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Home My WebLink About2010-00029 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2010-00029 2750 KELLEY PARKWAY ORONO, MN 5535G- DATE ISSUED: 02/02/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 25 CYGNET PL PIN : 04-117-23-22-0007 LEGAL DESC : SWAN LAKE ADDN : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 10,000.00 NOTI?: SEPERA"I'E PERMITS RGQUIRED: ELECTRICAL(STA'I�E) ADVANCED PLAN REVIGW-PERMI"C#2010-00030-PD$123.64 WI"1'H Cf IECK 13948 APPLICANT SKOOG EXTERIORS PERMIT FEE SCHEDULE 191.75 8600 GRACE LANE STATE SURCHARGE(VALUATfON) 5.00 LORETTO, MN 55357- TOTAL 196.75 Minnesota State License#: 20451795 OWNER MCLEAN, SEAN&MARIE 25 CYGNET PL LONG LAKE, MN 55356 ACREEMENT AND SWORN STATEMENT The H�ork for�vhich this permit is issued shall bc performed according to the approvcd plans and specifications,applicable City approvals,and the State[3uilding Code. This pennit is for only the work described and does not grant pennission for additional or related work which requires separate pennits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein."I�his pennit 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 suspe ided for a period of I ays at any time after work has commenced. The a lican ' nsibl for u � all required inspections are request in conformane ith t e State uilding Cpde.This permit may be revoked any time for du aus J z� v� l n �, Z, 2oiv npp P S re Date Issu By Signa ure Date SEPAR TE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. _ . , /, � � � � (,�,r. � � � z�� c� �.,, �5 City of Orono � Building Permit Application for New Structures or Additions /�O�_\ Mailing Address: Permit number: ��b� R / PO Box 66 � � �\ C stal Ba MN 55323-0066 Date received: / �� O .� O�� ry v, � a0/� � �, ��'�� '�'��,� s.'� Street Address:' Received by: ��'� �� '��,y;"�,� �� 2750 Kelley Parkway Plan review fee: �v� .(p t�kESH j Orono, MN 55356 p�U�O- �0�� 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: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a special 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/APPLICANT INFORMATION: � Name: �� {�Oc�� "�r'c,�c�c�� `� � - �. State License# Expiration Date: Phone: _ < < � _ c�v office � � �.� - `� �j U 3 r i '• cel I Mailing Address: G-2�� (�ti, Cit : __ s�, �� ZIP: ��'„-- Contact Person: `j ��,��._� �(c,��c,-- Applicant is: ntracto� / Homeowner (Circle One) Email and/or Fax: ___�-�` PROPERTY OWNER INFORMATION: Name: �' ��...� � �� ✓�c _� r� �� Phone (day): Address: 'Z� C� C,,�v��-- City� r�CZ-U �� ZIP� Email and/or Fax ARCHITECT/ ENGIN�INFORMATION: Name: � ��-�� Phone (day): Address: Cit : ZIP� Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8� ❑ New Construction Water Supply ❑ Single Family with ❑ Residence �Addition attached garage ❑ Gara e/Accesso Bld ❑Accessory Building ❑ Single Family with ❑ Deckg ry g� ❑ Public Sewer ❑ Relocation detached garage ❑ Office/Commercial ❑ Other: (specify) ❑ Private Sewer ❑ 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 (excluding land) $ i �, O(70 Last Updated: 9/29/2009 - 17 - STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame ❑ Masonry b.Width (ft.)= Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in spuare feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1S`Story = ❑ Other(please specify): e. 2"d Story= f. '/z Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable � ❑ Permit A plication � ❑ 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. i Applicant's Signature: Date: � ' � Z � �� .,� Last Updated: 9/29/2009 - 18 - Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: � � ` �� ` , Description of work: � �� 1OS > �X��`1 V G � Vv� �;�i-f� �.J .�� y�U` c�C� C. �V=ti 1/�C � �C " I I Vi � Septic review by: �r Date Approved: � `� � '�� Zoning review by: � �� Date Approved: � � 2 � `� � Building review by: � Date Approved: � - �?� � � U Grading review by: � � � /� Date Approved: � - f' �: ! (1 Zoning File#: _ ��-f�� Resolution#: Resolution Date: Z Zonin District Fire Department Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: ❑ Yes ❑ No Date of Survey: Pro osed Setbacks �- , Yyr�'�ti,v� Y �, _ ' �. Front(ta�Ce�- Rear(£�reet� ( N S (� W ) ( N S E N�) Other Buildings Wetland Side Side �j�t � � Vi v �I�'w,y,ci'� .�lv. S ' �'1 Cj �-��t ' -� /'t' /'L ��A ----�n�--��ld�-�.�{V Building Defined Height: Building Peak eight: � #of Stories Ok?: ❑ YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl START 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 round uppermost point on a round or other arch-type I or other arch-t e roof roof SUBTRACT half the distance between the highest window and SUBTRACT 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 basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet, whichever is less. EQUALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: '� y �� SF (I,ai •71 % Shoreland District MCWD Perm' Received Avera e Lakeshore Setback Bluff � ❑ Yes No ❑ N/A 0 Yes ❑ No I Yes ❑ No ❑ Yes ❑ No ❑ N/A �I�.,�,�,. �r. �,�e��- Permit Number: Setback: Hardcover Zones Existin Proposed Variance Required CUP Required 0-75' Yes � No ❑ Yes No 75-250' �V� � Type(s): Type(s): 250-500' ti C.'�%c.' ! �� :7�'__1 i�;..a._1L y e�, ��.�� C� d. , ,,�i'(--(' � �,,�� e�� v.�1'��t�s:� 500-1000' l=; �' �e�i�� REMARKS (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Char ed YES NO Permit Plan Review State Surcharge ,/ Investigation Fee SAC— Number of SAC Units Sewer Connection Water Connection Park Fee Site Inspection Other(specify) Miscelfaneous Fees Calculated By: �'. Square Foota e $ per S uare Foota e Basement X = $ 15t Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ � �%��c� U� Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site ❑ Plumbing � Grading / Filling � Well ❑ Hardcover Removal ❑ Mechanical ❑ Fire �' Electrical ❑ Footing ❑ Septic ❑ Water Connection ❑ Poured Wall � Fireplace ❑ Sewer Connection ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigation 0 Radon Rock Bed 0 Mfg. �raming 0 Other(specify) �nsulation 0 As-Built Survey �inal ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES � NO New: ❑ YES ❑ NO R�11�ARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) �,.-�% `> v t �.1� c---, �, �� , ! �,�. _ � � v��, �� \., � j� ��- ,-� ��-� C��o,-i_ f' I S �v� c,,/ Updated: 09/11/2009 z:\forms\plan review checklist.docx ��-ocba9 � DA TIME V CITY OF OR�NO CALLED IN � �� INSPECTION NOTICE SCHEDULED � '� PERMIT NO.��r�� COMPLETED �' � ADDRESS aJ� � �X� OWNER TELEPHONE NO.�n �C� Q9O 3 ��O CONTRACTOR ��, �I�O�i �: DESCRIPTION �rG��/��I '� �Q�'� � �Ns��' � � ❑ FOOTING ❑ PLUMBING FINAL ❑ 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 � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O �. � O � W � Q � Z W � W � � C1 ' ��}�ORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-46�� OwnerlContra si .' Inspector. ✓' White Copyllnspector's File Canary CopylSite Notice