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Home My WebLink About2009 - 00175 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2009-00175 - 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 04/30/2009 (952) 249-4600 FAX: (952)249-4616 ADDRESS : 2740 WHITE OAK CIR PIN : 04-117-23-42-0019 LEGAL DESC : REG. LAND SURVEY NO. 1447 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 49,000.00 NOTE: SEPERATE PERMITS REQUIRED: ELECTRICAL(STATE) SETBACKS TO BE CONFIRMED AT TIME OF FOOTING INSPECTION-MUST BE 45'FROM WETLAND KITCHEN REMODEL,DECK&PORCH APPLICANT PERMIT FEE SCHEDULE 671.00 PLEKKENPOL BUILDERS PLAN REVIEW 436.15 401E 78TH ST BLOOMINGTON,MN 55420- STATE SURCHARGE(VALUATION) 24.50 (952)888-2225 TOTAL 1,131.65 Minnesota State License#: 1797 OWNER BERRELL,ROBERT&KAREN 2740 WHITE OAK CIR 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 -- suspe i ded for a period of 180 days at any time after work has commenced. 4T a. icant is responsible far assuring all required inspections are r,. d i .on ance , h the State Building Code.This permit may be . ek. y[7- fir re cause. C2r7 - aka...1,(_ 44_____C 9' Applicant Perm'e. Signature Date IssueBy Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CHECK OFF LIST FOR ISSUANCE OF PERMITS FOR OFFICE USE ONLY ADDRESS OR LEGAL: d." 1/4-4 jh` le 0 A C r C t PID: DESCRIPTION OF WORK: 7 ya c(6-0(.-C Scz'e ccy (,1 ZONING REVIEW BY: ` ;AN el-- �� Y.• ' / DATE APPROVED: Zy BUILDINGREVIEWB DATE APPROVED: . z H_o y FEES TO BE CHARGED: Misc. Fees Calculated By: PERMIT Yes - No PLAN REVIEW Yes No SEWER CONNECTION STATE SURCHARGE Yes ✓ NoWATER CONNECTION INVESTIGATION FEE Yes No_� PARK FEE SAC Yes No SITEINSPECTION Number of SAC Units OTHER ( eci sP JJ) ZONING CHECK LIST Zoning District: K - 1 Fire Department: Post Office: School District: Lot Area: Sq ft. Acres 2t- Width Depth Survey Submitted. YesNo Date of Survey: 1`f 78) Proposed Setbacks: Front �-�� fes° -Right Side: v Rear(Street): JZ[> Left-Side: • Adjacent Structures: Wetland. • Building Height: Def Hgt. /l/1- Peak H 8t• Lot Coverage: (j4 Grading: StaffApproval Date: q /'7A By: Council Approval Date: Septic: Staff Approval Date: -02 Li-0 CI By: bib" Zoning File: # Resolution: # Resolution Date: Shoreland District: 14 4 Avg. Setback: MCWD Permit: Bluff Setback: Lot Coverage: Existing Proposed Hardcover: 0-75' 75-250' 250-500' 500-1000' Hardcover Variance Required: Yes No Date of Council Approval: REMARKS(in house): 33 BUILDING REVIEW CHECK LIST UBC: R-3 CONSTRUCTION TYPE: V 6 Sq Footage $Per Sq Ftg Basement • x 1st Floor • x = 2nd Floor x =-- Garage Garage x = x = TOTAL Estimated Construction Value: $ '11 000 ci2" Inspections Required: Work Requiring Separate Permits: Site Plumbing Fire Hardcover Removal Mechanical Water Connection pc Footing Septic Sewer Connection g Framing Fireplace Lawn Irrigation Insulation (Masonry) Other Wall Board (Mfg.) Well(State Permit) oc Final Grading/Filling ,< Electrical(State Permit) Other REMARKS(INHOUSE): REVIEW BY OTHERS: DATE: Access: Existing New Access Approval: Date By: REMARKS(TO BE NOTED ON PERMIT): 3 J bAicKs >t / cot,h?<</ firm c /oCDI,�l in SpcCIlcti ►-1 — fir) b, 4S ' �4� 34 City of Orono Building Permit Application for New Structures or Additions Mailing Address: Permit number: '2-O - Odl —l`� g,0,4. PO Box 66 O O \ Crystal Bay, MN 55323-0066 Date received: 1 + Z 31 ect a I wR s Street Address:' Received by: ��I le cyn '1. .o.• !„Ai••114 �� 2750 Kelley Parkway Plan review fee: -- ir1G(it ie-c-- .t ')xo4`+ Orono, MN 55356 Total Fee: / / 3 r , ''. 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: a i yo w I• c4 e Oak C& �J Job Site Address: 4( Gee Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes lArNo 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/a �e.IC,��IT INFOFj�MATI � � Name: ( ' � t...ta v5 State License# 1 1 Cj� Expiration Date: W�36j�°p Phone: ''5�—8'g ��a 5— (office) l?-3 _ ' (cell) Mailing Address: 44)7 . Easf 7 6-c4"---5(- City: ZIP: Contact Person: u-t,le_ Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: G15 --8-,-6-- ' PROPERTY OWNE Iy,FORMf�TION: p Name: v i I�sa-fa'�'-vl g v -. it Phone (day): 5a, •- vO4'- kayo Address: 740 Li.) © , C rc4 City: Ufr ZIP: 55.25, Email and/or Fax ARCHITECT/ ENGINEER NFORMATION: Name: /'1/-4• 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 2-Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with [a Deck ❑ Relocation �` detached garage ❑ Office/Commercial Private Sewer ,Other: (specify) P ❑ Multiple Family/Condo CIWarehouse K' 0 ' / 0 Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial g 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.orq Estimated Construction Valuation (excluding land) $ �fy(ytj" - 18 - STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame ❑ Masonry b.Width (ft.)= Number of garage stalls: ❑ Metal Attached= ❑ Pole Bldg. Areas in square feet Detached= ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1st Story = ❑ Other(please specify): e. 2nd Story= f. '/Story = g. Total Area= • REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not • Enclosed Applicable ❑ 0 Permit Application ❑ ❑ Proposed Building Plans ❑ 0 MN State Energy Code Calculations and Mechanical Code Requirements Form ❑ ❑ Survey(meeting all requirements) ❑ 0 Hardcover Calculation(s) ❑ 0 Septic System Site Evaluation Report ❑ ❑ Access Permit ❑ 0 Wetland Buffer Improvement Plan ❑ ❑ Engineered Plans for Retaining Walls 4 feet or above ❑ ❑ Plan Review Fee • ❑ 0 Other APPLICANT 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; • 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. y-3(..) -or Applicant's Signature: APP1111 - 19 - �DAIg CITY OF ORONO CALLED IN TIME INSPECTION WINECHEDULED c '� / 6 .3e PERMIT NO. COMPLETE ADDRESS eireP. a7o £2442//�a OWNER CONTR./�`� X��e& TELEPHONE NO. (�0-- —328 `36 • DESCRIPTION ! 7kg`�� 1.4 ❑ FOOTING ❑ MECHANICAL ❑ EXCAV/GRADING/FILLING 4. Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS c ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT • ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP IQ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc W CCS-ra f� D yrs ssel4 0 cc 0 z cc 0 W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CC W 1CORRECT WORK&PROCEED C'' ISSUE CERTIFICATE OF OCCUPANCY O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT 0 CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ElSTOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: ? Inspector. Cc./( r (' (SS White Copyllnspector's File Canary Copy/Site Notice dTIME T CITY OF ORONO CALLED IN D7� INSPECTION NOTI ESCHEDULED 6-/z-o7 /O.'.3D PERMIT NO4901 — 00l7S COMPLETED Cal/ ,, GG nn '' � to ADDRESS J // ' 027'10 W� - / c� OWNER CONTR.2 OJLL, TELEPHONE NO. (0/ a 3. $ - 13b4 • DESCRIPTION Food k. ti ❑ FOOTING ❑ MECHANICAL R ❑ EXCAV/GRADING/FILLING xt Lt. ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORENVETLANDS rd' O ❑ INSULATION ❑ WOOD BURNER/FIREPLACE 0 TREE REMOVAL • ❑ WALL BD. ❑ WATER HOOK-UP 9 SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP 0 PROGRESS 0 DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v 0 DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP LL 0 PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ElPLUMBING FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: cc W a it J 0 CC 0 W Q cnW Z W CC d WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE ❑CORRECT WORK&PROCEED ü ISSUE CERTIFICATE OF OCCUPANCY Ci ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 0 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/Contra •*•1 :'te: Inspecto'. /It� / White Copy/Inspector's File Canary Copy/Site Notice a _ y�l AT TIME V P' ; t aaa 3 � , I: o CITY OF ORONO CALLED IN INSPECTION NOTI E /7 SCHEDULED 9-/4t.el ��'''`' PERMIT NO.��1 / COMPLETED ADDRESS 077 2'`) tvotitz Oa-AA Ct... i OWNER / /CONTR. _ '-; /.I , TELEPHONE NO. 40ick_ &lZ 37S / i T DESCRIPTION F7n21— `4i ❑ FOOTING ❑ MECHANYCAL RI �� / �jy AV/ DING/FILLING Li- Q ❑ FRAMING 0 MECHANICAL FINAL/ / ze""L n �ETLANDS Q ❑ INSULATION ❑ WOOD BURNER/FIREPLACE/ oli E R VAL • ❑ WALL BD. ❑ WATER HOOK-UP (��❑0 SS I-E INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP IL ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES_NO o COMMENTS: cc W Q. CC 0 CC 0 Q W CC Q W Z W CC �iWORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑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!Contraq on si Inspector. T White Copy/Inspector's File Canary Copy/Site Notice • TIME CITY OF ORONO CALLED IN 7 0 ' INSPECTION NOTICE SCHEDULED 'f /0- &V PERMIT NO.olaa f—CO/7S COMPLETED ADDRESS X 7 0 te}h uD &A _/o OWNER CONTR.fe/eA a-e &AO TELEPHONE NO. LC &/A- 3 ??S- /3‘04( E DESCRIPTION ?Or(.//t__ • W ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/ G/FILLING QFRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS - ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SE+NNER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP 44 ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL ❑ PLUMBI ❑ FOUNDATION/REMOVAL Z OWN CONTRACTOR TO ET YOUf YES_NO o COMMENTS: CC W a cC O CC O ti W W CC S Lf W ORK SATISFACTORY:PROCEED ElPROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY OO LI CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.1 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: 6-7T363 � Inspector. White Copy/Inspector's File Canary Copy/Site Notice