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Home My WebLink About2013-00180 - addn/remodel/repair CITY OF ORONO * z 0 1 3 — 0 0 1 e e * 2750 KELLEY PARKWAY DATE ISSUED: 03/19/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4325 CHIPPEWA LA PIN : 31-118-23-42-0009 LEGAL DESC : CHIPPEWA : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 50,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING, ELECTR[CAL(STATE) FINISH LOWER LEVEL-REPLACE BATH&KITCHEN TWO WINDOWS IN LOWER LEVEL APPLICANT pERMIT FEE SCHEDULE 681.75 RICHARDSON, DALE PLAN REVIEW 443.14 4325 CHIPPEWA LA STATE SURCHARGE(VALUATION) 25.00 ORONO,MN 55356- TOTAL 1,149.89 OWNER RICHARDSON, DALE 4325 CHIPPEWA LA ORONO, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according[o the approved plans and specifications,applicable Ciry 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 o le for uring all required inspections are requested nfo an the State Building Code.This permit may be revoked at an me f ue cause. , __ ____ � / ! �// � � �/ �/ / Applicant Permitee Signature Date Iss cl By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ��y of �ro�o • Buif�ing �errnit Appfica�io� for Maintenance / Renovation (windows, doors, siding, re-ro�f, etc.) Mailing Address: I /�� /d� PO Box 6o i Permit number. /o Q \ Crystal Bay, MN 55323-0066 Date received: ��9;� 1 �' ! �a ( � -� �, ; Streef Address: Received by: p4,�, \�r� ; ,� ��/ 2750 Kelley Parkway Pfan review fee: \L9kEsxo4"� Orono, MN 55356 Total Fee: �//�� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us � This application form must be compfeted in full and all required information must be submitted. incompfete appficati s will be returrre�, (Please int) ��/ GENERAL INFORMATION: � � I/V�L/ Job Site Address: Will this be a Parade of Homes, Remodefers Showcase or other Display Home? ❑ Yes ❑ No !f yes, a spec�a/event permit is required with Pofice Deparrment and City Counci/approval 60 days prior to fhe event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events wil/not be allowed. CONTRACTOR/AP IC�NT INF RM T�Cj11�: Name: / � ��f� �-� /;.-,._ State License # Expiration Qate: Lead Certificafion Number: Expiration Date: (for work on homes thaf were constructed prior to 1978 Phone: (office) (cell) Maifing Address: � � City: ZIP: Contact Person: Appficant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER JA�O�MAT1qN: �� , �, Name: �-�� < ��'l�� :��-- Phone(day): �'� �� >�.,�' _�'�s r �-- . Address: � -� ' - '�__> <_�f� ��'/'c�w��; !�z ,, _� City: C��.,�r ZIP: `�),s' S'� Email and/or Fax �"�,,��. �s��, �: �� { � � � � PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) �(�Remodel MCWD review&permits: ❑ Fire Damage ❑ Re-roof, asphalt ❑ Re air � Minnehaha Creek Watershed District(MCWD} p ❑ Sform Qamage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Sidin Phone: 952-471-0590 g ❑ Other: (specify) � Fax: 952-471-0682 ❑Window(s) www.rninnehahacreek.orq Overall Project Description: t ,,, ,.� � � '� — - �_ _ .ti__ . ., � _ - - -�,__ � Estimated Construction Vafuation of Project(excluciing fand) $ ,fj �r,. ,;,�,, , � - -- 1 L_'r'��_ r.,"c ,- 1 L ��;i _�, APPLlCANT ACKNOWLEDGEMENT: �� • Agrees to provide all information required or requested by the Building Department; • Certifies that the information suppfied is true and correct to the best of his/her knowledge. The appficant recognizes that they are solely responsible for submitting a compfete 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 appiication is classified by State law as either private or confideniial. Private data is information which generally cannot be given to the public but can be qiven to the subject of the data. Confidential data is inTormafion which ge erall�aannot be given to either the public or the subject of the data. Our I purpose and intended use of this information to anr�ally update our records and records of other govemmental agE+ncies required b law. If ou refuse to su I the i orrxfation.tiye'ao fication ma not be issued. � , Appficant's Signature: / i � � Date: ,f-- / �, _ Last Updated: 08-09-2011 PLAN REVIEW CHECKLIST FQR I1�EW STRUCTURES / ADDITIOfVS /Address/�ermit Number: `�� --�'�"a r��'�'� �-.�� Description of work: ��,,�� ,�o, ,� , � Septic review by: �°r�`� Date Approved: Zoning review by: �r`'� Date Approved: Building review by: '� �- - Date Approved: "�••-� � ` '� � � Grading review by: � ��$ Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning'Lot Area: SF/AC 111�idth: Lot Coverage: SF _% Suneey Submitted: ❑ Yes 0 No Date of Survey: Revised date(?): Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W�^�� Other Buildings Wetland � Side Side �F � Defined Height: Pealc Heigh4: FFE:_„�` FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% _ #of Stories Ok? 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: The distance between the lowsst . FOR A BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the basemerit or crawl space)and the highest point of the roof. START WITH The distance behveen the top of slab and If you have a... the highest point of the roof, If you have a... *,. • GABLE OR HIP'PED ROOF(no . GABLE OR HIPPED ROOF(no windows): Subtract half the windows): Subtract half the distance distance between the highest point between the highest point of the roof of the roof to the low point of the to the low poin4 of the corresponding SUBTRACTION corresponding gable or hipped roof SUBTRACTION (BASED ON ROOF . GABLE OR HIPPED ROOF with (BASED ON � 9able or hipped roof ( GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance distance between the 4op 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 • ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat, mansard,etc):No subtraction. ` mansard,etc:No subtraction. ADDITION Add the distance between the top of slab SUBTRACTIBN Subtract the distance between the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenUcrawl space floor and the EXISTING, the foundation. GRADES) highest existing grade adjacent to the GRADES " foundation OR 10 feet(whichever is less). EQUALS Defined building height EQUALS Defined building height Shorelanc� Distriet NiC�lilD Permi�Received Avera e Lakeshore Setback IVlet? ' �EufF ❑ Yes � No � N/A !�.Yes � No C] Yes � No � Yes � IVo 0 N/A Permit Number: Setba�k: Storm�rater(�ualit�► Existing Rroposed �ariance F�equirecf Cl1R Required Overla Distri�t Tier I�ardcover �BPC�COV�P � � Yes � No � Yes C] No � Type(s): Type(�): Updated: January 2013 ' v:\forms\plan review checklist 2013.docx 6l i ` REMARKS (in-house): Fees to be Char ed YES IVO Permi# Plan Review �� State Surcharge � investigation Fee SAC—Number of SAC Units Other(specify) S uare Foota e $ er S uare Foota e Basement X - $ 1 St Floor X — $ 2nd FloOf X ' � Garage X - $ Estimated Construction Value: $ `_�� t`�'� "� Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site ,,�Plumbing 0 Grading/ Filling � Well � Hardcover Removal � Mechanical � Fire ,�Electrical � Footing � Septic � Water Connection 0 Poured Wall 0 Fireplace 0 Sewer Connection 0 Foundation Survey 0 Masonry 0 Lawn Irrigation 0 Radon Rock Bed 0 Mfg. �°''Framing 0 Other(specify) s�'"Insulation � As-Built Survey 6,�Final 0 Wetland Buffer � Other(specify) REMARKS (in-house): ( r Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES � NO New: � YES � NO � OFFICIAL REMARKS -TO BE NOTED Of� PERMIT AND INITIALLED �' Updated: January 2013 v:\forms\plan review checklist 2013.docx .. . � ., _ - .. � �,� .� . � .n,..; , � . . -._ . . ..�.,.. . .m.... __ ..- . �_ ; �:��,.. <�t i, ,7 , . �� FY �� "�z�. 4 . 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Cail for the next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary Copy/Site Notice `0��` DATE,,� TIME � CITY OF ORONO /�(L CALLED IN ��-��J � INSPECTION NOTIS�E � 7 SCHEDULED v �/ '� " `� PERMIT NO.oZD�J�' �� COMPLETED ADDRESS `Z 3�S �� OWNER 1�-- TELEPHONE NO.�lz �D� �vD�� CONTRACTOR �� 't- �� e >; DESCRIPTION � ��rn�' �� / �� — �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/G DING/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. ❑ FOLL(�W-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o �' )% I�.T�1 A-� 0 '` ��- O !� � 0 � � Te� �e.r2� ' �8 S � �' z �� J : v� t c�,�-- �vQ 2� W �' v ,� ,e.� �3 !� ��'c�-uw� w � c.� r� aow � � �UVORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-4600 OwnerlContractor on site: Inspector. (.t/' White Copyllnspector's File Canary CopylSite Notice