HomeMy WebLinkAbout2015-00751 - addn/remodel/repair CITY OF ORONO * z 0 1 5 - 0 0 7 5 1 *
2750 KELLEY PARKWAY DATE ISSUED: 06/16/2015
, ORONO, MN 55356-
� (952 249-4600 FAX: 952) 249-4616
ADDRESS : 1291 BRIAR ST
PIN : 10-117-23-31-0043
LEGAL DESC : CRYSTAL BAY MINNETONKA
: LOT 000 BLOCK 003
PERMIT TYPE : ADD[TION/REMODEL/REPA[R
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 5,000.00
NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE)
ADD A BATHROOM TO SECOND LEVEL
APPLICANT PERMIT FEE SCHEDULE 123.91
PLAN REVIEW 80.54
ROSE CREEK BUILDERS LLC STATE SURCHARGE(VALUATION) 2.50
P O BOX 68
LORETTO, MN 55357- TOTAL 206.95
(763)717-8000 Payment(s)
Minnesota State License#: BUIL-BC629805 CREDIT CARD 4087 206.95
OWNER
KELLETT, KEVIN CURLEY&W
P.O. BOX 41
CRYSTAL BAY,MN 55323-
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 goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construc[ion 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[he State Building Code.This permit may be
revoked at any ti due cause. ���!)
�
4r j��5- -^ �� � �-�_j��� �' � � (r� (�
Applicant Permitee Sign re Date Issued By Signatu Date
City of Orono
Building Permit Application for Maintenance / Replacement / Remodel
(i.�. �rvindavvs� dc�ars, s�a��g, rE-rc�c��; �tc. — NCJ STRUC�IJ�AL EXPA�ISIC?N)
� O�r MailingAddress: Permit number. �b/S -� �j�
�- �V� PO Box 66
Crystal Bay, MN 55323-0066� � Date received:
\
Sfreet Address: � ,��� Received by:
� � 2750 Kelle Parkwa
' ` Y Y � Plan review fee:
��t ` � Orono, MN 55356
qk�sE�o�� ..
Total Fee: �d�. �5'
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:
JobSiteAddress: ( �.. '�'j l �1p�(L. �'r 02.�y.JO M� ��39 (
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 wi//be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/AP LICANT INFORMATION:
Name: b� J� c�o�Er-S �.�L
State License# � (Qa,q �ps Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell)�'S Z- �5�. - � � (office) � ?�3. 7 ( ?- `�p�
Mailing Address: , o D (p $ �.,op.d�Cp /Yl� s"S?S�� City: ZIP: �' 7
Contact Person: �pt�E M p�� Applicant is: C n ractor Homeowner (CircleOne)
Email and/or Fax: ��� Ro-ytCp.e,E,k�i���octiS • c o�
PROPERTY OWN INFORMATION: /�
Name: �Wr��. ra,►.)c� ��lA-� � � fT�c,J g
Phone(day): (°p� 2... '� �� - 3 er f
Address: f 1.9 � (�j2..'n,� �� • City: DGZ,a�J• ZIP: S� 3�'�
Email and/or Fax:
PROJECT INFORMATION: Overall ro�ect description: ��F�v4n�M � Z``�
Type of Project: Any earth movement may also require
❑ Door(s) �Remodel ❑ Fire Damage MCWD review&permits:
❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) ww�v minnehahacreeko��
Estimated Construction Valuation of Project(excluding land) $ •
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 by law. If
ou refuse to su I the informati , e a I' tion ma not b issued.
ApplicanYs Signature: Date: � � � ��
Owner's Signature: Date:
Last Updated:January 2015
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: � Z. �'l. l �/`1 a.t/' ���'� Permit No.:
Description of work: �oG�`f'l�"mQrin /`S,G���ii Date Rec'd:
Septic review by: Date Approved:
Zoning review by: Date Approved:
Building review by: Date Approved: � ` �
Grading review by: Date Approved:
,
Zoning District: Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: SF /AC Width: Lot Coverage: SF %
Survey Submitted: � Yes � N Date of Survey: Revised date ? :
Proposed Setbacks:
Front (Lake) Rear(Street) � � E W ) ( N E W ) Other Buildings Wetland
S de Side
Defined Height: Peak Height: F FFE minus 6 feet = (Existing Contour)
Perimeter(linear feet) = 50% = L.F. below grade # of Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the low t p posed The distance between the top of
START WITH floor(of the basement or cra spac )and START WITH slab and the highest point of the
the highest point of the roof roof.
If you have a... If you have a...
• GABLE OR HIPPED ROOF
• GABLE OR HIPP D ROOF(no (no windows): Subtract half
windows): S�btr ct half the distanc the distance between the
between the hi est point of the roof highest point of the roof to
to the low poi of the corresponding the low point of the
SUBTRACTION gable or hipp d roof corresponding gable or
(BASED ON . GABLE O HIPPED ROOF(with SUBTRACTION hipped roof
ROOF TYPE) windows): Subtract half the distance (BASED ON . GABLE OR HIPPED ROOF
between e top of the highest ROOF TYPE) (with windows): Subtract
window nd the highest point of the half the distance between
roof the top of the highest
• ALL HER ROOF TYPES(flat, window and the highest
man rd,etc):No subtraction. point of the roof
• ALL OTHER ROOF TYPES
SUBTRACTION Subtract e distance between the (flat,mansard,etc):No
(BASED ON baseme crawl space floor and the subtraction.
EXISTING highest xisting grade adjacent to the ADDITION Add the distance between the top
GRADES) founda on OR 10 feet(whichever is less). (BASED ON of slab and the highest existing
EQUALS Defin d building height EXISTING grade adjacent to the foundation.
GRADES
EQUALS Defined building height
Shoreland District MCWD Permit Average akeshore Setback Bluff
Met?
O Yes � No ermit Number: � Yes No � N/A 0 Yes 0 No
N/A—see attached Setback:
Stormwater Quality Existin Hardcover Proposed
Overlay District (� and sf) Hardcover Variance Req 'red CUP Required
Tier circle one %and sf
� Yes � No O Yes � No
1 2 3 4 5 Type(s): Type(s):
Updated: January 2015
c:\users\rpeitso\documents\plan review checklist 2015.docx
REMARKS (in-house):
Fees to be Char ed YES NO
Permit �/'
Plan Review �j�'
State Surcharge
Investigation Fee �'
SAC—Number of SAC Units
Other(specify)
Square Foota e $ per Square Foota e
Basement X = $
1S` Floor X = $
2nd FIOOr X = $
Garage X = $
Estimated Construction Value: $ � , (�/��
Orono Inspections Required Work Requiring Separate Permits Required State Permits
0 Site Plumbing 0 Grading/ Filling 0 Well
0 Silt Fence/ Erosion Control Mechanical 0 Fire Electrical
0 Hardcover Removal 0 Septic � Water Connection
� Footing 0 Fireplace � Sewer Connection
O Poured Wall � Masonry 0 Lawn Irrigation
0 Foundation Survey � Mfg. � Landscaping
0 Foundation Waterproofing 0 Other(specify)
0 Radon Rock Bed
Framing
Insulation
� As-Built Survey
Final
0 ther(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: ❑ YES � NO New: 0 YES � NO
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED
Updated: January 2015
c:\users\rpeitso\documents\plan review checklist 2015.docx
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INSPECTION �OTICE
,,��� � � DATE TIME �
CITY OF /��/"O �G���CC' I CALLED-IN
SCHEDULED __������
PERMIT NO. COMPLETED
ADDRESS a � �
OWNER/CONTR. o��
❑SITE INSPECTION ❑MECHANICAL RI ❑ REINSPECTION
❑CONC SLABS ❑MECHANICAL FINAL ❑ FOLLOW-UP
❑ FOOTING ❑IN LATION ❑COMPLAINT
❑ POURED WALL ❑ TED ASSEMBLY ❑ FIREPLACE
❑FOUND. DRAINAGE UILDING FINAL ❑SPRINKLER SYSTEM
❑FRAMING ❑SEPTIC INSTALL O
� ❑SHEATHING ❑SEPTIC FINAL ❑
ti ❑PLUMBING RI ❑S&W HOOKUP O
� ❑PLUMBING FINAL ❑GAS LINE MANOMETER ❑
o COMME
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� FURTHER CORRECTIONS MAY BE REQUIRED RMIT FINALED
� ❑WORK SATISFACTORY: PROCEED ❑ PHOTO TAKEN
p ❑ CORRECT WORK&PROCEED
V ❑ CORRECT WORK.CALL FOR REINSPECTION BEFORE COVERING
❑ CORRECT UNSAFE CONDITION IMMEDIATELY.
O STOP ORDER POSTED. CALL INSPECTOR
❑ INSPECTION REC]UIRED. CALL TO ARRANGE ACCESS.
TO SCHEDULE YOUR INSPECTIONS
PLEASE CALL: (763) 479-1720
Metro West Inspection rvices
Owner/Contr. on site:
Inspector:
C��� 1 v��'" DATE TIM� /
CITY OF ORONO CALLED IN v
� INSPECTION NOTICE .�5` SCHEDULED --'��IS�
PERMIT NO. 7�/.� C� COMPLEfED
ADDRESS Z " I '' i Ct l
OWNER TELEPHONE N � ���' �� �
CONTRACTOR
�!� ����5
� DESCRIPTION
� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ S WER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ PTIC INSTALL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
� COMMENTS:
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W ❑�N K SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� ❑ ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O RRECT WORK,CALL FOR REINSPECTION TEMPORARY
V FORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL REfURN
O CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours'n advance. (952� 249-4600
OwnerfContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice