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Home My WebLink About2011-01297 - addn/remodel/repair � , CITY OF ORONO PERMIT NO.: 2011-01297 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE IssuEn: 1UO2/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 650 BROWN RD N PIN : 34-118-23-12-0004 LEGAL DESC : UNPLATTED 34 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPA[R PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ADDN/REMODEL/REPA[R ACTIVITY : 434-RESIDENTIAL VALUATION : $ 42,000.00 NOTE: SEYERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) K[TCHEN REMODEL&ENCLOSE (3)SEASON PORCH APPLICANT pERMIT FEE SCHEDULE 595.75 G. THOMAS CONSTRUCTION CO STATE SURCHARGE(VALUATION) 21.00 13750 IOTH STREET N TOTAL 616.75 STILLWATER,MN 55082- (651)436-6599 PAID WITH CC# 1184 Minnesota State License#: 542093 OWNER GARRETT, WARREN&TANA 650 BROWN RD N LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT "�he 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 relatcd 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 construc[ion authorized is not commenced within 180 days of the date of issuance,ot if construction is suspended for a period of 180 days at any time after work has commenced. The a plicant is responsible for assuring all required inspections are re ed in conformance with the State Building Code.This permit may be r o d at any time for due cau e. ; l i lll� � �� A licant rmi e igna ure Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � � - o ��`� �S , �� / � � . � City of Orono Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number. ��/ - � � � O�,D,�.O PO Box 66 Crystal Bay, MN 55323-0066 Date received: �� `�/— s,��„ � a ��,;`: s, Street Address: Received by: �'�,t ` G: 2750 Kelley Parkway Plan review fee: g • � .ykE$�� Oronq MN 55356 ' Total Fee: � v��`�� 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: �Sp �od --p�--�,, �.-v�,�., ,1�.:a�c� �. Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes (�No lf yes,a special event permit is required with Police Departmenf and City Council approval 60 days prior to the event. Shuttle bus service wif!be required unless applicant demonstrates s�cient on-site parking is available. Non-permitted events will nof be allowed. CONTRACTOR/APPUCANT INFORMATION: Name: G, Tdi a wi rtS L`c�h s�r cY�.��a^ �'.`a , State License# ��,, �<,Z�y�; -J-r Expiration Date: '�. r� . �o l 3 Lead Certification Number: �(J,47-_ c,�3•-/��_ � Expiration Date: /�� _ z c; - z O� � (for work on homes that were constructed prior to 1978 Phone: ��,��, .. �,�'�� (office) � �a'> �;�m �;� '�„�°" (cell) Mailing Address: �J -��,�, ��'�� j., �,f,�,•x� City: .'�"-�'r �� ZIP: �� Contact Person: �;,,^+,�,.x,� �,�w. ,,, Applicant is: ontractor / Homeowner (Circle One) , � Email andlor Fax: �, -r�-�:-,..,.�:..�r + � �<; � ��'�� „� ��,�. �"a�, �. PROPERTY OWNER INFORMATION`. Name: CxJar.�e�, ��.�t° l �� c'��+y�� Phone(day): �S z_t�`7�a,~ �2,�'�,r Address: ��'t.� /'Ir�os.�� ;;,�'��"�.�,�: x �'`}��,�� CitY: �,��.,�.,� Z►P: .�..`,..��yv Email and/or Fax --____, PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review 8�permits: ❑Door(s) �Remodel ❑Fire Damage 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) W�•minnehahacreek.orq Overall Project Description: ��,a o��, - �a�� a�,,, �°,:�� ,�.��;.., ;t'o,.�;,� . 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 altemative 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 � ormation is to annually up ate our records and records of other governmental agencies re uired b law. If ou refuse t I the information,the a ication ma not be issued. ApplicanYs Signature: � �� Date: � � Z� !/ Last Updated: OS-09-2011 , , . . Plan Review Ch�ckiist for New Struc�ures I Addi�ions ;4ddress/ PID/Legal: (oS� /V'b(2.�}-J �,�,p��J /��q.,� Description of work: �.�..�'Yvt.� �pL Septic review by: /U/�"y Date Approved: Zoning review by: 0�-� ( r4 Date APprovecf: Building review by: ,w.c,.._ Date Approved: (O -Z�- Zo l j Grading review by: /�1 f�l�- Date Approvecl: oning File#: Resolution#; Resolution Date: Zoning District Fire Department � Post Office � School Distr" � � � �� i � � �� %�� Zoning: LotArea: SF/AC Width: Dept : � Survey Submi d: ❑ Yes 0`No Date of SuruAy. Proposed Setback � ' Front(Lake) ear(Stceet) ( N S E W ) ( N S E W ) O er Buifdings Wetland Sitle Side Buifding Defined Height: Building Peak Height: #of Stories Ok?: ❑ YES FOR A BUILDING WITH-A BASEMENT OR CR L SPACE: FOR UILDING ON A SLAB FOUNDATION: START WITH the distance between the ba ment`floor/crawl ART the distance between:the slab and the highest space floor and the highestroo , eak,the top of ITH roof peak,the top of the cornice of a flat roof, i the cornice of a flat roof,,the deck e of a the deck tine of a,mansard roof,.orthe mansar d roo f, or t he uppermo5 t:poin n a roun d uppermost point on a round or other arch-type or other arch-t e roof roof SUBTRACT ' half the distance between fhe highest wind d SUBTRACT half the distance between the highest window I hi hest roof peak of a itched roof and hi hest roof eak-of a pitched roDf SUBTRACT the distance between the basementffoor rawl ADD #he.distancebetween the slab and the highest space floor and the highesfi exisfing gr e within existing grade within�the'foundation ! the foundation or 1D feet,whichever's less. EQUALS Defined buildin hei ht �'� EQUALS i Defined buildin hei ht Lot Coverags: SF % Shoreland District M D Permit Received I. Average L:a shore Setback Biuff Yes ❑ No ❑ N/A ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ N/A Permit Number. Setback: Hardcover Zon Existin. Pro osed Uariance Required Cl1P Required 4-75' ❑ Yes � No ❑ Yes ❑ No 75- 0' TYPe(S): TYP )� 0-500' �00-1000' REMARKS (in-house): N' � CHAivG e Updat=d: D9/11/2009 z:\formslplan review checkiist.docx . . . � Fees to be Charged YES ND �f`'�;�t�ti� ,�� -� .��, � w��": ��,"� ��'�.�_� � ;,� ,.. ";�r1�; Plan Review �axe�{ m -� ��_ ,. � ;w , .�,. _, . ., a��;�„am�e �; , s, ,.. � �u� ,�:ii�K.,. ��"'_.� , :xihi �� Investigation Fee S�A,C� � � ,:.. . Sewer'Connectio��f��F,� ._-�h:.. ' � N�um be�r�o`F ��, , . ..,,,��, ,.,,. ,_ �... ,, ., ( .. ,_ , �'� � �1J/ater Connecfimn'_ , `� � ,s.�-._ . , ...� .,.., �ts.�.. sx��rx .,_� � � �,_...� , �� . .� �_: , 9.��-., �,_ ��. ,�_ ; .. _ � Park Fee ,�.�. . . . �ii -.a��i�:n �� ;�'.��.�.��""`��s��. - Y ;4°` �*.�� , , , .� ,� � ��. _ �«.5 ;.� . � � �� T � ,..� �. � ,. �, _ .,.�; ; ; �ther;(specify) ; .. ` �lYJas e�3a�ra�'�F'�e� � .:,. _ �� ;,��r �-, °�,�� ,. bn� � _ � �� Calculatec! By.: Square'Foota e $ per Square Foota e ; � Basement I X ,I _ � 1� Floor : X _ � 2"d Floor X = $ �arage X = � Estimated Construction Vallie: � YZ�C�pO °—" Orono Inspections Required Work Requiring Separate'Permits Required'State Permits ❑ Site Plumbing ❑ Grading /Filiing ❑ Well � Fiardcover Removal �'Nlechanical ❑ Fire Electrical Footing � Septic � Water Connection ❑ Foured Wall � Fireplace D Sewer Connection ❑ Foundation Survey D Masonry � Lawn Irrigation ' ;`. ' � Radon Rock Bed � Mfg. Framin9 D Other.(specify) �''�nsulation � As=Built Survey �ina( ..,, �.' � ,� ,� . _: . ❑ Other(specify) . . ,.. � .; ' ;:: 'REMARKS (in-house): Other Review: Reviewed by: <Date Approved: Access:Existing: ❑ YE5 � NO New: 0 YES ❑ NO REMARKS (TO BE NOTED ON PERMIT AND iNITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\formslplan review checkfist.do� ��'� �C�J -J DA E TIME -C1TY OF ORONO CALLED IN � � �� INSPECTION �LQTICfE �+� SCHEDULED �a' � �" PERMIT NO. �� L I -"L��''1� COMPLETED ADDRESS ��('��,3d,1}��i • OWNER TELEPHO NO. �� 3�'��'�g� CONTRACTOR �1�'`�� : DESCRIPTION �� 11� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � O ❑ 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 ❑ SE T INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ S IC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRAC�F6A TO MEETYOU YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Catl for the next inspection 24 hours in advance. �952� 249-46QQ OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice ,,�� D TIME V CITY OF ORONO CALLED IN �� INSPECTION�jO�T/ICE SCHEDULED / � PERMIT NO.C�w�/— D/O�� COMPLETED � ADDRESS �� %��`7i1/LL— �CY � OWNER TELEP NE N �— �5 3��a �� CONTRACTOR • � � � >: DESCRIPTION ��`L � � ❑ FOOTING ❑ PLUMBING FINAL � EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHA�IICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON S�AB ❑ 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 Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O �. � O � W � Q � Z W � W � j GW RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED n ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑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� Z4J-46o0 Owner/Contractor on site: � ,-� Inspector. � _ White Copyllnspector's File Canary CopylSite Notice `-� ' � TE TIME , / CITY OF ORONO �iN // � d `� INSPECTION N7OTIC�_�� SCHEDULED / /J /b= 4"� PERMIT NO. �`D! COMPLETED ADDRESS �5D /�d- OWNER TELEPHON o��3�3 s�� CONTRACTOR � �'� �� ✓� >; DESCRIPTION �h�'� � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL �A4ECHANICAL RI ❑ LAKESHORE/WETLANDS O�'fiRAMING ❑ 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 ❑ SEP�T/IC'�INAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:�/YES_NO / � COMMENTS: � W a � /�1�.�� ,�,qF�. �s� o . � � E� ct - o 'I � � B 0 � W � Q � Z W � W � j GW �lO��ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952� 249-4f)�0 OwnerlContractor on si : Inspector. White Copyllnspector's File Canary Copy/Site Notice V�� `� � /` DATE l/ TIME CITY OF ORONO CALLED IN INSPECTION NOTICE C SCHEDULED / � PERMIT NO.C��—v�z` 7 COMPLETED ADDRESS�� OWNER TELEP NE NO. I- �3 5�/� CONTRACTOR - �� DESCRIPTION � � �� 11J ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ 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 � COMMENTS: � W C � � O � � O � W � Q � Z W � W � � GW �1QRK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED r ISSUE CERTIFICATE OF OCCUPANCY W Q ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-46�0 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice