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Home My WebLink About2014-01275 - remodel � � CITY OF ORONO * z 0 1 4 - 0 1 2 7 � 2750 KELLEY PARKWAY DATE ISSUED: 1U05/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1 165 FERNDALE RD W PIN : 02-117-23-43-0026 LEGAL DESC : NORTH SHORE COTTAGE ACRES LAKE : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION /REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/ REPAIR ACTIVITY : 434-RES[DENTIAL VALUATION : $ 175,000.00 \OTI:: SEPAR�1�l�E PGRMITS RI?QUIRI�;D: PI,UMI3ING. :Vll?CI IANICAL,FIRI�:PLACE, I�;LEC'1'RICAL(S"I'A"I'E) REMODEI, APPLICANT PERMIT FEE SCHEDULE 1,506.75 STREETER & ASSOCIATES STATE SURCHARGE(VALUATION) 87.50 18312 M[NNETONKA BLVD TOTAL 1,594.25 WAYZATA, MN 55391 Payment(s) (612)449-9448 CREDIT CARD 2061 1,594.25 Minnesota State License#: BUIL-1380 OWNF.R BROOK, ROBERT I l65 FERNDALE RD W WAYZATA, MN 55391- AGREEMENT ANll SWORN STATEMENT "I�hc work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only Ihe N�ork described and does not grant permission 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 no[specified herein.This permit will expire and become null and void if construction authorized is not commenced within ]80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time atter work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State[iuildin��Code.This permit may bc revoked at anv time for duc cause. ��- /l , � , /� Applicant Permitee Signature Date Issued �Signature Date - �- City of Orono Building Permit Application for Maintenance / Replacement / Renovation (No structural expansion. Oniy windows, doors, siding, re-roof, etc.) ��A, Mailing Address: _D� 'VO PO Box 66 Permit number: � Crystai Bay, MN 55323-0066 � Date received: /0 30 ! ' , ,� , Street Address: �� Received by: 'Y�, G� 2750 Keiley Parkway � � Plan review fee: . `�k£SH�� Orono, MN 55356 1 ',`��/� � Total Fee: `� 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 wiil be returned. (Please print) GENERAL INFORMATION: , / ^� � �-�, ,, , �, Job Site Address: (a �I -�j �' ��j„� �" �,{_�� ::��- t: � 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/approva!60 days prior to the event. Shuttle bus service wi//be required un/ess applicant demonstrates s�cient on-site parking is available. Non-pemritfed events wid nof be albwed. CONTRACTOR/APPLICANT INFQRMATION: �; � - Name: �•-'� � �=��:�• :s':,� .,,i �� j�•;a J.`A:,, , f: State License# " �.° � Expiration Date: ,� ' `> '�� Lead Certification Number: ��,=-� G(.�°"? � .,, Expiration Date: 1��-- (foi work on homes that were cRnstructed pria�to 1978 Phone: (cell) ` � � �' . , � � � , � � + � ,-��,. ��,�� (o�ce) e' �_��- � `�ti�.._ �,! �. c �r °::� � Mailing Address: � �? k t`� '' R-; ^ , `, . ty: ,1��-��<�.�T,� ��.r� c1 v..s �r�... " ` � ; ¢.,.._,�� ,a� y�� Ci . :�. �� ZIP: � +.. Contact Person: `�' �,,-{.', �.1�� ,` , pp icant is: � Contractor'? / Homeowner -*-- � A I �, (circle one) Email and/or Fax: � � � ` 4 t' . � •� , > �F < ,�"°"��--'' 1' :t'i � � , t"�'"Q� �`�c_,�`�' .� � . ,` PROPERTY OWNER I ORMA.TION ; � t�`f � �,, Name: '�j L., �.�i ; ..��a�,� �, c, � ,e ... ! .'� �'a� r' � Phone(day): z Address ��G �;.» .� ,t�l 6. �e ,,`;, x_r_: 1�,� City: �.r�� u�:' .:, ZIP: Emai!and/or Fax: � � ) w , �: PROJECT INFORMATION: Overall ro'ectdescri tion:r��''r " �` ''-� :.`• . � ' � �;� �?c, - � " ', 1 '�:i'r ''�, `' ° "f�, Type of Project: Any earth movement may also req ire ❑Door(s) �,Remodel ❑ Fire Damage MCWD review 8�permits: ❑Re-roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑Re-roof,cedar ❑Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ❑Re-roof,other(spectfy) ❑Siding ❑Other: (specify) Fax: 952-471-0682 �Window(s) www.minnehahacreek.ora Estimated Construction Valuation of Project(excluding land) $ ; �� D� 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 hislher 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 required by law. If ou refuse to su I th infor ion, the a lication ma not be issued. ' ��,' ._�-�..,�_�. r •i � :?..�� C� \ �_. ApplicanYs Signature: �.'�"�c�� - Date: .- I .-� . � � . Owner's Signature: Date: Last Updated:03/06/2013 `` P'Li41V F�EVIEUI�' CHECFCLiST FOR NEVII STRUC�URES / /4DDITIOIVS Address/Permit Number: 0 � �� fA�.�c � � Description o#work: '� `��-- � Septic review by: /�d /� Date Approved: Zoning review by: 4� Date Approved: Builciing review by: Date Approved: � �' �� '� Grading review by: �/ d�a Date Approved: Z ing District: Zoning File#: Reso#: Reso Date: Zoni : Lot Area: SF/AC Width: Lot Coverage: _% � Survey ubmitted: ❑ Yes 0 No Date of Survey: Revised d e 7 : Pro osed tbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E � � Other uildings Wetland Side Side Defined Height: Peak Height: FFE: FFE rni s 6 feet= (Existing Contour) Perimeter(linea�feet) = 50% _ �'of Stor' s Ok? 0 YES FOR A BUILDING WITH A BASEMfENT OR RAWL SPACE: The distance tween the lowest FOR UILDIPIG ON A SLA�FOUNDATlOfV: START WITH proposed Floor the basement or crawl space)and the hig st point of the roof. START WITH The distance between the top of slab and If you have a... the highest point of the roof. If you have a... . GABLE OR HIPPE OOF(no . GABLE OR HIPPED ROOF(no windows): Subtract h the windows): Subtract half the distance distance between the hi est point between the highest point of the roof of the roof to the low point the to the low point of the corresponding SUBTRACTION corcesponding gable or hippe oof SUBTRACTION gable or hipped roof (BASED ON ROOF e GABLE OR HIPPED ROOF(with (BASEO ON • GABLE OR HIPPED ROOF(with NPE) windows): Subtract half the � ROOF TYPE) windows): Subtract half the distance distance between the top of the between the top of the highest highest window and the highe window and the highest point of the point of the roof roof • ALL OTHER ROOF TYP (flat, • ALL OTHER ROOF TYPES(flat, mansard,etc):No sub ction. mansard,etc:No subtraction. ADDITION Add the distance between the top of slab ' SUBTRACTION Subtract the distance be en the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenUcrawl space or and the EXISTING the foundation. GRADES) highest existing grad adjacent to the GRADES foundation OR 10 f et(whichever is less). EQUALS Defined building height EQUALS Defined buildi height Shorelancf Destrict MCV�D Permit Received Avera e Lakeshore etback Met? Bluf# t' 0 Yes � No Q N/A C3 Yes 0 No � Yes Q No � Yes C� No N/A Permit Number: Setback: Stormwatec Q lity Existing Froposed Variance Required CUP equired Qverla Dist 'ct Tier Hardcover Hardcover � Yes � No � Ye Q No Type(s): Type(s): Updated: January 2013 v:\forms\plan review checklist 2013.docx ,, _ x,�,.� .�*�, _ ��,w_.-, kU ,.��_: . .::,e .......:..... ;:� , ... , . _ :-�� :_�.,_� . . �w-. ^��:.w�..��__.�..:,�.�_._�._._.____�f._<_...____..__...__� ,..�.��.�._ . . REMARKS (in-house): Fees ta be Charged YES NO Permit Plan Review State Surcharge to" Investigation Fee � S�lG—Numbee sf SAC Units 8--�'' Other(specify) S uare Foota e $ er Square Foota e Basement X - � 15t Floor X - $ 2nd FI00� X - $ Garage X ' $ Estimated Construction Value: $ �� f �v a �� Orono Inspections Required Work Requiring Separate Permits Required State Perr�its 0 Site �'Plumbing 0 Grading/ Filling � Well � Hardcover Removal �echanical ❑ Fire �" Electrical 0 Footing � Septic � Water Connection ❑ Poured Wall ,0' Fireplace 0 Sewer Connection � Foundation Survey �Masonry 0 Lawn Irrigation � Radon Rock Bed � Mfg. � Framing 0 Other(specify) p'Insulation 0 As-Built Survey �Final � Wetland Buffer 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES 0 NO New: Q YES � NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLEQ � � �, �: � � Updated: January 2013 v:\forms�plan review checklist 2013.docx �.< � � � � DATE TIME � CITY OF ORONO CALLED IN � �`� INSPECTIONr10Tl E SCHEDULED � PERMIT NO o� � COMPLETED ADDRESS ,�/�,o OWNER TELEP ONE NO.Ct-I��--`�`�� CONTRACTOR � � � � � �; DESCRIPTION � � - � :�OOTING O PLUMBING I � ❑ E AV/ RA IN LIN Q O POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Z Q O RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � O FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL � HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL � OWNERICONTAACTOR TO MEET YOU:_YES_NO � COMMENTS: �` ��. �" 6 a a.- ��. - Jo? „� �e�� r�// j �,.� r��s✓ � 6d " O•C . - o? r►�r�,5 � 0 �. ° ' Sr�r ti G e `�' � � . � O�r.�vl �Q W � D�l /Y• �KaP �,s l� �� _ OGJs�e� �i1�-- Q -- -- Z _�c�'��_�'�� o►l O� S!�e I.J/ �`� � rX.�e�s � /� "D�C_ W � � � /' � ��IIIGrfiK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ��CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca t inspection 24 hours in advance. (952) 249-46�0 Ownerl o tractor on site: e e t�, , Inspecto . White Copyllnspector's File Cenary CopylSite Notice �/� � DATE �,�IME CITY OF ORONO CALLED IN 3- // -�� INSPECTION TI E SCHEDULED �! �—LS � PERMIT N� � �� COMPLETE ADDRESS � OWNER TELEPHO E NQ� �^g $ CONTRACTOR e �� DESCRIPTION l� ❑ FOOTIN ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POU D WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ F NDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL ADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION RAMING ❑ MECHANICAL FINAL ❑ PROGRESS � IN LATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � W ( / � V W � � O W RK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � C RECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN iNSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 ours in adva 52) 249-4600 OwnerlContractor on site: Inspector_ White Copylinspector's File Canary CopyiSite Notice �(%1 r�� Q� TIME v ��TY OF ORONO `�%r GALLED IN � �' INSPECTION NOTICE CHEDULED � I�} I t5 g o��? ��.m PERMIT NO.aC�t� — �' � �-1�OMPLETED ADDRESS � �o� �"'� � OWNER�a��'�'�o � TELEPHONE NO.�-�-�a-��'� �a` CONTRACTOR � k'r�=�-��c' I� S S�- • I ��-�'-�� DESCRIPTION ��S'� �-�� a'Y� I l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GAADING/FILLING y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE AEMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION _ ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � �INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ EPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU�YES_NO � COMMENTS:� � a C'�e�i ws /s. �9rty ��..,c - C�L2S�� L�/l � j o � l��ls ' ,2 • !g t�T v�ao r �r��✓ � �. � ° v l� �a- �6U�� W � Q � 2 W � W � j GW �WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE � �CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: Inspector. -� � �w White Copyllnspector's File Canary CopylSite Notice �� _ , - ;i �,� DATE TIME � CITY OF ORONO CALLEa(r, INSPECTION NOTICE SCHEDULED � ��r PERMIT NO. ?� � �� COMPLETED ADDRESS �� -�',h-�'7 c�C� LP _ ��. �.� � OWNER TELEPHONE�b.'�O�Z ��'� ��/.3� CONTRACTOR � "��'' ��/7�(�;, � DESCRIPTION �l�?C� / �� ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ F AMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ A BUILT-SURVEY ❑ SE ER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ S PTIC INSTALI � OWNERICONTAACTOR TO MEET Y'OU: YES_NO v�i COMMENTS: a � " � � - , � J O ). � O � W � Q � 2 W � W � j d W ❑WORK SATISFACTORY:PROCEED OJECT COMPIETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WFIL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca�1 for the next inspection 24 hours in advance. (952) 24 - �� OwnerlContractor on site: Inspector: White Copyllnspector's File Cenary CopyfSite Notice