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Home My WebLink About2012-00181 - addn/remodel/repair �' � CITY OF ORONO �� * 2 PJ 1 2 — 0 0 1 s 1 * 2750 KELLEY PARKWAY ppTE �SSUEn: 04/03/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 3380 GRAHAM HILL RD PIN : OS-117-23-11-0013 LEGAL DESC : GRAHAM HILL PRESERVE 2 : LOT 5 BLOCK 2 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RES[DENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPA[R ACTI V ITY : 434-RESIDENTIAL VALUATION : $ 11,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) OUTDOOR FIREPLACE/PIZZA OVEN �� * AS-BUILT SURVEY IS REQUIRED PR[OR TO RELEASE OF ESCROW. �'"� (INITIAL) �� `� � * EROSION CONTROL TO BE INSTALLED AND SI IOULD REMAIN UNTIL VEGETAT[ON ESTABLISHED.�� (I ITIAL) � �, �� -� �� C�� U �� - � � � � � �� C� � � APPLICANT PERMIT FEE SCHEDULE 206.50 LUKE BUSKE� 1903 PRIMROSE PLACE PLAN REVIEW 134.23 HUDSON, WI 54016- STATE SURCHARGE(VALUATION) 5.50 (612)490-1037 TOTAL 346.23 OWNER RUDOW, DAV[D& LESLIE 3380 GRAHAM HILL RD ORONO, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according ro the approved plans and specitications,applicable City approvals,and the State Building Code. This permit is for only the work describcd and does not grant permission for additional or related work which requires scparate permits. All provisions of laws and ordinances governing this type of work shall be compied with 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 any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at�any time for-dU�'ca�se. , .. , --,�� -- `� i 3 i �"L i i Applicant Permi ee Signature Date Issued By gnature Date SEPARATE PERMITS REQU[RED FOR WORK OTHER THAN DESCRIBED AB E. 7 �� City of Orono Building Permit Application for New Structures or Additions _� Mailing Address: �Q� _�O� 4/ ;�g,D,j�\ PO Box 66 Permit number: �� '�Q , �� Crystal Bay, MN 55323-0066 Date received: � �/ / `�a �y�'�-: a,!� Street Address:' R e c e i v e d b y: `\�'�t�;�j��;�, �� 2750 Kelley Parkway Plan review f e: ��gESHo�'%� Orono, MN 55356 �----� 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 appfications will be returned. (P/ease print) GENERAL INFORMATION: Job Site Address: ��L� �j��r•�r,,, �� 1,1 �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, a specral event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will e required unless applicant demonstrates sufficient on-site parkrng rs available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: Li�tK� ��l�-�S State License# � � N �� yn ��,r�j� ` Expiration Date: Phone: (912-�{� - � 03�-- (office) (cell) Mailing Address: u3 ��n-��2�� uJ��.,, City: iDbQi�r ZIP: " �,� � Contact Person: GLr1�ne,, tZv'�o..� Applicant is: Contracto (Circle One) Email and/or Fax: rVl iY�,Q�(1t- G o� ,C�i„� PROPERTY OWNER INFORMATION: Name: _ , ,o�nv�e � �o�,.i��. 2u�A� Phone (day): �-��(�-�-Ly I$- Address: 33�� C�,RA�-!�� Cit : OCUn� ZIP: SS35(o Email and/or Fax �o�n�in� , r"u w �Ma� l.cs�� 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 & ❑ New Construction Water Supply ❑ Single Family with ❑ Residence ❑ Addition attached garage ❑ Gara e/Accesso Bld ❑ Accesso Buildin 9 �Y 9• ❑ Public Sewer rY 9 ❑ Single Family with ❑ Deck ❑ Relocation �! detached garage ❑ Office/Commercial ❑ Private Sewer Other:(specify) rl R � � '�` ❑ Muitiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water *"Any earth movement may require ❑ Commercial ,�Other(sPecify) ov.{'� MCWD review& permits. ❑ Industrial �'1RC.�W��p��n+�i1 �Private Well Minnehaha Creek Watershed District(MCWD) �Other: (specify) �T 18202 Minnetonka Blvd �,�,Own� d��y Deephaven,MN 55391 1 Phone: 952-471-0590 Fax: 952-471-0682 www.m innehahacreek.or Estimated Construction Valuation (excluding land) $ p�-� �� STRUCTURE INFORMATION: 1.Structure Dimensions 1. Structure Dimensions (continued) 2.Type of Construction ► �; J a. Length(ft.}= �_ Number of bedrooms= �� ❑Wood/Frame 1�..5«'`� Masonry "�f�� b.Width(ft.}= Number of garage stalls: ❑ Metal Attached= ❑ Pole Bldg. Areas in sauare feet �_ / Detached = ❑ ICF c. Basement- `v fr ❑ On-site Prefab - ❑ Off-site Prefab d. 1 Sl Story - ❑ Other(please specify): e.2"d Story= ' � f. 'h Story = �� g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclos Applicable ❑ Permit Application ❑ Pro osed Buildin Plans ❑ C-f' 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 ❑ Wetiand Buffer Im rovement Plan ❑ En ineered Plans for Retainin Walis 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: .� �� 'Z� �--� Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: .��tJ�(.� �`�� r� v��y a�?�l �i�! � l� � .�-- � Description of work: `� '� �� y''�' '��'�� ' �'� ' �,�<�� Septic review by: ��C�-- Date Approved: � �/� � �o� `, ,�� ,� � Zoning review by: �-� � � '"`��- Date Approved: �� - Building review by: � ��,-v Date Approved: �- 2 - I "Z-- . Grading review by: � , � Date Approved: � �a Zoning File#: � Resolution#: Resolution Date: -- -� Zoni Distri t Fire De artment Post Office School District ,p� �-. ' � � Zoning: Lot Area: �'-�• ; � SF AC��k Width: Depth: Survey Submitted: es � No Date of Survey:_ '� �`'�—� � � � Pro osed Setbacks: Front(I ) Rear(S�) (� S E W ) ( IV,�S;� E W ) Other Buildings IpFe�tarid� Side �-Side �y�., ��ti';� � � ` �� ' 4 �� tl @ j Building Defined Height: �"�� Building Peak Height: �� tl #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 tQp of WITH roof peak,the top of the cornice of a�lat roof, the cornice of a flat roof,the deck line,,�Y the deck line of a mansard r , or the mansard roof,or the uppermost pc�int on a round uppermost point on a r d 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 o#a itched roof and hi I�est roof eak of a itched roof SUBTRACT the distance b�tween the basement floor/crawl ADD the cl�tance between the slab and the highest space flo�nd 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 Goverage: �`�^/� SF % Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff � Yes � No � N/A 0 Yes o ;� � Yes � � Yes � No N/A t � Permit Number: ,� Setback: Hardcover Zones Existin Pro osed Variance Re uired CUP Re uired 0-75' � Yes o � 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 Cha� ed YES NO Permit � Plan Revievv State Surcharge � Investigation Fee SAC—Number of SAC Units Sewer Conrrection Water Connection Park Fee Site Inspection Other(specify) Miscellaneous Fees � Calculated By: Square Foota e $ er S uare Foota e Basement X = $ 1St Floor X = $ 2nd FIoOI' X = $ Garage X = $ Estimated Construction Value: $ � r (�� 1 J' Orono tnspections Required Work Requiring Separate Permits Required State Permits 0 Site � Plumbing ❑ Grading / Filling � Well 0 Hardcover Removal � Mechanical � Fire 0 Electrical `�Footing � Septic � Water Connection � Poured Wall � Fireplace � Sewer Connection � Foundation Survey � Masonry � Lawn Irrigation � Radon Rock Bed � Mfg. � Framing 0 Other(specify) 0 Insulation As-Built Survey � inal 0 Other(specify) REMARKS (in-house): Other Reviewr: Reviewed by: Date Approved: ' Access:Existing: 0 YES � NO New: � YES � NO �: �` . REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) � �� .�� .1!��.�� °� ��'��`�� li� '�``--' r�"�`.��.. �`�`9 ��,�� ,=�� P.�� -art�`��`� ��::��,�,�i � r�,�=��P� Y� �`$� � ' 1 ;� �s��'�'� -�_ �f„� ' .-; ,��. � �a � � � � �� `�� j��. �;;�,�� e r�� Updated: 09/11/2009 z:\forms\plan review checklist.docx .. . .M , '��: ��,��.u= �'� w��.5�� ..��- . �;:.,. •€�: Y ��.✓�,f.. �� g/R "� : �p,. � ; ,� ��: �; 1� 'k�! � � . . , , �, ( ,��:1�..q� ;� •. �„�,w„, � r? �`j.�� , �� ;z . -:. l. � �� '%,:� �� .;, ,� q �r � ,' � ! �i�p�� i �J '�' ��,n`+ .k' '�� t"f�"� !'� �:�$ �Idt3�:Y��f`� 1 � >�r .t:� � . . �II . � .t �T. �y:� ��Y r, � . / e ' , .. � �t � . . �l /u � 1 ��...� , ' r�� ! , •'J�� • .� P /.'" ..�„`�-- � ,,�', �..�,� ) x'� '� ;�� rr. z 3'";�.,- •x. . �rii..�s,^,'�.� /' �1' . , . � ,i�� M � � E�' `t�Ir,�{�'y . , �� y3 ':� , � �. a�.� rr , .P-� �}y d r.�•d' s ,,6v � i �* �:'"'7�1� a ��/' F.,�"� ;. 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' 2. r.,.� ��s i'�y,n�� t a� ��3 � 5 - ;� "f . 4 ,�� k 1�, ,!!`.b �tY ..I e� C � ��' � � ��, � . �' ,y,-. . ;� . fe i. . . . . 4 , � � � � s�� .r"s,r . a c ,r�e -ro �" c�* y�` _e 't� � �� ' � R vr� � � � ' .. �_�R�i: '"r�'r:. ,'rr�. . ,� .,� i {�° � • 1. � . .' y ..�� . �._.._a..tsrAeL`c�t�a�':-.iLa�"i: ��i ,t.....�n �. �, � ' w �� ' x x ,,i.�ad...i ' �� DATE TIME � � �f � �� CITY OF ORONO CALLED W �� - INSPECTION NOTICE`� � � � SCHEDULED G I Z � �'� PERMIT NO. ��.�1� � -�'��I COMPLETED ADDRESS �� G,( , �=;`'C:L G��-y� 1-7 ��I l IC�Y OWNER TELEPHON NO. �' �a `� � � �7 CONTRACTOR -/^ � , �: DESCRIPTION ^ � ~� ��b� � (�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/G ADIN /FILI[ING � 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FIN� ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES NO � COMMENTS: � W a j � (� ��1 T C7 �l 1 O >. � ° � ., �� U'/, ".� l�-� �•� � �1- �� W � Q � z W � W � � d W�,.�fA�9RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY O ❑Ct�RRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑ CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR WILL RETURN ❑ CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-460� OwnedContractor on site: Inspector. 1� .c � i"""r� � White Copyllnspector's File Canary CopylSite Notice �7 T TIME ✓ CITY OF ORONO CALLED IN ! �� INSPECTION�DTl�E � r� � SCHEDULED .�z _��9�j PERMIT NO. � COMPLETED ADDRESS ��38D CDI�I�"�� l�d-L� � OWNER (,IQ1�LC� /�-�Jd�TELEPHONE NO.s(�� S 5Z7� CONTRACTOR �-.u--� �U�-L.S�-�il � �krt-n�� I n SG� >; DESCRIPTION �ZZCC O� cfoz�.-- � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TFEE 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � a � �T� i 1� � �� . �-� TU .v� ��A -�n.a 2 Q - o �.l.�5.-4-.�t t'a�r' (�� 1� pt � ,—o t rz..v v A iS�� Yo� r 5'�'Q-�-iz S�/s+�ypa . �o.0 c.v. ,� c�� ,�r�.� -r- 0 � �� z,� s+� � �,�� ►,�t,�.;� � �t.c�� + c.:e�� a r' W Q �� 6-�� c-cJ:�I r�I.n S •f�.St 1 ,��r rA-� K R� e r u O � '> -4--(.� Z %�L G l4 �� .� s �,c� 1 _v� N c, ie y „ �l l,,.e g / (.�.i � i�C'i,. �7,' tZ .� {--l.A � 5 I.�a�� +� -�•�-Q �'Al�' o� W j �1.�. S:-ti P�►. �--�� . i � A � S� A�a. .. Fd r A-� y � � ❑WORKSATISFACTORY:PROCEED �PROJECC OMPLETE�� W ❑CORRECT WORK�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on si : Inspector. � � White Copyllnspector's File Canary CopylSite Notice