HomeMy WebLinkAbout2014 - 00990 - addn/remodel/repair CITY OF ORONO 'Ill //1111111 II II 11 II U
990 *
2750 KELLEY PARKWAY DATE ISSUED: 09/08/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 200 WOODHILL RD
PIN : 02-117-23-12-0001
LEGAL DESC : UNPLATTED 02 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN
VALUATION : $ 37,480.00
NOTE: FOUNDATION WALL ANCHORS
OTHER INSPECTION REQUIRED: DURING INSTALLATION
APPLICANT PERMIT FEE SCHEDULE 552.75
STATE SURCHARGE(VALUATION) 18.74
JESSE TREBIL FOUNDATION SYS INC. TOTAL 571.49
60335 U S HWY 12
Payment(s)
LITCHFIELD,MN 56387-
(320)974-8729 CREDIT CARD 3188 571.49
Minnesota State License#: BUIL-20446489
OWNER
CLUB, WOODHILL COUNTRY
200 WOODHILL RD
WAYZATA, MN 55391
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.
0 / 9/ 1-.// 7
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npPlicantrmitee t nature Da
ssueygnaure Date
SEP-3-2014 09:50 FROM:TREBILFOUNDATION SYS 3205938720 TO:1952249461E P.2'6
City of Orono
Building Permit Application for Maintenance / Renovation
(windows, doors, siding, re-roof, etc.
Mailing Address: Permit number. 1.Q Ill-Op q qr
P(:;:ilas
0, Cry tel Ba Crystal Bay,MN 55323-0066 Date received: �'-3-1� _
'\,,` Received by: I -E-
k`')i:1-*19'
Street Address;
-
2750 Kelley Parkway Plan review fee- $ i.9
Orono,MN 55356
Total Fee: �.
Main: - b Fax; 952-249.4616 www r on mn u _ ��
952 2 9-4600 _ .c,Qr �1�
This application form must be completed in full and all required information must be subreitted.--'
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: ,20-0 U30edJ\'aU ed •
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? 171 Yes No
ft yes,a special event permit is required with Police Department and City Council approval 60 days prior to the avont. Shuttle bus se will be
required unless applicant demonstrates sufficient onsite parking is available. Non-permitted ovonts will not be allowed.
CONTRACTOR I JiivAPPLICANT INFORMATION:
�
Name' Tt �?1l�r trt�s.,
State License# `(� Li.LILD LIS f Expiration Date: Z..,
Lead Certification Number;,. -1- j '1 Expiration Date: 41l(o ( U(Q
(for work on homes that were constructed prior to 1978
Phone: r 8'7r 9 (office) (cell)
Mailing Address: r/,fir C. City: .ax - ZiP:
Contact Person: .AM I: ea' dr Applicant is: ' ■ntractor / Homeowner (Ctrcieone)
Email and/or Fax: -
PROPERTY OWNER INF RMATION:
Name: 1J00.i i 1 'gif. .. . -3
Phone(day): As - • :2
Address; ,,.44 - ..A.•...iMr!1. . City: Orono ZIP: 55 391
Email and/or Fax
PROJECT INFORMATION:
Type of Project; Any earth movement may require
0 Door(s) 12Remodel ❑Fire Damage MCWD review&permits:
Minnehaha Creek Watershed District(MCWD)
❑Re-roof,asphalt Repair ❑Storm Damage 18202 Minnetonka Blvd
d Re-roof,cedar 0 Restoration ❑Water Damage Doophaven,MN 55391
Cl Re-roof,other(specify) ❑Siding
Phone: 9952-471-05900
❑Other:(specify) Fax:: 952-471-06822
Cl Window(s) www,minnehahacreek,oro
Overall Project Description: (��� Q Q Ch
Estimated Construction Valuation of Protect(excluding land) S 5-7/4g 0.se
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 bylaw. If you mfuee to supply the Information,the application may not be Issued.
Applicant's Signature: r
4- IA tk Mu MST`: Date: q,f 3 I 1
Last Updated: 08-09-2011
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address/Permit Number: ZOO J 9& (-4-t (-C (204 /)
Description of work: F0 LJAiL)A'yj o.f l4"Ce11912S
Septic review by: N/r- Date Approved:
Zoning review by: !� f� Date Approved:
Building review by: 6Qgv►- -- Date Approved: l- S " Z-0/1{
Grading review by: ti/en- Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
Zonin•: Lot Area: SF/AC Width: Lot Coverage: SF %
Survey S• •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 Buil' gs Wetland
Side Side
Defined Height: Peak Height: FFE: FFE minus feet= (Existing Contour)
Perimeter(linear feet) = 50% = #of Stories Ok? 0 YES
FOR A BUILDING WITH A BASEMENT OR C- . L SPACE:
The distance betwe= the lowest FOR A :i ILDING ON A SLAB FOUNDATION:
START WITH proposed floor(of the.-sement or crawl
space)and the highest p•' t of the roof. START WITH The distance between the top of slab and
If you have a... the highest point of the roof.
you
• GABLE OR HIPPED ROO o • ave a...
• GABLE OR HIPPED ROOF(no
windows): Subtract half the windows): Subtract half the distance
distance between the highest poi between the highest point of the roof
of the roof to the low point of the to the low point of the corresponding
SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof
(BASED ON ROOF • GABLE OR HIPPED ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with
TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance
distance between the top of th- between the top of the highest
highest window and the high- t window and the highest point of the
point of the roof roof
• ALL OTHER ROOF ES(flat, • ALL OTHER ROOF TYPES(flat,
mansard,etc):No subtraction.
mansard,etc):No s araction' ADDITION Add the distance between the top of slab
SUBTRACTION Subtract the distance•-tween the •SED ON and the highest existing grade adjacent to
(BASED ON EXISTING basement/crawl sp- e floor and the E TING the foundation.
GRADES) highest existing, -de adjacent to the GRA 9.S)
foundation O' 0 feet(whichever is less). EQUAL Defined building height
EQUALS Defined •.ilding height
Shoreland District MCWD Permit Received Average Lakeshore Setback Me ' Bluff
0 Yes 0 No 0 N/A • Yes 0 No
0 Yes • o - 0 Yes 0 No 0 N/A
Permit Number: Se ,ack:
Storming'. -r Quality Existing Proposed Variance Required CUP Required
Overla District Tier Hardcover Hardcover
❑ Yes ❑ No ❑ Yes 0
Type(s): Type(s):
Updated: January 2013 itt c G 1-3 ANJ
v:\forms\plan review checklist 2013.docx
REMARKS (in-house):
Fees to be ChargedYES/ NO
Permit V'
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: $ 3?,9 coo 00
Orono Inspections Required Work Requiring Separate Permits Required State Permits
O Site 0 Plumbing 0 Grading/ Filling 0 Well
O Hardcover Removal 0 Mechanical 0 Fire 0 Electrical
O Footing 0 Septic 0 Water Connection
O Poured Wall 0 Fireplace 0 Sewer Connection
O Foundation Survey 0 Masonry 0 Lawn Irrigation
O Radon Rock Bed 0 Mfg.
O Framing 0 Other(specify)
O Insulation
O As-Built Survey
Final
O Wetland Buffer
IS- Other(specify)
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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 2013
v:\forms\plan review checklist 2013.docx
t SEP-,3-2014 09:50 FROM:TREBILFOUNDRTION SYS 3205938720 TO:19522494616 P.3'6
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Approximate number of days for job completion:: _
ALL MATERIAL AND LABOR ARE INCLUDED IN TOTAL PRICE.
Additional
oal of rrge for moving area �Goph. One Amount of bid - Q' ".”-
J $ - .l ' 0 No Plus permit fees if quired
4 -f ,) 00" 0 Homeowner to get permit
Our prior(is to fix the problem with your foundation,that's what our custom" .dnd that
we can not be responsible for any finish carpentry,painting,paneling,etc.tw '-is
completed.Jesse Trebil Foundation Systems,Inc.will not be responsible f (9 p ling,
unless otherwise noted on bid.
We will call "Gopher One"to have all public underground lines located arnin l d_ fish
cables,propane line,sprinkler system,etc.you are responsible for mar ( '
Inc. will not assume responsibility if there is damage to private lines.If {,� (� I
only be located to the pole or your property l ne.If damage to any of th ... el_ ,t" �V w
occurs,you will be responsible for all repairs. If your city requires outs
rewritten to meet their recommendations. Any additional fees incurre . l l o .(1 n
customer's responsibility. •1 M-() Q v 11
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Representative's Signa are- � Authorized Si ��^�ct_ ,i g1)
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1 SER-3-214 09:51 FROM:TREBILFOUNDAT ION SYS 3205938720 TO:19522494616 P.4/6
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Approximate number of days for job completion: /-.2. Year Built: +/-
ALL MATERIAL. AND LABOR ARE INCLUDED IN TOTAL PRICE.
Additional charge for moving •""'t, ,' 5,, . „VII- One Amount .f bid
objects out of the v(4.!rk;‘iirea $ Ye: CI No -
Alb Fins .-rmit fees i re,ture ilir
* ' ,fee'L 4t.y=c2
gf. 1 . . ,. 0 Homeowner to get permit
Our priori to fix the problem with your foundation.that's what our customers rely on us for.Keep in mind,that
we can not be responsible for any finish carpentry,painting,paneling,etc.that may be necessary after our work is
completed.'Jesse Trebil Foundation Systems,Inc.will not be responsible for any landscaping,resee4Ing or re-soding,
unless otherwise noted on bid. .
We will call"Gopher One"to have all public underground lines located.Ifyou have private lines such as satellite dish
cables,propane line,sprinkler system,etc.you are responsible for marking them.Jesse Trebil Foundation Systems,
,Inc.will not assume responsibility if there is dame to private lines.If you live at a rural address,public lines will
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. only be rocated to the pole or yOur•Property line.If damage to any of these lines in an area that was not marked
occurs,you will be responsible for all repairs. If your city requires outside engineering,this quote may need to be
rewritten to meet their icommendations. Any additional fees incurred are not included in this bid and are the
customer's responsibility.
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SEP-3-2014 09:52 FROM:TREBILFOUNDATION SYS 3205938720 TO:19522494616 P.5/6
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Jesse Trebil Foundation Systems, Inc.
60335 US Highway 12
Litchfield, MN 55355
Phone: 320-593-8729 111111111
Fax: 320-593-8720
Fax
To: City of Orono From: Christine Smith
Fax: 952-249-4616 Date: September 3, 2014
Phone: 952-249-4600 Pages:
Re: Building Permit Application CC:
0 Urgent 0 For Review 0 Please Comment X Please Reply ❑Please Recycle
•Comments:
Forwarding building permit application for 200 Woodhill rd, Orono, MN 55391,
Please call with an amount after final approval and mail permit to our office.
Thank you
Christine
7 J ` DATE TIME J
J CITY OF ORONO CALLED IN L_!
INSPECTION�'v U�.TIcEL ��y SCHEDULED • ni �'()()
PERMIT NO. ` - COMPLETED
ADDRESS Za) LAL tic« 4°d
OWNER TELEPHONE NO. °I.c.7 "99 (/23
CONTRACTOR )occo tfeLj 0"4'"'
DESCRIPTION Po unact39- PI e 3
W ❑ FOOTING 0 PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
U. ❑ POURED WALL ❑ MECHANICAL RI ID /W
LAKESHOREETLANDS
h
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
• ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q 0 RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS
❑ FINAL 0 SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. 0 FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
CCW
❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ID CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
O STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call he next inspection 24 hours in advance. (952) 249-4600
Owner/ ntractor on si • t' Y
Lcfc,_
Inspector. q't.0v—
White Copyllnspector's File Canary Copy/Site Notice