HomeMy WebLinkAbout2013-00473 - addn/remodel/repair CITY OF ORONO * Z 0 1 3 — 0 0 4 7 3�
� ' 2750 KELLEY PARKWAY nATE tssuEn: 07/OU2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 265 BROWN RD S
PIN : 03-117-23-24-0009
LEGAL DESC : BYFIELD
: LOT 002 BLOCK 001
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 4�4-RESIDENT[AL
VALUATION : $ 80,000.00
NO"I�E: SEPARATE PF,RMITS RF;QUiRED: PLUM[3[NG, Mt?CHANICAL,�LLC"I'RICAL(STATF,)
REMOVE FLAT ROOF
ADD TRUSSES
REPLACE SIDINU
REPLACL WINDOWS
REPLACI: [NTERIOR DOORS
APPLICANT pERMIT FEE SCHEDULE 906.75
RESTORE TO FORM PLAN REVIEW 589.39
565 MONTCALM PLACE
ST PAUL PARK, MN 55116- STATE SURCHARGE(VALUATION) 40.00
TOTAL 1,536.14
OWNER
KEARNEY,ADRIAN
265 BROWN RD S
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 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.pfari of 180 davs at any time after work has commenced.
The applic r ,ponsible ssuring all required inspections are
reques i o or ce i� the State Building Code.This pemiit may be
rev e a ti or u cause.
r / /
_ .��� � � � � ( � �� � � �
A plicant Permit ignature Date Issu By Signalure Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCWBED ABOVE.
, 1 � lo��
C�ty of Orono
��
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roaf, etc.)
�,� _
Maifing Address: �
� ��� � PO Box 66 � Permit number: ��� —��-��j
��` Crystaf Bay, MN 55323-0066 ; C1ate received ' / —�3
� —_. _
° Received by:
� � � � StreetAddress� � --------�
, ;�, ,� �� 2750 Kelley Parkway ' Plan review fee:
F �� �,� ����f Orono. MN 55358 � -- ----�
; L '�E�St�oE,.- �
- ___ � Total Fee: ����/.�
# Main: 952-249-4600 Fax 952-249-4616 1�.���:� ����� n��= C�
' This application form must be completed in full and all required informatian must be submitted.
Incomplete applications wifl be returned. (Please print)
GENERAL INFORMA710N: � - '�'� T
i � �
Job Site Address: ��> ;� r`; <':��rJ ,JL`'{� �
, ' ----- ------ --- ___
Will this be a Parade af Homes, Remodelers Showcase Name ar other Display Home? ❑ Yes � No
/f yes a special event permit is r�equired with Patice Department and City Gouncil ap�roval 60 days prior to the event. Sh«ttle Uus service�vill be
reqiiired unless applrcant demonstrates sufficfent on-site parkmy is availaGle. Non-permitted events{roill not he allo�.verl
CONTRACTOR/APPLICAN7 INFORMATION:
Name:
-----..__.__.---- --__----�_._--._ ____.__._____.._______...........__....._..----------____.._ ___
State License# Expiration Date:
-- ------..__ _----------------__ _ __ _ ___.
Lead Certification Number: Expiration Date
--------------------- —
(for wark on homes that were constructed prior to 1978
Phone: (cell) (office}
-- __— __------------ ----_ __ _ __ _. _ __
Mailing Address City ZIP
_.__.___.,_�_.__.____��. __.__._ ___ ___-_._ _..._____.
Contact Person Applicant is: Contractor / Homeowner (Circle One)
Email and!or Fax: � � �
PROPERTY OWNER INFC�RMATIdN:
,
Name: � � � �� � �� ` � �
--, `'._� 7'Z� _�" � �_�`� t_ �
_ _ _ __
( Y}� �-- -- —___ -
Phone da �� I _ ��� - � �-� �
� Address: � � / � Cit : {� ZIP: � �� �£- �-J '
� --.�:.�'—�Xv����� ,_.n,•� �;�� Y ! C-F��t�v7"� �J � r
� Email and/or Fax --�_�s.�_���-�_�.z.`�� .�___��*1 ;. r�,, �:�! __._ yP",�, _ �.
.;, t:;. �_ �_ __
� PRUJECT INFORMATION: Overall praject description_ _ __ __ _
� _ �_ � ___ _.__ ..__ _.----- -_-,
; Type of Prqject: � Any earth movement may also require
�;Daor(s} �niT Z ��-1�i� Q Remodel ❑ Fire Damage �CWD review& permits:
I ; Minnehaha Creek Watershed District MCWD
� ❑ Re-roof.asphalt ❑ Repair ❑ Storm Damage � �
18202 Minnetonka Bivd
, ❑ Re-roof. cedar ❑ Restoration �Water Damage � Deephaven. MN 55391 ,
f ❑ Re-roof other(sp�cify) �Siding ❑ Other (specifyj �
Phone 952 471-0590
! Fax 952-471 Q682
�.1.7'►'�txsP1=(h� /Z4c_____.__ [�VVindaw(s) � �., ;, � ,.:�, �� �r i ��
A!l/� rhhlS�'S _-- -____ ------ ___ __.___..______.—__._.._ . ___ _ _ . - —_— _.___.._
Estimated Construction Valuation of Praject(excluding land) �
APPLICANT ACKNC?WLEDGEMENT:
�_�-------------______.___._..______..._____.__ _ �._ �_.___._.__. _ _ __ _
i • Agiees to provide alI information required ar requested by the Building L�epartment,
' • Certifles that the information supplied is true and correct to the best of his/her knawledge. The applicant recognizes that they are :
solely responsible for subr7iitting a compEete applicatian being aware that upon failure to do so, the staff has no aftemative bui to �'
reject if until it is complete;
• Some ar all of the ii7forrnatic�n tha! you are asked to provide on this applicatian is classified by State law as either private :; i
� confidential Pnvate data is informatian which gei�erally cannot be given to the puhlic but can be given ta the subject of the dat�s
' � Confldential data is ir�forr77ation wiiich generally cannot be given ta either the public or the subject of the data. Our purpose an;,
intended use af this informatian is ta annually update our records and records of other governmental agencies required by law It '
; you refuse to s�app�the inforrnation,the�plication may not be issued ��
Applicant's Signature: t Date:
��JrJ; % - r
Owner's Signature� �j � ,��'�� t� �% C�at� �� -� �� - °
as!�.�' 1 r7�, �i> > ;�!i�� � �
PLAN REVIEW CHEC�CLIST FOR IiIEW STRUCTURES / ADDITIONS
AddresslPermit Number: ��� ����%�'� ��N-� ����-1
Description of work: $ -� �"�'°'����
Septic review by: �;T�� Date Approved:
Zoning review by: ,+u�I � Date Approved:
Building review by: � ' �� Date Approved: � �"�� �`4�
s Grading review by: � Date Approved:
�:
Zoning District: Zoning File#: Reso#: Reso Date:
Zo ing: Lot Area: SF/AC Width: Lot Coverage: SF %
`" Surve Submittecl: � Yes � No Date of Survey: Revised date . :
Pro osed tbacks:
Front(Lake)``� Rear(Stree�) ( � � E W ) ( N S E W ) Other Buii ngs 1lVetland
�' � Side Side
�<,�
�
Defined Height: ���. Peak Fieight: FFE: FFE minus 6 eet= (Existing Contour)
�
� Perimeter(linear feet) _ `'�, 50%_ #of Stories Ok? 0 YES
,; �
FOR A BUILDING WITH A BASEMENT OR CRAWL`�PACE:
�' The distance between th�lowest FOR A BUI ING ON A SLAB FOUNDATION:
START WITH proposed Floor(of the baserr�nt or crawl The distance between the to of slab and
space)and the highest point o e roof. START WITH P
the highest point of the roof.
If you have 2...
If you have a...
a"- • GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no
windows): Subtract half the windows): Subtract half the distance
distance between the highes4 point between the highest point of the roof
of the roof to the low point of the to the low point of the corresponding
SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof
(BASED ON ROOF • GABLE OR HIPPED ROOF(with (BASED ON e GABLE OR HIPPED ROOF(Wlth
T�'PE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance
distance between the top of the between the top of the highest
highest window and the highest window and the highest point of the
point of the roof roof
e ALL OTHER ROOF TYPF�(fl8t,
• ALL OTHER ROOF TYPES(flat,
mansard,etc):No subty�ction. mansard,etc:No subtraction.
ADDI ON Add the distance between the top of slab
SUBTRACTION Subtract the distance be en the (BASED and the highest existing grade adjacent to
(BASED ON EXISTING basemenUcrawl space oor and the EXISTING the foundation.
5- GRADES) highest existing gra adjacent to the GRADES
foundation OR 10 eet(whichever is less). EQUALS Defined building height
EQUALS Defined buil : g height
ti. �'
� Shoreland District MCNVD Permit Received Avera e Lakeshore Setback Met? Bluff
,/' 0 Yes 0 No 0 N/A 0 Yes 0 No
� Yes � 0 Yes 0 No 0 N/A
Permit Number: Setback:
Stormwater uality Existing Propased �ariance Requirec� CUP Required
Qverla D' trict Tier Hardcover FEardcover
� Yes � No � Yes � No
Type(s): Type(s):
Updated: January 2013
� v:\formslplan review checklist 2013.docx
��
REMARKS (in-house):
Fees to be Char ed YES NO
Permit
�.
Plan Review
State Surcharge
Investigation Fee
�' SAC—Number t�f SAC Units �
Other(specify) "`
S uare Foota e $ er S uare Foota e
Basement X = $
1 S`Floor X = $
2nd Floo� X = $
�''
Garage X = $
Estimated Construction Value: $ �C.��,�:°� `���
Orono Inspections Required Work Requiring Separate Permits Required State Permits
0 Site f�lumbing 0 Grading/ Filling � Well
� � Hardcover Removal �PJlechanical � Fire � Electrical
� Footing � ;3eptic � Water Connection
� Poured Wall 0 f=ireplace � Sewer Connection
�` 0 Foundation Survey 1� Masonry 0 Lawn Irrigation
� Radon Rock Bed [7 Mfg.
w': �Framing � Qther(specify)
�nsulation
��� 0 s-Built Survey
�inal
� Wetland Buffer
;; � Other(specify)
REMARKS (in-house):
� Other Review: Reviewed by: Date Approved:
" Access: Existing: 0 YES � NO New: 0 YES � NO
z OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED
i
Updated: January 2013
v:\forms�plan review checklist 2013.docx
�
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� DATE TIME ` /
CITY OF ORONO� CALLED IN "' -I �
1�.� �
INSPECTION TICE �/� SCHEDULED 7- Z_i�
PERMIT NO�l 3��'t'73 COMPLETED
ADDRESS �"J --��5
OWNER ELE HONE NO�S�'.�I�"�SS��
CONTRACTOR � �� I����
� DESCRIPTION D� "
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVEfLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ 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
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ f-0UNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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��WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
W o�bRRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-460�
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notiee
�� � �� D TE � TIME �
CITY OF ORONO CALLED IN 9�
INSPECTION NOTICE 2 SCHEDULED � � � �
PERMIT NO � `3 � J COMPLETED
ADDRESS a�oS ��n%81.UZ'( /��' S.
OWNER TELEPHONE NO. � I Z ZSI �I6/
CONTRACTOR L��a,�P��YU U��`-E��P LL G
>; DESCRIPTION ��� � � �
� ❑ FOOTING ❑ PLUMBING FI L ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ 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 MEET YOU:_YES_NO
� COMMENTS:
�
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GW �,�ATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CQRRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �95Z� Z49-4600
OwnerlContractor on si :
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DAT TIME �
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED — "� �
PERMIT NO.��l3-4�1�7-3 COMPLETED
ADDRESS �
OWNER TELEPHONE NO. Z Z S (
CONTRACTOR «y Q ��r 4 ���. /",�7��-
�: DESCRIPTION ��'����n V
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ 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
i ❑ 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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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.�b/3 -� GXx`s 7� COMPLETED �l - � -i 5
ADDRESS v���� �•'u�,..:•t �E'.C%� S.
OWNER TELEPHONE NO.
CONTRACTOR �C P�s tai'� .� ��.•-�
� DESCRIPTION T�rss�s -5��.,� _ t«�:����..,.5
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNERIFIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� �FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
Q ❑ DEMO-SITE ❑ SEPTIC MAINT. ,J�OLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI � SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEEf YOU:_YES_NO
y COMMENTS: �';r,.•�" ica��F v �-rtr.�c��t'J � c•� // �a..� �'c
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� �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECdVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDEH POSTED.CALL INSPECTOR �CITATION ISSUED
V�iNSP .TION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advan 952) 249-4600
OwnerlContractor on site:
Inspector. � 7�-- �
White Copyllnspector's Ffle Canary CopylSite Notice
�_ � � � D TIMF�
CITY OF ORONO CALLED IN �� _�=�=��
INSPECTION NOTICE �, �j SCHEDULED
PERMIT NO���� 3���` COMPLETED
ADDRESS �� `S
OWNER T EPHONE NO.
CONTRACTOR ��� ' �
� DESCRIPTION - ��ti`-� "
�
4� ❑ FOOTING DE -FINAL ❑ SEPTIC FINAI
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
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WtLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 2a hours in advance. (952 249-4600
OwnerlContractor on site:
inspector. �
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