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Home My WebLink About2015-00805 - addn/remodel/repair CITY OF ORONO * z m 1 5 — 0 � e 0 5 * _ 2750 KELLEY PARKWAY DATE ISSUED: 06/24/2015 t ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 994 HUNT FARM RD PIN : 30-118-23-41-0012 LEGAL DESC : HUNT[NGTON FARM : LOT 001 BLOCK 006 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCT[ON TYPE : ADDN/REMODEL/REPA[R ACTI VITY : 434-RESIDENTIAL VALUATION : $ 60,000.00 NOTE: SEPARATE PERMITS REQUIRED: MECHANICAL LOWER LEVEL F[N[SH APPLICANT PERM[T FEE SCHEDULE 794.64 STATE SURCHARGE(VALUATION) 30.00 HAVEN RESIDENTIAL MANAGEMENT TOTAL 824.64 4142 AVONDALE STREET Payment(s) MINNETONKA, MN 55345- CHECK 1896 824.64 (952)930-0421 Minnesota State License#: BUIL-BC635447 OWIYER LA[NG, LANCE&HILARY 994 HUNT FARM RD 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 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 separate 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 revoke t�y ' for due cause. �� / � / / . i / - -��-�- �k:-( � �l rs _t��: � -� /- . �.s c� � �� , �� i� Applicant P itee Signature ate Issued By Signa ure Date City of Orono �d�; (�-- �;�ilding Permit Application for Maintenance / Replaceme t / Remodel ` (i.e. windows, doors, siding, re-roof, etc. N STRUCTURAL EXPANSION) �O� MailiPO Bo�r66� �I� Permit number: �C` �� OS � Crystal Bay, MN 5 23-0066 Date received: � � 1 1 ►S Street Address: �j�'� ��'��"--"—'"�"`-�----- y G� 2750 Kelley Parkway ��-r�/" - Plan review fee: � >� �-- � `� Orono, MN 55356 1�xFSH�� '___ _--- .._ .. __.,.__.__.._�._.._ _._....____�.__.__ _.____ _.__.._� 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 applications will be returned. (P/ease print) GENERAL INFORMATION: Job Site Address: �� Zl�'I 0141� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus se ic will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR I APPLICANT INFORMATION: Name: '�µ�' ��/�E �il� �I�Nl�?C7�/YIE� State License# �jc(o�j5�l�7 Expiration Date: 3 3f / Lead Certification Number: �/�}-r_��3p� -� � Expiration Date: � �� /7 (for work on homes that were consfructed prior to 1978 �� Phone: (cell) 9S� -80 _ (office) 9-s� -`�30 -c�'��% Mailing Address: � v,�/� � City: �,t/�t/�p��}- ZI P: SS3�.s Contact Person: �� /'r.1C��f�N Applicant is: ontractor / Homeowner (CircleOne) Email and/or Fax: G�v�-�� ;yyj��. ��- PROPERTY OWNER INFORMATION: � / Name: L-l4N� ANt� f�"�L�7r l�//JE� Phone (day): �/7 _970 -/930 Address: 9 9tf ,/�c�`1' �h9 2C�0 City: a�Qp�� ZIP: 5'S 35!v Email and/or Fax: �{SL�//�/� �C Urr/piL PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof, other(specify) ❑ Siding �Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 �Window(s) /=1/��5�-{GOc�€R(,EvEI� www.minnehahacreek.orq Estimated Construction Valuation of Project (excluding land) $ faD,ODU 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 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 ou refuse to su I the in o a ' . the a lication ma not be issued. Applicant's Signature: Date: � � /S Owner's Signature: Date: ��J�� Last Updated:January 2015 ' PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS t �Address: 7 Z � �� it�EL Permit No.: Description of work: !n •�� / l�'I !5 � �/�� F�'l D►Q/8( Date Rec'd: Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: � Date Approved: �� Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: � Yes 0 No Date of Survey: Revised date(?): Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S W ) Other Buildings Wetland Side ' e Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50%_ - L.F. below grade #of Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lowest posed The distance between the top of START WITH floor(of the basement or crawl s e)and START WITH slab and the highest point of the the highest point of the roof. roof. If you have a... If you have a... . GABLE OR HIPPED ROOF • GABLE OR HIPPED OOF(no (no windows): Subtract half windows): Subtrac alf the dista ce the distance between the between the high t point of the ro f highest point of the roof to to the low point the correspondin the low point of the SUBTRACTION gable or hippe roof corresponding gable or (BASED ON . GABLE OR PPED ROOF(with SUBTRACTION hipped roof ROOF TYPE) windows): ubtract half the distance (BASED ON . GABLE OR HIPPED ROOF between t top of the highest ROOF TYPE) (with windows): Subtract window d the highest point of the half the distance between roof the top of the highest • ALL HER ROOF TYPES(flat, window and the highest man rd,etc):No subtraction. point of the roof • ALL OTHER ROOF TYPES SUBTRACTION Subtract e distance between the (flat,mansard,etc):No (BASED ON basem Ucrawl space floor and the subtraction. EXISTING highe existing grade adjacent to the ADDITION Add the distance between the top GRADES) foun tion OR 10 feet(whichever is less). (BASED ON of slab and the highest existing EQUALS De ned building height EXISTING grade adJacent to the foundation. GRADES EQUALS Defined building height Shoreland District MCWD Permit Av rage Lakeshore Setback g�uff Met? � Yes 0 No Permit Number: 0 s � No 0 N/A 0 Yes 0 No 0 N/A—see attached Setback: Stormwater Quality xisting Hardcover Proposed Overlay District (%and sfl Hardcover Var ance Required CUP Required Tier circle one %and s � � Y s 0 No 0 Yes � No 1 2 3 4 5 Type(s): Type(s): Updated: January 2015 c:\users\rpeitso\documents\plan review checklist 2015.docx REMARKS (in-house): Fees to be Char ed YES NO Permit Plan Review (/� State Surcharge Investigation Fee SAC— Number of SAC Units Other(specify) Square Foota e $ per Square Foota e Basement X = $ 1 St Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ �pC% (��D Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site 0 Grading / Filling ❑ Well � Silt Fence/ Erosion Control Mechanical ❑ Fire 0 Electrical 0 Hardcover Removal ❑ Septic � Water Connection 0 Footing ❑ Fireplace ❑ Sewer Connection � Poured Wall 0 Masonry 0 Lawn Irrigation 0 Foundation Survey � Mfg. � Landscaping 0 Foundation Waterproofing 0 Other(specify) � Radon Rock Bed �Framing �,Insulation � As-Built Survey Final � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: �Access: Existing: 0 YES � NO New: � YES ❑ NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED � Updated: January 2015 c:\users\rpeitso\documents\plan review checklist 2015.docx �- � �- � —�A J� TIME CfTY OF ORONO cnLLED IN 'Z INSPECTION NOT CE Q� HEDULED �02�—t S /� PERMIT NO '�' w�MPLETED ADDRESS OWNER T LEPHONE N09S�7—��7" �°� CONTRACTOR �� DESCRIPTION Y �� — ��" 4~j ❑ FOOTING ❑ DEMO-F A ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERfCONTRACTOR TO MEET YiDU:_YES_NO � COMMENTS: � j 0 � 0 W OC Q � W � W � j O W WORKSATISFACTORY:PROCEED ❑PRWECTCOMPLEfE � ❑ RECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK�LL FOR REtNSPECTION TEMPORARY V BEFORECdVERING PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHpTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �pTATION ISSUED ❑INSPECTION RE(]UIRED_CALL TO ARRANGE ACCESS_ Call for the next inspection 24 hours' advance 95 -46�0 Owr�IContractor on site: inspe�tor. White CoPYAnapacta's Flk CanuY�PYISits Notkx � i ,� �/� DATE TIME CITY OF ORONO cnLLED IN INSPECTION NOTICE SCHEDULED ,�/. -�,��, PERMIT NO. ��g� COMPLETED ADDRESS 7 % `"� �`��f ��-� � OWNER TELEPHONE NO. �� CONTRACTOR �� DESCRIPTION ��a / — � r/��' 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL 2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ S TIC INSTALL 2 OWNERlCONTRACTOR TO MEET Y�OU: YES_NO � COMMENTS: W a /�/ P/'ov�� c l��,� �,.ti:�L � ' o �pro��d� ��.��K,c�G-� ��G � � 0 � W � ' Q 2 CC� �l �b t �'C�t 'Z 5 Yl¢c�/a+... � W � � , d W ❑YVORK SATISFACTORY:PROCEED O PROJECT COMPLETE � ❑CORRECT YIfORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O O CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED �INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. ✓ � C r the nex 24 hours in advance. (952) 249-4600 O ctor on sit • Inspeator: Whits CopyAnspector's Ffle Canary CopyfSite Notice