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Home My WebLink About2011 - 00258 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2011-00258 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 06/07/2011 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1930 WEST FARM RD PIN : 27-118-23-43-0021 LEGAL DESC : THE FARM AT LONG LAKE : LOT 022 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 135,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,AND ELECTRICAL(STATE) ADVANCED PLAN REVIEW PAID-$823.39-PERMIT#2011-0257 KITCHEN AND FAMILY ROOM REMODEL APPLICANT PERMIT FEE SCHEDULE 1,266.75 LAKE COUNTRY BUILDERS, LTD STATE SURCHARGE(VALUATION) 67.50 339 2ND STREET TOTAL 1,334.25 EXCELSIOR,MN 55331 (952)474-7121 Minnesota State License#: 20349679 OWNER LYONS,MICHAEL&DEBRA 1930 WEST FARM RD 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 is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. Applicant Pe ee Signature Date Issu/ By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. (oZ/ 1,j,i( City of Orono/Li/4A Buildingb'- Permit Application for Internal Work O5 pp 1.33 T (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: ad//—eV .>8 4::::3;,_,0_-_____4,._ j,0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: Vt9 // I i,%--, , � Received by: , 4 . , ?� A,, Street Address: 1�, a'1 M ti 2750 Kelley Parkway Plan review fee: # TA3,39 `� iessoOrono, MN 55356 ©f/-0-V ?57 - 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: ,l Job Site Address: I 31 °J L.) . 1—c'/vim +t - O(' D/"t Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑ Yes El 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: Lc�l-ce.. CO u�► e,-1L-- State License# ZL 17 O rj6,7 rk / Expiration Date: 3 / 3 l 1211 Lead Certification Number: a V, ft V( q Expiration Date: (for work on homes that were constructed prior to 1978' Phone: (office) (cell) Mailing Address: ' YJ3`-1 ce044 $. City: tXteK Dr- ZIP: 5557 1 Contact Person: �, ,(.,(,L Applicant is: Ctrac1o) / Homeowner (circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: Phone (day): 9 2`t 7L- 71 2, ) Address: 1 9 3D Q , ice r" i\�t I v`✓ A ' Y"1 K1 City: Oc,:;n ,; ZIP: 3 9.:.Email and/or Fax ` PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) g Remodel ElWater Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd I=ISiding 111Restoration 111Other: (specify) Deephaven, MN 55391 Phone: 952-471-0590 El Re-roof ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq_ Overall Project Description: K't 6A ' y / hi--k,\)\,1C`-AA, ;�c\M Estimated Construction Valuation of Project(excluding lan ) $ 13S U 1 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 whi generally cannot be given to either the public or the subject of the data. Our purpose and intended use of . in ormat. ' is to annua ..:.te our records and records of other governmental agencies required by law. If you refuse to s pp y the 'sr .tion,t'e applicati•n may not be issued. Applicant's Signature: 1� Al Date: �� 'Z °� ZG' , Last Updated: 03-01-2011 Plan Review Checklist for New Structures / Additions Address/ PID / Legal: / 1y 30 ( J f 11Jt°i i-c3 r44 Description of work: j2t n"0 O -C—L 't `I 1 (i4Acr Septic review by: i'i ill Date Approved: Zoning review by: t4 L 1- L -00 Date Approved: 5-- 1 1 - 1 t Building review by: .J L Date Approved: S--1 2-- I l Grading review by: /v/A- Date Approved: Zoning File#: Resolution#: Resolution Date: Zoning District Fire Department Post Office School District Zonin•. Lot Area: SF/AC Width: Depth: Survey Su:•fitted: 0 Yes 0 No Date of Survey: Proposed Setba : Front (Lake) -ar(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Building Defined Height: Building Peak Height: #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPA FOR A BUILDING • A SLAB FOUNDATION: START WITH the distance between the basement floo crawl START the distance between the slab and the highest space floor and the highest roof peak,the t• 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 an• ' BTRACT 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/ , awl ADD the distance between the slab and the highest space floor and the highest existing gr-.a within existing grade within the foundation the foundation or 10 feet,whichev- s less. EQUALS 'efined building height EQUALS Defined building height Lot Coverage: SF 00 Shoreland District CWD Permit Received Average Lakeshore Setbac Bluff 0 Yes 0 No 0 N/A • Yes 0 No 0 Yes 0 No 0 Yes 0 No 0 N/A Permit Number: Setba• : Hardcover nes Existing Proposed Variance Required CUP Requ ..Td 0 0 Yes 0 No 0 Yes 0.No -75-250' Type(s): Type(s): 250-500' / 500-1000' REMARKS (in-house): AA, C 1-1'74rV Updated: 09/11/2009 z:lformslplan review checklist.docx V Fees to be Charged YES NO voiwomoott Plan Review�yy *., ✓ yc 1 air e o w,1 x.1 4 �1?i n vi j'^s .l �kq,+�`�ur.p'�i a As a � Investigation Fee .__ ., Aikg*tRNM µms. *AN Sewer Connection ,•. wc04t b .,h:, w'. Ttr:'kt Park Fee .k*tL1 0w3nIZINTAN t . t Other(specify) M1*-41:437#00:00:-WWitainaefett Mar Calculated By: Square Footage $ per Square Footage Basement X = $ 1St Floor X = $ 2"d Floor X = $ Garage X = $ Estimated Construction Value: $ 1 35,000 `}� Orono Inspections Required Work Requiring Separate Permits Required State Permits O Site Plumbing 0 Grading / Filling 0 Well ❑ Hardcover Removal Mechanical 0 FireElectrical O Footing 0 Septic 0 Water Connection O Poured Wall 0 Fireplace 0 Sewer Connection ❑ Foundation Survey 0 Masonry 0 Lawn Irrigation O Radon Rock Bed 0 Mfg. ,Framing 0 Other(specify) Insulation O As-Built Survey inal ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: 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 z:\forms\plan review checklist.docx // DATE ( TIME V CITY OF ORONO CALLED IN `l'Du� INSPECTION NOTICE SCHEDULED 11/O- If /D;O 0 PERMIT NO.c9b/1— CbC251 COMPLETED_ � ct ADDRESS /930 W ,rn, ,ed OWNER TELEPHONE ? NO. 6/2 6S5 /35 CONTRACTOR d-44 >. DESCRIPTION /- /n"a IQ CIFOOTING ElPLUMBING FINAL DI EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS (2 ❑ FRAMING ❑ MECHANICAL FINAL O l=1 TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP 0 PROGRESS 0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT v O DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES NO o COMMENTS: ec Lu a cc O cc W �. C) . D e -V e cue ti.J'e-Gc-'e_ci Q W T amil t d ' Drc 1 v v--{r k. (3c?drod A-k . GcJ ti 4 ( A__c_ 4 r fic) 7414 t -2 C ,are- c F W cc O Lj ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE W El CORRECT WORK&PROCEED ❑ IS UE CERTIFICATE OF OCCUPANCY 0 10 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY Q BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑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: ` f(J 5 Inspector. b./2 White Copyllnspector's File Canary Copy/Site Notice C Yet (p( DATE TIME \A CITY OF ORONO / J/ CALLED IN T2-7 .l / INSPECTION JI/EDU 2 COMPSCHEDULED @�_�3. PERMIT NO. A ,coMPETED -/ ADDRESS /9'33 4 ��%�� _ Rei OWNER - TELE HONE NO. -5:3S 7.353 CONTRACTOR dr,Ce G �; DESCRIPTION b--1 L Li ClFOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS r4 ❑ FRAMING ❑ MECHANICAL FINAL CI ID TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE Cl SEPTIC MAINT. ❑ FOLLOW-UP _ CI -FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES_NO o COMMENTS: CC W Q. J 0 CC O 4. tz 6. z W Z W cc J !� d 4ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY Oc.) BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN CI 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 /4— / /D• E TIME V CITY OF ORONO CALLED IN ` / INSPECTION NOTICE SCHEDULED kms, PERMIT NO. v30//- ODo7.59 COMPLETED i ADDRESS OWNER TELEPHONE NO. 4-8 s 1 /� CONTRACTOR G' ( ( 9umzi7 &J/) 1 DESCRIPTION / W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING • ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS ❑ FRAMING 111 MECHANICAL FINAL TREE REMOVAL • ❑ 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 ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL • OWNER/CONTRACTOR TO MEET YOU:_YES NO o COMMENTS: cc W Q. CC O CC O W CC W W cc d WCC ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑ 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/Contract Inspector. White Copy/Inspector's File Canary Copy/Site Notice