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Home My WebLink About2011-00553 - adv plan review CITY OF ORONO PERMIT NO.: 2011-00553 , 2750 KELLEY PARKWAY '' ORONO, MN 55356- DATE ISSUED: 06/29/2011 � (952) 249-4600 FAX: (952) 249-4616 1 ADDRESS : 3424 EASTLAKE ST PIN : OS-117-23-13-0044 LEGAL DESC : BAYSIDE BEACH : LOT 003 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENT[AL COIVSTRUCT[ON TYPE : ADVANCED PLAN REVIEW VALUATION : $ 30,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OP PERMIT:$ 30,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT-ADDITION PERMIT#THIS PRE-PAYMENT IS TIED TO:2011-00554 APPLICANT ADVANCED PLAN REVIEW 303.39 RADKE, THOMAS&MARGARET TOTAL 30339 3424 EASTLAKE ST LONG LAKE, MN 55356- OWNER RADKE, THOMAS& MARGARET 3424 EASTLAKE ST LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT Thc work for which this permit is issued shall be performed according to the approved plans and specitications,applicable Ciry approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additionai or related work which requices separate permi[s. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of[he 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 all required inspections are requested i nformance with the State Building Code.This permit may be revok(ed a� time for due cause. ._� � � / / / / icant Permitce ignature Date Issued By S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRBED ABO E. � �r � � City of Orono Building Permit Application for New Structures or Additions � MailingAddress: Permitnumber: o�� —Db55`� '��,�.� PO Box 66 /0 ,a 0�� Crystal Bay, MN 55323-0066 �Date received: �O`z'�/-/l £X} �SI� Received by: ��a �'�� _ �,�, Street Address:' ��'�, � �x,� �� 2750 Kelley Parkway Plan review fee: ,303• ✓�9 � �6�2 ��t ��,t. t1r �'vG (v�?� J I �'�gE$Hog� Orono, MN 55356 �p/�� p�3 � ``�-_- ' Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us , ��J This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) ��5--,�� GENERAL INFORMATION: Job Site Address: �' � � �,��"� C .�`� �Q,c�G- ��f�� '" 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/APPL�ANT INFORMATION: Name: �j 6 ir.t �4pri F State License# E.xq+�a�ie+�at�'— Phone: �� t�/�� z�( � (office) �J,S—z �Z� ? �� j� ��z (cell) Mailing Address: � 2 � t=/4-J L � sT Cit :L a u- L�4- r ZIP: s—s—.�s— Contact Person: �_.� f��ty�K F' Applicant is: Contractor / omeowner �c��ie o�e� Email and/or Fax: Z� �,��;�F � T�cT�� S-/-��- c c.� PROPERTY OWNER INFORMATION: Name: ��r, � ,�7 K� /1il z4-� G�4-�'�c=T J'�141�Kr= Phone (day): 61 S'-? 9 z� � � •? � Address: � �-j 2 c� ��s-� J�� T City:L v�>j L�.��LI P:.S—S"�S—�„� Email and/or Fax �'r��y ;�'>�a-��.f��, -�'�-�T-�t��-�S-r4-��1- _ C .� h ARCHITECT/ ENGINEER INFORMATION: Name: ��-/�-fT� d- �f'��c.��l ll�! 7�.�r Phone (day): �� - y7 s —.�--� c � - vJ� Address: y l a N'� �Ty. ,��..t�.�s�Z��v 5-�- City:s`7~��i✓L�y ZIP:��/ �� Email and/or Fax: �..�-2, za 7S- g� S �, � 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 8�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) $ �c�� c c� .- f,- L ...-� � �.!l 1� � � _ .. � __--..__._._ .0 i�y o��6 ro n o Building Permit Application for New Structures or Additions Mailing Address: Permit number: o?U//—Q �1,�, j�v�,�\ PO Box 66 � i0 �� Crystal Bay, MN 55323-0066 Date received: � 9 // I j �� '� � I,�� y't�,�,:;, �,�, Street Address:� Received by: �` �nt��„�, �� 2750 Kelley Parkway Plan review fee: ��3�o2�U \gEs�iog� Orono, MN 55356 - ----� Total Fee: ��—DD�� 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. (P/ease print) GENERAL INFORMATION: Job Site Address: � �? � � � C S- Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No !f yes, a special event permit rs 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: State License# Expiration Date: Phone: (office) (cell) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER,I�NF RMATION�• Name: -" � <M l ` �} L7 fT� Phone (day): ��2 c� z� � �� c� Address: ? c/� c� ,� �,�z��---�-- City:f..c()� Le¢rc ZIP•�'S�S�� Email and/or Fax ARCHITECT/ENGINEER 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 �Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation f � detached garage ❑ Office/Commercial ❑ Private Sewer ❑ Other. (specify) < <`�/r't U �G L ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water "'Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review 8 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.m innehahacreek.or Estimated Construction Valuation (excluding land) $ � O �j 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 sauare feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 15�Story - ❑ Other(please specify): e. 2"d Story= f. YZ 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 Application ❑ ❑ 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 ❑ ❑ Septic S stem Site Evaluation Re ort ❑ ❑ Access Permit ❑ ❑ Wetland Buffer Im rovement Ptan ❑ ❑ 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; • 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 agreement to ensure completion of the as-built survey and all site improvements. � � ,--'� ApplicanYs Signature: � Date: � o-