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Home My WebLink About2011-01416 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2011-01416 2750 KELLEY PARKWAY , ORONO, MN 55356- DATE ISSUEn: 1 U14/2011 ^ � (952) 249-4600 FAX: (952) 249-4616 ADDRE� : 3405 HIGH LA PIN : OS-117-23-11-0002 LEGAL DESC : REG. LAND SURVEY NO. 0843 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION /REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 45,000.00 NOTG: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELGCTRICAL(STATE) [NTERIOR REMODEL OF KITCHEN, DINETTE,POOL ROOM AND[3ATH APPLICANT PERMIT FEE SCHEDULE 628.00 AMBERWOOD CONSTRUCTION PLAN REVIEW 40820 5333 RIVER BLUFF CURVE BLOOMINGTON, MN 55431- STATE SURCHARGE(VALUATION) 22.50 (612)868-0903 TOTAL 1,058.70 Minnesota State License#: BC333751 PAID WITH CC# 0735 OWNER RE[LLY, KEVIN& DENISE 3405 HIGH LA LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State Building 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.This permit will expire and becomc null and void if construction au[horized is not commenced within 180 days of the date of issuance,or if construction is suspendcd for a period of 180 days at any time after work has commenced. The applicant is responsible r assuring all required inspections are requested in nfo ance ' t te Building Code.This permit may be revoked a y e for �/ �/ / � /� Appli nt Permi e Signature — Date / / Issued By Sig re D SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO . . � C i ty of O ro n o >> �� Building Permit Appiication for IV�aintenance / Renovafion I' � ' (windows, doors, siding, re-roof, etc.) � Mailing Address: Permit number: 0�0// -b/ / /O y O PO Box 66 _ i ��y. � Crystal Bay, MN 55323-0066 Date received: /- �a ''�"� s, ' Street Address: ' Received by: k �-<,. ��n 'o„'�,_ �ti� 2750 Kelley Parkway Ptan review fee: f�y'"� Orono, MN 55356 9 kES�/ Total Fee: � � �J-�� v Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This appfication 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¢�� /.�� .i �G�3�6 L� /�'f�l/• SS3S;( Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o If yes,a specia/event permit is required with Police Department and City Counci!approval 60 days prior to the event. Shuttle bus service wil/be required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted events wifl not be allowed. CONTRACTOR/APP ICANT INFORMATION: Name: �.yfj�Zkl�Ap �l�(/Sj�r/Gll� 7/YC State License# �4 3�3 7S Expiration Date: 3-�`-/Z Lead Certification Number: ��-_,699Z � Expiration Date: 7/,�-/� (for work on homes thaf were constructed prior to 1978 Phone: �z-868'p963 (office) (cell) Maiiing Address: ,s'",3�3 �j ��f ��2v� City: ��j^/67PY121P: SS 3 Contact Person: � s Applicant is: ontrac or Homeowner (Circle One) Email and/or Fax: � � ��✓OGY>CA�✓Sr2�/LJZ�-�.G�7 - /- ,�6 / PROPERTY OWNER INFORMATION: Name: _/�!//N/�lYd ,��/�lS� �l�G��/ Phone (day): L''3f36-.�O/L Address: ,3,�OS / /6yc� � City: LA�✓6 L�'�(Cv� ZIP: $".�3,�;6 Email and/or Fax �jjq�/q�`o 1�p �qG.�,v� PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) �Remodel ❑ Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restorafion ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other s eci Phone: 952-471-0590 ( p fy) ❑ Siding ❑ Other: (specify} Fax: 952-471-0682 ❑Window(s) www.minnehahacreek,orq Overall Project Description: �iI/T�/�Z ��L ��`��,��t/ r�►/��jT �G � T�! Estimated Construction Valuation of Project(excluding land) $ �QO� 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 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 alternafive 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 th' inf atio is to annually update our records and records of other governmental agencies re uired b law. If ou refuse su th io h a fication ma not be issued. ApplicanYs Signature: Date: �l�' �j l� Last Updated: 08-09-2011 Pfan Review Checkiist for New Structures I Addi#ions o.ddress•/ PID/Legal: 3y 0 S 1� �Vl-� C��lc� Description of work: �;n��D(1+.:�--- Septic review'by: r.1�� Date Approved: Zoning review'by: � Date Approvecf: Building review by: Date Approved: /1 "1 �(- 1 ( Grading review by: N(d� Date Approved: Zoning File#: Resolution#: Resolution Date: Zoning District Fire Department Post Office School Dis ct � i � �� , Zoning: Lot Area: SF/AC Width: D �� 5urvey Submitt � ❑ Yes ❑ No Bate of Suruey:_ Pro osed Setbacks: �� front(Lake) I R r(Street) ( N S E 1N ) ( `N S � W Other Builciings Wetland I Side Side �' � ��' Building Defined:Height:. Building Peak Heigt�'� #of Stories Ok?: ❑ YES (y FOR A BUILDING WITH A BASEMENT OR CRAWL CE: �FOR A BUILDING'ON A SLAB'FOUNDATION: `START WITH the distance between the basemen ` oor/crawl START 3he:distance between the sfab and the highest space floor and the highest roof peak,' e top 1NITH roof peak,the top of the cornice of a'flat roof, the comice of a flat roof,.the deck fine of s� the deck(ine of a mansard roof, orthe mansard roaf, or the uppermoSt point on r nd uppermost point on a round or other arch type or other arch-t e roof roof SUBTRACT half the distance between#he high window and SUBTRACT half the distance between the highest window hi hest roof eak of a itched roc� and hi hest roof peak of a itched roof SUBTRACT #he distance between the bas ent floor!crawl �DD the distance between the slab and fhe highest space floor and the highest isting grade within '� exisfin rade withinthe foundation I the foundation or 10 feet�✓hichever is less. EQU S Defined buildin hei ht EQUALS Definetl buildin �hei h �� Lot Coverag�e: � �� SF �� Q�p Shoreland District MCWD Rermit Received Avera e L:akeshore etback I Biuff ❑ Yes ❑ No ❑ N/A i ❑ Yes ❑ No ❑ Yes ❑ o � Permit Number: � Yes ❑ No a � � S te back: I Hardcove ones Existin, , Proposed Variance Required C Required � �� I � � � Yes ❑ No I ❑ Yes ❑ No 5-250' Type(s): I Type(s): 250-500' I � 5DD-1000' I REMARKS (in-house): Cl Updated: 09/11/2009 , z:lformslplan review checkfist.docx Fees to be Charged YES NO ��P�errni��'� ��``�� ,� ��. r ��,�� a` �..'�.�`,� • , �. �' � Plan Review . „-� ti, , . .�, ��. Sfa�e':�Sure�a �e a[�. , , . . , ,_ -_ , ._--�,u.r��.."��ns.�r,.��l. �t.Y�i`��.�a.?k.. l a i4. ' . � ..... ,�... vn, ..�.�.. -.. �.... �>.,... fnvestigation Fee ��C, -,"Number:o'�'�A'C�U.nats �"� � k;��, . _. � _ -'� ,,r�. TM,,:. �,�'-�_:, ._,,: , _,.:: - : Sewer Connection '��',�,�,�,w1��lID��' � � �' ,'� ��,:��;,y; ��'� �`�°��.�'�+�, ,:�� P:ark F.ee "�u�+e`;��'"�bi�o:n ,: .. . . , .... ��.:�,�� _ ,, .. ��.., ..��.� . _� . . ��_.. '� __ _...�� .__. , - Other(specify) ; � ' ' WiM�`i� `aip�'H1Pf�5PW'�'x1K`�9Y ..f .-. . . . . y ,. . . � .. (Y _..� . �y�� . ,.�,_. : ��°��..w�nna+�n��an�6�a��"��„.,��- . .�1 .. .. . ;- •_.....,: ._. .. .. _ �S�.E,�$111�1 - ,, Y� � . �. Cafculated:By,: Square Foota e $per Square Foota e � Basement I X = � �5t Floor X _ � 2"d FloOr )( i = � Garage X : - $ ; a Estimated Construction Value: � YS�,t104 �'' Orono lnspections Requiretl � Work Requiring Separate Permits Required"State Permits ❑ `Site Plumbing ❑ Grading /Filling ❑ Well ❑ Hardcover Removal Mechanical � Fire Efectrical fl Footing ❑ Septic � `Water Connection ❑ Poured Wall ❑ Fireplace ❑ Sewer:Connection ❑ Foundation Survey ❑ Masonry ❑ Lawn Jcrigation ❑ Radon Rock 8ed ❑ IVlfg. Framing ❑ Other(specify) Insulation ❑ ,�s-Built Survey �Final - ❑ Other(specify) REMAF�KS_(in-i�ouse): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YE5 ❑ NC� Nsw: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSDN PULLING PERMfT) Updated: D9/11/2009 z:\formslplan review checklist.docx D E TIME V CITY OF ORONO CALLED IN INSPECTIO O ICE SCHEDULED ��.�_3U� PERMIT NO �� COMPL TED� ADDRESS OWNER TEL HON NO�//�—��g'��3 CONTRACTO �� ' \ �: DESCRIPTION ��Z,�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS 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 FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � O � � O 7, � v W � Q � Z W � W � � /� GW /�f �1C7PtK SATISFACTORY:PROCEED CI PROJECT COMPLETE � ❑CORRECT WORK&PROCEED c� ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WlLL FIETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 Owner/Contractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice , 'r-�"-� - -�-' ( �F �- � �,� � / AjE ` TIME � CfTY OF ORONO _ p��(� CALLED IN / �'�, � INSPECTION NQTICE cHE�u�Eo ,�.�.:��-,>� %% �' 1 - ��'i� PERMIT NO. �! OMPLETED ADDRESS '`,�f � `- H/(�;� � � !�— OWNER TELEPHONE NO.��=� �'��Y�� CONTRACTOR f � � �T ��-�'�� S _�_ ,, , . ��:�'� �. , . � DESCRIPTION ,'/ %"� / i �-*�s�'�:;r_�v � �� tl! ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � � � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPIAtNT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPT,�FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOH� TO MEEf YOU:i�YES_NO � COMMENTS: � W C o ��S A „ � -�, � � �',.`J 'D c.�-e e � � �� N� � W � Q � z W � W � � GW ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE � ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR r CITATION ISSUED G INSPECTION REOUIRED.CALLTO ARRANGE ACCESS. Ca11 tor the next inspection 2a hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. � � White Copyllnspector's File Canary CopylSite Notice