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Home My WebLink About2014-00103 - addn/remodel/repair � CITY OF ORONO * 2 0 1 4 - 0 0 1 0 3 * , 2750 KELLEY PARKWAY DATE ISSUED: 02/06/2014 ORONO, MN 55356- ' (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 753 BOULDER DR PIN : 33-118-23-11-0074 LEGAL DESC : STONEBAY THIRD ADDITION : LOT 002 BLOCK 002 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 33,387.00 NO"I'E: SEPARATE PERMI"CS REQUIRED: PLUMB[NG,MF,C}�[ANICAL,FIRF,PLACE, ELECTRICAL(STATE) REPAIR WATER DAMAGE APPLICANT PERMIT FEE SCHEDULE 509.75 STATE SURCHARGE(VALUATION) 16.69 GIERTSEN COMPANY TOTAL 526.44 8385 I OTH AVE N GOLDEN VALLEY, MN 55427- Payment(s) (763)546-1300 CREDIT CARD 3846 526.44 Minnesota State License#: BUIL-BC1796 OWNER MASCHOFF, JOHN &DEBRA 2670 KELLEY PKWY ORONO, MN 55356- AGREEMENT AND SWORN STATEMENT l�he work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State E3uilding 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 whe[her 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 suance,or if construction is suspended for a period of 180 days at a time after work has commenced. The applican[is respon�ible for assu g all required inspections are requested in conformance with th ,tate Building Code.This permit may be revoked at any time for due c e. �� /�='�� ---��`� � /' � � �'`�� / / i A-�ptrc�I ermitee Signature Da �� Issued By � nature Date � "� Cit of Orono r'w` z"S- I � v�sc� y ��P B uil din g P ermi t A p plica tion for Maintenance / Re placement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O� Mailing Address: Permit number: c+�0/y. �U/03 O PO Box 66 Crystal Bay, MN 55323-0066 Date received: �-3 - �� Street Address: Received by: y ` 2750 Kelley Parkway Plan review fee: F � Orono, MN 55356 `�'�ESH�� J ��!/. �� 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: ,� � `� / y % ��i Will this be a Parade of Homes, Remodel rs S owcase Home or other Display Home? ❑ Yes No If yes, a special event perrnit is required with Police Department and City Council approva160 days pnor to the event. Shuttle bus rvice � .6e required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT II�FORMATION: Name: ��!E�1�`�"�� State License# � 2, -�"j� ' Expiration Date: —� /�J Jj'�� _ Lead Certification IV�umber: ��.. -h j— Expiration Date: L��,F,-��<� (for work on homes that we�structed prior to 1978 Phone: "� (cell) '� �' •�' ��,�� (office) /`;�-� ._ — '"�� Mailing Address: � � ' � � Cit :,� —.'�1, Contact Person: � � � Applicant is: Con actor Home wner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: �' Name: Phone (day): Address: City: ZI P: Email and/or Fax: _ � '" i PROJECT INFORMATION: Overall project description: ! !�� f' �) �'' _ �-'-� ��" Type of Project: Any earth movement may o require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration �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) $�,�,��J`� APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private �ata is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies required by law. If ou refuse to su I the inf rmation, the ication ma not be issued. ApplicanYs Signature: Date: ;�"—� `� Owner's Signature: Date: Last Updated:03/06/2013 PLAIV REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address/F�ermitNumber: �S3 ��G� ��,�� Description of work: VJ��=� ��v��($�l� �L.�"P� l� Septic review by: _ �i r�i Date Approved: Zoning review by: � /� Date Approved: Building review by:__ s�..-- Date Approved: �� '" �O/'�y' _ _ . --------__--— - ----- -----__-- ---------- — Grading review by: N/d�- Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF _% Survey Submitted: � Yes � 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 � � � ' Defined Height: � Peak Height: FFE: FFE minus 6 fee (Existing Contour) Perimeter(linear feet) = 50% _ #of Storie Ok? 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: The i ce between the lowest FOI�CBUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the basement or crawl space)and the highest point of the roof. '� START WITH The distance between the top of slab and 3 If you have a... % the highest point of the roof. F i� If you have a... , • GABLE OR H ED ROOF(no . GABLE OR HIPPED ROOF(no windows): Subtra .half the � windows): Subtract half the distance distance between the ighest p t of the roof to the low poi o e� between the highest point of the roof to the low point of the corresponding SUBTRACTION corresponding gable or h� d roof SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR HIPPED OOF( 'h (BASED ON . GABLE OR HIPPED ROOF(with TYPE� windows): Subtra alf the ROOF TYPE) windows): Subtract hatf the distance distance betwe the top of the between the top of the highest highest wind and the highest window and the highest point of the point of th roof roof • ALL �f IER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat, ma ard,etc):No subtraction. � mansard,etc:No subtraction. ADDITION Add the distance between the top of slab SUBTRACTION Subtr t the distance between the (BASED ON and the highest existing grade adjacent to (BASEO ON EXISTING ba menUcrawl space floor and the EXISTING the foundation. GRADES) ghest existing grade adjacent to the GRADES foundation OR 10 feet(whichever is less). EQUALS Defined building height EQUALS Defined building height � Shorel� District NiCWD Permit Received Avera e Lakeshore Set ck Met? Bluff � Yes ❑ No � N/A 0 Yes � No ;: � es � No ❑ Yes � No 0 Permit Number: Setback: Stormwater Quality Existing Proposed uariance Required CUP Required Overla District Tier Hardcover Hardcover � Yes � No � Yes ❑ No Type(s): Type(s): Updated: January 2013 ,��j f v:\forms\plan review checklist 2013.docx ��"` C/�� ,....�.��.,, . ,, „ .,. _ , . ,:. � m �.. � REMARKS (in-house): Fees to be Char ed YES NO Permit Plan Review � State Surcharge '---- - _ _ _ --- - _ _ _ . -- - _ . ___ _ -- -- _ _ _-- ------- -- --- , Investigation Fee ---- -- SAC-Number of SAC Units Other(specify) a S uare Foota e $ er S uare Foota e Basement X - $ 1 St Floor X - $ 2nd Floor X - $ Garage X ' $ Estimated Construction Value: $_�3�� Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site ,�Plumbing 0 Grading / Filfing 0 ell 0 Hardcover Removal Mechanical � Fire Electrical 0 Footing � Septic 0 Water Connection � Poured Wall 0 Fireplace � Sewer Connection � Foundation Survey 0 Masonry � Lawn Irrigation 0 Radon Rock Bed � Mfg. 0 Framing � Other(specify) �Insulation � As-Built Survey Final � Wetland Buffer L7 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES � NO New: � YES ❑ NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED :, Updated: January 2013 � v:\forms\plan review checklist 2013.docx /� V CITY F ORONO CALLED IN �l%[/TE/� TIME _________-1L,� .� INSPECTION ICE SCHEDULED �/�2 /`f' � PERMIT NO�� -�COMP ED - ADDRESS 7 OWNER �TELEP NE NO. 3 '� CONTRACTOR `- �; DESCRIPTION `� � �� ^ � ly ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q ❑ 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 J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Q OWNERICONTRACTOR TO MEET YOU:_YES_NO � 2 � COMMENTS:� /pldd�h � c�«✓�G�L �oYG i�Dc.'� W a � v�W1��13s � CO - DI� 0 � �// �'K �»`+�.�l� - 0 � Q �l�I�t� ��r�� e��i'�G�C �s�,/ .� � z W � w � J W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS. Ca ext inspection 24 hours in advance. (g52) 249-4600 Ownerf ntractor o ite: '�' Inspector. White Copyllnspector's File Canary CopylSite Notice �y �� oATE TIME ✓ CIN OF ORONO CALLED IN a �O INSPECTION Ir�j E SCHEDULED � � ;U� PERMIT NO.��`►—�D�b3 COMPLETED ADDRESS 753 �Dl.2.�� OWNER TELEPHONE NO.��3 �3S 53�g CONTRACTOR ��C Y��l��l/�� DESCRIPTION �Vl Su_.(� � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREMIETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE O SITE INSPECTION Q O RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: � W a � J O ). � O � W � Q � 2 W � W � J d W RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑ RECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY � BEFORECWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hou in advance. 49-46�� I OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice