HomeMy WebLinkAbout2010-00839 (deck) CITY OF ORONO PERMIT NO.: 2010-00839
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/17/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 3855 BAYSIDE RD
PIN : OS-117-23-23-0007
LEGAL DESC : AUDITOR'S SUBD.NO. 203
: LOT 063 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DECK ATTACHED
ACTIVITY : 434-RES[DENTIAL
VALUATION : $ 3,000.00
NOTE: SEPERATE PERMITS REQUIRED: GLECTRICAL(S7'A'CE)
REYLACF,DECK
APPLICANT PERMIT FEE SCHEDULE 88.50
THIESSE, JOHN
3855 BAYSIDE RD PLAN REV[EW 57.53
LONG LAKE, MN 55356- STATE SURCHARGE(VALUATION) 5.00
TOTAL 151.03
OWNER
TH[ESSE,JOHN
3855 BAYS[DE RD
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 pcnnission 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}YAth the State Building Code.This permit may bc
revoked at�n f ic f �tie cause.
; � � �
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ApplicantPermiteeSignature Date ��`�-� L��nC-�-�� � �
, Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address: o70/O-DU�"��'
�v�,� PO Box 66 Permit number:
�Q F\ Q Crystal Bay, MN 55323-0066 Date received: 1�'��'�0
� ��`� i Received by: '�?/f
��� ,���'������� �, � StreetAddress:�
��'�n �h��'�.�. oti� 2750 Kelley ParkwaY Plan review fee:
L�'kESH 4� Orono, MN 55356
Total Fee: /5�, O 3
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: ��SS / E
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No
If yes, a special event permit rs 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:
State License# Expiration Date:
Phone: (office) (cell)
Mailing Address: City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: �.�Qi;�n1 �/�SS�
Phone (day): 2 -
Address: `<z=�s/SL.�" .�.�f/.J CitY� Q.�O�cJO ZIP� �����
.
Email and/or Fax i t`I /�,S'��_�_�S�T o���(�ti
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 ❑ Single Family with ❑ Residence
Addition attached garage ❑ Garage/Accessory Bldg. �Public Sewer
❑ Accessory Building � Single Family with Deck
❑ Relocation detached garage �] Office/Commercial ❑ Private Sewer
�Other. (specify) � ��L ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
"'Any earth movement may require ❑ 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.or
Estimated Construction Valuation (excluding land) $ �, �o
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= 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. 15`Story = ❑ Other(please specify):
e. 2"d StOry =
f. '/z Story =
g. Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
N ot
Enclosed Applicable
❑ Permit A lication
❑ Pro osed Buildin Plans
� MN State Ener Code Calculations and Mechanical Code Re uirements Form
� Surve meetin all re uirements
� Stormwater Pollution Prevention Plan
� Hardcover Calculation(s)
� Se tic S stem Site Evaluation Re ort
� Access Permit
� Wetland Buffer Im rovement Plan
� En ineered Plans for Retainin Walls 4 feet or above
� ❑ 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.
ApplicanYs Signature: Date: �� l�
Last Updated: 9/29/2009
- 18 -
Plan Review Checklist for New Structures / Additions
Address/ PID / Legai: �gS� i3/=!�/S i t7 � �2p�q/�
Description of work LJ2G(� �;jQ���p�; _ �N (<<,a,�
Septic review by: lV�Yq Date Approved:
Zoning review by: _ /1�` ja Date Approved:
Building review by: -- Date Approved: 9'— �6—I a
Grading review by: �1/ //q Date Approved:
Zoning File #: Resolution #: Resolution Date:
Zonin District Fire De artment � Post Office School Dist ' t �
I
Zoning: Lot Area: SF /AC Width: Depth:
Survey Sub itted: ❑ Yes ❑ No Date of Survey:
Pro osed Setb ks:
Front (Lake) Rear(Street) ( N S E W ) ( N S E W ) Other uildings Wetland
Side Side
Building Defined Height Building Peak Height:
FOR A BUILDING WITH A BASEMENT CRAWL SPACE: FOR A BUILDI ON A SLAB FOUNDATION:
START the distance betwee the basement floor/ START the distance between the slab and the '
WITH crawl space floor and e highest roof peak, WIT highest roof peak, the top of the cornice
the top of the cornice of flat roof, the deck of a flat roof, the deck line of a mansard
line of a mansard roof, or t uppermost roof, or the uppermost point on a round or
oint on a round or other arc -t e roof other arch-t e roof
SUBTRACT half the distance between the � hest SUBTRACT half the distance between the highest
� window and highest roof peak of pitched window and highest roof peak of a
roof i itched roof
SUBTRACT the distance between the basement f or/ ADD the distance between the slab and the
crawl space floor and the highest isti highest existing grade within the
grade within the foundation or 1 feet, foundation
whichever is less. EQUALS ' Defined buildin hei ht
EQUALS � Defined buildin hei ht
Lot Coverage: SF %
Shoreland District ! CWD Permit Received Ave e Lakeshore Setback Bfuff
0 Yes ❑ No Yes ❑ No ❑ N/A p Yes ❑ No ❑ N/A � Yes ❑ No
Permit Number: Setback:
Hardcover Zone ; Existin Proposed ; Variance quired CUP Required
0-75' � 0 Yes ❑ ❑ Yes ❑ No
75-25 ' ! TYPe�s)� Type(s): ,
250- 0' I i �
50 1000' I I
REMA S (in-house): /U� C/��^�G
Updated: 07/01/20Q9
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Fees to be Char ed YES NO
�P�enr��t - i/' .
Plan Review �/
`State';5ur.c�h�r e
Investigation Fee
"S�1'C-�:N�m'beraof S�ACkU:nits .
Sewer Connection
'?�fatsr.i��on�n�c#�on ,
Park Fee
:Site=lnspection _ °
Other(specify)
:Miscellaneous:Fees
Calcu{ated B : ,
UBC: Construction Type:
Square Foota e $ er S uare Foota e I
� i
Basement X = $
1 S Floor X � _ $
2" FlOor X - I $
Gara e X - �
�
Estimated Construction Value: � 3���`��
Orono Inspections Required Work Requirinq Separate Permits Required State Permits
❑ Site ❑ Plumbing ❑ Grading / Filling ❑ Well
❑ Hardcover Removal ❑ Mechanical ❑ Fire ❑ Electrical
J�ooting ❑ Septic ❑ Water Connection
❑ Foundation Survey ❑ Fireplace ❑ Sewer Connection
,�' Framing ❑ Masonry ❑ Lawn Irrigation
❑ Insulation ❑ Mfg.
❑ Wall Board ❑ Other(specify)
❑ As-Built Survey
Final
❑ Other (s eci )
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO
REMARKS (TO BE NOTED ON PERMIT AND INfTIALLED BY PERSON PULLING PERMIT)
Updated: 07/01/2009
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CITY F ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED ��
PERMIT NO. aG�d'- 00�`j C TED
ADDRESS �
OWNE ��-�TELEP NE NO �D- l�g�
CONTRACTOR
>; DESCRIPTION ` 7�-+�---�
�
ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS
�
Q FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z 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
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� COMMENTS:
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GW ;'jB�WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� v �
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor on site:
Inspector. � j I �/ r� �
White Copyllnspector's File Canary CopylSite Notice