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Home My WebLink About2010-00111 - addn/remodel/repair � '� CITY OF ORONO PERMIT NO.: 2010-00111 2750 KELLEY PARKWAY �,� ORONO,MN 55356- DATE IssuEn: 02/26/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 4149 HIGHWOOD RD PIN : 07-117-23-44-0018 LEGAL DESC : HIGHWOOD LAKE MTKA : LOT 022 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 76,700.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,ELECTRICAL(STATE) INTERIOR REMODEL-BATH APPLICANT pERMIT FEE SCHEDULE 884.25 WOOD WORX CARPENTRY, INC STATE SURCHARGE(VALUATION) 3835 2320 NORWOOD LANE TOTAL 922.60 MOLJND,MN 55364- (952)201-7937 Minnesota State License#:20633701 OWNER KOCH,MARK&NANCY 4149 HIGHWOOD RD MOIJND,MN 55364 AGREEMENT AND SWORN STATEMENT The 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 the work described and does not grant permission for additional or related work which requires sepazate 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 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 any time fo due cause. i i l �� /O pli an e 'ee ignature ate I ed By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � . � Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: '�/) �cJ ��"��+�'�wC�� /1,ur9� Description of work: �/�-11 j �YYLD/)(�L Septic review by: n!/a4 Date Approved: Zoning review by: N/r/1 Date Approved: Building review by: � Date Approved: Z•L� • I o Grading review by: Date Approved: Zoning File#: Resolution#: Resolution Date: Zonin District Fire Department Post Office School District Zoning: ot Area: SF/AC Width: Depth: i Survey Submitted: �'� .,0 Yes ❑ No Date of Survey. Pro osed Setbacks Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wet{and Side Side 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 I 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 % Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff �II Yes ❑ No ❑ N/A ❑ Yes ❑ No ❑ Yes ❑ No 0 Yes ❑ No ❑ N/A Permit Number: Setback: Hardcover Zones Existin Proposed Variance Required CUP Required 0-75' ❑ Yes ❑ No ❑ Yes ❑ No 75-250;%' Type(s): Type(s): 250- 0' 50 -1000' � REMARKS (in-house): Updated: 09/11/2009 z:\formslplan review checklist.docx Fees to be Charged YES NO �� Permit , _ : .�-- Plan Review ��- 'State Surcharge - Investigation Fee SAC—.Number of SAC;Units Sewer Connection Water,Cnnnection . ; , . . Park Fee Site Inspection` �. • . ;,., ; .� <<�� , � , _.. , _ _. Other (specify) 'M�iscellaneous:Fees _ } ;= . ; , -; � � , . , , . . ,,_. Calculated By: S uare Foota e ' $ per Square Foota e Basement X = $ 1S` Floor X = $ 2nd FlOo� X = � Garage X = � Estimated Construction Value: � 7 t�,'�lc�u °j� Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site �lumbing ❑ Grading / Filling ❑ Well ❑ Hardcover Removal 0 Mechanical ❑ Fire ,P�Electrical 0 Footing ❑ Septic ❑ Water Connection ❑ Poured Wall ❑ Fireplace ❑ Sewer Connection ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigation ❑ Radon Rock Bed ❑ Mfg. J�Framing 0 Other(specify) �'Insulation ❑ As-Built Survey �inal ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMfT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.docx C� � - � �� City of Orono Building Permit Application for New Structures or Additions Mailrng Address: �.+�.�� PO Box66 Permit number: �C� p-Q(`j /� Q �, QA� Crystal Bay, MN 55323-0066 Date received: � �s,�� ,� I��'��' �) Received b , �,,�, s. Street Address:' Y� �c� ��''�' �.� �� 2750 Kelley Parkway � l � � '� � Plan review fee: �kE5Ho4�' Orono, MN 55356 Total Fee: �j�� O 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: L..l�� q �-,�q �� , � Will this be a Parade of Homes, Remodelers Sl�wcase Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit is required with Police Department and City Council approva/60 days prior to the evenf. Shutt/e bus service will be required unless app/icant demonstrates sufficient on-site parking rs available. Non-permitted events wil!not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: V�o od V�l o,r�JC �� v�� ,•�-1-rT, I v� L State License# �06 �-�->o i Expiration Date: 3�31��► o Phone: � 5�-a o 1-��i 3"� (office) (cell) Mailing Address: 23z� �a,,,,�,oo� �,� Cit : un ZIP: 56 b Contact Person: ,�l.,S�e ,,��,A„�„(,' A licant is: ontrac or Homeowner Email and/or Fax: �� pp (Circle One) PROPERTY OWNER INFORMATION: Name: �(Y1 a,rK IC.��,, Phone (day): ��t�,- �� Address: L}�y�� .��, h,}, �� City� ('�r-r,,� �, ZIP� 5'� � � Email and/or Fax 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 ❑ Gara e/Accesso Bld ❑ Accessory Building (� Single Family with ❑ Deck9 ry g' � Public Sewer ❑ Relocation - detached garage ❑ Office/Commercial ❑ Private Sewer �Other: (specify) �!� � ❑ Multiple Famity/Condo ❑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) $ �f70 DO Last Updated: 9/29/2009 - 17 - � , , 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 I 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. '/z 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 A lication � ❑ Pro osed Buildin Plans � ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form � ❑ Surve meetin all re uirements � ❑ Stormwater Pollution Prevention 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 � ❑ 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 compteted 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 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. I ApplicanYs Signature: Date: p�,p15�� Last Updated: 9/29/2009 - 18 - � !� DATE TIME � CITY OF ORONO CALLED IN �� INSPECTION NOTIC�_�f�/ SCHEDULED PERMIT NO. OMPLETED ADDRESS �� OWNER T LEP E NO. CONTRACTOR �'V� v(/�� DESCRIPTION I 1'1�/ � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ 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 ❑ WARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W C. � � O �. � � � �� fl R� �� W � Q � Z W � W � � d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR RE�NSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECANDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice CITY OF ORONO INSPECTION NOTICE / SCHEDU�� PERMIT NO. ��D�D��( COMPLETED � - ADDRESS �7�I��I l�c�GGIJ'4L�1�/�Gf OWNER TELEPHONE NO. gsiz°i 79�37 CONTRACTOR G�4a�w'�L+�s ° �: DESCRIPTION � ❑ FOOTING ❑ PLUMBING FI ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ 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 ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO v�, COMMENTS: � W C � � O >. � O � W � Q � Z W � W � � � �fORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W �❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECANDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. �t r� White Copyllnspector's File Canary CopylSite Notice �� r( '� DATE TIME " CITY OF ORONO J`� CALLED IN �� INSPECTION NQT/'�C�j'} /� SCHEDULED �!�/d � PERMIT NO. ��'�1'�/�v�-vvI�I COMPLETED ADDRESS ` OWNER TEL HONE��^aL� ` �� 7 CONTRACTOR � �: DESCRIPTION �I n� l - � / �Q� � �1�� ❑ 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 ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPT C FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W � � J O �. � O � W � Q � Z W � W � � d W ❑WORKSATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REOUtRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. 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