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Home My WebLink About2014-01204 - addn/remodel/repair CITY OF ORONO * z a 1 4 - a 1 z 0 4 * , ` 2750 KELLEY PARKWAY DATE ISSUEU: 10/22/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1675 CONCORDIA ST PIN : 17-]17-23-22-0043 LEGAL DESC : REG. LAND SURVEY NO. 1628 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN /REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 30,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMI3ING, MECHANICAL, EL�CTRICAL(S"[�ATG) KITCHEN REMODEL APPLICANT PERMIT FEE SCHEDULE 466.75 PLAN REVIEW 303.39 KEN LARSON CONSTRUCTION STATE SURCHARGE(VALUATION) 15.00 11624 TIMBERL[NE ROAD MINNETONKA, MN 55305 TOTAL 785.14 (612)210-8486 Payment(s) CHECK 77�2 785.14 OWNER TRAINOR, HELEN 1675 CONCORDIA ST WAYZATA, MN 55391 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 davs 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 inspectiuns are requested in conCormanee with the State Building Code.This permit may be revohed at any time lor due cause. � / p ,�L,�'" (, '�-�'�.r—� � �L �� ZZ� I plicant Fermitee Si�naturc Datc lssued y Signaturc Date i:ity of urono E3uilciang Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) O Mailing Address: Permit number: �� /�—d l 026 �- ^/\ PO Box 66 � Crystal Bay, M N 55323-0066 Date received: /a—� �o—f Streef Address: � Received by: % :�� 2750 Kelley Parkway / Plan review fee: ,`� �� Orono, MN 55356 'p��I�y� \�'�fSFi� � � -�_,._,- 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) -i� 3�` GENERAL INFORMATION: Job Site Address: � Ca 5- �-D�CU f Q� S'�'r��' Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If yes,a special event permif is required with Police Department and City Council approval 60 days prior to fhe event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: Lc�v-sov� Co1/��-1'i0 �-� State License# BL,��6 Expiration Date: 3 3/ l fp Lead Certification Number. ��,'�'-. �24 ��-�( Expiration Date: -r�' `� /� T (for work on homes that were constructed prlor to 1978 Phone: (cell) ( _a p�g (office) Z-- 5q�.-� � —' MailingAddress �h,� � �� City: �( ZIP: cj'� o Contact Person: � Applicant is: ontractor / Homeowner (Clrcle One) Email and/or Fax: .� ��dln � �j -�- , �'� PROPERTY OWNER INFORMATI N: - Name: �r� c7lV� 1J ei [ `�Gv�c�,4yl,�%� Phone (day): «(( Ce(Z- ' l$'-- '3�{(� ( J Address: Z GOdtiC4 T '�'`C�� c�tY: Gro Q ZIP:T'J�Q 1 Email and/or Fax: �-Fr-q,;h o y-� 0�,�i-k'�" . LD Uh PROJECT INFORMATION: Overall roject description: Type of Project: Any earth movement may also require ❑Door(s) �Remodel ❑ Fire Damage MCWD review 8�permits: ❑Re-roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Rescoration ❑Water Damage Deephaven, MN 55391 ❑Re-roof, other(specify) ❑Siding ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ 3 t�� APPLICANT ACKNOWLEDGEMENT: . Agrees to provide all information required or requested by the Building Department; . Certifies that the information supplied is true and corred 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 altemative but to reject it until it is complete; • Some or all of the information that you are asked to provide on this application is Gassified 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 ou refuse to su 1 the information,the a ication ma not be issued. Applicant's Signature: Date: �� l Owner's Signature: Date: ��-��l�v� �e�o� � �o r �a r�� ►v�- Ne i � `�"v��f�� . �� . . ��7 5� C o►nco+��c,� S fi Q ro�n� �C �I ,5-S 3Q 7 _... __..�.n�,_..�..�___._...._.d_--�____�__.__.�--_� _ .�...__.N__�.._.�_...�.�.`.�. .�.��__.._____.�._ ._.m.�..�..._..�,_...�_.__..am.__ .. �� '° �.� �. 5'�`'� �i �� "�r ,� `—Q.�'� ,� � 0 }.}' " - ---�---y -----___.._ . ___.____._. _.. .._.__� ._...�_____,....___ _._. _ _. _.. _.,._._ ..... __.._� ._.�._..._� _ �� 4ss Z"�.r�t ---��P _ - _ { � .� , .�:._� _.._._....�...__....._.. _ _ � r � I i �l/C...�.�.�6��! 1/�! �`r5�'I 1 nf � d l� �� '� St y v�c� 1 � ' I ' ��r, �r�c� � _._� .�. ___,_ ___. 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O -�� i� S �. � C �; t ��--z �� 41 X�2'`� -�a��'�� ''at�J l REVIEU�ED fo�r Ct�� Nl�L�/�!lVCE PLAN CHECKED BY DATE �LAN REVIEV1f CHECKLIST FOR NEW STRtJCTURES / IQDDITION� Address/Permit IVumber: �� e � °�"T' a Description of work: _�� '14�� `�� Septic review by: ,�/f� Date Approved: Zoning review by: � f� Date Approved: Building review by: Date Approved: �� "��0� � Grading review by: l� Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zo ' g: Lot Area: SF/AC Width: Lat Coverage: SF _% Survey ubmittec�: Q Yes 0 No Date of Survey: Revised dat . � Pro osed tbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E VI� ) Other B ' dings Wettand Side Side Defined Height: Peak Height: FFE: FFE mi s 6 feet= (Existing Contour) Rerimeter(linear feet)= 50% _ #of St es Ok? 0 YES FOR A BUILDING WITH A BASEMENT OR C L SPACE: The distance betw n the�owest F A BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the asement or crawl space)and the highest int of the roof. START WITH The distance between the top of slab and If you have a... ^ the highest point of the roof. �, If you have a... • GABLE OR HIPPED RO (no . GABLE OR HIPPED ROOF(no windows): Subtract half the windows): Subtract half the distance distance between the highest p t 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#gof SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR HIPPED ROOF vith (BASED ON . GABLE OR HIPPED ROOF(with TYPE� windows): Subtract half t ROOF TYPE) windows): Subtract half the distance distance between the to of the betwezn the top of the highes4 highest window and t highest window and the highest point of the point of the roof roof • ALL OTHER ROOF TYPES(flat, • ALL OTHER R F TYPES(flat, mansard,etc:No subtraction. mansard,etc� o subtraction. y :� ADDITION Add the distance between the top of slab SUBTRACTION Subtract the dis ce between the , (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenUcra space floor and the �EXISTING the foundation. GRADES) highest exi ng grade adjacent to the GR,4DES foundatio OR 10 feet(whichever is less). E ALS Defined building height EQUALS Defin building height :� `'� Shoreland Distric MCWD Permit Received Avera e Lakeshore Setba�c Met? Bluff 0 Yes a No 0 N/A � � Yes 0 No C] Yes �No � Yes Q No � N/A ��"� � Permit Number. � etback: y;. Stormw er Quality Existing Proposed Variance Required CUP Required Overl District Tier Haedcover Hardcover 0 Yes 0 No 0 Yes � o � Type(s): Type(s): Updated: January 2013 v:\forms�plan review checklist 2013.docx REMARKS (in-house): Fees to be Char ed YES ; NO PermiE ` Plan Review State Surcharge � investigation Fee �, SAC—Number of SAC �nits Other(specify) � S uare Foota e $ er S uare Foota e Basement X - $ 15t Floor � - $ i 2nd Floo� X - � Garage X ' $ � Estimated Construction Value: $ ��,t7�0 °� Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site Plumbing � Grading/ Filling � Well 0 Hardcover Removal �echanical 0 Fire Electrical � Footing � Septic � Water Connection O Poured Wall � Fireplace � Sewer Connection � Foundation Survey Q Masonry � Lawn Irrigation � Radon Rock Bed � Mfg. �Framing 0 Other(specify) Insulation � As-Built Survey Final � Wetland Buffer � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES � NO New: O YES � NO OFFICIAL REMARKS -TO BE NOTEQ ON PERMIT AND INITIALLED Updated: January 2013 v:\forms�plan review checklist 2013.docx � `� I v� �ATE TIME � �� CITY OF ORONO �� CALLED IN INSPECTION NOTI E �� SCHEDULED f - � �ERMIT NO.` C�M�LETED ADDRESS ICG �`� C`_O►�lC�:rca (C� �� OWNER TELEPHONE NO. l� I Z �'O`0�� CONTRACTOR � �-��'ti7� � DESCRIPTION � ► V1GL� I��"►' � � ' l� ❑ 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 Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL ❑ DEMO-SITE EPTIC INSTALL ❑ FOUNDATION/REMOVAL Q OWNER/CONTRACTOR TO MEET YOU: YES_NO v�i COMMENTS: ` I QC• �r ►�.k! ' /o� - /a` ��/ � W a o �� ✓0� K !'o r� n��f-� ¢- G.��-...t �� . � � �Cr w� •L ��t4�� ' W � Q � 2 W � W � � W ❑WORK SATISFACTORY:PROCEED �'�i9dE6T COMPLEfE � �CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY w O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN �NSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector_ '�^� White Copyllnspector's Ffle Canary CopylSite Notice �� e�;�� DATEr TIME � CITY OF ORONO CALLED IN I - � _�,�— INSPECTION N TI SCHEDULED — PERMIT N• � - � C PLETED �_ ADDRESS -� �3 OWNER TELEPHONE NO - ��-a CONTRACTOR �: DESCRIPTION ��L��-' � t� ❑ FOOTING ❑ PLUMBING FINAL p EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q O RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL � HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERICONTRACTOFi TO MEET YOU:_YES_NO � COMMENTS: � W a � J O ). � O � W � Q � 2 W � W 2 j GW ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑ RECT WORK,CALL FOR REINSPECTION TEMPORARY V BE ORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 ho rs in advan 52) 249-46�� OwnerlContractor on site: Inspector. White Copyl�nspector's File Canary o yfSite Notice DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOT ,C�EraO SCHEDULED PERMIT NO. COMPLETED ��d� ADDRESS��75 Cb�o�� 5� • OWNER TELEPHONE NO. CONTRACTOR �a� �✓s�n. �a►�+�f�'� �; DESCRIPTION � K.f��c�w � ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL O MECHANICAL RI ❑ LAKESHORE/WETLANDS � FRAMING ❑ MECHANICAL FINAL ❑ 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 � ❑ PLUM8ING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � a ��c-t - ��.�- D x. � � O � � r ne/�J 1lJl�./Il'1�[.� l i�6 C A�t 515�/ti� d.�/1S . 4J� � GtXi�Sli�ti� �L e��ar- �� W L n � �Q�/@ .�i� QCi3/' � I1 d�,e� /LO,i�r/ Q '� 1 /� � 2 � ��.t� �l Q.64��Y1` � �I�GC,rl��i' ill� �� ` � -�^ W ��j-ov�b-� S'�� li�s��e� -� r� �6 i s� a5 �r.sc��.y�!'j � �p�'�c.�-�- G� /�Sk/ � W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � �60RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail forthe next inspection 2a hours in advance. (952� 249-4600 OwnerlContractor on site: � Inspector. h" White Copyilnspector's Ffle Canary CopylSite Notiee