HomeMy WebLinkAbout2012-01077 - addn/remodel/repair 3 �
CITY OF ORONO * z 0 1 z — m 1 7 7 *
2750 KELLEY PARKWAY DATE ISSUED: 10/ 6/2012
ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 3�55 JAMESTOWN RD
PIN : 2$-118-23-33-0012
LEGAL DESC : CAMELOT
: LI�T 001 BLOCK 001
PERMIT TYPE : ?yDDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : AiDDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 10,000.00
NOTE: SEPERATE PERMITS REQijIRED: PLUMBING,ELECTRICAL(STATE)
ADV.PLAN REVIEW OF$317.36 WAS RECEIVED BASED ON ORIGINAL VALUATION OF$32,000
KITCHEN REMODEL AND PARTIA�,ROOF REPAIR(REMOVING SKYLIGHTS)
ORIGINAL VALUE WAS CHANGEDi FROM$32,000 TO$10,Q00-NO PLAN REVIEW WAS REQUIRED. WE OWE THE CONTRA TOR
THE DIFFERENCE OF$120.61
APPLICA T pERMIT FEE SCHEDULE 91.75
THOMAS BREN HOMES STATE SURCHARGE(VALUATION) 5.00
2073 WAYZATA BLVD. W.#50
WAYZATA,MN 55391 TOTAL 196.75
(952)475-6777
Minnesota State License#: BC 128144
OWNER
DECUBELLIS,KENNETH&JENfNIFER
3155 JAMESTOWN RD
LONG LAKE,MN 55356-
AGREEMENT AND SWaIRN 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 oqly the work described and does
not grant permission for additional or reladed work which reyuires sepazate
permits. All provisions of laws and ordin�nces governing this type of work
shall be compied with whether or not spec�fied herein.This permit will
expire and become null and void if const ction authorized is not
commenced within 180 days of the date o issuance,or if construction is
suspended for a period of 180 days a[any ime after work has commenced.
The applicant is responsible for assuring a I required inspections are
requested in conformance with the State ilding Code.This permit may be
revoked t any time f due cause.
.'"�.,���1�;.� �� / d'�l � 2 �� l �Cpl �Z
App lican t Permi tee Signa ture Da te Is By Signature Date
SEPARAT PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
, . � � II
City of Orono
Building IPermit Application for Maintenance / Renovation� II
_ �T� � a5
(vinndows, doors, siding, re roof, etc.) ,
Mailing Address: Permit number: � —� 7
O4.r�.�0 PO Box 66
I� Crystal Bay, MN 55323-0066 Date received: /D-Z — (Z
� - Street Address: Received by:
�'� G�`� 2750 Kelley Parkway Plan review fee: O�a —0/ 7
'�Rg�Hag4' Orono,MN 55356 ,r�.,
Total Fee: `3�� �1"
Main: 952-249-4 0 Fax: 952-249-4616 www.ci.orono.mn.us
This applicationl 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: / f�I�{ZSTd G�/,� /�� ,
Wtll this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No I�
If yes,a special evenf permit is required with Police Department and City Council approva160 deys pnor to the event. Shuttle bus sernce will b�e
required unless applicant demonslrates sulricient on-site parking is available. Non-permitted events wil/not be allowed.
CONTRACTOR/APPUCANT INFORMATION:
Name: �.��r � ��, ��
State License# �C �Z.� �l�[� Expiration Date: 3 / !
Lead Certification Number: Expiration Date: 2 Z
(for work on homes that were constructed pNor to 1978
Phone: g,sZ- ? - (office) !2- ,S - (o Q (cel)
Mailing Address: Za 3 G✓� !�/A� Z�T��9 Lf/�� 7� ��tY� Gon/ L�,��P� S �o
Contact Person: ?" �/t � � Applicant is: Contracto / Homeowner (Circle One►',
Email and/or Fax: ��r�� ,� .��a�,�S �r /1 DrN�S < C a n� '�
, a
PROPERTY OWNER INFORMATION:
Name: � � ��2 ��.l,t �LL/S I
Phone (day): r
Address: ��,��� City. Z�p: I��
Email and/or Fax +
PROJECT INFORMATION:
Type of Project: Any earth movement may require i
❑ Door s �Rerroodel MCWD review 8 permits: I
O ❑Fire Damage Minnehaha Creek Watershed District(MCWD) i
❑Re-roof,asphalt ❑RepBir ❑Storm Damage 18202 Minnetonka Blvd �
❑ Re-roof, cedar ❑Restoration ❑Water Damage Deephaven,MN 58391 I
Phone: 952-471-0590
❑Re-roof, other(speciTy) ❑Siding ❑Other:(speafy) Fax: 952-471-0682
❑Wind�ow(s) www.minnehahacreek.orq ',
Overall Project Description: �rG� 2�C o 1lflst'Iv�•( ✓v�s}-t�L �doF" ,Z �2
Estimated Construction Valuation of Project(excluding land) $ �. � c1,c��b� �
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department; I�
• Certifies that the infortnation supplied is true and corred 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 altemativei�
but to reject it until it is complete; �
• Some or all of the informaUon that you are asked to provide on this application is classified by State law as either private or��
confidential. Private data is infoRnaUon which generally cannot be given to the public but can be given to the subjed of the i�
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 tMis information is to annually update our records and records of other governmental agencies �
re uired b law. If ou refuse to su I the information the a lication ma not be issued.
ApplicanYs Signature: , Date: Q d2-
last Updated: 08-09-2011
���o
C ITY OF ORONO
� � Street Address: Mailing Address: Telephone(952)249-4600
S' G� 2750 Kelley Parkway P.O. Box bb Fax (952)249-4616
F
! t�, Orono,MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us
�kE5H0�
' I
TO: Peter Zimmerman
FROM: Monica Fadness, Administrative Asst.
SUBJECT: Refund
DATE: October 29, 2012
The City of Orono had collected an advanced plan review fee of $317.36 for a building
permit at 3155 Jamestown Road. After reviewing the application, the valuation was
changed and it was determined that no plan review would be required. The amount we
had originally collected paid for the entire permit fee with a refund being owed to the
builder for $120.61.
I am requesting a refund in the amount of $120.61 made payable to Thomas Bren
Homes.
Please mail the check to: Thomas Bren Homes
2073 Wayzata Blvd W#50
Wayzata, MN 55391
Thank you.
� C���---
.� �� �✓�.-e-� � �
Lyle Oman d�- �
Building Official ` �
� � � . C� J 7�
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,�
Plan Review Checkiist for New Structures / Additions
Address/ PID/ Legal: .�r i S ��/�-j�j � �v�/ �,�
Description of work: (<� •�c_f� Fr� ��''���`-'�-
Septic review by: �t!/� Date Approved:
Zoning review by: /� Date Approved:
Building review by: Date Approved: l v �5 "�1 Z
Grading review by: it1/JL D�' `pproved:
Zoning File#: Resolution#: �lution Date:
ZoningDistrict Fire Department � School District
- r
Zoning: Lot Area: SF/A� ` `� Oepth:
,
Survey Sub �tted: ❑ Yes ❑ No
\. ��
� —
Proposed Setba s: `'�
t
Front (Lake) Rear(Street) � � � �� Wetland
�
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• `� =.._., �� �
U �J
.
Building Defined Height: Builc. \�` ,�v,l, Stories Ok?: ❑ YES
_ ��1 �`�A�
FOR A BUILDING WITH A BASEMENT O CRAWL SPACE: �` �jy ;�NDATION:
START WITH the distance between t basement floor/crawl � �..;e between the slab and the highest
space floor and the highe t roof peak,the top of ' �. , �, ,� ,ak,the top of the cornice of a flat roof,
the cornice of a flat roof,th deck line of a '`�, ? � �eck line of a mansard roof, or the
mansard roof, or the upperm t point on a round!� � .ppermost point on a round or other arch-type
; or other arch-t e roof ' � ,/,I� i roof
SUBTRACT half the distance between the hig st window and SU. t/, halfthe 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 fl /crawl ADD the distance between the slab and the highest
space floor and the highest existing gr,a within existin rade within the foundation
! the foundation or 10 feet,whichever�i's fess. EQUALS Defined buildin hei ht
EQUALS Defined buildin hei ht
Lot Coverage: ' SF %
Shorefand District MCyVD Permit Received verage•Lakeshore Setback Bfuff
❑ es ❑ No � N/A � Yes 0 No
0 Yes ❑ No ❑ s ❑ No ❑ N/A
ermit Number: Setback:
� Hardcover Zones Existin Proposed Variance equired CUP Required
D-75' ❑ Yes ❑ No � 0 Yes ❑ No
75-250 j' Type(s): Type(s):
250 00'
0-1000'
RE RKS (in-house): /U� C�*'/►� �
Updated: �9/11/2009
z:\forms\plan review checklist.docx
• ,
Fees to be Charged �(fS �10
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Pfan Review
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Park fee
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Other-(spscify)
Galculated By: .
� uare Foota e $ er uare foota e
Basement X : _ �
.'1 St Floor X = $
�nd FIooT - X _ �
Gacage � _ �
Estimatetl Constr��tipn Value: _ _ /0�0 t�0 d�
Orano inspections Required �Alork Reqwiring:Separate PErmits Requiretl 5#ate Permifis `
` � .Site Flumbing � �rading /Filling fl 1Nell
� Hardcover Removal � ilJlechanical � Fire Electrical
`� FoAting � Septic � 1Na#er:Connection
0 Poured 1Nall � "Fireplace D :Sewer�onnection
"O FoLndation Survsy 0 Masonry � Lawn trrigation
' ,� #�atlon R�ck'Bed a Mfg.
Framing G Othsr(specify) `
0 lns�lation`
.� As-Built Survejr
:j�Final
� Dther�specify)
REMi�RKS (in-house); _
_ Ott�er;i3eyiew.: -R�vie�wed by;, Da�e.Ap�roa�ed:
Access:Existing: � YES ' � NO New; -� YES � NO
ia2EMA#�KS (T�BE NOTED dN PERMIT A1�1D�1�1T11�LLED B�tf PERS�J1�1 PULLING PERMIT)
Updated: D9/1112009
z'lfiormslplan:review chec�list:docx
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� I ��—�% DATE TIME ✓
CITY OF ORONO CALLED IN
INSPECTION f�OO�I�E DIO�? SCHEDULED (2-5-/ Z �(.�D
PERMIT NO. al �l COMPLETED
ADDRESS ���Si> �QiY���IZTI-C?-V\ /
OWNER T EPHONE N0.6�Z ��� ��? :
CONTRACTOR
>; DESCRIPTION � rarn 1 n ���� �"'r/d�
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� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
O p 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
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRA TO MEET YOU:_YES_NO
� COMMENT : �1� 1 �rC�� �C� � S 1�1 Q 7 ���
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�O NORK SATISFACTORY:PROCEED `❑ PR07E�OMPL'ETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALLTOARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-46��
OwnerlContractor on site:
Inspector._� �
White Copyllnspector's File Canary CopylSite Notice
�� ��� ATE TIME � � � �
CITY OF ORONO CALLED IN
�-�-�3 '
INSPECTION NOTICE �CHEDULED a-�-� � �
PERMIT NO. o�,�o�-����/c LETED
ADDRESS I S �
OWNER EPHONE NC�'a=3v� -a'�
CONTRACTOR � � "� �r
>: DESCRIPTION ��- � —�T�-� ��a"`�-'�
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS
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
� ❑ 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:
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W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
� O CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
��ORRECT WORK,CALL TEMPORARY
V PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (J52� 249-460�
OwnerlContractor on site:
Inspector.
White Copy/l�spector's Fite Ca�ary CopylSite Notice