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Home My WebLink About2010-00698 - addn/remodel/repair � ' • CITY OF ORONO PERMIT NO.: 2010-00698 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUED: OS/24/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2515 COUNTRYSIDE DR PIN : 04-117-23-11-0007 LEGAL DESC : COUNTRYSIDE MANOR : LOT 003 BLOCK 002 PERMIT TYPE : ADDITION /REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN /REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 20,000.00 NOTE: SEPGRATG PGRMITS REQUIRF.D: ELECTRICAL(STATE) PLAN REVIEW PGI;COLLLC7'I;D 2010-00698 $220.51 APPLICANT PERMIT FEE SCHEDULE 339.25 BUILDERS BY DESIGN STATE SURCHARGE(VALUATION) 10.00 21185 VIKING BLVD. TOTAL 349.25 WYOMING, MN 55092- Minnesota State License#: 20026555 PAID WITH CC# 1097 OWNER KAHLER, CHRIS& DELPHINE 2515 COUNTRYS[DE DR LONG LAKE, MN 55356- AGREEMENT AND SWORIY STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specificatlons,applicable City approvals,and thc 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 rype of work shall be compied with whether or not specitied herein.'fhis permit will expire and become null and void if construction authorized is not commenced ti�ithin 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work ha ommenced. The applicant is res nsible for assurin�all rc rCd ins tions are requested in co � ance with S • c[3u ii Co . his permit may be revoked at a � e for due �e. o ' , � ,z� ; a io Applicant Permitee Signatur Date Is By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . . � ��,o �� City of Orono � Building Permit Application � � ,�.� for New Structures or Additions `� Mailing Address: Permit number: G�� "' �44'�� /�,�� PO Box 66 /��..p� �\\ Crystal Bay, MN 55323-0066 Date received: =�1 1 r� I� • Received by: a � ��_j'� �.,, StreetAddress: �'�,s,t�� ti�' 2750 Kelley ParkwaY Plan review fee: acZd.`�l 9kE3H�4'� Orono, MN 55356 �___- a7�<0 — ��a �� 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: ��_� 1�� C �� ,�-t-f�., ,�;� 1,>( • Will this be a Parade of Homes, Remodelers �howcase Home or other Display Home? ❑ Yes No If yes, a specia/event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR I APPLICANT INFORMATION: Name: ��,��i S 1��u �r`��ic.;r� State License# , ,�;� �y,c�e,Gj Expiration Date: ?� - 3 1 - ,��i 1 Phone: - � � - ��3 1 office � � - � � �; - c�i r'� cell Mailing Address: �5�� ►�, �� -:, Cit : �'c m;y�c ZIP: � � � � Contact Person: „� Applicant is: ontract r / omeowner (Circle One) Email and/or Fax: ��,� � l� �i- �-13�-1 - �`�1s�51 PROPERTY OWNER INFORMATION: Name: ` �-��S ,_s �C_�{��VI.�' Cz �,� Phone (day): Sp i:� - ��I��- 03c� Address: City: ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 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 ❑ Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (speCify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (exduding land) $ ��!��7�-� , �� Last Updated: 9/29/2009 ' - 17- STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction t a. Length(ft.)= � Number of bedrooms= �(Wood/Frame � ❑ Masonry b.Width(ft.)= ��Z Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 15t Story = ❑ Other(please specify): e. 2"d StOry= 3-� `_.c ��- f. '/z Story = g.Total Area= � S ,-�� REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ Permit A lication �7 ❑ 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 ❑ � Access Permit ❑ � Wetland Buffer Im rovement Plan ❑ � En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ 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; • 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 you refuse to supply the information, the application may not be issued. ApplicanYs Signature: �� Date: � -" - ( �� Last Updated: 9/29/2009 - 18- � � � Plan Review Checklist for New Structures / Additions Address/ PI D/ Legal: � S , � � �� 't�'E �, �Q 'D(', Descripfion of work: � o R,,.�.�,,� Septic review by: Date Approved: � - �� Zoning review by: Date Approved:_ � �l� - � (7 Building review by: Date Approved: Q � /� -('Q Grading review by: N(✓�" Date Approved: Zoning File #: Resolution#: Resolution Date: Zonin District Fire Department Post Office School District Zo Lot Area: SF/AC Width: Depth: Survey Su itted: ❑ Yes ❑ No Date of Survey: Pro osed Setbac � Front(Lake) r(Street) I ( N S E W ) ( N S E W � Side � Other Bui ngs Wetland Side Building Defined Height: Building Peak Height: # of Stories Ok?: ❑ YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR UILDING ON A SLAB FOUNDATION: START WITH I the distance between the basement floor/cr ' ART the distance between the slab and the highest space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the mansard roof, or the uppermost point on a roun uppermost point on a round or other arch-type I or other arch-t e roof I roof , SUBTRACT half the distance between the highest win w and SUBT T half the distance between the highest window � hi hest roof eak of a itched roof and hi hest roof eak of a itched roof � SUBTRACT ' the distance between the basemen oor/crawl ADD distance between the slab and the highest space floor and the highest existi grade within exis ' rade within the foundation ! the foundation or 10 feet, whic ever is less. EQUALS � Define ildin hei ht EQUALS Defined buildin hei ht Lot Coverage: SF o�o Shoreland District � MCWD Permit Received � Avera e Lakeshore Setback � Bluff � ❑ Yes ❑ No ❑ N/A � ❑ Yes ❑ No , ❑ Yes ❑ No , ❑ Yes ❑ No ❑ N/A I Permit Number. Setback: ; I Hardcover nes I Existin i Proposed Variance Re uired CUP Required �-� � ❑ Yes ❑ No I ❑ Yes ❑ No 7 -250' � TYPP(S)� ; Type(s): 250-500' 500-1000' i REMARKS (in-house): �/'p �,�,q ,JG,� Updated: 09/11/2009 z:\formslplan review checklist.docx Fees to be Charged YES NO � � ' P.ermit,,=�._ . , _ Plan Review � State:;Surcharge �/ Investigation Fee ';SAC-;�N�mber of SAC:Units . Sewer Connection 1Nater;;Connection ;: > ` ° ;% ; Park Fee 'Site�ln5�ection - ' Other (specify) 'Miscellaneous�Fees --. 1� �:: _ .. _. Calculated By: � Square Footage � � $ per Square Foota e � Basement I X � - $ 15t Floor � X i = � 2"d FIOOr I X = ' � Garage X = � Estimated Construction Value: � 2��oC9p �� Orono Inspections Required Work Requiring Separate Permits Required State Permits � ❑ Site ❑ Plumbing ❑ Grading / Filfing ❑ ell � ❑ Hardcover Removal ❑ Mechanical ❑ Fire Electrical ❑ Footing � ❑ Septic ❑ Water Connection ❑ Poured Wall ❑ Fireplace ❑ Sewer Connection ❑ Foundation Survey ❑ Masonry 0 Lawn Irrigation ❑ Radon Rock Bed ❑ Mfg. �Framing ❑ Other(specify) Insulation ❑ �s-Built Survey ��Final � Other(specify) � REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMfT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.docx S(..i� DATE TIME � CITY OF ORONO CALLED IN �/ INSPECTION NOTICE SCHEDULED �!- -// � 3C� PERMIT NO.a� ��-�� COMPLETED ADDRESS � � S L OWNER TEL HONE N0.7�� 2�7 37�k CONTRACTOR � � �1 (�?� P� ��- J��- >; DESCRIPTION �� ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: W �c�ro -- d o �'� l a- o �a � � c�o �3 7 � 2a t v -c�� c o'1 `�t� � o � c� � o�� 0 � � � . , �-� C�' W � a Q � Z � �' � µ� W � � d W ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE � Cl ORRECT WORK 8 PROCEED �:i ISSU CERTIFICATE OF OCCUPANCY W � CT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOR COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED � INSPECTIOfV REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. � White Copyllnspector's File Canary Copy/Site Notice �� C U—J ��tj DAT/Ey � TIME � .. CITY OF ORONO CALLED IN w '�/ v � INSPECTION NOTICE SCHEDULED �o_!3"Ca ��sL— PERMIT NO.a��O—D06� COMPLETED ADDRESS �5�� i��' � OWNER TE EPHONE NO.�p J 2- 70/ y�'72- CONTRACTOR ��a �P�-�Lt >; DESCRIPTION �Od�7�'L � � ❑ FOOTING ❑ PLUMBING AL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � � � � �� O � C� cJ ,�v�(� � W k Q � Z W � W � j d W� ❑WORKSATISFACTORY:PROCEED CI PROJECTCOMPLETE W ORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING 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 hours in advance. �952� Z49-4600 Owner/Contractor on site• Inspector_ � � White Copyllnspector's File Canary Copy/Site Notice �' �\<x� DA E TIME � CITY OF O ONO LLED IN �'1�� INSPECTION NOTICE cHE�u�E� � PERMIT NO.� COMPLETED " ADDRESS � �- OWNER T EPHONE .7�3-7`��d�� CONTRACTOR >; DESCRIPTION � t1� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS Q Q � FRAMING ❑ MECHANICAL FINAL TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIRE CE 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 Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a oc� r rv� e1— � �.�'� c' '� � � ( � � 0 � W � Q � z W � W � � W� /�YWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W �C7�CORRECT WORK&PROCEED '= ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT OCORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-46�� Owner/Contractor on site: Inspector. White Copyllnspector's File Canary Copy/Site Notice � �: � � p�/ AT /� TIME CIT OF ORONO CALLED IN �/ �_� INSPECTION NOTICE /� p� SCHEDULED � �2-�� PERMIT NO.�ID—�i�!CJ COMPLETED �- ADDRESS ��S OWNER T E NO ��" CONTRACTOR � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z I�INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q �C7 RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � �� O � W � Q � Z W � W � � d W��WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED '�: ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CAII FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 2Q9-460� OwnerlContractor on ite: Inspector. �� White Copyllnspector's File Canary CopylSite Notice ` U ' D T TIME CITY OF ORONO CALLED IN � � � INSPECTION NOTICE SCHEDULED ��/D 0 PERMIT NO '�� COMPLETED ADDRESS a 5i5 OWNER ELEPHONE NO. � 7d� �� CONTRACTOR �; DESCRIPTION �d�� l� ❑ FOOTING ❑ PLUMBING FIN L ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � � �.� O a � O � W � Q � Z W � W � � d W ❑WORK SATISFACTORY:PROCEED Cl PROJECT COMPLETE � ❑CORRECT WORK&PROCEED � ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CAII FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR � CITATION ISSUED ❑ INSPECTION REOUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice