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Home My WebLink About2012-00904 - pool � � CITY OF ORONO * Z 0 1 2 - 0 0 9 0 4 * 2750 KELLEY PARKWAY pATE �SSu��: 09/28/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3340 GRAHAM HILL RD PIN : OS-117-23-11-0012 LEGAL DESC : GRAHAM H[LL PRESERVE 2 : LOT 4 BLOCK 2 PERMIT TYPE : ACCESSORY STRUCTURE PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : POOL- IN GROUND VALUATION : $ 71,000.00 N TE:/� * ESCROW MONEY W[LL NO"f[3E REFUNDCD UNTIL AS-13U(L'1'SURVEY IS SUBMITTED nND APYROVGD. E ��`� (INITLAL) APPLICANT QUALITY POOLS PERMIT FEE SCHEDULE 839.25 10350 WOODHILL BLVD STATE SURCHARGE(VALUATION) 35.50 LAKEVILLE, MN 55044 TOTAL 874.75 (612)985-7665 OWNER MCCARTY, LEROY & LISA 3340 GRAHAM HILL ROAD LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT Thc ti•ork 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 work described and docs not grant permission for additional or related work which requires scparate permits. All provisions of laws and ordinances goveming this type of work shall be compied wi[h whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at airy time after work has commenced. The applicant is responsible for assu ng all required inspections are requested in confonnance with the 'ate Building Code.This permit may be revoked time r due cause � ` � �� / / npplicant Pcrmi ee Sign• ure Date Issued By Si ture Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E. , � � �`J`- �r✓ City of Orono � -� �� i , , �,ti Building Permit Application , � for a Swimming Pool - Mailing Address: �,�,� PO Box 66 Permit number: ��'<<� �• '<�� Q � � Crystal Bay, MN 55323-0066 Date received: �� "�/� ' /�' ��,. ,`�� Re ' d b : ___ � � ,�,�„A� �, Street Address: – - — _ I �,n ' �� 2750 Kelle Parkwa , l f -� 5/ •,�. � �� Y Y Plan review fee: L�kE3H04' Orono, MN 55356 ----- . �______�_i � �C�3 .___.- ---- otal ee: ------ Main: 952-249-4600 Fax: 952-249-4616 w�rJsv ci orono rnn.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: �3�U �� 1��f� �a�/ CONTRACTOR/APPLICANT INFO�ATION: Name: GVv.�Z��i� 1"�cAS L �L State License# Expiration Date: Phone: C�'�z c�+�'��7�U� Fax: Address: �035'� �;./od Q /��/ %�1��/- City��,�/� ,• � ZIP' �'S"d jt.� Contact Person: , I,�,,�(-, t.��t_ ContacYs phone number(��1- ��y ��,�fQ Email Applicant is: Contractor Homeowner �c��ie o�e> PROPERTY OWNER INFORMATION: Name: �,7� l��s Phone (daY)� .�3Yo G'o�e,�i1�� f/ � Mailing Address: ZIP: Email and/or Fax ENGINEER INFORMATION: Name: Phone: Address: City: ZIP: Email Fax: PROJECT INFORMATION: 1. Pool Dimensions: 4.Accessory to: 5. Pool Type: 6. Sewage Disposal 8� ZO X �p feet Water Supply [�Single Family ❑Above ground 2. Heated? ❑ Multiple Family/Condo �n-ground � Public Sewer �s ❑ no ❑ Private Sewer ❑ Public ❑ Other(specify) 3. Excavated materials will be: ❑ Commercial ❑ Public Water �removed from site ❑ Industrial 6. Retainin Walls? g ❑ Private Well �used on site ❑ Other: (specify) ❑ yes ❑ no ❑ Other: (specify) Height Total Cubic Yards Estimated Construction Valuation $ �`,��Oc�� Last Updated: 10/28/2010 - 7 - � . REQUIRED SUBMITTALS: ' All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable �' ❑ Permit Application ❑ ❑ Plan Review Fee yys�' 0 ❑ Pool Plans ❑ Surve includes radin plan EY ❑ Hardcover Calculation Worksheets �� ❑ Erosion Control Plan or cop of MCWD Permit ❑ ❑ Septic S stem Certification ❑ ❑ Wetland Buffer Improvement Plan ❑ ❑ Escrow& Escrow A reement ❑ ❑ Other ❑ ❑ Other ❑ ❑ Other ❑ ❑ APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Planning&Building Departments; • 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; • 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 permit may not be issued. Applicant's Signature: ��=-er�c � Date: �' �/—�� Owner's Signature � Date: � Plan Review Checklis� for IVevv Structures / Adc�itions ,.. Address/ PID/ Legal: � � � ( � �\� ,�� -�" Lr � � Description of work: � - � � , �, y� Septic review by: � � Date Approved: � - �� l � Zoning review by: Date Approved: Q• � '`�- Building review by: Date Approved: � � � Grading review by: o�� Date Approved: aS /� Zoning File#: Resolution#: Resolution Date: Zonin District Fire Department Post Office School District Zoning: Lot Area: �.� SF C Width: Depth: Survey Submitted: � Yes � No Date of Survey: � °�� ° ��- Pro osed Setbacks: Front(Lake) Rear(Street) l N (� E W ) ( A S E W ) Other Buildings Wetland ��ide Side �� '�' ,� � [ � � E�e Building Defined Height: — Building Peak Height: �' #of Stories Ok?: � YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl START the distance between the slab and the highest space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the mansard roof,or the uppermost point on a round uppermost point on a round or other arch-type or other arch-t e roof roof SUBTRACT half the distance between the highest window and 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 basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existin rade within the foundation < the foundation or 10 feet,whichever is less. EQUALS Defined buildin hei ht ` EQUALS Defined buildin hei ht Lot Coverage: ��' SF % Shoretand District MCWD Permit Received Avera e Lakeshore Setback Bluff � Yes � No � N/A 0 Yes �1Vo � Yes �0 0 Yes � No ��/A Permit Number: Setback: Hardcover Zones Existin Pro osed Variance Required CUP Re uired 0-75' 0 Yes o 0 Yes o 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Char ed YES NO Permit Plan Review State Sur�harge Investigation Fee SAC—Number of SAC Units ' Sewer Connection � Water Connection Park Fee Site Inspection Other(specify) Miscellaneous Fees , Calculatec! By: Square Foota e $ er S uare Foota e Basement X = � 15t Floor X = $ 2nd FIooI' X = $ Garage X = � Estimated Construction Value: $ � � i��o �� Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing � Grading / Filling 0 Well � 0 Hardcover Removal Mechanical � Fire � Electrical � Footing 0 Septic � Water Connection � � Poured Wall � Fireplace 0 Sewer Connection 0 Foundation Survey 0 Masonry 0 Lawn Irrigation Q Radon Rock Bed � Mfg. � Framing 0 Other(specify) � Insulation �" As-Built Survey �Final � Other(specify) REMARKS (in-house): Other Review: Revieweci by: Date Approved: Access:Existing: � YES � NO New: � YES � NO �` REMARKS(TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) �—�� tiv~t�t '�� 11 �►o� �� a��. � ��- � �- ��r�� t�,b�i t-�c� � �t�. Updated: 09l11/2009 z:\forms\plan review checklist.docx � DAT TIME ' // CITY OF ORONO CALLEo iN �`_ ��— v INSPECTION NOTICE SCHEDULED _I(LL�L� � -� PERMIT NO.aD�a- Oa90�COMPI.ETED t'� ADDRESS -�� -�"t �`'�'P � OWNER . TE EPHONE NO.�Z 9�9 �702 CONTRACTOR u �� : DESCRIPTION �� '7 — l� DD � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ 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 � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W C � J O � � O � W � Q � Z W � W � � d W� �WORK SATiSFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED '-: ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT �CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CA�L INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46�� OwnerlContrac n si : Inspector. White Copyllnspector's File Canary Copy/Site Notice