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Home My WebLink About2010-00045 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2oia000as 2750 KELLEY PARKWAY ORONO, MN 55356- DATE�SSUEn: OU29/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2700 KELLY AVE PIN : 21-117-23-23-0033 LEGAL DESC : VERN-MAR MANOR : LOT 008 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 45,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING.MECHANICAL,ELECTRICAL(STATE) INTERIOR REMODLE WITH SOME WINDOW AND DOOR REPLACEMENTS. APPLICANT pERMIT FEE SCHEDULE 628.00 MIKE NORTH CONSTRUCTION PLAN REVIEW 408.20 574A NORTH BROWN ROAD LONG LAKE,MN 55356- STATE SURCHARGE(VALUATION) 22.50 (612)246-0027 TOTAL 1,058.70 Minnesota State License#:20636890 PAID WITH CC# 9784 OWNER JOHNSTON,ALEX 2700 KELLY AVE EXCELSIOR,MN 55331- 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 governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if consVuction 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 aze requested in conf ance w�h the Stat uilding Code.This permit may be revoke at any ' e for caus � i /� � ,� �, /v pl�cant P ite Signature Date Issu y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: � �,0,�. PO Box 66 Permit number: d/� �� .. � Crystal Bay, MN 55323-0066 Date received: 6 � /� �'�r'��` Received by: ,� "�;� _ �, Street Addr�ss: '�,�, �� "� ��' 2750 Kelley Parkway Plan review . l9xE$HO¢�' Orono, MN 55356 � � � Total Fee.�T � 5�. 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: ��V��. Job Site Address: 2.'ZO� L<.G�`�/ �• �V� — Will this be a Parade of Homes, Remodelers S owcase Home or other Display Home? ❑ Yes [� No If yes, a specia/event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service wib be required un/ess applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR I APPLICANT INFORMATION: Name: /'V��•�1.�,�� 1 ol�d•� State License# Zp��(�,$9p Expiration Date: 3�31- 1 I Phone: ., Z,�{ - office cell Mailing Address: �,.r Ci : � I.CL ZIP: SS Contact Person: 1 kL IV o r 4-�-.. Applicant is: ontract / Homeowner (Circle One) Email and/or Fax: n,o r-6� S�4 L Q. c-�C4_.ri�-I-.✓te."f' PROPERTY OWNER �v FORMATION: ►vame: /:�L�t,�r 5o�ns�on Phone(day): �j'S'2+2Z 1 -7 7 y 5( Address: Z'7p0 !%c I l y �4�,.c_ City: Q(2c�1Vp ZIP:,,�'S 3 3 � Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review 8�p�rmits oor s �Remodel ❑Water Damage . �'d' Minnehaha Creek UVatershed District(MCWD) �v�) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage ww_w_minnehahacreek:org Overall Project Description: �,�.}e,.�� e-e,+�od� w/ Scn�.._ 1.��locv/C�co� rG(G,T, ce�,t�'�" s E�timated Construction Valuation of Project(excluding land) $ ty��pa � . �.., 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 confid�ltial. 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 generatly 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 re uired b law. If ou refuse to su I the information,the a lication ma not be issued. � STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction r a. Length (ft.)= � Number of bedrooms= � �Wood/Frame ❑ Masonry b.Width (ft.)= � Number of garage stalls: ❑ Metal Attached=� ❑ Pole Bldg. Areas in square feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ?b g ❑ Off-site Prefab d. 1S`Story = ��2`"L ❑ Other(please specify): e. 2nd StOry= "'' f. 'h Story = '" g.Total Area= � REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclos A licable ❑ Permit A lication ❑ Pro osed Buildin Plans ❑ L�- MN State Ener Code Calculations and Mechanical Code Re uirements Form 0 .B� Surve meetin all re uirements ❑ p� Stormwater Pollution Prevention Plan ❑ �- Hardcover Calculation s ❑ ,� Se tic S stem Site Evatuation Re ort ❑ Access Permit ❑ ,0"" Wetland Buffer Im rovement Plan ❑ .B— En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ Other APPLICANT ACKNOWLEDGEMENT: Agrees to provide atl 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 compfeted 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,tf e application may not be issued. ApplicanYs Signature: Date: �� . • ` Fees to be Char ed YES NO '��i.s,.rt r�; i �" tiU: ' - .� Y :i +. r _ . . .�, _i �� e �.. , .., . ...: � . ..,_ ,._': Plan Review v `Stat�"'�vrcfia�,ge a = - - ,�;,� _ Investigation Fee �S�i��..�taurn'be��af��AC�n�ts::F �, �' � ' t�w �.�_ �` "; `�s � { - �:� s.;� Sewer Connection NY,Y��.`n�'��/A�� 7' +il. �'i',.R 6"hsa- f'S*: 7 f .k.. ��„r 4� ,�,et'�C�_ .+y�4 �. Park Fee ,a�',�1�P�i�S'�'�."��IOII��' t + �;, � � ,�', r��s'#� �''�;�} , ��,��wR t ,�-•,�,� g` �, w,r_ �:,.,�., s� M -�' �. Other(specify) x`�111�s�aa�l�ot�s��ee�,:��'��. ;��x.:?�`�Y�'� ``"� � �`�.�)�� ;��`�y�J ��;: MNau. N.�Me a, . SF.M-r�6+Mw�+F. iR ..!�,�7 X�S,�S'�f" l .��n ..� f.fYT +� . Y` '2'+: � .,aW.T 2�V.A`}{`F. Calculated By: S uare Foota e $ er S uare Foota e Basement X = $ 1�Floor X = � 2nd FI00� X _ _ $ Garage X = � Estimated Construction Value: $ �S`. �O�v � Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site lumbing 0 Grading/Filling 0 Well � Hardcover Removal �echanical 0 Fire � Electrical 0 Footing 0 Septic 0 Water Connection 0 Poured Wall � Fireplace � Sewer Connection 0 Foundation Survey 0 Masonry 0 Lawn Irrigation 0 Radon Rock Bed � Mfg. �' Framing 0 Other(specify) ,e( Insulation � As-Built Survey ¢�Final 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES 0 NO New: � YES O NO REMARKS (TO BE NOTED ON PERMIT AND lNtTIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms�plan review checklist.docx • . Pian Review Checklist for New Structures / Additions � Address/ PID/ LegaL G'7(�� (c` ��.,� Description of work: Q,�iv��L Septic review by: �l/� Date Approved: Zoning review by: �cI/� Date Approved: Building review by: Date Approved: �-2�i-!a Grading review by: iv //f Date Approved: Zoning File#: Resolution#: Resolution Date: Zonin District Fire De artment Post O�ce School District Zoning�� Lot Area: SF/AC Width: Depth: Survey Subrrktted: 0 Yes 0 No Date of Survey: � Pro osed Setba s: Front(Lake) Rear(Street) ( N S E W ) ( N S E ) Other Buildings Wettand Side Sid Building Defined Height: Building Peak H ' ht: #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR AWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the asement flooN cr START the distance between the slab and the highest space floor and the highest of peak,the p of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the k line o the deck line of a mansard roof,or the mansard roof,or the uppermost oin n a round uppermost point on a round or other arch-type or other arch- e roof roof SUBTRACT half the distance between the hi es indow and SUBTRACT half the distance between the highest window hi hest roof eak of a itched oof and hi hest roof eak of a itched roof SUBTRACT the distance between the b ement floor/ awl ADD the distance between the slab and the highest space floor and the high existing grade w t in existin rade within the foundation the foundation or 10 fe , whichever is less. EQUALS Defined buildin hei ht EQUALS Defined buildin hei t Lot Coverage: SF % Shoreland District MCWD Permit Received A ra e Lakeshore Setback Bluff 0 Yes 0 No � N/A 0 Yes � No � Yes 0 0 0 Yes 0 No 0 N/A Permit Number: Setback: Hardcover nes Existin Pro osed Variance Re uired CUP Re uired �'� 0 Yes No 0 Yes � No 75 50' Type(s): Type(s): 0-500' 500-1000' ' RE ARKS (in-house): Updated: 09/11/2009 z:\forms�plan review checklist.docx �� DATE TIME CITY OF ORONO CALLED IN 3'Z� INSPECTION NOTICE �[ SCHEDULED .3�3- /D /:�� PERMIT NO.O�ZO�O "O�!S COMPLETED ADDRESS a 7D0 l�P,l-f-�/ 7�t1�, OWNER CONTR.�l� tI�J07'��l �4-Y� TELEPHONENO. � �� -�-�lP -DD Z7 � DESCRIPTION r � � FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. � FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOH TO MEET YOU:_YES_NO c�., COMMENTS: � W a J O �. � O � W � Q � Z W � W � � W r�WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUiRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 twurs in advance. (952) 249-4600 OwnerlContractor on site: Inspector._�� /. . � White Copyllnspecto�'s File Canary CopylSite Notice