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Home My WebLink About2014-00064 - addn/remodel/repair CITY OF ORONO * 2 0 1 4 - 0 0 0 6 4 * 2750 KELLEY PARKWAY DATE ISSUED: 02/26/2014 . ORONO, MN 55356- . (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 258 CYGNET PL PIN : 04-117-23-23-0019 LEGAL DESC : SWAN LAKE ADDN : LOT 010 BLOCK 003 PERMIT TYPE : ADDITION/REMODEL/ RFPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/ REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 6,400.00 NO"I�E: SEPARA�CF,PERMI"1'S RF,QUIRF,D: ELECTRICnL(STA7�E) BASEMLNT RL'MODEL ADV PLAN REVIEW 2014-00063 $95.88 APPLICANT PERMIT FEE SCHEDULE 147.50 STATE SURCF{ARGE(VALUATION) 3.20 DOUG LARSON CONSTRUCTION TOTAL 150.70 16102 TEMPLE LANE MINNETONKA, MN 55345 Payment(s) �� CREDIT CARD 2064 1�0.70 Minnesota State License#: BUIL-BC06418 OWNER HUBBARD, ANNIE 258 CYGNET PL LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT I�he�vork ibr which this permit is issucd shall be performed according to the approvcd 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 Ihis type of�vork 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 I 80 davs of the datc of issuance,or if construction is suspended for a period of 180 days at any time alter�vork has commenced. I�he applicant is responsible for assurin�all required inspections are requested in conformance N�ith the State Building Code."l�his permit may bc revoke.d�at e�1y time for due cause. �- C�" ,,. � � �� ti� � � Ap icant Permitee Sig a re Date Issued I3y gnature � Date City of Orono �°�`� Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O�O Mailing Address: Permit number: o�O/ �`-'bD 1S6 PO Box 66 Crystal Bay, MN 55323-0 66 Date received: /-aa-� �! Street Address: �� j ,�" Received by: � y�, ` 2750 Kelley Parkway / �{,"�` Plan review fee: 9 S �� t q R�,�' Orono, MN 55356 ��'�� D!�-a o o b KFSHo Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.�n us This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (P/ease print) GENERAL INFORMATION: Job Site Address: �5 g �y��a y1�-(- � � C�� Will this be a Parade of Homes, Rem lers Showcase Home or other Display Home? ❑ Yes � No /f yes, a special event permit is required with Po/ice Department and Ciry Counci/approva/60 days prior to the event. Shutt/e bus service wi//be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �pv 1.., 'v` 6 State License# �, Expiration Date: S-- j- Lead Certification Number: �(�-T'_ �Q �c..� �� - � Expiration Date: �-�(� .-( (for work on homes that were constructed prior to 1978 Phone: (cell) ��(�`� -L�j y (office) S ti� Mailing Address: � ;,� ( �� City:j�, L�� _ ZIP: - �( � Contact Person: ,� - L.,�� ,� Applicant is: ontractor •/ Homeowne� (circ�e one) Email and/or Fax: PROPERTY OWNE, INFORMATION•J r � � Name: �j Phone (day): �� '� p—��_S Address: � � C N.� � City: Q .•�� ZIP:S'-� 3 ,� Email and/or Fax: PROJECT INFORMATION: Overall pro�ect description: Type of Project: Any earth movement may also 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) $ � 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 afternative 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 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 ou refuse to su t information, t lication ma not be issued. ApplicanYs Signature. � � Date: �^�Z— ��"( Owner's Signature: Date: Last Updated: 03/06/2013 ;, PLAN REVIEW CHECKLIST FOR NEViI STRUCTURES / ADDITIONS AddresslPermitNumber: Z�� `(�I��T (��AG:: ry� Description of work: �..�u>��- c..,�:��-�n�� 1# f a. Septic review by: Al l� Date Approved: Zoning re�riew by: N� Date Approved: Buiiding review_by:__ �-- Date Approved:_ �� - �f� ---- ------------ ------------- ___--- _ - __..-- — Grading review by: Ni� Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: �= Zo 'ng: Lot Area: SF/AC Width: Lot Coverage: SF % Surve Submitted: � Yes � No Date of Survey: Revised dat� Pro ose etbacks: Front(Lake�., Rear(Street) ( N S E W ) ( N S E W ) Other ildings Wetland '� Side Side � � Defined Height: '�� Peak Height: FFE: FFE mi s 6 feet= (Exist�ng Contour) Perimeter(linear feet) _ �`�,� 50%_ #of Stor' s Ok? � YES ,� `�� FOR A BUILDING WITH A BASEMENT OR�2AWL SPACE: The distance b een the lowest FO BUILDING ON A SLA�FOUNDATION: START WITH proposed floor(oXthe basement or crawl space)and the hig�est point of the roof. START WITH 7he distance between the top of slab and the highest point of the roof. If you have a... `,, If you have a... . GABLE OR NIPPE�'�OOF(no . GABLE OR HIPPED ROOF(no windows): Subtract ha�he windows): Subtract haif the distance distance between the highest point between the highest point of the roof of the roof to the low point otthe to the low point of the corresponding SUBTRACTION corresponding gable or hipped roof SUBTRACTION gabte or hipped roof (BASED ON ROOF . GABLE OR HIPPED ROOF(wit ` (BASED ON . GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance distance between the top of e between the top of the highest highest window and the h� est window and the highest point of the point of the roof � roof . ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF j1'PES(flat, mansard,etc:No subtraction. mansard,etc):No erubtraction. ADDITION Add the distance between the top of slab Subtract the distan etween the � (BASED ON and the highest existing grade adjacent to SUBTRACTION basemenUcrawl s ce floor and the ��. (BASED ON EXISTlNG highest existing ade adjacent to the G�R�4D SG the foundation. GRADES) foundation O 0 feet(whichever is less). �,� E�UALS Defined buildEng height S, EQUALS Deflned b ding hetght � �� Shoreland District MCWD Permit Received Avera e Lakeshoee etback Met? Bluff ❑ Yes 0 No � N/A 0 Yes 0 No � O Yes 0 0 0 Yes � No �� N/A � Permit Number. Setback: � �; k f �' Stormwate uality Existing Proposed Variance Required CUP� equired , Overla "steict Tier Hardcover Hardcover }` 0 Yes � No � Y � No '' Type(s): Type(s): � � � Updated: January 2013 �(� y1 c �� v:\forms\plan review checklist 2013.docx / V V � d i : REMARKS (in-house): Fees to be Char ed YES IVO Permit �� Plan Review State Surcharge � `, --�---- _ _ _ - _ - - --_ _ __ _-- ____ _ _ _ ------ __ _ _ _ -- � _ - — -tnvestigatioe� Fee__.-- �,. SAC-N�mber of�AC Units � Other(specify) �``� S uare Foota e $ er S uare Foota e Basement X - $ 151 Floor X - � 2"d Floor X � $ Garage X - $ Estimated Construction Value: $ ,(��°� Orono Inspectians Required Work Requiring Separate Permits Required State Permits � Site � Plumbing � Grading/ Filling 0 Well � Hardcover Removal � Mechanical 0 Fire Electrical 0 Footing � Septic 0 Water Connection Q Poured Wall � Fireplace � Sewer Connection � Foundatior� Survey ❑ Masonry � Lawn Irrigation � Radon Rock Bed ❑ Mfg. ,�'Framing � Other(specify) ,0�Insulation � As-Built Survey �'�Final 0 Wetland Buffer ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES � NO New: � YES 0 NO OFFiCIAL REMARKS -TO BE NOTED ON PERMIT ANQ iNITIALLED Updated: January 2013 v:\forms\plan review checklist 2013.docx � � CITY OF ORONO CAL�ED IN a/DA� TIME INSPECTION OTI E SCHEDULED �� : � PERMIT NO. ��"D�� COMPLEfED ADDRESS 25 g �-�t�� SLs�-�� OWNER TELEPHONE NO. �o�oj QB�o �O�o�I � CONTRACTOR 1�JD I�CG LCC.y'�rOY`- >; DESCRIPTION �� ""`�� ❑ FOOTiNG ❑ PLUMBING AL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS Q �,FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z �INSULATION ❑ WOOD BURNER/FIREPLACE O 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 v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � �L. ��'I b�S�i. a � !P�c.• IRZ - l�l� � J O � � ��SLL!• ` � p� �t �O!I+� QH !(� 4��s � � � c4»tS ' �tDa�� W � Q ' �Sr as s — e.Y�,s�..,� — Z __ - /=rt,,.� � �`� ` d� � - JY� �I�.Q✓�-s ..t j �,� -� c��.P .� � a W� �10LRKSATISFACTORY:PROCEED ❑ PROJECT COMPIEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COYERING 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 for the next inspection 24 hours in advance. (952� 249-4600 Owner ontractor on site: �O L� Inspecto . � White Copyllnspector's File Canary CopylSite Notice `�� DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED i�,�— -�-�� PERMIT NO.-''�� - � � " COMPLETED ADDRESS �'��4' �<-a�_c�r' �t�li-c_�= OWNER �� TELEPHONE NO.��,,1- i�� - �y� CONTRACTOR � � �-i�'''� J � , � �; DESCRIPTION �" ''' � ��% '``�� lL ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/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 ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERfCONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � 2 W � W � j GW ❑WORKSATISFACTORY:PHOCEED ROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED I UE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR U INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours' advan ) 249-4600 OwnerlContractor on site: Inspector. White Copy��spector's File Canary CopylSite Notice