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Home My WebLink About2010 - 01075 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2010-01075 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 11108/2010 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 925 WILLOW VIEW DR PIN : 28-118-23-44-0008 LEGAL DESC : WILLOW VIEW : LOT 007 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 24,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE AND ELECTRICAL(STATE) BASEMENT FINISH APPLICANT PERMIT FEE SCHEDULE 398.25 FINISHED BASEMENT CO. PLAN REVIEW 258.86 1380 DUCKWOOD DRIVE EAGAN,MN 55123- STATE SURCHARGE(VALUATION) 12.00 (612)710-0391 TOTAL 669.11 Minnesota State License#:20460771 OWNER ELLIS,LOUIS&MARY 925 WILLOW VIEW DR 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 tirlte for due cause. / � ' " —,1/ b / / ppl_ nt Permit a Signat re Date Issued By i:.nature / Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE\ l ..._ City of Orono -� �' \\\klio Building Permit Application for New Structures or Additions Mailing Address: Permit number: 0-61075- 0"3.4V) PO Box 66Crystal Bay, MN 55323-0066 Date received: 8 c9, /0 ,., .;V.,. � �, Street Address:' Received by: 7)4, ��c, y � �1"�+ G�ti 2750 Kelley Parkway Plan review fee: ..t 0,11".,p Orono, MN 55356 !!� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us Total Fee: '4 9.// P This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION /I l - Job Site Address: C7 5, `0 4 rj �, >° t) �f-, Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [ b 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/APP ICA T INFORMATION: Name: irro� /cc. -e-,ir-P Cc. State License# , It _ p? 7 Expiration Date: / ,7766 z Phone: t�'�- 1 gg= e (office) „.,„....-_e____ (cell) Mailing Address: /'gam ,(�yy��,,.,„," 4,.. 5 - 9 Cit : £a. , ,,,- ZIP: \3175'L,2� C•. act Person: ♦Gt ve__ /Vci- Applicant i- ontra 'or Homeowner (Circle One) 411M and/or Fax: . % ,le-e 5 .ter;5 -...' 5en2e ? - . 6jvi PROPERTY OWNER INFORMATION: Name: Lou -94 /liar, E-- L/c.5 Phone (day): 4 / --'7/8/-- . 4 A s: 1 a5' 4),//o,J e-k) Or-. City: ( /0,-2_ p ZIP: 57.5--,3 377 Email nd/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: 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 ngle Family with Residence E Addition attached garage ❑ Garage/Accessory Bldg. ublic Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation Ledetached garage ❑ Office/Commercial Private Sewer \� Other: (specify) 4.60�C3e41 /J� ❑ Multiple Family/Condo ❑Warehouse � L El Public ❑ Storage CV(1Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. El Industrial ❑ 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) $ 07"/ D eY-o--. c)-6 Last Updated: 9/29/2009 - 17- STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions (continued) 2.Type of Construction a. Length (ft.)= 6-{0 Number of bedrooms= / —/3 a ood/Frame ❑ Masonry b.Width (ft.)= 2 72 Number of gar a #ails: / ❑ Metal Attached = El Pole Bldg. Areas in square feet Detached = ❑ ICF On-site Prefab c. Basement= (2 SO ❑ ❑ Off-site Prefab d. 1st Story = ❑ Other(please specify): e.2nd Story= f. 'h Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ ❑ Permit Application O 0 Proposed Building Plans O 0 MN State Energy Code Calculations and Mechanical Code Requirements Form ❑ 0 Survey(meeting all requirements) ❑ 0 Stormwater Pollution Prevention Plan ❑ 0 Hardcover Calculation(s) ❑ ❑ Septic System Site Evaluation Report O 0 Access Permit ❑ 0 Wetland Buffer Improvement Plan ❑ 0 Engineered Plans for Retaining Walls 4 feet or above ❑ 0 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. Applicant's Signature: Date: ///, .//a Last Updated: 9/29/2009 - 18 - •.,..r • Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: Cizc wtu..ow '( te \A) ez Description of work: E P,SCEML NT l Sal\ SH Septic review by: 11A Date Approved: Zoning review by: N I IA Date Approved: Building review by: (QAA,IruI.—_ Date Approved: 1 k - ‘-{ - t 0 Grading review by: N I Ar Date Approved: Z. ing File#: Resolution #: Resolution Date--' oning District Fire Department Post Office School District Zoning: of Area: SF/AC Width: Depth: Survey Submitted: ❑ Yes ❑ No Date of Survey: Proposed Setbacks: Front (Lake) Rear(S -et) ( N S E W ) ( N S E W ) Other Buildings Wetland Side ide Building Defined Height: Buildi • Peak Height: i / FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START the distance between the basement floe START the distance between the slab and the WITH crawl space floor and the highest roo peak, WITH highest roof peak, the top of the cornice the top of the cornice of a flat roof, e deck of a flat roof, the deck line of a mansard line of a mansard roof, or the uppermost roof, or the uppermost point on a round or •oint on a round or other arch, .e roof other arch-type roof SUBTRACT half the distance between t highest S :TRACT half the distance between the highest window and highest roof peak of a pitched window and highest roof peak of a roof / pitched roof SUBTRACT the distance between e basement floor/ ADD the distance between the slab and the crawl space floor a.. the highest existing ..hest existing grade within the grade within thelozundation or 10 feet, fo 'dation whichever is lets. EQUALS Defin-• building height EQUALS Defined builWng height Lot Coverage: SF ok Shoreland District MCWD Permit Received Average Lakeshore Setback Bluff 0 Yes /❑ No 0 Yes 0 No 0 N/A _ ❑ Yes 0 No 0 N/A 0 es 0 No _ / Permit Number: Se •ack: // Hardco 'er Zones Existing Proposed Variance Required j CUP Re. ired 0-75' 0 Yes 0 No 0 Yes ❑ O 75-250' .. Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): N0 G(-IAN (,L Updated: 07/01/2009 z:\forms\plan review checklist.docx Fees to be Charged YES NO "Permit ty— Plan Review State Surcharge Investigation Fee SAC—'"Number of SAC Units Sewer Connection Water;Connection Park Fee Site inspection Other(specify) Miscellaneous Fees Calculated By: UBC: Construction Type: Square Footage $ per Square Footage Basement X = $ 1St Floor X = $ 2nd Floor X = $ Garage X = $ c� Estimated Construction Value: $ 2 -{ (ZOO `2'- Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site Plumbing ❑ Grading / Filling ❑ Well ❑ Hardcover Removal Mechanical ❑ Fire Electrical ❑ Footing ❑ Septic 0 Water Connection ❑ Foundation Survey ,6'Fireplace ❑ Sewer Connection Framing 0 Masonry 0 Lawn Irrigation Insulation Mfg. O Wall Board 0 Other(specify) O As-Built Survey ,'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 CITY OF ORONO Y` 'CALLED IN DATE TIME INSPECTION NOTICE _ SCHEDULED - .- PERMIT NO. C'��5 COMPLETED ADDRESS (i?--6 ( Lf" //C t.( ' / % c U/e OWNER TELEPHONE NO. ('5f -/I CONTRACTOR / ifsfSL"'�� .%i`�I�r� r `V I DESCRIPTION r// ?C-r / �--1-/T,' • t �'' t f ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q• ❑ POURED WALL ❑ MECHANICAL RI 0 LAKESHORENVETLANDS U.) ❑ FRAMING 0 MECHANICAL FINAL ❑ TREE REMOVAL • 0 INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q LI RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL 0 PLUMBING RI ❑ SEP,TJC FINAL CI FOUNDATION/REMOVAL • OWNERICONTRACTOR TO MEET YOU:X YES NO o COMMENTS: cC W Q. o Co ( 0Ueco o J z cc Lu• ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE CC W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 LI 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/Contractor on site: / Inspector. if c White Copy/Inspector's File Canary Copy/Site Notice — /Q AT TIME CITY OF ORONO CALLED IN /` /' 4 INSPECTION NOTIC ��7,�Ht DULED /// /C7 /D.'D6 PERMIT NO..2 0/0 /, 1J C MPLETED/, ADDRESS 9035 GO,(10,0 V[ 30- OWNER LEPHON NO. ,S� 83 8889 CONTRACTOR Of.A J,LtiCr 14V* 4V.e-� DESCRIPTION �,1-- LU ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING ct 0 POURED WALL 0 MECHANICAL RI 0 LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL Cl SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ClSEPTIC FINAL ❑ FOUNDATION/REMOVAL • OWNER/CONTRACTOR TO MEET YOU:_YES NO o COMMENTS: cc W cc %0 (Z • TO 6—o ,4-14L4 c1 K cc 0 W CC &,4s2 4-11 c,rt. z LSA f3 IJ+ W W cc 0 tINVORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE CC W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY C) ❑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/Contractor on site: Inspector. (--J6–AD-5 White Copy/Inspector's File Canary Copy/Site Notice