HomeMy WebLinkAbout2011-00372 - addn/remodel/repair �
CITY OF ORONO PERMIT NO.: 2011-00372
* 2750 KELLEY PARKWAY
ORONO, MN 55356- �ATE IssuEn: 06/27/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 325 BROWN RD S
PIN : 03-117-23-24-0011
LEGAL DESC : N/A
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTI V ITY : 434-RESIDENTIAL
VALUATION : $ 12,000.00
NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE)
REMODEL LOWER LEVEL BATHROOM
ADVANCE PLAN REVI6W FEE 143.81 PERMIT 2011-00371 PD 5/24/11 CK 043441
APPLICANT PERMIT FEE SCHEDULE 221.25
BOYER BUILDING CORPORATION STATE SURCHARGE(VALUATION) 6.00
3435 COUNTY ROAD 101 TOTAL 227.25
MINNETONKA, MN 55345
(612)475-2097
Minnesota State License#: 2988
OWNER
WILSON, STEVEN& SUSAN
325 BROWN RD S
CRYSTAL BAY,MN 55323-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
[he 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 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�s responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at 3n� ime f due cause.
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Applicant Pe ' ee Signature Date Issued By ignature Date
SEPARATE PERM(TS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
City of O�rono �h/ � �
1 ��� V
. Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number: �Ol/— 6C�J 37Z...
/g,�,� � PO Box 66 �
� � �
' Crystal Bay, MN 55323-0066 Date received:
�,� �'' �4�' a, Street Address: Received by: �'/� � ��
�'� ' 'q�� Gti�' `\ ' n, '�� 2750 Kelley Parkway Plan review fee: �7"3•8/
t�kESH��`'� �Y � Orono, MN 55356 �p/�— O437J y�
Total Fee:
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: �j�� _�;��6� /"��Z��,,� /�,�;G��,(
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No
/f yes,a special event permit is required with Police Department and City Counci/approval 60 days prior to the event. Shuttle bus service wil/be
required unless applicant demonstrates sufficient on-site parking is available. Non-permifted events will not 6e allowed.
CONTRACTOR I APPLICANT INFORMATION:
Name: �� �, � � "
� i_�;;� l��ti �c C.�'v �c,�� �' vv✓
State License# ���-� Expiration Date: ZL. I "z
Lead Certification Number: Expiration Date:
(for work on homes fhat were constructed prior fo 1978
Phone: `�S�-�t"1.5 _ �.0`�I (office) (cell)
Mailing Address �3c 3s C ►z c�� � City: �;:�,����� ZIP: 5-s � —
Contact Person: �~'�yy,� ��'-��;- .�,� o,,t ���, ,���, ,�,� Applicant is: rac / Homeowner (Circle One�
Email and/ Fa 7�Z_—� � ' - ��G;S-
PROPERTY OWNER INFORMATION:
Name: 51f:�,�t + ��'�i-t �,:t�S��--'
Phone (day): G1�,Z_��-�3--�ll 3
Address: �:>Z.S S , r.>i2 L„,., r�=.�,f City: G�L>.,�, ZIP: �5_��1�
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
❑ Door(s) �2emodel ❑Water Damage MCWD review&permits:
� Minnehaha Creek Watershed District(MCWD)
❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391
Phone: 952-471-0590
❑ Re-roof ❑ Fire Damage Fax: 952-471-0682
www.minnehahacreek.orq
Overall Project Description: ��yLi:G�.E..� (�.%��t ; \� �-�
\ \��-��'�1� 'c.r;��1
Estimated Construction Valuation of Project(excluding land) $ `2, Qt��
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
re uired b law. If ou refuse t su I the information,the a lication ma not be issued.
Applicant's Signature: ��� ' � Date: ���� �/
��T�
Last Updated: 03-01-2011
, � Plan Review Checklist for New Structures / Additions
Address/ PID / Legal: 3�-S Sp�;1�! (3(2� �N lw�
Description of work: �,���} �Z`,,vv�.��Q�.. L
Septic review by: Date Approved:
Zoning review by: Date Approved:
Building review by: Date Approved: �— / — /�
Grading review by: Date Approved:
Zoning File#: Resolution#: Resolution Date:
Zonin District Fire Department Post Office Sc ol District
Zoning: Lot Area: SF/AC Width: � Depth:
Survey Submi d: � Yes ❑ No Date of Survey:
Pro osed Setbac :
Front (Lake) Rear(Street) ( N S E W ) { N S E �) Other Buildings Wetland
Side Side
i
Building Defined Height: Building Peak Heigh : #of Stories Ok?: ❑ YES
FOR A BUILDING WITH A BASEMENT OR C WL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
START WITH the distance between the b ement floor/crawl START the distance between the slab and the highest
space floor and the highest ro peak, the top of WITH roof peak,the top of the cornice of a flat roof,
the cornice of a flat roof, the dec line of a the deck line of a mansard roof, or the
mansard roof,or the uppermost po t on a r und uppermost point on a round or other arch-type
or other arch-t e roof roof
SUBTRACT half the distance between the highest ow and SUBTRACT 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 baseme floor/cra ADD the distance between the slab and the highest
space floor and the highest exist� g grade within existin rade within the foundation
the foundation or 10 feet, whic ever is less. EQUALS Defined buildin hei ht
EQUALS Defined buildin hei ht
Lot Coverage: SF %
Shoreland District CWD Permit Received Avera Lakeshore Setback Bluff
Yes � No � N/A 0 Yes 0 No
❑ Yes � No � Yes �No 0 N/A
Permit Number: � Setback:
Hardcover Zone Existin Proposed Variance Require CUP Required
0-75' ❑ Yes ❑ No ❑ Yes 0 No
75-25 Type(s): Type(s):
250 00'
50 -1000'
REMARKS (in-house): C� C�'F
U pdated: 09/11/2009
z:\forms\ptan review checklist.docx
Fees to be Charged YES NO ,
Permit '
Plan Review
'State:Su rcharge
Investigation Fee
SAC— Number of SAC Units �
Sewer Connection
Water Connection
Park Fee
Site Ins,pection
Other (specify)
'Miscellaneous Fees
Calculated By:
S uare Foota e $ per S uare Foota e
Basement X = $
1 St Floor X = $
2nd FIOOf X = $
Garage X = $
Estimated Construction Value: $ I �-,O�a �`'
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site �Plumbing � Grading / Filling � Well
0 Hardcover Removal �echanical ❑ Fire �lectrical
� Footing � Septic � Water Connection
❑ Poured Wall � Fireplace 0 Sewer Connection
❑ Foundation Survey � Masonry ❑ Lawn Irrigation
0 Radon Rock Bed 0 Mfg.
�Framing 0 Other(specify)
�3'Insulation
�s-Built Survey
Final
0 Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access:Existing: � YES 0 NO New: ❑ YES ❑ NO
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
Updated: 09/11/2009
z:\forms\plan review checklist.docx
� DAT TIME �/
CITY OF ORONO CALLED IN �r Z�
INSPECTION NOTICE SCHEDULED 7'Z - _��
PERMIT NO.aO!/- ��7�-- COMPLETED
ADDRESS 325 ���-z�x � S.
OWNER TELEPHONE NO. �4�� �63 I q��-J'
CONTRACTOR
>; DESCRIPTION / ���'�'�'�-Q�1'L�
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� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
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Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLA�NT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTHACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REOUIRED.CALLTO ARRANGE ACCESS.
Ca11 for the next in pection 2 hours in advance. (J52� 249-46�0
Owner/Contractor on site:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
S� Dg��E TIME ` /
CITY OF ORONO CALLED IN 9-U �
INSPECTION NOTICE SCHEDULED 1�''�3-�� °�:U C�
PERMIT NO.�d��`��`�7�--COMPLETED
ADDRESS .�a�s ����� � S
OWNER TELEPHONE NO.9SZ �7S ZO 1'7
CONTRACTOR ����
>; DESCRIPTION ���� -" '��"� ����
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Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O ❑ 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 INAL ❑ FOUNDATION/REMOVAL
� OWNE RACTOR TO MEET YOU: YES NO
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� ❑WORK SATISFACTORY:PROCEED �RQOJECT COMPLETE
W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CQRRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED
0 INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46��
Owner/Contractor on site:
Inspector. /-1 c �
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