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Home My WebLink About2011-00037 - addn/remodel/repair � CITY OF ORONO PERMIT NO.: 2011-00037 2750 KELLF,Y PARKWAY ORONO, MN 55356- DATE ISSt1ED: Ol/26/2011 952 249-4600 FAX: 952 249-4616 AUDRESS : 1 14 CHEVY CHASE DR PIN . 36-118-23-41-0035 LEGAL DESC : HILL O'WAY MANOR : LOT 001 BLOCK 002 ' PERMIT TYPE : ADDITION / REMODEL/ REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/ REPAIR ACTNITY : 434-RESIDENTIAL VALUATION : $ 10,000.00 NOTE: SEPARA"I�E PGRMI"fS RLQUIRGD: PLUMBING AND ELECTRICAL(S"I�ATG) BUMPING [3AT1 IROOM IN"I'O GnRAGF.O�F MUDROOM �--- APPLICANT PERMIT FEE SCHEDULE 191.7� MARK D. W[LL[AMS CUSTOM IIOMES, INC. STATE SURCHARGE (VALUATION) 5.00 P.O. BOX 551 TOTAL I96.75 WAYZATA, MN 55391- (612)251-9750 PAID WITH CC# SOSI Minnesota State License#: 20494403 OWNER MCLEAN, CI�iRISTOPHER& ELIZABETH I 14 CHEVY CHASE DR WAYZA"I'A, MN 55391- AGI2EEMENT AND SWORN STATEMENT "fhe��ork lor which this permit is issued shall be performed according to thc approvcd plans and specitications,applicablc City approvals,and thc Statc I3uilding Code. This permit is for only the work dcscribed and docs not grant permission for additional or rel��ted wurk which requires separate permits. All provisions of la��s and ordinanccs guvcrning lhis typc of work shall be compied with whethcr or not spccificd hcrcin.'I'his permit will expire and become null and void if constructiun authorized is not conunenced��ithin I 80 da}�s of the date uf issyancc,or if construction is suspended for a period of I 80 da��s at aEiy tim��r work has commenccd. The applicant is r�sponsible�br assuringplfi'rc ircd inspections are requested in conformxnc�t�ith thc StpCc,[j�ing Code.'I�his permit may be � revo� d at an�-time.�for duc c�x�s;i,-�"� . ;-l'� � /� / // / / A lic��1'ern�itee� ignature ��— Date Issued l3v.' ature Datc SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABOV . � �J� � � � � City of Orono Building Permit Application �.� for New Structures or Additions � i �� Mailing Address: Permit number: 1-L�� - r`C C � 7 �,0,�. PO Box 66 Q �a\ � ,\ Crystal Bay, MN 55323-0066 Date received: J 1 �`��'�� Received by: � � C��(��i'� ��'�-' ,� I�ti��-`� ,, Street Address:' �'�, � ��C��. �� 2750 Kelley Parkway -t1,��( -(�`b3�. Plan review fee: � , (� 'v g� r�ESHo�`,� Orono, MN 55356 Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us O5 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: � ( ,,,� � �, �r Will this be a Parade of Homes, Remod lers 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 ill be required unless applicant demonstrates sufficient on-site parking is available. Non-permrtted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: I Name: !�c,rlL D. .,•) � .; �;�..5 CuSt�+�-� �'t�w�es : v, C State License # �a•i q �w o �� Expiration Date: Phone: C�I,}.-�sl —`� >�� (office) (cell) Mailing Address: 9.�� . �o x S- + Cit : �,, r <.,},�, ZIP: S� �t i Contact Person: Vy��rl� ti� ,\\; �-w. S Applicant is:�Confrac r� / Homeowner (CircleOne) Email and/or Fax: -'�ct ,�?' 11 ; �w�s I�.�v,,,�s c�' ��,L�c•c� ��w, __.__ - PROPERTY OWNER INFORMATION: Name: C �r;S iVl� (�� ^ Phone (day): �/Sd- �S� - a?a � Address: �/,--� ��„F L��; rt,,,�,se r,�� . City: �►^� �v ziP: S�3�, L Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal & 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) p 18202 Minnetonka Blvd ��`�1 �S ��c`�� Deephaven, MN 55391 % �� ,S�fc,� Phone: 952-471-0590 'r Fax: 952-471-0682 �'"� �ln�G��cc� www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ ��. �•ov, `'" Last Updated: 9/29/2009 - 17 - STRUCTURE INFORMATION: . 1. Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction a. Length (ft.)= b Number of bedrooms= Wood/Frame � Masonry b.Width (ft.)= � Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1 S'Story = ❑ Other(please specify): e. 2"d StOry= f. '/ 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 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 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 F�" '_ - �-- / / ,,/ y � �� ApplicanYs Signature: � �� "�''j , Date: �jl�' • �-' � Last Updated: 9/29/2009 - 18 - , � Plan Review Checklist for New Structures / Additions Address/ PID/ Legai: /l�( GH E V y C_r�A SL A� . Description of work: �_�r��„�� p.r; (3,q.Tt-� �.pp,,,.� ,r�i-i�.a ��1�.f�i�(� e T Septic review by: /tI//� Date Approved: Zoning review by: /J//� Date Approved: Building review by: � o � Date Approved: /-2�- ��! Grading review by: N //� Date Approved: Zoning File#: Resolution #: Resolution Date: nin District Fire Department Post Office Scho C District Zoning: Lo rea: SF/AC Width: epth: Survey Submitted: Yes ❑ No Date of Survey: / Pro osed Setbacks: Front (Lake) I Rear(Stre ( N S E W ) ( N S E Wjf Other Buildings Wetland Side � Side I Building Defined Height Building Pe Height: FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START ' the distance between the basement floo START the distance between the stab and the WITH crawl space floor and the highest roof pea , WITH highest roof peak, the top of the cornice the top of the cornice of a flat roof, the ck of a flat roof, the deck line �f a mansard line of a mansard roof, or the upperm st roof, or the uppermost point on a round or point on a round or other arch-t e oof other arch-t e roof SUBTRACT i, half the distance between the hi est SU RACT ' half the distance between the highest window and highest roof peak f a pitched window and highest roof peak of a ', roof itched roof SUBTRACT '� the distance between the asement floor/ ADD the distance between the sfab and the crawl space floor and t highest existing � hest existing grade within the grade within the fou ation or 10 feet, � � fou ation whichever is less. EQUALS Define buildin hei ht EQUALS ; Defined buildin ei ht Lot Coverage: SF % Shoreland Distric ! MCWD Permit Received Avera e Lakeshore Setback Biuff � '� ❑ Yes ❑ No ❑ N/A i ❑ s ❑ No ❑ Yes No Permit Number: ❑ Yes ❑ No ❑ N/A Se ack: Hardcove ones Existin Proposed Variance Required CUP R�quired I � �� ❑ Yes ❑ No ❑ Yes ❑ No -250' ' Type(s): Type(s): 50-500' i 500-1000' ' i i , REMARKS (in-house):�L/fi�iv�,( Updated: 07/01/2009 z:\formslplan review checklist.docx Fees to be Char ed YES NO -:P�rrnit � Plan Review ,/ �S�tE'��ur.char e Investigation Fee S�'C-':Nurii'6er•of"SAC#Un:its Sewer Connection �Ilater.�:Con'rrecfion Park Fee .Site��nspection Other(specify) ,>Masce:Ilaneous�Fees- Calculated By: UBC: Construction Type: Square Foota e $ er S uare Foota e � ' I Basement � X i = I � 1 S Floor X �, - I � 2" FIOOr X = � Gara e X I = � Estimated Construction Value: $ I �, o o c� `'—� Orono Inspections Required Work Requirinq Separate Permits Required State Permits ❑ Site Plumbing ❑ Grading / Filling ❑ Well ❑ Hardcover Removal ❑ Mechanical ❑ Fire Electrical ❑ Footing ❑ Septic ❑ Water Connection 0 Foundation Survey ❑ Fireplace ❑ Sewer Connection ,�Framing ❑ Masonry ❑ Lawn Irrigation ,�Insulation ❑ Mfg. ❑ Wall Board ❑ Other(specify) ❑ As-Built Survey �Final ❑ Other (specif ) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES 0 NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMfT AND INfTIALLED BY PERSON PULLING PERMfT) Updated: 07/01/2009 z:\forms�plan review checklist.docx � r � _ - D TIME ✓ CITY OF ORONO CALLED IN � --_-�� INSPECTION NOT CE /� SCHEDULED PERMIT NO. � �Dv� COMPLETED ADDRESS �� OWNER E P NEN0.��1-0��17SO CONTRACTOR ' � r >; DESCRIPTION � ll� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � 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 ❑ SEPyfe FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOUI�YES_NO � COMMENTS: � W a � J O � � O � ti � Q � Z W � W � � GW '�-a(ORK SATISFACTORY:PROCEED [� PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ;, ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� Owner/Contractor on site: Inspector. "�/" -r �� White Copyllnspector's File Canary CapylSite Notice � a D�(E TIME CITY OF ORONO CALLED IN �^ 'C-� INSPECTION NOTICE SCHEDULED o2-ld-�� 3 =00 PERMITNO.��!/`�� COMPLETED ADDRESS �� Gf��a �� L� OWNER TELEPHONE NO. QSZ SL�S /3�'� CONTRACTOR �� D �GGL�Q-rl�'.e >; DESCRIPTION /��"�' L�1'l � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ 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 � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � � � O ( W � Q � Z W � W � � � d W ❑WORK SATISFACTORY:PROCEED [.� PROJECT COMPLETE � ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑ CORRECT WORK,CALL FOR RE�NSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONOITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 24J-46�0 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice S� DATE TIME V CITY OF ORONO CALLEO IN � INSPECTION OTICE SCHEDULED 2/-1 l /D.'o0 PERMIT NO��II-DOD�J7 COMPLETED ADDRESS �� CL1� �-! ��-e � OWNER TELEPHONE NO.��Z �S� �7-50 CONTRACTOR �� /��n'� ��''�� : DESCRIPTION �� — �� / W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � 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 � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 4 � � i�ur�t �.e ��c�,r-S �C� C��.;.�� 0 � L n.� �v C1�l � �� r�� f2� /.�-w c� 0 � � �� l� /�-� l- �C L. � P i.��' � W � G - C.� , '�� •-�-� C' ��.S �� C� `„'r'Pc.� Q z �..�' �' �f i„�-�,v 1 L� ' �� f=L.��Ff 13 Qc�d'cx�k-. � �Ca n�t�P'�c>/' T� �'it ,S •f1�1-! �-' '�Z�c�i'��/. W � � GW ❑WORK SATISFACTORY:PROCEED C�ROJECT COMPLETE � ❑CORRECT WORK&PROCEED '= ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED � INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (J52� 249-4600 OwnerlContractor on site: Inspector. ��-- White Copyllnspector's File Canary CopylSite Notice