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Home My WebLink About2010-00364 - addn/remodel/repair ,� CITY OF ORONO PERMIT NO.: 2010-00364 ' 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE 1SSUEu: OS/18/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2690 FOX ST PIN : 04-117-23-42-0003 LEGAL DESC : AUDITOR'S SUBD.NO.229 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTNITY : 434-RESIDENTIAL VALUATION : $ ]00,000.00 NOTI;: "rHIS PERMI"I'IS FOR COMPLETION OF WORK NOT DONE ON OR[GINAL PERMIT. APPLICANT PERMIT FEE SCHEDULE 1,056.75 ACME GENERAL CONTRACTING STATE SURCHARGE(VALUATION) 50.00 421 VAN BUREN AVE N HOPKINS, MN 55343- TOTAL 1,106.75 (612)282-6050 Minnesota State License#: 20265224 OWNER BREHMER, RANDY 239 BRYONDALE WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perfonned according to the approved plans and specifications,applicable City approvals,and the State Duilding 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.'I'his permit will expire and become null and void if construction authorized is not commenced within I 80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. "rhe applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code. Chis permit may be r time for duc causc. � � _ _.�-. � � v -- --___ , , / �--- �-�- , � , �Applicant Pe itce Signature Date s d By SignaTure Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � . , City of Orono Building Permit Application for New Structures or Additions �� Mailing Address: �, �� PO Box 66 Permit number: �� 0� Crystal Bay, MN 55323-0066 Date received: �/� �� ag,,T, ��,� ��, ��- �j Received b �,, s, StreetAddress:' y� 1 � 1'�� o:�.:-',-� �'�t '` �A^�,� ��F� 2750 Kelley Parkway Plan review fee: �kESH�4"� Orono, MN 55356 Total Fee: i 7S 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: �� /�' ��;� � Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit rs required with Police Department and City Council approva/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: E N E Rf't� �� a �-�(�,��tiT� - 2an nY �G4t�'►�C� O�J✓le� State License # _ 22 Expiration Date: �� ' Phone: (D �2 - 2 $� -�.�. 6�bS� (office) q S 2- 3$ � 2oy � (cell) Mailing Address: 2 Q h �. 2 Cit : ZIP: 55 3 3 Contact Person: 1 2 - ✓►z C h Applicant is: rac or Homeowner (Circle One) Email and/or Fax: q5� _ ci'� - Cb�7� �.� PROPERTY OWNER INFORMATION: Name: � Q�t� 2 Phone (day): _ (op w � Address: Z 3�1 a��O��hL� Cit C� ZIP� 5�$3q� Email and/or Fax �(L,F}��.�,(a� M L�S t o,AiV 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 & � New Construction Water Supply �Single Family with � Residence ❑ Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Other: (specify) ❑ Multi le Famil /Condo ❑ Private Sewer p y ❑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) $ o Last Updated: 9/29/2009 - 17 - , , A 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 square feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1 S`Story = ❑ Other(please specify): e. 2"d Story= f. '/2 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 Appiication � ❑ Pro osed Buildin Plans � ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form � ❑ Surve meetin all requirements � ❑ Stormwater Pollution Pr�vention 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 � ❑ Pian 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 submi;ting 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 generafly cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annualty 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. ,��v. _ -�c - -- - ----. --� _.___ Applicant's Signat — Date: � �O Last Updated: 9/29/2009 - 18 - DATE TIME " CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. z�+� - a�3 6�{ COMPLETED /O '3�'/I ADDRESS Z b `1� ��'` s T- OWNER R� =H n� - TELEPHONE NO. CONTRACTOR U w� � �: DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL � ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � � �/�A-✓�►N5 + o!D ,e-�.�I � � 0 � � 0 � W � Q � Z W � W � � � �ORKSATISFACTORY:PROCEED �JECTCOMPLETE W ❑ CORRECT WORK&PROCEED _ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING �PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on site• Inspector. � White C yllnspector's File Canary CopylSite Notice � � �` ATE TIME ✓ CITY OF ORONO CALIED IN �� INSPECTION yO��E ��,L SCHEDULED l� �3-.3� PERMIT NO.�� T COMPLETED ADDRESS ��D 7 0 7( . S�j'1�� OWNER LEP ONE NO.�' ��8 a^��'SD CONTRACTOR � �� ; DESCRIPTION ��'�v�-"� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z � INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � �FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J /LJ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPT�C INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � 5 '�v a S �.�. f o `J `.. � � •r� c.vs � 0 � w � Q Z � � fl .°�i�—T ;S U,1 1�✓/�� P C� W �T- rt G+n.t.P O� .-1� S�e Fi 2�� j d W� ❑WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED SSUE CERTIFICATE OF OCCUPANCY O ❑CARRECT WORK,CALI FOR REINSPECTION TEMp:ORARY V BEFORECOVERING �ERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN 0 STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-4600 , OwnerlContractor on site: Inspector. l r� White Copyllnspector's File Canary CopylSite Notice � DATE TIME CITY OF ORONO CALLED IN J!� INSPECTION NOTICE � SCHEDULED ��-.3� � PERMIT NO. ��6—�a-� COMPLETED �- ADDRESS �� /��/% OWNER .C�✓IZ��1L�� TELEPHONE N0. ��Z �Z /��5� CONTRACTOR /7�� v�'�� • >; DESCRIPTION ��rn� �� '`'"�L � tL� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS h O ❑ FRAMING ❑ MECHANICALFINAL ❑ TREEREMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a �=, �v./� ( �r�/��.� �C� ��f f�� - % � o ,�v ia � � �`'Q� 1� ��!� �v P �3 �" S � ��.a ' W � Q � �r � ( R < < r►�� s c. ,� �t z . � � . ;� � u,� �; t � i >� a W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED �SSUE CER TE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOA REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED C INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Ca11 tor the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on site: Inspector. r� y � � White Copyllnspector's File Canary CopylSite Notice