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Home My WebLink About2011-01000 - void CITY OF ORO O PERMIT NO.: 2011-01000 2750 KELLEY PA WAY , ORONO, MN 553 6- DATE ISSUED: 09/22/2011 952 249-4600 FAX: 95 249-4616 ADDRESS : 4465 BAYSIDE RD PIN : 06-117-23-21-0006 LEGAL DESC : JOHNSON WHEELER 1ST ADDN : LOT 001 BLOCK PERMIT TYPE : ADDITION/REM EL/REPA PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : PORCH RESIDE IAL ACTIVITY : 434-RESID TIAL VALUATION : $ 2,000.00 NOTE: PAID$49.00 CK#2212,OVERPAID BY$l. 6 WHIC BE DEDU T PERMIT#20 1 1-0 1 000. BUILDING SCREN PORCH ON EXI DECK. / ` `0 `/ APPLICANT PERM[T F E SCHEDULE 72.69 CARLSON, ROBERT 4465 BAYSIDE RD STATE SU CHARGE(VALUATION) 1.00 MAPLE PLAIN, MN 55359- TOTAL 73.69 OWNER CARLSON, ROBERT 4465 BAYSIDE RD MAPLE PLAIN, MN 55359- AGREEMENT AND SWORN STATEMENT I The work for which this permit is issued shall be performed according to the approved plans and specitications,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 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 any time for due cause. / / / / Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE. ` � C 1 t�/ Of 0�'O O �.� ' Building Permit �4 plication for New Structure� or Additions �0-�' MailiPOBo�r66. Permitnumber: �IUI1 - �`•�C�C.�.�j / � � Crystal Bay, MN 55323-0066 Date received: � -� � i � �( 0�� VV\ �I ,�; � � Received by: F_� ' ;� ;�1 1,a � ' a,�, Street Address:' ��' ��'` � ` ti� 2750 Kelle Parkwa � � c� ,-�g l �� \t��Ix�,�,�/ Y Y ��t+�� Plan review fee: Orono, MN 5535f�C(� r � ,,�s�o � Fa �i.�� -;��.:>+-��-r �,�v�� nL��_�� - _ _ � Oj i.'t�"Z � Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.oro o.mn.us , ; � This application form must be completed in full and all r uired information must be subrrttted < Incomplete applications will be retu ned. (Please print) :�� ' GENERAL INFORMATION: -�- Job Site Address: ' � S�/�� . ��'� .�� - �� . Will this be a Parade of Homes, Remodelers Showcase Home r other Display Home? ❑ Yes ❑ No /f yes, a specra/event permit is required with Po/ice Department and City Counci/appro al 60 days prror to the event. Shuttle bus service wi/!be required unless applicant demonstrates sufficient on-site parking is available. Non-per itted events will not be allowed. CONTRACTOR I APPLICANT INFORMATION: Name: State License# � t Expiration Date: Phone: � office cell Mailing Address: Cit : ZIP: Contact Person: Applic nt is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: �;� - �':�r� T ��rr,��S�c� � Phone (day): = fs' � � - �/ Address: � S/ .�� 5 /�ri '-' .�i r i2�:��. Cit : �, « �, ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: �-/'- Phone (day): Address: Cit : ZIP: Email and/or Fax: PROJECT INFORMATION: I 1.Type of Project 2. Proposed Use 3 Structure Type 4. Sewage Disposal & Water Supply ❑ New Construction ❑ Single Family with Residence �Addition attached garage Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building �Single Family with Deck ❑ Relocation -, detached garage Office/Commercial �nvate Sewer �Other: (specify) 5C"`c'�'i'�� f"� �'c`f� ❑ Multiple Family/Condo Warehouse ��C- ,) c�GV f'X i y T�� ❑ Public Storage ❑ Public Water ""`Any earth movement may require ❑ Commercial Other(specify) MCWD review&permits. �C'�� ❑ Industrial � 'cr�� G� N �Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other. (specify) � X � S ��1 j 18202 Minnetonka Blvd C 6� � Deephaven, MN 55391 Phone: 952-471-0590 �_- C' f: Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) � O v �`' STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction • /� a. Length (ft.)= �� Number of bedrooms= �Wood/Frame , ❑ Masonry b.Width(ft.}= /� -� Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in s4uare feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 15t Story = �%� � ❑ Other(please specify): e.2"d StOry= f. '/z Story = -cT g.Total Area= %� REQUIRED SUBMITTALS: All of the information must be submitted in order for your appfication to be processed: Not Enclosed Applicable ❑ ❑ Permit Application ❑ ❑ Pro osed Buildin Plans ❑ � MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ .� Surve meetin all re uirements ❑ .� Stormwater Pollution Prevention Plan ❑ � Hardcover Calculation s ❑ Se tic S stem Site Evaluation Re ort ❑ �7. Access Permit ❑ � Wetland BufFer Im rovement Plan ❑ En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee �[-�-9'— �/ � ❑ ❑ Other APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • 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; • Acknowledges the Escrow Agreement is completed and signed; • Understands 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 govemmental agencies required by law. If you refuse to supply the information,the application may not be issued. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow agreement to ensure completion of the as-built survey and all site improvements. � ApplicanYs Signature: Date: �� – /� Plan Review Checkiist for N w Structures / Additi�ons . Address/ PID /Legal: i/ 6.� QA Y S�QCS !L(� Description of work: �C�.�� D�/1�l 0� L x i �?'>j�•.► �C{� Septic review by: nJ Date Approved: Zoning review by: /�'� L Date Approved: 9�2-i- / J Building review by: ,� �n,�•--- Date Approved: S•�2(- 1 � Gcading review by: /U//� Date Approved: Zoning File#: Resolution#: Resolution Date: Zoning District Fire Department I Post Office � -School:D' trict � Zoning: Lot Area SF!AC idth: `D th� Survey Sub itte�l: ❑ Yes ❑ I�o ate of 5urvey: Pro osed Setb ks: Front(Lake) Rear(Street) ( N S E VV ) ( `N S � W ) 9 �er Builiiings `Wet{and Side Side Building Defined Neight: Building Peak H ight: #:of Stories Ok?: ❑ YES 'FOR A$UILDING 3NITH'A BASEMENTOR AWL SPACE: FOR UILDING ON A SLAB FOUNDATION: START WITH the distance between the sement`floor/crawl ART the distance between°the slab and#he highest space floor and the highest of peak,the top of WITH roof peak,the top of the.comice of a flat roof, the cornice of a flat roof,.the d k line of a the deck Iine of a mansard roof,.or the mansard roof, or the uppermoSt„ int on a round � uppermost point on a round or other arch-type � or other arch-t pe roof � roof : SUBTRACT half the distance between the highest 'ndow nd SUBTRACT half the distance between,the highest window hi hest roof peak of;a itched roof �� and hi h�st roof eak of a: it�hed roof SUBTRACT the distance between the basement ffoo c wl I ADD the:distance h�` sn the slab and:the highest spacs floor and the highest existing gr de wit � i P�'-`' ��thefoundation ! the foundation or 10 feet,whicheve%s less. EQt�o� ^ ht EQUALS I Defined buildin hei ht � ` • � , � L�t Coverage: � � �SF ' ' r , � � Shoreland District MC. D;Rermit Rec � ``�� Bfuff ,� � ❑ es ❑ 'No �''� � \ �l,'`i '� 1 Yes ❑ No ❑ Yes ❑ No (� �" Pc� ermit Number: � , " /,� ,'��. � �ack: .,�1,�'� �, �� ,.��.��, HardcoverZones Existin Propo: �` `P Re uired D-75' `�"��f� �, � ❑ No 75-250' 1 250- 0' � � � � 5D -1000' i REMARKS (in-house):_ N d GI��1 N L�L� � Updated: Q9/11/20Q9 z:\formslplan review checkiist.docx Fees to be Charged �'ES NO _ , . • ��' � � ,- � .. .., � . - . , � �'r�'�nu�' n�� .." f ��rr� ;� W � ', ��,.,. �,� t .,.. . _a .. . .,�. .� _n<�ra_ :_ ,kr, . .,:�,' .,, ..x, ., ��' ' �� Ptan Review ��. ..,,axarmu��:. � �� .. . . y�. .. -.. ._ ... ... .. N'i �1,�� , _ ..,. ra...ry.MYs� .iWd t6. Investigation Fee �C��. C �S2JNtA't - _ � _ niN'Llm!bL'u.�o�`f�5�'��IAai� r {' . ,.� ., , ..c . ,k�, . FN:_. fi+. - . . �:_, , , _ .. ._. .,. .,, - .... ..��.: ._. . .. ....,. . .. .,..,. .. ; Sewer Connection ., s , v �^ .y,_ �IJGaterFConnecfi�on-; , � y :�j. r..� ,•. ��;, } .Y ....: - .. -^h .,�7�'1,7t�`A. -.iGCA. '_ �i.i.,,�., .�, . .�r..�i . rc .�. ' ��`:... 3.. .. Park Fee I �� 1��1�:11 �.��w��";�'�. I "'`>��;a`7 .y,?' n�',�i._ . ' i: .. „; � `s,_ �ther�(specify) I ° �. . : :�� .,;�� .,. _ ,rs�.e�F3a�ru�„�,� �ae•e� �� "�� -r�. :� �� `��«�� b � ��au .a Caiculateci By: � . . : � S uare.Foota e $ per Square'Fnota e I � Basement X ; _ � 1� Floor : X ; _ � 2nd FIDo� X _ $ Garage X = � Estimated Construction Value: � Z, C�Oc� "—" Orono Inspections RequirecJ Work Requiring Separate'Permits Required State Permits ❑ Site � Rlumbing ❑ Grading /Filiing ❑ Wel1 ❑ Hardcover Removal 0 Mechanical ❑ Fire lectrical � footing � 5eptic 0 Water Connection ❑ Poured Wall 0 �irepiace ❑ Sewer Connection � Foundation Survey ❑ Nfasonry ❑ Lawn lrrigati�n �adon Rock Bed ❑ IVlfg. Framing ❑ Other.(specify) 0 'Insulation ❑ �rs-Built Survey �Final ❑ Other�specify) REMARKS {in-fiouse): Other Review: Reviewed by: Date Appro�ed: Access:Existing: ❑ YE5 � NO NEw: � YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMtT) Updated: D9/11/2009 z:lformslplan review check(ist.docx TE T ME �/ CITY OF ORONO CALLED IN �� /� INSPECTION NOTICE SCHEDULED / i� PERMIT NO � 7 COMP TED ADDRESS OWNER EPH E NO. CONTRACTOR K� �: DESCRIPTION �� ❑ FOOTING ❑ PLUMBING F A ❑ EXCAV/G�ADIN /FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHQRENV LANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE RE�y+IOVA � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INS�ECTI Z Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRE$S � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLA�NT Q ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW1UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD CCDVER EMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDA�fION/ EMOVAL Z OWNER/CONTRACTOR TO MEEf YOU:_YES_NO i � COMMENTS: � � e � � i � � 0 � � 0 � w � � Q � ' z W � W � I � GW ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPL�TE W ❑CORRECT WORK&PROCEED � ISSUE CERTIFICF��fE OF CCUPANCY � ❑CORRECf WORK,CALL FOR REINSPECTION TEMP�RAR V BEFORE COVERING PERMWNEN ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN j INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � GTATION ISSUE[� ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next ins ction 24 hours irt advance. - � (95�) 2 9 4600 Owner/Contractor on site: Inspector. White Copyllnspector's File Canary CopylSit�Notic � DATE I TIME " CITY OF ORONO CALLED IN lNSPEC7'ION NOTICE SCHEDUIED PERMITNO. �o�!'OldB7 COMPLEfED ' ADDRESS �S 6 ^ • OWNER TELEP6iO1VE NO. CO►�TRACTOR �iK e {r��o�f A DESCRIPTION - �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCA /GRA ING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOR ETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE�iEMO AL � ❑ INSULATION O WOOD BURNER/FIREPLACE ❑ SITE INSPE ION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMP�AINT' � ❑ DEMO-SITE ❑ SEPTIC MAINT. �`FOLLOW-UP g ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVE REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNtbATlO /FIEMOVAL � OWNERlCONTAACTOR 7�AAEE'!Y04D:_YES_PIO � COIIAMEN�S: � - - -a� - -- w � � *OLD PERMIT - NO FINAL INSPECTION R QUESTED. � � c d c� e �a 2 O >. � � �(f /J �/� �L /c �/!G /�e/'f�e� �ja^, /'O!/�r�C4'i� - ,� � '�L � l{/Or,� - dtoi �a�.,c /� -�- i� ;e � � r.+c it ��tQ j d W� ❑WORK SATISFACTORY:PROCEED ROJECT COMPIETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF CCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPt�RAR � OEFORECOVERING PERMANEN ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PNOTO TAKEN INSPECTOR WILL RETURPJ ❑STOP ORDEfl POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION RE4.lU1RED.Cr�,L�_TO ARRANGE FICCESS. Ca11 fo��he��x��s�ction�4 ho�a�en�sivan�, (952� 2 9�4600 �wnerlContracior��pu�. �avspector:� / �^- 7'� White CopylBnsp2ctor's Fil� Canar�CopylSi4e otice I I I�