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Home My WebLink About2012-00008 - add/remodel/repair ' ' �` CITY OF OR NO PERMIT NO.: 2012-0000s 2750 KELLEY PA KWAY ORONO, MN 5 356- �ATE ISSUED: OU10/2012 952 249-4600 FAX: 9 2 249-4616 ADDRESS : 4105 BAYSIDE RD PIN : 06-117-23-14-0023 LEGAL DESC : BAYSIDE RIDGE : LOT 002 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTNITY : 434-RESIDENTIAL VALUATION : $ 80,000.00 NOTE: SEPEI2ATE PERMITS REQUIRED: PLUMBING,MECHANICAL, ELE TRICAL(STATE) MASTER BATH REMODEL APPLICANT PERMIT FE SCHEDULE 906.75 THE HOUSE DRESSING CO., INC. PLAN REVI W 589.39 3322 W 32ND STREET MINNEAPOLIS, MN 55402- STATE SU HARGE(VALUAT[ON) 40.00 (952)920-8301 MISC FEE 0.00 Minnesota State License#: 20218741 TOTAL 1,536.14 OWNER BURKE,N[CK& SUE 4105 BAYSIDE RD MAPLE PLAIN,MN 55359- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and speciYications,applicable City approvals,and the Sta[e Building Code. This permit is for oniy the work described and does � not grant permission for additional or related work which requires separate pennits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permit will �I expire and become null and void if wnstruction authorized is not commenced wi[hin 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 res onsible for assuring all required inspections are requested in confo ance with the S[ate Building Code.This permit may be r ked a a� for due cause. � c , �o , 2 , � �, � Appl' nt Permi ee Signature Date Iss e y ignature Date SEPARATE PERMITS REQUIRED FOR WORK OTHE THAN DESCRIBED ABOVE. �,�r` ,\�/ City of Or no �'�0 Building Permit Application for aintenance / Renovation (windows, doors, sidin , re-roof, etc.) Mailing Address: Permit number: D - d bL�g Og,�,�.0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: � ' �"��a—' ��. ,� 1 �; �-�_ �, Street Address: Received by: �'�c, ' ` � Gti�' 2750 Kelley Parkway Plan review fee: �.��Hog� Orono, MN 55356 , / — Total Fee: �J�-��v . / 7 Main: 952-249�600 Fax: 952-249-4616 ��^�w.ci or r�o mn u� This application form must be completed in full and all quired information must be submitted. Incomplete applications will be ret rned. (Please print) GENERAL INFORMATION: Job Site Address: �(� SI � p4 Will this be a Parade of Homes, Remodelers Showcase Home or ther Display Home? ❑Yes No If yes,a specra!evenf permit rs requrred with Police Department and City Council proval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is av ilable. Non-permrtted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: N�me: "�'�� • S. � S IJIo ri�J' 1�J�. State License# � —)� � Expiration Date: 3�?,j-�Z Lead Certification Number: � �-�� Expiration Date: �j`—Z�,�5 {for work on homes that were constructed prior to 1978 Phone: C'SZ— 2Cj' ; 0� (office) �,j —��b— (cell) Mailing Address: Z2 zSl 32�'� � 4��— City: � Q�S ZIP: �y�(1, Contact Person: �E�.� ��c, Appli nt is: ontracto / Homeowner (Circle One) Email and/or Fax: r `�� ` 4 - PROPERTY OWNER INFORMATION: Name: � � , •� Phone(day): �p(2—�(� ' y�Gg,°o Address: - City: � ,,�Cj ZIP: ��3,�j Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) [�Remodel ❑ Fire Damage N�CWD review 8�permits: � , Minnehaha Creek Watershed District(MCWD) ❑ Re-roof,asphalt ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ❑ Re-roof,other(specify) ❑ Siding ❑Other: (specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orca Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ "�;�`) .��- APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building epartment; • Certifies that the information supplied is true and correct to the best o his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being awa 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 a plication is classified by State law as either private or confidential. Private data is information which generally cannot be gi n to the public but can be given to the subject of the data. Confidential data is information which generally cannot be giv to either the public or the subject of the data. Our purpose and intended use of this informati is to annually update ou records and records of other governmental agencies r uired b law. If ou refuse to su I t rmation,the a lication a not be issued. ApplicanYs Signature: � �, / Date: �� -j 2 Last Updated: OS-09-2011 � ' Plan Review Checkiist for ew Structures / Additions Address/ PID/ Legal: I�0 � c�f} Sf r�` /}-,� Description of work: �Z�'►2 �..� � Septic review by: ,'vt Date Approved: Zoning review by: �"/� ' Date Approved: Building review by: „�(��LL�.�- Date Approved: i -E. - Z,tJ� L Grading review by: N i/� Date Approved: Zoning File#: Resolution#: ; Resolution Date: � bnin District Fire Department Post Office hool District Zoning: Lot Ar,ea: SF/AC idth: �'� Depth: �,; Survey Submitted: O.Yes ❑ No ate of Survey: �,-'� Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( S E .=�111 ) Other Buildings Wetland Side Sid� Building Defined Height: Building Peak Hei t: #of Stories Ok?: ❑ YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: ,'�� OR A BUILDING ON A SLAB FOUNDATfON: START WITH the distance between the basement floor/crawl j START the distance between the slab and the highest space floor and the highest roof peak, the top of� WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line of a `y the deck line of a mansard roof, or the mansard roof, or the uppermost point on a round `�,, uppermost point on a round or other arch-type or other arch-t e roof roof SUBTRACT half the distance between the highest window and UBTRACT half the distance between the highest window hi hest roof eak of a itched roof and hi hest roof eak of a itched roof SUBTRACT the distance between the basement floor/crawl L bD the distance between the slab and the highest space floor and the highest ex�sting grade within existin rade within the foundation the foundation or 10 feet, whichever is less. QUALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: SF % Shoreland District MCWD Permit Received A era e Lakeshore Setback Bluff � Yes 0 No � N/A 0 Yes 0 No � Yes � No � Yes ❑ No �i,. N/A Permit Number: Setback: Hardcover Zones Existin Proposed Variance Required '� CUP Required 0-75' Yes 0 No �.Yes 0 No 75-250' TYP (S)� Type(s)� 250-500' 500-1000' REMARKS (in-house): �1 C �'(:i C' Updated: 09/11/2009 z:\formslplan review checklist.docx � I� Fees to be Charged YES NO Permit � Plan Review � `State°Surcharge : , _ Investigation Fee SAC=�Numberof'SAC=Units - ',�� ` _ }�f'�' �j3�.,�;�� _ Sewer Connection '�IJl.ater�Conne:ction ° � �:„g ; r��.��t.� Park Fee Site=lnspecfion �_ , , ..,:, � ..� �,,. Other (specify) � "Miscellaneous Fees � ;_, Calculated By: S uare Foota e $ er Square Foota e Basement X = � 15` Floor X = $ 2nd FIOo� X = � Garage X = $ Estimated Construction Value: $ Yf�,�C�C �= Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site lumbing 0 Grading /Filling ❑ Well 0 Hardcover Removal �Mechanical � Fire ,�Electrical � Footing � Septic � Water Connection � Poured Wall ❑ Fireplace ❑ Sewer Connection � Foundation Survey ❑ Masonry 0 Lawn Irrigation � Radon Rock Bed ❑ Mfg. Framing ❑ 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: ❑ YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:lforms\plan review checklist.docx � �d�/� ( DA � TIME � CITY Vr VR NO CALLEDIN INSPECTI O ICE SCHEDULED � PERMITNO.��a bOOO� C PLETED ADDRESS lD t OWNER TE HONE NO — �— � � CONTRACTOR — � >; DESCRIPTION — � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GR DING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHOR ETLANDS y RAMING ❑ MECHANICAL FINAL ❑ TREE REM AL ZINSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPE TION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAIN J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-U _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL � HARD COV REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIO /REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o v l !� k� O' ( (� � ° C�n, �-'1- (P��1-�ON � � � �h�� r�� Q � � � S ��SS z W � W � � d W �Q'9RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ,_i ISSUE CERTIFICATE OF CCUPANCY W O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORAR V BEFORECOVERING PERMANEN ❑CQRRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 24 -46�0 OwnerlContrac r on te: Inspector. White Copyllnspector's File Canary CopylSite Notice '� DATE IME �/ CITY OF ORONO CALLED IN _.�_\7V' INSPECTION NOTICE SCHEDULED �� PERMIT NO.°?��O�— 006� COMPLETED ADDRESS T��S � OWNER TELEPHONE NO. b� � � CONTRACTOR � �: DESCRIPTION �` ��-`"� � W ❑ FOOTING ❑ MBING FINAL ❑ EXCAV/GRADIN /FILLING � ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENV LANDS � ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVA Z ❑ INSULATION � WOOD BURNER/FIREPLACE ❑ SITE INSPECTI Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER R MOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/R MOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O >. � O � W � Q � Z W � W � � GW ❑WORK SATISFACTORY:PROCEED �OJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF O CUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. L, pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALLINSPECTOR C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z4 -4600 OwnerlContractor on site: Inspector. � White Copyllnspector's File Canary CopylSite Notice