HomeMy WebLinkAbout2012-01060 - bathroom remodel , • CITY OF ORONO * 2 0 1 2 - 0 1 0 6 0 *
2750 KELLEY PARKWAY DATE ISSUED: 10/22/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 480 DEBORAH DR
PIN : 31-118-23-23-0007
LEGAL DESC : MCCULLEY FARM
: LOT 004 BLOCK 002
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENT[AL
VALUATION : $ 17,500.00
NOTE: SEPERATE PGI2M11�S RL;QUIKED: NLUMQING,ELECTRICAL(STATE)
BATHKOOM RF,MODEI.
APPLICANT pERMIT FEE SCHEDULE 309.75
MICHAEL HAYES HOMES, INC. PLAN REVIEW 201.34
2421 LORIEN ST
HOPKINS, MN 55305- STATE SURCHARGE(VALUATION) 8.75
(952)975-9394 TOTAL 519.84
Minnesota State License#: 2163 PA[D W[TH CC# 2668
OWNER
TRAPANESE,ALBERT& CHERYL
480 DEBORAH DR
MAPLE PLAIN, MN 55359
AGREEMENT AND SWORN STATEMENT
Thc�vork for which this permit is issued shall bc perfonned according to
die approved 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 goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is no[
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring ali required inspections are
requested in conformance with Ihe State Building Code.This permit may be
revoked at any time for due cause.
t/.�%/� /���� l� Z � I�1 � �
Applicant Permite �gna�r��� Date ssu � y Signature � \ /�Da��
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
Building Permit Application
for New Structures or Additions
MailingAddress: Permitnumber: ���Q�'o��Cw
Og,�,�.0 PO Box 66
Crystal Bay, MN 55323-0066 Date received: �� -aa-� �
�, '� � �, Street Address:� Received by: �•� •
�',� GtiF 2750 Kelley Parkway Plan review fe
'�9�.EgH�g'F' Orono, MN 55356 �
Total Fee: 5� g
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 ap lications will be returned. (Please print)
GENERAL INFORMATION: ��JO✓a--� �✓^! l�`P
Job Site Address: �ffU _
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ,�No
/f yes, a specia/event permit is required with Police Department and City Counci/approval 60 days prior to the event. Shuttle bus service wil/be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: ��?�ici���� / �-���,�.� ���
State License# �/�3 Expiration Date: 3-� ��— / y
Phone: �5 Z_ � 7�_S �� � (office) (cell)
Mailing Address: �o <<�� ,� Ci � � ti� �l��<,., ZIP: �
Contact Person: ��/� _ Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: %5'�;/ ����� c��
Phone (day): r
Address: ��� ���v,�n / City: o�� ZIP:
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: ZI P:
Email and/or Fax:
PROJECT INFORMATION: ���'� ''"�`" ��'°""`'��`
1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8�
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 (excluding land) $ /7S`��
Packet Last Updated: 03-06-2012
-21 -
.
STRUCTURE INFORMATION:
1. Structure Dimensions 1. Structure Dimensions (continued) 2.Type of Construction
a. Length (ft.)= Number of bedrooms=
❑Wood/Frame
b.Width (ft.)= Number of garage stalls: ❑ Masonry
Areas in s4uare feet Attached = ❑ Metal
❑ Pole Bldg.
c. Basement= Detached = ❑ ICF
d. 151 Story =
❑ On-site Prefab
e.2"d Story=
❑ Off-site Prefab
f. '/2 Story =
❑ Other(please specify):
g.Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
❑ ❑ Permit A lication
❑ ❑ 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/OWNER 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;
• Understands 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.
• Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the
Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000
escrow to ensure completion of the as-built survey and all site improvements.
ApplicanYs Signature: Date:
Owner's Signature: Date:
Packet Last Updated: 03-06-2012
-22 -
' Plan Review Checklist for New Structures / Additions
Address/ PID / LegaL y�C,� !�� �����`��N
Description of work: �F1'7�1+ �Cr�� (�,,.1;✓VL�4�C��--
Septic review by: �'t/ I i� Date Approved:
Zoning review by: �0/� Date Approved:
a
Buifding review by: �- � z^�---� Date Approved: �� ��2?- �z--
;
Grading review by: ��/� Date Approved:
Zoning File#: Resolution#: Resolutio �ate:
ning District Fire Department Post Office School District
Zoning: ot Area: SF /AC Width: Depth:
Survey Submitted: ❑ Yes ❑ No Date of Surve .
Proposed Setbacks:
Front (Lake) Re (Street) ( N S E W ) ( N S E W ) I Other Buildings Wetland
Side de
Buifding Defined Height: Building Peak H � ht: #of Stories Ok?: ❑ YES
FOR A BUILDING WITH A BASEMENT OR CRAWL S CE: FOR A BUILDING ON A SLAB FOUNDATION:
START WITH the distance between the basemen oor/crawl START the distance between the slab and the highest
space floor and the highest roof peak, e top WITH roof peak,the top of the cornice of a flat roof,
the cornice of a flat roof,the deck line of the deck line of a mansard roof, or the
mansard roof,or the uppermost point on a nd uppermost point on a round or other arch-type
or other arch-t e roof roof
SUBTRACT half the distance between the highest ' dow an 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 basemen oor!crawl ADD the distance between the slab and the highest
space floor and the highest existi grade within existin rade within the foundafion
the foundation or 10 feet, which er is less. E ALS Defined buildin hei ht
EQUALS Defined buildin hei ht
Lot Coverage: SF %
Shoreland District MC D Permit Received Average•Lakes re Setback Bfuff
❑ Y s ❑ No ❑ N/A � Yes ❑ No
❑ Yes ❑ No ❑ Yes ❑ No N/A
Pe mit Number: Setback:
Hardcover Zones `Existin Proposed Variance Required CUP Required
0-75' ❑ Yes ❑ No Yes ❑ No
I 75-250' I Type(s): Type(s �
250-500'
500-1000'
REMARKS (in-house): ,rv�.�
Updated: 09/11/2009
z:lformslplan review checklist.docx
Fees to be Charged YES NO '
,P:erm�it �� �� �� � � � .. ° ,, , ;
. ..-�� ��, ., ,._.
F:,r„4
Plan Review � � f
State:Surcharge � �'"
Investigation Fee
°SA�C=�t�urriber�of;"S;4C,U:nits ;;- ,� � , �; ,.�� - ;
. _ ,
Sewer Connection
���T��Tilitl��'�IY�II�,���v,�ia��`�',.&�`� �" :��.i:'`��:*��°�. �r��i ���r..2� .�' ,gl����'���
Park Fee
`;��i#e�lns,�pe��tion���`������ �" �,� � � � ��;t �� . �t�� .�,�
- s«��..t.z �+� �_ ,�s �.�'� r�. �; ,>i ��r�e�,���
. _ . �,..� _ 6, . _ .
..
Other(specify)
���SCI°a��il�ne��s�`F�ee;s � ' �'+����-� ���,-�'��� ����'r 's� � �' �
9-. 7�aw�..:s, _ nr..+?�R���r 1fi +'��..�,m�Fr.�� .ra'al����•'�.4t-�'�'�t�',"C � �:,,,i
Calculated By:
Square Foota e $ per Square Foota e
Basement X = �
15t Floor X = �
2"d Floo� X = $
Garage X = �
Estimated Construction Value: � !7,�ou�=
Orono Inspections Required Work Requiring Separate Permits Required State Permits
❑ Site Plumbing ❑ Grading / Filling ❑ Well
❑ Hardcover Removal ❑ Mechanical ❑ Fire Electrical
� Footing ❑ Septic D Water Connection
0 Poured Wall ❑ Fireplace ❑ Sewer Connection
� Foundation Survey ❑ Masonry ❑ Lawn Irrigation
❑ Radon Rock Bed � Mfg.
,O�Framing ❑ Other (specify)
�'Insulation
� As-Built Survey
�inal
❑ Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access:Existing: ❑ YES ❑ NO New: 0 YES ❑ NO
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
Updated: Q9/11/20D9
z:\forms�plan review checkfist.docx
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CITY OF ORONO ` � CALLED IN �-L �
INSPECTION NOTICE (��` SCHEDULED 2--�.% �
PERMIT N0. s�,� )I.� '�LDIG'v COMPLETED
ADDRESS ��f� �Y�i��yJ r-�P
OWNER TELEPHONE NO. � �����a���
CONTRACTOR �I�-�'��� ����
>; DESCRIPTION ����� ��! �'�����
�
� ❑ 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 ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL � SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTf FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YO • YES_NO
� COMME TS:
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�y � ORK SATISFACTORY:PROCEED C; PROJECT COMPLETE
W ❑CORRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITNIN HOURS. � pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance. �952� 249-4600
:,
OwnerlContractor on site: -
Inspector. �A
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White Copyllnspector's File Canary CopylSite Notice