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Home My WebLink About2012 - 00483 - addn/remodel/repair CITY OF ORONO 11111 11111111111111H 11111111111111111111111111111 * 2012 - 00483 * 2750 KELLEY PARKWAY DATE ISSUED: 06/06/2012 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 985 WILLOW VIEW DR PIN : 28-118-23-44-0011 LEGAL DESC : WILLOW VIEW : LOT 010 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 8,000.00 NOTE: SEPERATE PERMITS REQUIRED: ELECTRICAL(STATE) ENCLOSE UNDER PORCH ADV PLAN REVIEW COLLECTED 2012-00459 5/29/12$105.46 APPLICANT PERMIT FEE SCHEDULE 162.25 BRENNAN PROPERTIES LLC STATE SURCHARGE(VALUATION) 4.00 15680 FISH POINT RD SE TOTAL 166.25 PRIOR LAKE,MN 55378- (612)616-4447 Minnesota State License#:20381410 OWNER BROCKMAN,JENNY&GERRY 985 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 perio I -f 180 days at any time after work has commenced. The applicant is re .on ible for assuring all required inspections are requested in :1.rm. - •th the State Building Code.This permit may be revoked• any me fe due c. se. Q /- Cv / W / b/ /o; Al I leant P rmitee igna .re Date Issue is y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. t City of Orono Building Permit Application , (i7 for New Structures or Additions , 061(4g3 Mailing Address: Permit number: OXV/A-01:7 tolOterit 0— .4- c:) PO Box 66 Crystal Bay, MN 55323-0066 Date received: 5- -4-,ib ' `3. __ ›,, Street Address:' Received by: `. 1 ' ;l s Gtiti 2750 Kelley Parkway Plan review fee: 04 L9kESH04� Orono, MN 55356 060/6 —00 X59 -- 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 submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: . Job Site Address: g� Gil,/1O4/ 1/;Cr-✓ I)f?i a6----- Will 6Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes u-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: [;RE/J/J' 2vopPr-1-1r_ State License# ao3 31y I a Expiration Date: 3! i 3 Phone: to;i---(0;,4,.— -{Li'-I-7 (office) (cell) Mailing Address: 1�cr,' Q FL.;/1- Po,,,1¢- i City:pc,,,i (1;,C ' ZIP: 3 73 Contact Person: Joe t rC ri el, +-� Applicant is:—eonrtrac / Homeowner (Circle One) Email and/or Fax: q3-2 -- F_..rf: - N/ PROPERTY OWNER INFORMATION: Name: t� �� LCe_Dca<.,+--; Ate, Phone (day): Co CZ- (Q On -- --o 'ill Address: c[c— (..--'1110 Ili-,'.--, 0(i ye City: 0 -.),,.j ZIP: Email and/or Fax ARCHITECT I ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: F.2i(.1.)449-� / ,i,i4fr% (,'✓i `'r)ci/' 7' . 1.Type of Project 2.Proposed Use --) 3.Structure Type 4.Sewage Disposal& Water Supply ❑ New Construction ®Single Family with G'' Residence 111 Addition attached garage ❑ Garage/Accessory Bldg. 0 Public Sewer Accessory Building 0 Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer El Other: (specify) El Multiple Family/Condo El Warehouse El Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial 0 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) $ i 000 Packet Last Updated: 03-06-2012 -21 - 33�• • C-day / F a h • 3 E • • .04 t Tejo x5 ' >,Fw y 'E < h" STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= /(r> Number of bedrooms= ❑Wood/Frame b.Width(ft.)= /(y Number of garage stalls: ❑ Masonry Areas in square feet Attached= ❑ Metal ❑ Pole Bldg. c. Basement= Detached= ❑ ICF d. 1st Story = . ❑On-site Prefab e. 2nd Story= Z� El Off-site Prefab f. '/ Story = ❑Other(please specify): 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 ❑ 0 Proposed Building Plans ❑ 0 MN State Energy Code Calculations and Mechanical Code Requirements Form ❑ 0 Survey(meeting all requirements) O 0 Stormwater Pollution Prevention Plan 0 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 ❑ 0 Plan Review Fee O 0 Other: APPLICANT/OWNER 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 altemative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Understands 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. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. Applicant's Signature: _ ----7- Date: % -e--C -i Owner's Signature: Date: Packet Last Updated: 03-06-2012 -22- Plan Review Checklist for New Structures / Additions Address/ PID/Legal: 9 ,85 w %\t.Ow \triZ..i Oa Description of work: (-: #J S iz. c.).0%,0-4-1 A aC,l Septic review by: /V/A Date Approved: _, Zoning review by: N/4 Date Approved: Building review by: 4e1.616.,..— Date Approved: S 21- 2O' Z Grading review by: N/A Date Approved: Zoning File#: Resolution#: Resolution Date: Zoning District Fire Department Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Subm 'ed: ❑ Yes ❑ No Date of Survey: Proposed Setbac • Front (Lake) -ear(Street) ( N S E W ) ( N S E W ) Other : .ildings Wetland Side Side Building Defined Height: Building Peak Height: #of Stories Ok?: ❑ YES FOR A BUILDING WITH A BASEMENT OR CRA .SPACE: FOR A BUILD •G ON A SLAB FOUNDATION: START WITH the distance between the basem= t floor/crawl START the distance between the slab and the highest space floor and the highest roof pe- the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line . a the deck line of a mansard roof,or the mansard roof,or the uppermost point on - round uppermost point on a round or other arch-type or other arch-type roof roof SUBTRACT half the distance between the highest window -,d SUBTRACT half the distance between the highest window highest roof peak of a pitched roof ' and highest roof peak of a pitched roof SUBTRACT the distance between the basement floor/cra \ ADD the distance between the slab and the highest space floor and the highest existing grade 'ithin \ existing grade within the foundation the foundation or 10 feet,whichever is - s. =li UALS Defined buildin• hei•ht EQUALS Defined building height \ Lot Coverage: SF Shoreland District MC Permit Received Average Lake- I ore Setback Bluff ❑ es ❑ No ❑ N/A ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No 0 N/A - ermit Number: Setback: Hardcover Zon Existing Proposed Variance Required CUP Required 0-75' 0 Yes 0 No ' Yes 0 No 7 50' Type(s): Type(s: /50-500' 500 1000' REMARKS (in-house): NO cif-r9/'G els- Updated: sUpdated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Charged YES NO Permit"- ,y4^ 44: j V.; '.t,, ., '' 4 Plan Review y Investigation Fee 41: Sewer Connection Park Fee to ei a ff Y++.a1Rz^'rz�txr�-r�Yc. 'x ,M�• 1�' .n,�.i ��. ...� W �!- �`'6��. Other(specify) elQ S eS F� E i � w .10, n is ay s ;, =a�.�4`�.'t.�. --"N �_� ro'�f��p�.d�-. Calculated By: Square Footage $ per Square Footage Basement X = $ 1st Floor X = $ 2" Floor X = $ Garage X = $ Estimated Construction Value: $ ' ,000 as9 Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site 0 Plumbing 0 Grading / Filling 0 Well O Hardcover Removal 0 Mechanical 0 Fire elel Electrical ,12r Footing 0 Septic 0 Water Connection O Poured Wall 0 Fireplace 0 Sewer Connection O Foundation Survey 0 Masonry 0 Lawn Irrigation ❑ Radon Rock Bed 0 Mfg. ,,OFFraming 0 Other(specify) ❑ As-Built Survey e "nal 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: 09/11/2009 z:\forms\plan review checkiist.docx DATE TIME CITY OF ORONO CALLED IN 7 / ��— INSPECTION OTICESCHEDULED 7 A7 - 3 PERMIT NO. �"-U � COMP ADDRESS 5 Wil (I &< l/`42-/ OWNER TEL ONE N .-/' ' - i• CONTRACTOR B� Q - l ' C) Id*'es DESCRIPTION wL 4Ld ov) a -1-7 eRAr/PANT ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/ DING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI 0 LAKESHORE/WETLANDS fackeicgilAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL • 0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION • ❑ RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS • 0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. 0 FOLLOW-UP -C ❑ DEMO-FINAL CISEPTIC INSTALL 0 HARD COVER REMOVAL 0 PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: W CC O CC O W CC W W CC 4J. IQRK SATISFACTORY:PROCEED CI PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.1 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. White Copyllnspector's File Canary Copy/Site Notice r).icA , I.* TIME CITY OF ORONO CALLED ININSPECTION O I E SCHEDULED Ii PERMIT NO./a l�Y C TED ADDRESS 975 /c. /`i� (� ._„;.N_ "!- OWNER /�,,,o No .40P/d`— i/ �' 0 7 CONTRACTOR KJ' �-� I�I I///K � - -.1 �� DESCRIPTION 7 L n.C� ,c/f7 ,... u❑ FOOTING 0 PLUMBING FINAL EXCAV/GRADING/FILLING Q 0 POURED WALL 0 MECHANICAL RI LAKESHORENVETLANDS " 0 FRAMING 0 MECHANICAL FINAL ❑ TREE REMOVAL Z 0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION Q ❑ RADON SLAB 0 WATER HOOK-UP 0 PROGRESS • 0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT v 0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP _ 0 DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL 0 PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES NO o COMMENTS: cc W a CC O CC 6, c1 n PI iv-A l 0 A_?l `1 0 7 I-- Z fel nn-r A— S CC IQCg'14tORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W IDCORRECT WORK&PROCEED tilISSUE CERTIFICATE OF OCCUPANCY C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP 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: Lu( L� V0,39_1,Inspector. White Copyllnspector's File Canary Copy/Site Notice