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HomeMy WebLinkAbout2011 - 00064 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2011-00064 2750 KELLEY PARKWAY " ORONO, MN 55356- DATE ISSUED: 02/16/2011 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2600 WEST LAFAYETTE RD PIN : 21-117-23-21-0002 LEGAL DESC : REG. LAND SURVEY NO. 0131 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 25,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) BASEMENT FINISH 2ND FLOOR BATH-MAIN LEVEL FIREPLACE • APPLICANT PERMIT FEE SCHEDULE 413.00 LECY BROS CONSTRUCTION • 15012 HWY 7 STATE SURCHARGE(VALUATION) 12.50 MINNETONKA, MN 55345 TOTAL 425.50 (952)746-3783 Minnesota State License#: 20325555 OWNER RADUN,JEFF 2600 WEST LAFAYETTE RD EXCELSIOR,MN 55331 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 rev e at any time for du use. 4/ les . / azuuo 4o, // Applicant Permitee ignature Date Issue+�ty Signature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono 5. 50 Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: / g,0 � PO Box 66 Permit number: ��r/� d�f0 O Crystal Bay, MN 55323-0066 Date received: aild1/4 Received by: Street Address: T 8 titi 2750 Kelley Parkway � L� o Plan review fee: Orono,rono, MN 55356 O//—DOD4o3 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 nsub�ed. �� Incomplete applications will be returned. (Please print) GENERAL INFORMATION: (� Job Site Address: Lc*A ?e..k+ Rci Will this be a Parade of Homes, Remodelers Showcase 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 service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: Levy B rbs . t-k Pvte_s State License# 3 a 5555 Expiration Date: 3- 31 - 001 a Phone: 459-'14 e- 3'l 25.3 (office) (cell) Mailing Address: t Soia {i-wY -I Cit : _ Ivw a-}onka ZIP: $S3&4S Contact Person: Dcvins inn a.irk Applicant is: 4 ontractor / Homeowner (Circle one) Email and/o&It 952.-94-ka- to 68 PROPERTY OWNER INFORMATION: Name: 3,1' La(r►rn Ro�du►r•z Phone (day): fo1Z-"'lt9 -3S' Address: 2a•c5a 1&[ Lf .yep-+ . Ri City:Ecce lscor ZIP: SS 331 Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑ Door(s) Q(Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: ecksetrviev-.(. �' � Q ,ck , Gln f1sc3 yvt rite� -�tv+¢�luce Estimated Construction Valuation of Project(excluding land) $ as,orb 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 application may not be issued. Applicant's Signature: Date: oD©(I . Last Updated: 05-04-2009 Plan Review Checklist for New Structures / Additions Address/ PID/Legal: Z Go C9 0 l.�`S LA f-AN c i i E. �_4/9 6 Description of work: (,0w,erL L\JP I✓ IJN I- J-j Septic review by: Al j A Date Approved: Zoning review by: N (A Date Approved: Building review by: 4,66 044..ein, Date Approved: 2. -3 - 7-11 I Grading review by: (U 16 Date Approved: Zoning File#: Resolution #: Resolution Date: NZoning District Fire Department Post Office School Dis ict Zoning: Lot Area: SF/AC Width: Dep •. Survey Sub •fitted: 0 Yes 0 No Date of Survey: Proposed Setba• s: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) 0 er Buildings Wetland Side Side Building Defined Height: Building Peak Heigh : FOR A BUILDING WITH A BASEMENT OR -AWL SPACE: FOR • =UILDING ON A SLAB FOUNDATION: START the distance between th- easement floor/ . ART the distance between the slab and the WITH crawl space floor and the hi, est roof peak, WITH highest roof peak, the top of the cornice the top of the cornice of a flat ,if, the deck of a flat roof, the deck line of a mansard line of a mansard roof, or the upp_ most roof, or the uppermost point on a round or point on a round or other arch-type r..f other arch-type roof SUBTRACT half the distance between the highest SUBTRACT half the distance between the highest window and highest roof peak of a pit, ed window and highest roof peak of a roof pitched roof SUBTRACT the distance between the base -nt floor/ ADD the distance between the slab and the crawl space floor and the high-st existing highest existing grade within the grade within the foundation .r 10 feet, foundation whichever is less. EQU• S Defined building height EQUALS Defined building heigh Lot Coverage: SF Shoreland District MCWD Permit Received 1 Average Lakeshore etback Bluff ❑ Yes 0N 0 Yes 0 No 0 N/A 0 Yes 0 No Permit Number: ❑ Yes 0 No • /A Setback: Hardcover Zone: Existing ' Proposed Variance Required CUP Required 0-75' 0 Yes 0 No 0 Ye 0 No 75-25" Type(s): Type(s): 250-500' 500-1000' I REMARKS (in-house): N0 Cy/iNGL� Updated: 07/01/2009 z:\forms\plan review checkiist.docx Fees to be Charged YES NO • Plan Review StatitSiiittarge t. . Investigation Fee 4 lberafSAC baits Sewer Connection IitelA1�TA1@OA..`; Park Fee ite ras cion.. .. Other(specify) 9sc71a�ae�aases. ,r . ;- Calculated By: UBC: Construction Type: Square Footage $ per Square Footage • Basement X I _ $ 1st Floor X = $ 2ntl Floor X = $ Garage X = $ Estimated Construction Value: $ ZS, 000 9-9- Orono "Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site )2'Plumbing ❑ Grading / Filling ❑ Well 0 Hardcover Removal ,2 Mechanical ❑ Fire Electrical ❑ Footing 0 Septic 0 Water Connection ❑ Foundation Survey 'Fireplace 0 Sewer Connection ,0r'Framing CI/Masonry 0 Lawn Irrigation insulation fg O all Board 0 Other(specify) 'fvey Final O 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: 07/01/2009 z:\forms\plan review checklist.docx