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2013-00549 - pool
� � CITY OF ORONO � _ � 2750 KELLEY PARKWAY 1 3 0 0 5 4 9 * DATE ISSUED: 08/28/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 3625 JACOBS MILL RD PIN : 32-118-23-24-0013 � LEGAL DESC : JACOBS MILL : LOT 003 BLOCK 002 PERMIT TYPE : ACCESSORY STRUCTURE PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : POOL-IN GROUND ACTIVITY : 649-ALL OTHER BUILDING&STRUCTURES VALUATION : $ 28,000.00 NOTE: M-GROUND POOL APPLICANT pERMIT FEE SCHEDULE 445.25 JRS POOLS PLAN REVIEW 289.41 1105 CROFOOT AVE.NW STATE SURCHARGE(VALUATION) 14.00 BUFFALO,MN 55313 TOTAL 748.66 OWNER SCHMID, KURT&CAROL 2950ISLAND VIEW DRIVE MO[JND,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 a ny time for due cause. t � l /� Vl��I �J Applicant Permitee Signat re Date ssued y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono Building Permit Application for a Swimming Pool O Mailing Address: Permit number: /�j-� PO Box 66 � � Crystal Bay, MN 55323-0066 Date received: ���" � � Street Address: `3 Received by: y ��' 2750 Kelley Parkway (2'�� Plan review fee: `� � Orono, MN 55356 � ��KFSHo�`�` Total Fee: � 7��'� �� 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: '� � ��- ,�,4 �� � /1� �`� �B,q G� CONTRACTOR/APPLcICANT INFORMATION:, Name: hl R � �a o�r State License# N/A Expiration Date: Phone: '7�,� � �O,�,�- �3 (F 3 Fax: � - 6d a� � 6 Address: t ld Cr o •+� Ci : ZIP: �0 3r Contact Person: ER� �_�A� GE-�v ContacYs phone num Email: A licant is: ractor Homeowner (Circle One) PROPERTY OWNER INF�RMATION: Name: u,r�f `� �i� � �c�n,,' cQ Phone (day): � Mailing Address: o .S' ` � Z�P� Email and/or Fax: ry� „ 4 � ENGINEER INFORMATION: Name: c.v o . Phone: Address: ' Ci : .�,r ZIP: �/ (o 0 Email: Fax: �� PROJECT 1NFORMATION: _ 1. Pool Dimensions: 4.Accessory to: 5. Pool Type: 7. Retaining Walls? l�J X '��feet (�Single Family ❑Above ground ❑yes �no Height " 2.Heated? ❑ Multiple Family/Condo �.In-ground *A building permit is required [�,yes ❑ no � Public for any wall over 4 feet in ❑ Other(specify) height measured from the 3. Excavated materiats will be: ❑ Commercial bottom of the footing to the top ❑ Industrial of the wall, even if it replaces ❑removed from site 6.Sewage Disposal 8� an existing wall. �used on site ❑Other: (specify) Water Supply Tiered walls are considered ❑Other: s eci ) ❑ Public Sewer one wall unless they are � p � separated by twice the height � [1�,Private Sewer of the higher wall. �� Total Cubic Yards ❑Public Water Private Well Estimated Construction Value $ � Q pp O � -� Packet Last Updated: 03/29/13 ....._ ..-���----.... . .,, ........ _..,_......__._.._._.. ,,...... —._...._ ---�- �� ---�--_ _... 08/22/2013 99:39 9�22a8a6i6 oRONO /�./nb)• .��—�M�,�PaGE 0�la3 �►�- .� R�au�R�u sueM�rTaLs: All of khe i�fcrrrr+atlnr: muet b�submftted In order ter our a lication to be ro�essed: Not nclosed A liaAblo p p Perm1C A I1C�tlQn p p Plan R�vigw Foa � � Poal Plans ; p q $u �nCludes radin lan i Q C] Hardcaver Caiculativn Warktheeb ip a �roalan Control F�Ien o�co of MG1ND F��rm�c � p p Se tl�S et�m CartitiCation � p C� We�and Buffet Im rovom�nt Plan � ❑ Esaraw&E�arow t��ment . 4 n o otnet . p 1� U�her p ' ❑ Ott,ar i p � I � APPI.ICANT ACKNOWLED�EI�AENT: I • Agroea�o provfd��n In�orqnnadon raqulrad or roqueatad hy the Plannin�d�6ulldlnp DeWirtm�nta; • Undc�stends,if appir.able, an a�-bupE•un+ey end a�built hanloaVor r�vA�ealculations, w'r requf�d ta bs auQmtttad aftot'ho prnjoal la wmplotv(Includlnp�inal grNdln�eAtl 1��dsCoptng)priert�rel�ndinp the escroar: • Ca�ti�ioa that tlt�iMom�ation eupplleQ le truo antl oareef�x eo tho b�st Ct hi�/h►er knowlodSs• The aRD�SC���roeeQn�tea 4t10t they ene solely �eeponsible for eubmitting �aompleto e�pplic�ntlen being ewar�lhet upon fpllur0 to do ao, thv of��F h�s no a�torn�ti�Q � but to raJeet It�mtp!t b eomplete; • Sort�e er ell of the lntcrmsNon thnt yau 8ro esked to provlClo on thlA sp�icatlon ie deeait�ed by 8tmte Isw ao dthql'p��ete ar confldtntlel. P�ivahe data I�hiArri►atlon which generefty cannot bw glvon to Ma pubtic but can ba�Iv�n to tMe�subjcol ottho dat+. Co�dentiel date fs Informatbn which Qeneraly r,�nnot be plva�to 4kher the public cK�10 eubJeat of i�do�. Our purposs arrod intarxl�d u#0 df qti�Inlonnallon E�te ennueny upd�i�our r'eoorda snd recorda af other povorrtMental apenda�requirod qy isw. If you rafuw to supply the infarmati�n,tha p4rm(t moy nAt be iasued li I �� AAPli�anYs Sipirature: p�°� '' ���-ti�:�'����.�� 8-�4-2Q13 Doco: � Owne�s Siqnatur� ., I; I i i PeaJ�ot LAet R►DdeMd� D3�4/i�3 p�y4 of Yt O ' O�' �O' l�� O �Y�OYIO � a a. �. 1 F G~ \\tqkE6H�¢� 2750 Kelley Parkway � P.O. Box 66 Crystal Bav, MN S�323 (9.52) 249-�600 Fax.• (9.i2) 249-4616 . FAX TRANSNIISSION COVER SHEET Date: �Z�p�� To: �06 5 F�:: 7c�3-(�ga— o� S Re: Sender: _�(�}/�L�� YOU SHO ULD RECENE PAGE(S), INCL UDING THIS COI'ER SHEET. IF YOU DO NOT RECEIVE ALL THE PAGES, � PLEASE CALL (952) 249-4600. .L �. �t vr�. D LCM�-�'`S �l �C."� � � v� �'� ��.-Q ,_�� � ' ' , � . . . � i� ,�.,a � � �'. (�,C Ovt, ��� �S � �-�- �' � ��-� �,{,/� (,(� ��I Q- ' ��(Jt� ��.� ��C..�� _ .--�j �( • ��� �� � � � ' ' PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address/Permit Number: Z � �V`-� _.. . .r . � �+ . ��,. Description of woHc: � ` :� � , , �?.. Septic review byc . Date AppcovedR '�'��:�11'�„'13.- ,.. . �� 7_oning review,by: =,Date.ApprYaY�d.,� ,Y�� ��''�, Build,ing review by: Qate�ApPrbr+,esli � '�`'�, � � ��� G�a�ting review tiy: ,�+.� .Date A � rov�tl ,���� •�� � Ap � ' : : ... ... . ' " ' .:. ... .,fi . . . ., . ,.;.a . . - .sr _ � '.,.. ..: ,;:.,. �:e: ' .� , :'" .. S ..:<� . ,.;A„ . .. ..,,r,: Zoning Distri.Ct: � '��� :Zonin� File#: Resoj�: Reso Date:�� � . � . - � � � Zoning: �:at Area: !• � SF� - W�dt� Lo#�overage; SF� %X � Survey Submitted. :Yes G No Da'te of S�rvey: � �l I� ��vis�d tlatet7) , : � , ,_: - ..� � � R � � � �r � Pro 6seda�etbacks: `< - d ..� , . .�. .. � , ��. ,.,y 5 � . : .' � .� . A Z �roint(��k�) �'te�r��Street) ( �1 $ � �11') �.( 'N S�.�.;� ���� =Qthe�r�u�ltl�n�� �tf�i��� ° ` , Srd�. � .� Sit�e , . : . -' .. �' y . i �.. . . .�. . . „ . . ._._ � �_. _ .-... w-....a� w,�N� .�v,...l,ad� ,�.... 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F�ar��o,��r� _ �s. � �� .,�rr� � ;����,��� � � .� 'E � Yes �lo = � Xes� ^ �3w a - � �YP��s)- �` �`T�p��1• � � ' Upda#�d: January 2013 , ; v:\form's�plar�review�.checklist^s043.doqr' REMARKS (in-house): Fees to be Char ed YES NO Permit Plan Review State Surcharge Investigation Fee �AC—Number o#SAC Units Other(specify) S uare Foota e $ er S uare Foota e Basement X = $ 15`Floor X = � 2nd FI00� X = $ Garage X = $ E�timated Construction Value: $ Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site O Plumbing � Grading / Filling 0 Well 0 Hardcover Removal 0 Mechanical 0 Fire � Electrical ooting 0 Septic � Water Connection � Poured Wall � Fireplace � Sewer Connection � Foundation Survey � Masonry � Lawn Irrigation � Radon Rock Bed 0 Mfg. CI Framing � Other(specify) 0 ulation -Built Survey Final � Wetland �uffer 0 Other(specify) REMAE2KS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES 0 NO New: 0 YES � NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\forms�plan review checklist 2013.docx OWNER ��� �OOp/S CONTRACTOR — �� V �QOt//1 I j, DESCRIPTION � EXCAV/GRADING/FILLING W ❑ FOOTING ❑ PLUMBING FINAL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ POURED WALL � TREE REMOVAL , Q ❑ MECHANICAL FINAL � '� f j ' � ❑ FRAMING •�,�_ � % ; � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION l, f � ❑ PROGRESS , Q ❑ RADON SLAB ❑ NIATER HOOK-UP � COMPLAINT � _ ❑ FINAL ❑ SEWER HOOK-UP 0 FOLLOW-UP ` � ❑ SEPTIC MAINT. �1 � `` � ❑ DEMO-SITE ❑ HARD COVER REMOVAL %� + ❑ SEPTIC INSTALL �� �-'� W ❑ DEMO-FINAL ❑ FOUNDATION/REMOVAL �.,� ,, , .� _ ❑ PLUMBING RI ❑ SEPTIC FINAL _, �� � J YES_NO �.._`� / • Q OWNERICONTRACTOR TO MEET YOU:_ j�., �� Z � ��� � f y i �' � COMMENTS: ' !; / � � w ' ; � � a � 1 � ,� / �. � � ��, , � � ,�� a � � �,, , � , , , .,` � o � � ,f� �= �� " ' 1' , ` � �; ' Q � , � l f. � 1 � / '� ; � j #� ; z . :��� , � �, _ W � , i � i� / / / i `, � W � � � � ' �� � '�, %" � , � � ❑ PROJECTCOMPLETE �� ,� ' �,�: W RK SATISFACTORY:PROCEED r; ISSUE CERTIFICATE OF OCCUPANCY f � � E I �` �: ❑CORRECT WORK&PROCEED TEMPORARY �. ' � i �� ��: p ❑CORRECT WORK,CALL FOR REINSPECTION pERMANENT i �', � � � � � BEFORE COVERING � � , t �' U HOURS. � � ' � ❑CORRECT UNSAFE COND�TION WITHIN ❑ PHOTO TAKEN �` t � ° INSPECTOR WILL RETURN ❑ CITATION ISSUED � � ,% � � ' � I 1 ; 1 1 �� ❑STOP ORDER POSTED.CALL INSPECTOR , , !'� ,' i � , � ❑INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS. 'i � f O�� , 249-4600 ' � � ' ��� � � ; o, �„ ; , � / �' u" , '.,. rij�,.t`�i ill.�_i!III � � � Call for the next inspection 24 hours in advance. �952� r � 1 , ' 1 r ' ` a�� � OwnerlContractor on site: '� �� �� � � � ' �\����: �"�� 1 �° '� Inspector �'' � ,� � �� y � ._. Canary CopylSite Notice �� � � � � ;i , White Copyllnspector's File ���„�� ,�r' . ^�' � � �� � � ,.. �, �,�;`y . `, �,�j°�\ f � .,.,: ,,,�,�QJ'�' �*P i �l 1 � � , � -" ' . �� , aµ;,; 1 � �� �....� � ���� "�� ��w�� � � I a ..` `f\ .»d 4 ` . 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