HomeMy WebLinkAbout2015 - 00522 - addn/remodel/repair CITY OF ORONO *12 10 I I 15 II 10 I 0 15II 2 12 I*I
2750 KELLEY PARKWAY DATE ISSUED: 05/06/2015
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 993 WILDHURST TR
PIN : 07-117-23-12-0003
LEGAL DESC : UNPLATTED 07 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 75,000.00
NOTE: SEPARATE PERMITS REQUIRED:PLUMBING,MECHANICAL,ELECTRICAL(STATE)
(REMODEL KITCHEN,BATH,ENTRY&STAIRS)
APPLICANT PERMIT FEE SCHEDULE 912.84
PLAN REVIEW 593.35
ROHAN LUND INC. STATE SURCHARGE(VALUATION) 37.50
925 CREEKWOOD ST
CHASKA,MN 55318- TOTAL 1,543.69
(952)474-3440 Payment(s)
Minnesota State License#: BUIL-BC192981 CHECK 5843 1,543.69
OWNER
PFAFF,BRAD
993 WILDHURST TR
MOUND,MN 55364-
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.
DaIf?ft/6//, CyVl (
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)
OA, Mailing Address: Permit number: D 16- vU 5i
`VO PO Box 66
Crystal Bay, MN 55323-0066 Date received: �� cJ
Street Address: Received by:
Z 2750 Kelley Parkway Plan review fee: �( f\
F L Orono, MN 55356
11kESHow"
Total Fee: ' 5► 12 (o
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us `t J
This application form must be completed in full and all required information must be submitted. U� d
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: ' 11 / LrvtscT 515/11—
Job Site Address: ??3r c" / /i�j (>,2S 71" ]'wk.
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? El Yes ,allo
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: je m A 1.-7., t° u el d /4i 6 s
State License# /GC - /g 2- 9 8 l Expiration Date: 3 31/a 2/ 7
Lead Certification Number: Aid 770 c.,/5,4,5-/ Expiration Date: frq/Q , /7, 020/
(for work on homes that were constructed prior to 1978
Phone: (cell), /02 - 757_a pp , (office) . r C
Mailing Address: !a ke.EK[Jv e,o D .57-.. city:e i-Sk 63 ZIP: �5,3/
Contact Person: p/./ Lv ti(. Applicant is: ontractor / Homeowner (Circle one)
Email and/or Fax: ton&A7' c.>'1 - /40 7 ,r101-/• eow, 15-.2 — Lj 7 c1/- 3(/`/0
PROPERTY OWNER INFORMATION'
Name: ,A R-J 1,1401/a
Phone(day): ,(/a- - y/q �/
Address: 9?3 tc' C D/fv 2 S r '7" City: )/Lrt C)DZIP: ,3'-?-3Email and/or Fax: 46/y gyp- 1 /Z/�/L✓4`�• bi Z
PROJECT INFORMATION: Overall project description: / � 4" / , �j 4 rn r - ,LS l ai-rw
Type of Project: Any earth movement may also requite
'Door(s) ,Remodel 0 Fire Damage MCWD review&permits:
❑ e-roof,asphalt E] Repair 0 Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof,cedar ❑Restoration 0 Water Damage Deephaven,MN 55391
❑ Re-roof,other(specify) 0 Siding 0 Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
0 Window(s) ' www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ $, COO
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 othergovernmental agencies required by law. If
you refuse to supply the i ormation,th applicat may not be issued. _
Applicant's Signature: V � %y Date: I / 21D/5
Owner's Signature: ` ,id: 70, ..1 . ...---
T a-?'-1 Date: /to
r f
Last Updated:January 2015 vJ
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: 'lei 3 w 1 t.-0 H 2_s:; i t(.._ Permit No.: 7..A:)'� - v v_>2 2
Description of work: It k rC.t4N i -1= V O C L. Date Rec'd: --5-1 - /`rt'
•
Septic review by: (J/ Date Approved:
Zoning review by: N 1 rt‘' Date Approved:
Building review by: c J C.Q.4�t..w Date Approved: -. `." - I S
Grading review by: l �"/ Date Approved:
•ning District: Zoning File#: Reso#: Reso Date:
Zoni •: Lot Area: SF/AC Width: Lot Coverage: SF ok
Survey Sb •mitted: ❑ Yes 0 No Date of Survey: Revised date( .
Proposed Se •acks:
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Bu' :ings Wetland
Side Side
Defined Height: Peak Height: FFE: FFE min : 6 feet= (Existing Contour)
Perimeter(linear feet) = 50% = L.F. below grade # of Stories
FOR A BUILDING WITH A BASEMENT OR CRA` SPACE: FOR A BUI •ING ON A SLAB FOUNDATION:
The distance betw--n the lowest proposed The distance between the top of
START WITH floor(of the basemen •r crawl space)and START WITH slab and the highest point of the
the highest point of the ..f. roof.
If you have a... If you have a...
• GABLE OR HIPPED ROS no • GABLE OR HIPPED ROOF
windows): Subtract half the•'-tance the windows): Subtracthalf
the distance between the
between the highest point of the •o highest point of the roof to
to the low point of the correspond' - the low point of the
SUBTRACTION gable or hipped roof corresponding gable or
(BASED ON • GABLE OR HIPPED ROOF ith SUBTRACTION hipped roof
ROOF TYPE) windows): Subtract half .-distance (BASED ON • GABLE OR HIPPED ROOF
between the top of the ghest ROOF TYPE) (with windows): Subtract
window and the hig st point of the half the distance between
roof the top of the highest
window and the highest
• ALL OTHER-'aOF TYPES(flat, point of the roof
mansard,e• :No subtraction. • ALL OTHER ROOF TYPES
SUBTRACTION Subtract the d' ance between the (flat,mansard,etc):No
(BASED ON basemenUc - I space floor and the subtraction.
EXISTING highest e ' ting grade adjacent to the ADI ION Add the distance between the top
GRADES) founda'.n OR 10 feet(whichever is less). (BAS .ON of slab and the highest existing
EQUALS Def ed building height EXISTIN t grade adjacent to the foundation.
GRADES)
EQUALS Defined building height
Shoreland Distric MCWD Permit Average Lakeshore Setback Bluff
Met?
❑ Yes No Permit Number: 0 Yes ❑ No 0 N/A 0 Yes 0 No
❑ N/A—see attached Setback:
Stormwater 'uality Existing Hardcover Proposed
Overlay r istrict (%and sf) Hardcover Variance Required CUP Required
Tier(c' cle one) (%and sf)
❑ Yes ❑ No ❑ Yes ❑ No
1 • 3 4 5 Type(s): Type(s):
Upda ed: January 2015
z:\forms\plan review checklist 2015.docx no c +._I- A f _49
REMARKS (in-house):
Fees to be Charged YES NO
Permit
Plan Review
State Surcharge
Investigation Fee
SAC— Number of SAC Units
Other(specify)
Square Footage $ per Square Footage
Basement X = $
1st Floor X = $
2nd Floor X = $
Garage X = $
Estimated Construction Value: $ 1 k9(-9C)
Orono Inspections Required Work Requiring Separate Permits Required State Permits
O Site 2lumbing 0 Grading/ Filling 0 Well
O Silt Fence/ Erosion Control Mechanical 0 Fire Electrical
O Hardcover Removal 0 Septic 0 Water Connection
O Footing 0 Fireplace 0 Sewer Connection
O Poured Wall 0 Masonry 0 Lawn Irrigation
O Foundation Survey 0 Mfg. 0 Landscaping
O Foundation Waterproofing 0 Other(specify)
O Radon Rock Bed
Framing
O Insulation
O As-Built Survey
inal
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 2015
z:\forms\plan review checklist 2015.docx
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CITY OF ORONO CALLED IN 5 [T .t TIM
INSPECTION N TonSCHEDULED
PERMIT NO. v,Z1e6/n ED
ADDRESS W -Pim.✓1 !►'
OWNER j I TELEPHONE NO.�/1751"' X�
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CONTRACTOR A _Ra (14-t' 6�( •
DESCRIPTION lia_44L // i9" ' /
FOOTINGDEMO-FINA/ � �y SEPTIC FINAL
W ❑ 0 ❑
WQ ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/' NG
Q ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI ❑ SITE INSPECTION
C 0 FRAMING 0 MECHANICAL FINAL 0 PROGRESS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
LAJ ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 HARD COVER REMOVAL
, ❑ DEMO-SITE EPTIC INSTALL 0 FOUNDATION/REMOVAL
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OWN ERICONTRACTOR TO MEET YOU_: YES_NO
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RRECT WORK&PROCEED El ISSUE CERTIFICATE OF OCCUPANCY
O CICORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
CISTOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. ! ' 49-4600
Owner/Contractor on site:
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Inspector.
White Copyllnspector's File Canary Copy/Site Notice
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CITY OF ORONO CALLED IN
INSPECTION NQ3�CE Q� SCHEDULED /. .'D�
PERMIT NO.o((J/J ,�_ MPLETED
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ADDRESS /J �-t�ti
OWNER ZLE,N7. 1,02_7S7_2��CONTRACTOR C • O'')Z1
DESCRIPTION 71./..A Z1.1,/0(iti
u., ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
H ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 F AMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ SULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
v FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
iNl ❑
BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
v ❑ DEMO-SITE 0 SEPTIC INSTALL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
r0.) COMMENTS:
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IQ 0 WORK SATISFACTORY:PROCEED I�'PROJECT COMPLETE
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❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0• ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. U PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. '
Call for the next inspection 24 .urs in a ,?' (952) 249-4600
Owner/Contractor on site: /'�
A� `
Inspector: �
White Copy/Inspector's File Canary Copy/Site Notice