HomeMy WebLinkAbout2015-01280 (add./remod./repair) CITY OF ORONO * z 0 1 5 - 0 1 2 8 0 *
2750 KELLEY PARKWAY DATE ISSUED: 10/12/2015
ORONO, MN 55356-
(952 249-4600 FAX: (952 249-4616
ADDRESS : 3229 B CASCO CIR
PIIY : 20-117-23-43-0003
LEGAL DESC : REG. LAND SURVEY NO. 1333
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENT[AL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 12,000.00
NOTE: REPLACE DECK BOARDS WITH CEDAR.
APPLICANT PERMIT FEE SCHEDULE 232.34
FAIR&SQUARE REMODELING PLAN REVIEW 151.02
210 EAST DEAN AVE STATE SURCHARGE(VALUATION) 6.00
CHAMPLIN,MN 55316- TOTAL 389.36
(612)245-5826 Payment(s)
Minnesota State License#: BUIL-BC638907 CREDIT CARD 4709 389.36
OWNER
SWANSON, KENT&MARY
3229 CASCO CIR
WAYZATA,MN 55391-
AGREEMENT AIYD 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 au[horized 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 the State Building Code.This permit may be
revoked at an [ime for due cau e. ,, rC�l
� � �% �" (� �,� .� ��� ������ � � r j
/ �� i i
A icant Permitee Signature Date Issued By Signature Date
� City of Orono
Building Permit Application for Maintenance / Replacement / Remodel
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
Mailing Address: Permit number: ^
�Q�� PO Box 66 � �� ' �� '
Crystal Bay, MN 55323-0066` Date received: /G ����J
� Street Address: G� �- c�'�� Received by:
ti�, G� 2750 Kelley Parkway �� �d� Plan review fee:
`qxESH04� Orono, MN 55356
Total Fee: 3 �9', ��
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 pri � � �
GENERAL INFORMATION: X -eV�'�
Job Site Address: 322� � CzSc.O � �C��
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 Po/ice Department and City Council approval 60 days prior to the event. Shuttle bus service wi/l be
required un/ess applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: Fai� -�' Sct,�a.r� �2u,✓�n.o��.�5
State License# �G�3 c�, c�p--� Expiration Date: 3/3� /1 l�
Lead Certification Number: /�l�}T (D 5 ylb- � Expiration Date: ��� ��
(for work on homes that were constructed prior to 1978
Phone: (cell) (o�2 - c���� _ g 33� (office) (o I Z —5(� 8 - 2 y�2�
Mailing Address: 210 E ��.a v¢, City: G�,aw� li� Z�P� S 3 l lo
Contact Person: .�5� ��`�� Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax: '�Q SS2 an�ai� aha.S�ivarerr��oda, . Co�
PROPERTY OWNER INFORMATION:
Name: K�r�.� -� 5�2y S�a�S�
Phone (day): (9S 2) Y71- 7/DO
Address: 2,2 $ CaSco C?.-c. C�tY� D�o-� o ZIP: S53`j
Email and/or Fax: SwahS 0��� a ol• Cow., or Swavi QQ� c�o�. ccx�
PROJECT INFORMATION: Overall pro'ectdescription: r �2C.e, c�.eCk l,�oa�ds � n �,.)ho�.e.. c�� wr-���
Type of Project: Any earth movement may also require
MCWD review& ermits:
❑ Door(s) ❑ Remodel ❑ Fire Damage p
❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
15320 Minnetonka Blvd
❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345
❑ Re-roof, other(specify) ❑ Siding �J Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) R�l? �ZG� d2L�n9 www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ /02� DDp
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 i ation,the lication ma not be issued.
ApplicanYs Signature:G--' � Date: �b s S
Owner's Signature: Date:
Last Updated:January 2015
PLAN I�EVIEW CHECKl�IST FOR NEW STRUCTURES / AQDITIONS
Address: _ .��� � � � �.C��GC; �f�' �� Permit No.:
Description of work: Date Rec'd:
Septic review by: ,������' �� �f�°�C(sP Date Approved:
Zoning review by: ; ,� Date Approved:
0
Buelding review by: Date Approved: l� � A `�
Grading review by: ,I���� Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: SF/AC Width: Lot Coverage: SF %
Survey Submitted: � Yes Q No Date of Sunrey: Revised date(?):
" Pro osed Setbacks: �
,
Front(Lake) Ftear(Str et) ( N S E W j ( N S E W ) Other Buiidings ' Wetland
;:
Side Sicle
�
Defined Height: Pea Height: FFE: FFE minus 6 feet= (Existing Contour
Perimeter(linear feet) = 50% = L.F, low grade #of Stories
;
' FOR A BUILDING WITH A BASEMENT OR CRA SPACE: FOR A BUILDING ON A AB FOUNDATION:
The distance be een the lowest proposed The distance between the top of
- START W ITH floor(of the base nt or crawl space)and ART W ITH s�ab and the highest point of the
the highest point o he roof. roof.
If you have a... If you have a...
• GABLE OR HIPPED ROOF
• GABLE OR HIP ED ROOF(no (no windows): Subtract half
windows): SubV ct half the distance the distance between the
between the hlgh t point of the roof highest point of the roof to
to the low point of e corresponding the low point of the
SUBTRACTION gable or hipped roo
(BASED ON . GABLE OR HIPPED OOF(with SUBTRACTION h pped oof'ng gable or
�' ROOF TYPE) windows): Subtract h If the distance (BASED ON . GABLE OR HIPPED ROOF
between the top of the ighest ROOF TYPE) (with windows): Subtract
window and the highes oint of the ' half the distance between
roof the top of the highest
• ALL OTHER ROOF TYP (flat, window and the highest
mansard,etc):No subtrac n. point of the roof
• ALL OTHER ROOF TYPES
� SUBTRACTION SubVact the distance between th (flat,mansard,etc):No
(BASED ON basemenUcrawl space floor and th subtraction.
� EXISTING highest existing grade adjacent to t ADDITION Add the distance between the top
` GRADES) foundation OR 10 feet(whichever i ss). (BASED ON of slab and the highest existing
f EQUALS Defined building height EXISTING grade adjacent to the foundation.
GRADES
EQUALS Defined building height
� Shoreland District �CWD P mit Average Lakeshore Setback Bluff
Niet?
C] Yes � No Permit Number: ❑ Yes � No � N/A 0 Yes � No
� N!A—see att hed Setback:
� Stormwater Quality �xisting Hardcover Proposed
Overlay District (%and s� Hardcover ariance Required CUP Requireci
;; Yier circle one %and s
� Yes � No � Yes � No
1 2 3 4 5 TYPe�s}: Type(S):
Updated: January 2015
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� REMARKS (in-house):
;
Fees to be Char ed YES NO
Permit ��
Plan Fteview � �
State Surcharge �
Investigation Fee
S/�C—IVumtaer of SAC Units �
Other(specify)
S uare Foota e $ er S uare Foota e
4.: Q,
� Basement X - ".
1St Floor X = $
2"d Floo� X - �
Garage X - $
�� .� ��� �
�' Estimated Construction Value: � �
Orono Inspections Reguired Work Requiring Separate Permits Required State Permits
� 0 Site � Plumbing 0 Grading/ Filling � Well
;" � Silt Fence/ Erosion Control 0 Mechanical � Fire ❑ Electrical
- 0 Hardcover Removal � Septic 0 Water Connection
: ❑ Footing Q Fireplace � Sewer Connection
'-` � Poured Wall � Masonry � Lawn trrigation
�; 0 Foundation Survey � Mfg. � Landscaping
`> ❑ Foundation Waterproofing 0 Other(specify)
' 0 Radon Rock Bed
: ' raming
❑ Insulation
❑ s-Built Survey
Final
- ❑ ther(specify)
' REIIAARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: � YES � NO New: � YES � NO
OFFICIAL REMAIZKS -TO BE NOTED ON PERMIT AND INITIALLED
;
k
Updated: January 2015
z:\forms\plan review checklist 2015.docx
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DA C TIME
CITY OF ORONO CALLED IN c�
INSPECTION NOTICE SCHEDULED � — �
PERMIT NO.r�J S aI a$� COMPLET D �-
ADDRESS �O�j.O�GI l� �iD (itCl CX�
OWNER EPHONE NO. a—� g�/
CONTRACTOR � � ��-.�-�-
� DESCRIPTION �� �-C
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADO LAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FR ING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
Z
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2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
v�i COMMENTS:
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� ❑CORRECT WORK&PROCEED ❑ I UE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
O CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN
INSPECTOR WFLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in advance. 9-46��
OwnerfContractor on site:
Inspector:
White Copyllnspector's File Cenary CopylSite Notice
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/ _��� TIME
CITY OF ORONO CALLED IN
INSPECTION NO CE SCHEDULED JC2=-�� �
PERMIT NO. S����COMPLETED
ADDRESS�a�,�0�� �/f/�1G�-� � �
OWNER _ T EPH 0.���s�7 �3�7
CONTRACTOR � ��� `��
� DESCRIPTION
W ❑ 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
�F&JtMING ❑ MECHANICAL FINAL ❑ RATED WALLS
�❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: �bG✓¢✓ �io� '��c b t�,e�,� .�rc4
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W O WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WlLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection�i�ours in advance. (g52) 249-460�
OwnerlContractor on site: S
Inspector. �`"'-'
White Copyllnspector's File Canary CopylSite Notiee
�. � 1 � �
�
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE � SCHEDULED
PERMIT NO.�n �-��-���`-'D COMPLEfED
ADDRESS � �
OWNER TELEPHONE NO. �� �y������
CONTRACTOR �
� DESCRIPTION
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ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q �iAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
� ❑ DEMO-SITE ❑ PTIC INSTALL
2 OWNERICONTHACTOR TO MEET YOU: YES_NO
c�.� COMMENTS: ^�
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� CALL FOR REINSPECTION TEMPORARY
� BEFORECWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
'�FIJ6PECTION REQUIRED. ' "�_ Qy�' �"'�"'�
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Call for the next inspection 24 hours in advance. (J52� 249-46��
OwnedContractor on site:
Inspector��"f� ''"'
White Copyflnspector's File Canary CopylSite Notice