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Home My WebLink About2012-01261 - addn/remodel/repair ' � CITY OF ORONO * 2 0 1 2 — 0 1 2 6 1 * 2750 KELLEY YARKWAY DATE ISSUED: OUO2/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 475 DEBORAH DR PIN : 31-118-23-23-0004 LECAL DESC : MCCULLEY FARM : LOT 004 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 20,000.00 NOTE: SGPERATE PF,RMITS REQUIRED: PLUM131NG, GLECTRICAL(STA"1'E) KI"fCHF,N REMODEL/NEW PATIO DOOR/REMOVAL OF NON-{31iARING WALL APPLICANT PERMIT FEE SCHEDULE 339.25 DREAMMAKER PLAN REVIEW 220.51 6801 WAYZATA BLVD. ST. LOUIS PARK, MN 55426 STATE SURCHARGE(VALUATION) 10.00 (952)417-9999 MISC FEE 0.00 Minnesota State License#: BC204058 TOTAL 569.76 OWNER KATHERINE M. SWEETMAN,JAMES G WA[GHT& 475 DEBORAH DR MAPLE PLAIN, MN 55359- AGREEMENT AND SWORN STATEMENT The��°urk for�vhich Uiis permit is issued shall be perli�nned according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work describcd and does not grant perniission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.'I'his permit 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 suspended for a period of 180 days at any time aRer work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance w�th the State E3uilding Code."�his permit may be revoked at an_y time for d��eause. c ', /T(_�� % / "2 � �--3 j � 3 �� A�i�an �'ermitee Signature Date ls� d By Signature Date SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. . ��,v � i��a� City of Orono `2 � RFc ��FO Building Permit Application for Maintenance / Renovatior�r��,� � , (windows, doors, siding, re-roof, etc.) y2��2 ��, Mailing Address: F /�,�,�0 PO Box 66 Permit number: Q 0 / � Crystal Bay, MN 55323-0066 Date received: a- _ a- 1 " �,,�,.. Received by: a Z •, :. �, Street Address: �'� � '� G� 2750 Kelley Parkway Plan review fee: ��g�Hog� Orono, MN 55356 �_-_-"/ -7 Total Fee: � S109. `� 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: '� 17 ��f3o^�++ ��t;;` 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: �irRM �'►.�� c'�rN o..,� ,<a:�.+:c., State License# �2�:.�0;� Expiration Date: o,;j j,/L,�;,� Lead Certification Number: n�.�r- za��+G- 1 Expiration Date: o;.�� (tc;� (for work on homes that were constructed prior fo 1978 Phone: "�7 2 . �-I i z. 99�r1 (office) ��'L.338 aG.c.� (cell) Mailing Address: ��,, w[.�Y�A'iA 3�L� City: S;, �v�:s az�( ZIP: ��s�l'L� Contact Person: L.�.,,� .�,�a.,��,� Applicant is: Contractor / Homeowner �c�►�ie one� Email and/or Fax: c��Z y��, qag� PROPERTY OWNER INFORMATION: Name: 3,.,,,� ;,�.a�c.:ar � +G3r,�;r S:J,��r..�,.�,� Phone(day): yyz, �f 3 . �l��19 Address y 7� /��+3o2.4r� Daw� CitY: c3kv�.,o ZIP: ;�>3Sy Email and/or Fax ��,�3i,�;�e+M�.�v C� c��,� �,�,�,� PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) �Remodel ❑ Fire Damage MCWD review 8 permits: Minnehaha Creek Watershed District(MCWD) ❑ Re-roof, asphalt ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ❑ Re-roof, other(specify) ❑ Siding ❑Other:(specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Overall Project Description: r<�:c�+c:v 2E'�c'�i.L .:V�:w „4��[• :Jo-� Q�Mc�.�z �� N�,�,- 6c�a,,,c,, :�,aL� Estimated Construction Valuation of Project(excluding land) $ •Z�y, �� 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 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 re uired b law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: i'� ��"'-- Date: /z/�_�z.. _ Last Updated: 08-09-2011 . . . Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: �-!�� Qo��`1�-► �2�vG Descriptionofwork: �G►T-cr�c.n-► f2.t.✓►�✓J�L Septic review by: _ N�1� Date Approved: Zoning review by: NI ►A Date Approved: Buifding review by: Date Approved: +2-2'7 - Z�o�2 Grading review by: N�� Date Approved: Zoning Fife#: Resolution#: Resolution Date: Zonin District Fire Department Post Office School District Zoning: ot Area: SF/AC Width: D th: Survey Submitted: ❑ Yes ❑ No Date of Survey: Proposed Setbacks: Front (Lake) Rear Street) ( N S E W ) ( N S E W ) Ot r Buildings Wet{and Side Side Building Defined Height: Building Peak Height: #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL S CE: FOR A BU DING ON A SLAB FOUNDATION: START WITH the distance between the basemen loor/crawl STAR the distance between the slab and the highest space floor and the highest roof peak, e top of WIT roof peak, the top of the cornice of a flat roof, the cornice of a flat roof,the deck line o the deck line of a mansard roof, or the mansard roof, or the uppermost point on a und uppermost point on a round or other arch-type or other arch-t e roof roof SUBTRACT half the distance between the highest window a 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 with existin rade within the foundation the foundation or 10 feet, whichever is less. QUALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: SF °!o Shoreland District MCWD Perm' Received Average•L eshore Setback Bluff � ' ❑ Yes No � N/A � Yes ❑ No ❑ Yes ❑ No � Yes ❑ 0 N/A Permit Nu �er: Setback: Hardcover Zones Existi g Proposed Variance Required CUP Required 0-75' � ❑ Yes ❑ No 0 Yes ❑ No 75-250' � Type(s): pe(s): 250-500' � 500-1000' REMARKS (in-house)� N° cl�n/G e Updated: 09/11/20 z:\forms\plan revi checklist.docx Fees to be Charged YES NO • P.er.mit �' ��,� �; ,��,�� .,�: ��;. Pfan Review �� ,State.Surcharge ';� �.; s � Investigation Fee �SS�9cC Number,of.'SACdUrr`its.• ,�;��A, �,: .,.-� �,. .�,_ ,.. , _ .. ., , Sewer Connection �.��CT��i7�eC`xlD.fl��*.`�'��'.ul��`��s��=�,x,��az��....s.s`�'�j"xafit�:.�.., ".�''`�`� Park Fee � ';`S�#e�l�,is ec'�ion�`��°� '� rk > � • � �::. , _ .,_..� .... Pr��Ect� e�.•��'�};;.a,��. ' �,.4��, a � ,�+:� � - � ;._ . . .,„ ..,_.... �.. ._ � �..�,�. Other(specify) u�Miscellane.o,�us�F�e�es��T��1.q��;q�i��ti� ��'� �,{��q � ��° �W�� .. ,a- . ..�n, -,rV`�i'GxlK:�WCM:',�i ��4,•r��R 1'L.,_�W,',�i, ..�F�#,`�M1�'{� � �4wb�,� Calculated By: Square Foota e $ per Square Foota e Basement X _ $ 15' Floor X - $ 2nd FIoO� X - $ Garage X = g Estimated Construction Value: $ Zib, odo =-° Orono Inspections Required Work Requiring Separate Permits Required State Permifs ❑ Site ,O�Plumbing � Grading / Filfing 0 Well 0 Hardcover Removal ❑ Mechanical ❑ Fire Electrical 0 Footing � Septic ❑ Water Connection 0 Poured Wall ❑ Fireplace 0 Sewer Connection 0 Foundation Survey ❑ Masonry ❑ Lawn Irrigation � Radon Rock Bed � Mfg. ,�Framing � Other(specify) ,�Insulation � As-Built Survey ,O�Final D Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES 0 NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMfT) Updated: 09/11/2009 z:\formslplan review check(ist.docx � — � � A E TIME �/ CITY OF ORONO /CALLED IN /�� • �� INSPECTION NOTICE � SCHEDULED ��.J� �-� ___�/_Z PERMIT NO�� -d�z co PLETED � t ADDRESS OWNER TELE HONE NO.Z�3 -°Z3�` �� CONTRACTORl��/`��. � � >; DESCRIPTION � �J � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPIAINT J ❑ 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 C � ,1 - l' C 0 � �C;%� - C�C%C� � � � � � {� � � : �� 'f c�S-�— W J — Ic:` � / � Q � z W � W � � d W� '�WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on site: Inspector. �1`9��s.�� White Copyllnspector's File Canary Copy/Site Notice