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Home My WebLink About2014-00824 - addn/remodel/repair , ' CITY OF ORONO * Z 0 1 4 - 0 PJ S 2 4 * 2750 KELLEY PARKWAY llATE ISSUED: 08/12/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2630 COUNTRYSIDE DR W PIN : 04-117-23-12-0015 LEGAL DESC : OLD CRYSTAL BAY ROAD ADDN : LOT 007 BLOCK 002 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN!REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 98,000.00 N07�F,: SEYARA�I��, PERMI"I�S REQUIRED: PLUMBING, Ml?C}��ANIC�11.. I�IRI�;PLnCI�:. I�:I.}�:C'�I�IZIC'�1L(S"I�A"I�F.) KI`I'CI[EN AND I,Ai1NDRY ROOM RFMODF,I. APPLICANT PERMIT FEE SCHEDULE 1,041.75 STATE SURCHARGE(VALUATION) 49.00 PHF,ASAN'I' RUN CONSTRUCTION TOTAL 1,090.75 1 ]09 141ST LANE NE HAM LAKE, MN 55304 Nayment(s) (763) 862-2106 CREDI"I'CARD 4403 1,090.75 Minnesota State License#: BUIL-20193061 OWNER URNESS, TODD& KATHERING 2630 COUNTRYSIDE DR W LONG LAKE, MN 55356 AGREEMENT AND SWORN STATEMENT t�he ti�ork tbr which this pemii[is issued shall be peribnned according to the approved plans and specifications,applicable City approvals,and the Sta[e Building Code. This permit is for only the work described and docs not erant permission for additional or related work which requires separatc permits. All provisions of laws and ordinances governing this type ofwork shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not conune;nced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after��ork has commenced. The applicant is responsible for assuring all required inspections are requestcd in confbrmance with the State Building Code.This permit may bc revoked at any tin�c f<>r due cause. � _�"" ) -- ,-, ------.._._..___ � -/� -i� = .-��---�-� , , Appl��frf` e itee Signature Date Issued B��Si� iture te , ' �b � �o�o � City af Qrono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.} � Mailing Add�ss: pg��{number. 02 / -� �08 Z � �� Crysta(Bay,MN 55323-0066 Date recaived: '/ - / � Street Addisss: Received!ry: � � 2750 Keltey Parkway Plan reviewfee; 7 �7 `� 4� Orono,MN 55358 � `'°kFs Ho�ti ao i�-00��3 Total Fee: Main: 952-249-4fi00 Fax: 952-249-4616 vwvw,ci.orona.mn.us Ti�is application form must be corr�pleted in full and all required information must be submitted. Incomplete applications witt be retumed. (Please prrnt) QENERAL INFORMATION: ' \w � Job Site Address: ` �,�,� Wil!this be a Parade of Homes, Remodelers Sha case Home or other[?ispiay Homa7 Yes Na lf yes,s speda/svetrt permit is required with Police Uepartment and City Council approval 60 days prior to the event, Shuttle bus wit!be requirod un/ess appGcarrt demanstrates suA�ent on-site parking is availaWe. Non-peRnitted everrts wiJi rrat be attower/. CONTRACTOR 1 APPLc�ICANT INFORMATI�N; Name: i��fl�.SGLw'E"- Iti�"^�-- �S'�1�f w•.. State License# Expiratiorf Date: 3�g 1—�sr' Lead CertificaUon Number. -- 3 s'as�- i Expiration Dete: ,�. 7—/.�; (for worh on homes that wane consfructed prlor to 1978 Phone: (celi) 1 (��? Mailing Address: � � � � City: ZIP: ��-( Contact F'erson: n � Applicartt is: ontra / Homeowner �ci�m on� Email and/or Fa7c: �, - � �,��, ,,,., PROPERTY OWNER INFORMATfON: Name: l�� - K�,��✓'�1�.P. ��{v�neSS PhonB{day): � 1 r a� Address: ��}� La�S�t,� '��ri�l�( �.I�S�" City: �✓2a1J ZIP: .S3�S� Emaii andJor Fax: "'�'"t,�nc�s3 �3 1.eJ.w ��[_;nm PROJEC7INFORMATION: Overali ro'ectdes ' tlon: � u�. � Q'Ynv � a ; l�� Type oi Project: Any eart vement may a o require ❑Door(s) �$emodel ❑Fire Damage MCWD review 8.permits: ❑Re-roof,asphaft ❑Repair ❑Storm Damage Minnehaha Creek Watershed Distnct(MCWD) i6202 Minnetonka Blvd ❑Re-roof,cedar ❑Resioration ❑Water bamage Oeephaven,MN 55391 ❑Re-mof,other(specity} ❑Siding ❑Other.(specify) Phone: 952-4�71-0590 Fax: 952-471-0682 ❑Window(s) www.minnehah�creek.or� Estlmated ConsM�ction Valuatlon of Project{exc{uding fand) � � APpUCANT ACKNOWLEDGEMENT: . Agr+ees ia provide aN information required or requested hy the Building Department; • Certifies that the i�omiation supplied is true and carrect to the best of his/her knoadedge. The app8cant recognizes that they are solety responsible for submitti�g a complete appiication being aware that upon failure to do so,the sta�f has no alfemative but to reJect it untii it is complete; • Some or a1! of the information thai you ane asked fn provide on this application is classiSed by Sfate law as either private or confidential. Private data is information which generaliy cannot be given to the public but can be given to the subject of the data. Confidential data is infarmation which generally cannot be given to eiiher the public or the subjecl oi the data. Our purpose end intencled use of this information is ta annualiy update our recorcis and records of other govemmenlal agencies required by law. If ou refuse to su the'nfo an the a lication ma nat be issued. Applicant's Signafure: - Date: _ '` �"�� wnePs Signature: / Da#e: _ 7• � 0•!y Last Updated:03/0672013 .___ - -- __-_.- „ - _ - _ .... PLi4N REVIEW CHECKLIST �OR IVE1N STF�UCTURES / ADDtTIOIVS Address/Permit Number: �� 5p�t� ��t�- V✓ Description of work: � 9��,,,,a �- (�Vraj�� 0� � � Septic review by: ��e� Date Approved: Zoning review by: 'ld � Date Approved: Building review by: Date Approved: �-�'-��'''� Grading review by: �<� Date Approved: Zo ing District: Zoning File#: Reso#: Reso Date: � Zonin Lot Area: SF/AC Width: Lot Coverage: SF /o �` Survey Su itted: � Yes d No Date of Survey: Revised date ? : �� Pro osed Setba s: Front(Lake) ear(Street) ( N S E W ) ( N S E W ) Other Buildi s Wetland Side Side Defined Height: Pe Height: FFE: FFE minus 6 f t= (Existing Contour) Perimeter(linear feet) _ %_ #of�tories Ok? 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPA The distance between the Iowe FOR A BUIL NG ON A SLAB FOUNDATION: START WITH proposed floor(of the basement o rawl space)and the highest point of the ro . 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 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 point of the corresponding SUBTRACTfON corresponding gable or hipped roof SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR HIPPED ROOF(with (BASED ON . GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance distance between the top 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 TYPE (flat, � mansard,etc:No subtraction. mansard,etc):No subtr tion. DDITION Add the distance between the top of slab SUBTRACTION Subtract the distance be en the ( SED ON and the highest existing grade adjacent to (BASED ON EXISTING basement/crawl space or and the EXI TING the foundation. GRADES) highest existing gra adjacent to the GRA S foundation OR 10 et(whichever is less). EQUAL Defined building height EQUALS Defined buil ' g height Shoreland District BACWD Permit Received Avera e Lakeshore Setba Met? BlufF 0 Yes � No 0 N/A � Yes � No � Yes 0 N � Yes � No 0 N/ ' Permit Number: Setback: Stormwrater ality Existing Proposed Variance Requirec9 CUP Requ ed Overla Di rict Tier H�rdcover Hardcover � Yes � I�o � Yes � No Type(s): Type(s): Updated: January 2013 �� v:\forms\plan review checklist 2013.docx ,��. � ;��a. � ,�ti 6s�s � � , . . . . , y'-' .»13.�Ax'�.��x. ' 3 . REMARKS (in-house): Fees to be Char ed YES NO Permit 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 - $ M 2nd Floo� X = $ Garage X ' $ Estimated Construction Value: $ ��n o �U17 � Orono Inspections Required Work Requiring Separate Permits Required State Permits 0 Site Plumbing 0 Grading /Filling � Well � Hardcover Removal 0 Mechanical 0 Fire lectrical 0 Footing � Septic � Water Connection C! Poured Wall Fireplace 0 Sewer Connection 0 Foundation Survey 0 Masonry � Lawn Irrigation � Radon Rock Bed �Mfg. Framing � Other(specify) � Insulation � As-Built Survey Final 0 Wetland Buffer 0 Other(specify) REMARKS (in-house): � Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES 0 NO New: 0 YES � NO OFFIClAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED � Updated: January 2013 v:\forms\plan review checklist 2013.docx �. l, �.. / �� DATE t TIME � CITY OF ORONO CALLED IN _ INSPECTION NO I . CHEDULED ^� D PERMIT NO. y � ' '��cOMPLETED ADDRESS OWNER TELEPHONE NO. CONTRACTOR �`��rz-`�� >`; DESCRIPTION ��a � �l -, � l� ❑ FOOTING ❑ PLUMBING FINAL ❑ XCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORENVEfLANDS H 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP � ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SE�C FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO � COMMENTS: ✓— � W a � � O �. � O � W � Q � 2 W � W � j GW ❑WORKSATISFACTORY:PROCEED � ROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ IS E 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. Ca11 for the next inspection 24 urs in advan � (952� 249-4600 OwnerlContractor on site: Inspector. , White Copylinspector's File Canary CopylSite Notice