well
O Hardcover Removal 0 Mechanical 0 Fire -Electrical
O Footing 0 Septic 0 Water Connection
O Poured Wall 0 Fireplace 0 Sewer Connection
O Foundation Survey 0 Masonry 0 Lawn Irrigation
O Radon Rock Bed 0 Mfg.
Framing 0 Other(specify)
O Insulation
)1:211/As-Built Survey
Final
0 Wetland Buffer
O 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
44 It p
. WIthrii' • •
Project Project No Page
Client Prepared by Date Ag.
Bonestroo
Calculations for Reviewed by Date
2_o t.
Approved numbers or address shall be provided for all new
buildings in such a posit:on os to be plainly visible and
legible from the street or road fronting the property.
Pefb4-
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PLAN CHECKED BY ( .--- DATE z -2,t)
d- TIME
CITY OF ORONO CALLED IN /r ...
ATE 1 4
INSPECTION TICE SCHEDULED /-3 - / /1,
PERMIT NO.9/ -t '2f'6 C/OM, ED
ADDRESS ` 0� - (�f
OWNER .�L.i_, • TELE H E NO.2J 3 " 1-1cj°-"33V
CONTRACTOR / X
>; DESCRIPTION
I�
4, ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI _ ❑ LAKESHORE/WETLANDS
y FRAMING ❑ MECHANICAL FINAL LI 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
ct
_ ❑ DEMO-FINAL CISEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
cc o COMMENTS: �// �/,[p� / �—
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W ORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
CCW
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
CZ ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
• BEFORE COVERING
PERMANENT
0 CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN
INSPECTOR WILL RETURN
CI CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. SCOTT
White Copy/Inspector's File Canary Copy/Site Notice
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