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Home My WebLink About2010-00195 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2010-00195 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 04/20/2010 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 625 FERNDALE RD N PIN : 36-118-23-11-0021 LEGAL DESC : UNPLATTED 36 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 50,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) ADV.PLAN REVIEW$443.14 PD 4/6/10 PERMIT NO.2010-00194 INTERIOR REMODEL,ROOF AND WINDOW REPLACEMENTS APPLICANT PERMIT FEE SCHEDULE 681.75 LECY BROS CONSTRUCTION STATE SURCHARGE(VALUATION) 25.00 15012 HWY 7 MINNETONKA,MN 55345 TOTAL 706.75 (952)746-3783 Minnesota State License#: 20325555 OWNER GLAD,CARSON&KAROLIEN 625 FERNDALE RD N 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 requ- -d in conformance with the Stat- :uilding Code.This permit may be r- oked:t any time for due;yam e. // 4 %cs��„ � yi ao /lo /L�/ C� L �1�� / /O pplicant Frermitee ignature Date Iss?.t=i By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �O 53 City of Orono Building Permit Application for New Structures or Additions 7040.16 0 MailingO Bdodrss6s: Permit number: jo/O -40195 Crystal Bay, MN 55323-0066 Date received: a y Street Address:' Received by: �yS 2750 Kelley Parkway Plan review fee: ��3 ,/q kEsso� o/D OD/ 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: S Npr-'-., Fv-nd dd.. Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes %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: Lot Evos, apvylpc State License# a,0 a ss SS Expiration Date: 3....a1- (t Phone: C(S'a — cR4'4—ggqq (office) (cell) Mailing Address: 1501 a 1..twv —f City: t oka ZIP: S534S Contact Person: 0etil NrN 5 L..rLvl dyy1Gt'.i .L Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: S3-014a-1068 PROPERTY OWNER INFORMATION: Name: Car stn. t, Kacrr~o inn Glo.d- Phone (day): "1 b3- a a l- 4 1 4 id Address: (795' fJ --In Fe.;t' wAr p City:()0Lyzo ZIP: S$3q Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Le.y Bros 4-0 y 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 El New Construction X.Single Family with igt Residence ❑Addition attached garage ❑ Garage/Accessory El Accessory Building CI Single Family with ❑ DeckBldg. Public Sewer ❑ ❑ Relocation L n detached garage ❑ Office/Commercial ®,Other: (specify) `CrtOr Rene d;❑ Multiple Family/Condo El Private Sewer e,�(�� P y ❑Warehouse **Any earth madement ire u� ir�ie -) ❑ Public ❑ Storage ❑ Public Water may q ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ 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) $ l5O)00o Last Updated: 9/29/2009 - 17 - STRUCTURE INFORMATION: 1.Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction a. Length (ft.)= Number of bedrooms= N R ❑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 = ElOther(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 O MN State Energy Code Calculations and Mechanical Code Requirements Form ❑ Survey(meeting all requirements) O 7g4 Stormwater Pollution Prevention Plan ❑ Hardcover Calculation(s) O � Septic System Site Evaluation Report ❑ �( Access Permit O Wetland Buffer Improvement Plan ❑ Engineered Plans for Retaining Walls 4 feet or above O ❑ Plan Review Fee ❑ ❑ 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: / _ PP ' 9 i i ��.!'� �, � Date: Z4 4141_4 Heoriec eir Last Updated: 9/29/2009 - 18 - Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: 6 )s- f(> d19 (? Mor •(--t.• Description of work: Septic review by: 1 —CO- f O Date Approved: („Li(,— Zoning review by: J'A/ ,' Date Approved: 6 Buildin review 9 by: ��-E� �1n.�LA,.� Date Approved: `I'7 'I G Grading review by: IU 144 Date Approved: Zoning File#: Resolution#: Resolution Date: Zoning District Fire Department Post Office School D.- rict Zoning: Lot Area: SF/AC Width: D-.th: Survey Subml d: 0 Yes 0 No Date of Survey: Proposed Setback • Front(Lake) ear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Building Defined Height: Building Peak Height: / #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR AWL SPACE: ,FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the sement floor/crawl i/ START the distance between the slab and the highest space floor and the highest IV peak,the top of ,/ WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the de k line of a / the deck line of a mansard roof,or the mansard roof, or the uppermost ',int on a royrfid uppermost point on a round or other arch-type or other arch-type roof roof SUBTRACT half the distance between the highest ipw and 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 oor/ . awl ADD the distance between the slab and the highest space floor and the highest existinggrade wi in existing grade within the foundation the foundation or 10 feet, whichover is less. EQUALS Defined building height EQUALS Defined building height Lot Coverage: / SF Shoreland District i1pCWD Permit Received rage Lakeshore Setback Bluff a Yes 0 No 0 N/A 0 Yes 0 No 0 Yes 0 No 0 Ye 0 No 0 N/A 'Permit Number: Setback: Hardcover Zones,," Existing Proposed Variance - -quired CUP Required 0-75' 0 Yes a No 0 Yes 0 No / 75-250,' Type(s): Type(s): 250-,5'00' 500-1000' REMARKS (in-house): �fl %(.h(- /Updated: 09/11/2009 / z:\forms\plan review checklist.docx Fees to be Charged YES NO Permit Plan Review I/ StateSurcharge v( Investigation Fee SAC—Number of SAC Units Sewer Connection Water Connection Park Fee Site Inspection Other(specify) Miscellaneous Fees (j Calculated By: Square Footage $ per Square Footage Basement X = $ 1st Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ 'S-6166(^) Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site Plumbing ❑ Grading / Filling 0 Well ❑ Hardcover Removal )Mechanical 0 Fire 0 Electrical O Footing 0 Septic 0 Water Connection O Poured Wall 0 Fireplace 0 Sewer Connection ❑ Foundation Survey 0 Masonry 0 Lawn Irrigation O Radon Rock Bed 0 Mfg. Framing 0 Other(specify) insulation ❑ As-Built Survey "Final ❑ 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 checklist.docx z _. v ' E TIME CITY OF ORONO CALLED IN v/AT `_ INSPECTION NOTICE /J� �f��se�EDULED �� /17 v?' PERMIT NOp9O/, 7 //✓COMPLETE. ADDRESS / % 1. At . _1 "/ OWNER �3 19. /1 LEPHONE No ' / '� CONTRACTOR DESCRIPTION W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS Ci) ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL 3ULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU:_YES NO ce)• COMMENTS: ec W cc O C 0 0 C..! U- cc W z W cc )cWORK SATISFACTORY:PROCEED CIPROJECT COMPLETE W ❑GORRECT 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 ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED 0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor o site: Inspector. White Copy/Inspector's File Canary Copy/Site Notice _ J DATE TIME CITY OF ORONO CALLED IN I t I i 6 INSPECTION TICESCHEISISL D l 19 1 lb `t .30 PERMIT NO. C' (C'CC IC-lb-COMPLETED ADDRESSIC-t(C OWNER TELEPHONE NO. CONTRACTOR S C L -8 it, (• {o • DESCRIPTION car } 11 ,10 J rI * ❑ FOOTING ❑ PLUMBING FINAL .) ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP • El DEMO-FINAL El SEPTIC INSTALL ❑ HARD COVER REMOVAL ❑ PLUMBING RI ❑ SEP FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU: YES_NO o COMMENTS: cc W cc 0 cc 0 W cc toW W CC LPKW_SJYIK SATISFACTORY:PROCEED CIPROJECT COMPLETE W ❑CORRECT WORK&PROCEED LTISSUE CERTIFICATE OF OCCUPANCY OO ❑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: �V �r�� Inspector. White Copy/Inspector's File Canary Copy/Site Notice DATE TIME � 50— g CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED $-5-16 3. 30 PERMIT NO.j4/0'OO/`1 COMPLETED ADDRESS 6 25 l'ci A) OWNER TELEPHONE NO. ( '/2 703 Z26,8 CONTRACTOR DESCRIPTION `n /�-6001--`C Lk. ❑ FOOTING ❑ PLUMBING FINAL ❑ E AV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL • OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: CC W Q. CC A kAct 7 c-1. (-1 (25-c W � cc cc • ❑WORK SATISFACTORY:PROCEED . PROJECT COMPLETE CC ❑CORRECT WORK&PROCEED ❑ SUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V 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 Copy/Inspector's File Canary Copy/Site Notice