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HomeMy WebLinkAbout2016 - 00052 - adv plan review CITY OF ORONO I '1 1' 1 111E1 I I [MI * ♦• 2750 KELLEY PARKWAY * 2 1 6 - 0 0 0 2 DATE ISSUED: 01/15/20162016 t ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2610 WEST LAFAYETTE RD PIN : 21-117-23-24-0043 LEGAL DESC : SHORE HILLS : LOT 011 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 180,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 180,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: REMODEL PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00053 APPLICANT ADVANCED PLAN REVIEW 1,049.05 MCGOWAN DESIGN BUILD INC TOTAL 1,049.05 Payment(s) 11180 33RD CIRCLE NE ST MICHAEL,MN 55376- CREDIT CARD 3076 1,049.05 Minnesota State License#: BUIL-BC642682 OWNER ENQUIST,CYNTHIA 2610 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 revoked at any time for due cause. Applicant Permitee Signature Date Issued By Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) �O�o MailingAddress: Box 66 Permit number: o2C�/(o-b OCs - Crystal Bay, MN 55323-0066 Date received: 1-1 5- / Street Address: Received by: I'Yf f y� 4' 2750 Kelley Parkway :).k`' Plan review fee: ?" o 49. Qj l�KESH�4�G Orono, MN 55356 ` J © !( Total Fee: P - �O 5-.. 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: 2G 10 L(/2S. La?ty. ,e Rpp Will this be a Parade of Homes, Remodelers Sho, case 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 I APPLICANT INFQ�RMATION:: Name: /f1e�t �c cet 1k yii ufli/X/' rte• State License# SC gy2 6 82 Expiration Date: 3-3/20/7 Lead Certification Number: 4/417 - //29n-/ Expiration Date: //-2171-2 to/g (for work on homes that were constructed prior to 1978 Phone: (cell) 75,2.- /2 --/76.6 (office) -- Mailing Address: /3o 33, late 'eciezA bA, 04. 32'/ City:,tteimii ea ZIP:S-S-30 - Contact Person: J04,1 /Pt a Go Applicant is:Cror ctor ' Homeowner (Circle One) Email and/or Fax: j 0in Q c G.04,0QA est yA it/4j1, c 0,6-, PROPERTY OWNER INFORMATION: t� Name: C/)1,10.- -1, V j s-2L Phone (day): 61.z - 3$2 - p Address: 2fo 1O GteeSr- La � f / 0ed City: ©r0/70 ZIP: S-.S.1??/ Email and/or Fax: c tine or,e/z i . c c PROJECT INFORMATION: Overall project description: /i7741-rA ` /'e/eecXe7 9- 'A" 'j`/W Xe--46 Type of Project: Any earth movement may also require 71-Door(s) RemodelMCWD review&permits: 0 Fire Damage ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd 0 Re-roof, cedar 0 Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) N'Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ,181.W i n d o w(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ /$O, Ooa ` - 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 ma not be issued. Applicant's Signature: 4-60‹` Date: /-/5--/G Owner's Signature: Date: Last Updated:January 2015 �1. / Ia Survey for RALPH D. BURGESS, JR. N LEGEND O mom MONUMENT •P.P. POWER POLE nc71 - ^' ''' P.A. PLANTINCa AREA d �° aI •• sk.,/ \� MINIMUM 6UILDING SETBACK LINE 'LI �' ;t"'z•3 r.s. �S67D G GAS MAIM * .A x 1 \\ T UNDERGROUND TELEPI.oME CABLE ® -6'H16H WAIN Ix\Y.' z 55 SANITARY SEWER \ LINK PENCE.• 1 �M� O �✓ WATER MAIN \ 0 ` ->ka OVERHEAD POWER L114E y:5 Pttt �I E1• /) \3 '- '-t x':.,.., EDGE of EITUMINOUS pipfet \', ,67 G 4 \A ,• ,...\- • w le . / O 1�. f t,1!::6;. , Ne \ I 1,110't-yy .2 ?oN Se•9 G £t N EO e \ in : .,'N% ,\ --•ste --sr• ft 4.... \?.. . : •^ '� A ' Ain btl ''.1 I Z,,,-; �.'' ....,J' Fr , w k V IS. • r -,•,p • v m ;° c a v L.SS• A ,e ,., �%. Od • 24 n mM C s SS;e11tr �• I ,,� 9 IM NIT'IB si'61�! Y •y+ .:19_ 0) t h, I rp J • r ., H ,z Q 11 o r, IJ, '',1 YI VI 55 ID ( LG.T k I I N OOi , 3 and• J 4ACA6i6 N li•'- \__w w o r N ,f .W 1 P o / �o I:� �1 35.0 \\. .-�' 1 M r Q '• t 1 2e,„Av.� ____.L.. '\ \ .5-11•A4."' Z 4. \-----' . - s'''‘ \ -. .•. • N O U0. M �� �� -tea}_ V 7 I LEGAL DESCRIPTION: pIO,II?S: 1. All bearings shown are assumed. All of Lot 11, SHORE HILLS, Hennepin County, Minnesota, except the Southeasterly 2. Current minimum building setback lines shown are from the City of Orono. 15 feet, front and rear. 3. Sanitary sewer and water main data shown are from the City of Orono. 4. Gas main data shown is from Minnegasco locator. Subject to easements and restrictions of record, if any. 5. Under,,3round telephone cable data shown is from H.W. Telephone Co. Locator. 6. All utility data shown is based on available information. 7. Call utility companies for exact field locations prior to any excavation. CERTIF'ICATIONo 8. There are no easements on the premises as per the title opinion by I'redrikson F Byron dated 11/6/85. I hereby certify to Ralph D. Burgess, Jr. that this is a true and correct plat of 9. The property contains 54,400 + square feet or 1.25 + acres. The arca cannot a survey of the above described property• that said survey shows the location of be determined exactly because the property has lake shore which is irregular. all buildings, structures and other improvements situated on said premises, all applicable setback lines and all easements, rights-of-way and any encroachments on or from the premises that are known to the undersigned, that are visible on the premises or that are of record. r---------__ z iiOF Ods\iNv t SITS P' ' I. '' t, • '.S2T �.._ _ Sim . . §§ o cOP' S c"4-t--c -- U ^ (/ / THEREBY CERTIFY THAT THIS SURVEY,PLAN,OR REPORT WAS PREPARED !Y C. E. COULTER & ASSOCIATES INC, DATE 64/86 SCALE 1•• = 20' ME OR UNDER MY DIRECT SUPERVISION AND THAT I AM A DULY REGISTERED 7 REVISIONS LAND S�U,'RV)-1 „,,1 EYOOt "U/O[E THE LAWS of THE STATE OF MINNESOTA, ^ WW PROFESSIONAL REGISTERED SURVEYORS Joe No. 10,703 ` �_��9 \(` '� REGISTERED MINNESOTA S WISCONSIN LICENSED crrr OF MINNEAPOLIS V_ 3300 LYNOALE AVE. SO. MINNEAPOLIS, MINN. 55408 IK./PG.260-1/142* I DATE I7/ 1-/ /RSP REG. NO, 1374Z— TELEPHONE ' 812-824-0370 111 _ FILE NO. 3-5-31 Sl10Ei 1 OF E • 7" 1.