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Home My WebLink About2012-00787 - in-kind deck replacement CITY OF ORONO * 2 0 1 2 - 0 0 7 s 7 �k 2750 KELLEY PARKWAY DATE ISSUED: 08✓28/2012 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 2755 KELLY AVE PIN : 21-117-23-23-0026 LEGAL DESC : REG.LAND SURVEY NO.0891 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 5,000.00 NOTE: IN-KIND DECK REPLACEMENT APPLICANT pERMIT FEE SCHEDULE 118.00 LOCAL LAKES CONSTRUCTION STATE SURCHARGE(VALUATION) 2.50 445 NIAGARA LANE N PLYMOUTH,MN 55447- TOTAL 120.50 (612)418-4478 PAID WITH CC# 3044 Minnesota State License#:BC473986 OWNER KAVERMAN-GESELL,DREW GESELL&K 2755 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 pertnits. 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 18 days of the date of issuance,or if construction is suspended for a peri of 180 days at any time after work has commenced. The applicant is r onsible for assuring all required inspections aze requested i ance with the State Building Code.This permit may be revoke ' e for due cause. , /p? // � �/ �� ican ermitee Sigr►ature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � . . City of Orono . . � � � � Buildin Permit A lica ion �" J pp t I � for New Structures or Additions �J2�a � Mailing Address: �D�a-U�-� g 7 O�D,�O PO Box 66 Permit number: Crystal Bay, MN 55323-0066 Date received: 0 -� 3-� �`�''�'�'° Received b � �„a '�'� �, � StreetAddress:' y� � y�� ' 2750 Kelley Parkway Plan review fee: � ,?� � � "� '� Orono, MN 55356 ��/a _�-� �� \t� og'/ ��ESH,� 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. (Please print) GENERAL INFORMATION: Job Site Address: ;[�j j ,�� y �{� Will this be a Parade of Homes, Remodel rs Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: / Name: 1�Ccr l ��t�' lv�5��-cCh�� State License# [j�/�3�'g(� � Expiration Date: 3-3 y I�/ Phone: (��- �J�1�t��b' (office) (cell) Mailing Address: �y� /�/�a��, J.�,.Q �l/ City: %�i�;,�_ ZIP: S'�'yy� Contact Person: ��,-, �a��5,,,,,, Applicant is: Contr ctor / Homeowner (Circle One) Email and/or Fax: �.��,,G}�Q/f,q�fS4-�"/.�i.tC�is��^� � PROPERTY OWNER INFORMATION: Name: /�a[�-, /��ut�.��r, Phone (day): - 1/� - �3 Address: 5 � � �n Cit : ,`o ;� ZIP: 3 Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZI P: Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal & Water Supply ❑ New Construction �Single Family with ❑ Residence ❑ Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building ❑ Single Family with �Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer ❑ Other: (specify) ❑ Multiple Family/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) $ �,��,� STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions (continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame b.Width (ft.)= Number of garage stalls: ❑ Masonry Areas in square feet Attached = ❑ Metal ❑ Pole Bldg. c. Basement= Detached = ❑ ICF d. 15i Story = ❑ On-site Prefab e. 2�d StOry= ❑ Off-site Prefab f. Yz Story = ❑ Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: N ot Enclosed A licable ❑ ❑ 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/OWNER 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 tc do so, the staff has no alternative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Understands 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. . Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of he as-built survey and all site improvements. , / � �� j ApplicanYs Signature: Date: � r Owner's Signature: Date: ': , , ; . ; `. ��a� ��r �h��i�t �c�� 1Ne�v �tru�t��s � Adc��t�or�s � Address/PtD/{.egal: �? � J�� " f�-� � � � � ; t7�scrip�ion of wcirk: � � �,- �� t�:l ,K r^n0 ��'t' � �--- , , , , , . f �eptic re�iew by: � �� . �ate�►}�rAved: � '��"� � +�"t- -��„� ( Zoning revieHr by: �� Date Approvet�: , � Bwilding rev�ew by: ��,�A�.prbved:�."�^ l'� , , . ., .. . r _ b. .� +Cradir�g review by: di/�'l� Q�t.��4pprov�d: � �,, . +i, , � � �oning fli�#: Re,solu:tion#> Resalu�io�1 pate: � " nit� D.is#r�c# Fice��a �rtm nt ' Post�e ' ..Sa . c�l'Qis#�ri��. :,; . , , . . . , ; , , _ _ ! : : , , ' Zonir�c�: tot:Ar� S�./:AC VUidth,� :.�. .t�e#�th; . �. , ` : � r St��y�u�i�i�ed: Et�Yes CI�Vo' �t�b��urvey ' ��` "' �` �� =Pro t�sec��tba�kS: ' ;, �� v . ; � ,_, _, . �. . ��. � r s � �ror�k{I.ak�e) �sa �xreet� � ( � 5��..� W )� ( �ri! .�t ..� YII. �th�r�t�9irt��s; �� : ��g ��p �`� �`� p �, ., .� * t $ C ^� - �' f K�q„ ': ; . ,�x :r ; �+, � �. i ;,$Ui�S�.f��B�ACf�@T��1t B�t�'dlt1�,��1C��1��,,.-�-,.�..-..�.'� ��C`�;�� ( ' � ��'`bR�'1��t�iCD1,�WI�#A��yS�N1��0,!R�F�li1�t1, A�� I'�,��L1�Dl�{'��ii l��l f� 4 �iq�. � �{ � �* �. a� � r �m e��!�� '� I { �'�'Af�T th�rlist�nce'��trr�e�r�tFte�ia flp�rl c�tawi : � ,��"A��'�*�� '` `'b��ir�r� '�, �t - � sp��a'�n��aei�igh�§f r�f pea th�:�o�cf �=�IIT� :- � _ �� ,�. � ��att f th "��tA��tl�i�e�a�rs�-o�� ` f, tM�cq i�cf � . � ` � ,�. `�. ;��.i�efc�� '' ��" ` }� ��roa�t��`pper�o ��p`ai�� - x � � p�� t: �� i�� r�r-�� o�ethelr,a�'�� 4t�f � > � 4f � ��, �. � �: ;r � �� ltF3fi#�A �' � 1�,��f{�°tl'��- ��j� L-�etwe� ;�,,1��sf v�tt � d�; � ��' �h ��t ��e �1 � ,�� i� �..� � 1�� 11�,raxvY: �It�.� �ihe.Y � ,i t '��.+�t �rz .. y k ni � a� r, 'i�t�tlis�ai�ce'6g �n�re bas$��ta. �o,�f c�awf �D `tl�t�� s'pas�fls�or ar�d the M� #�est�ex�s�i; x � ��' ,��. �.�,�'�'��s� ,�rn� �� t�i�f,� � g�'�de w�h�p �< } , h < �`� � �•,� � ; ihe.#�3u��t.:rlorl�':�eet,, i er�s� $� � >;� � � � � �. , a�� Q�� #ih � �ciirt �a:� l�t` ; >�.� s � ` f ' �� : � = �� .fl��rf)�1��,� �'`� p�p�, 5^P a '`` � , , , •. . i �� ,:_ � � z .s . . .. .- . k ;� �' [ F�IO�I�IICI D�!`ttf'IC'�' ` V� �@ft�l�I�C@!Y@� . A1/$� �- �S,$�I1b�$ ��3�G�C3 , ��il� : � " � � � � �� Yes �� G� I�o �l��N�A- �. � ��;` �� " � �' � Q �es. i� No� : � �1�1 Yes �-� G No � � G �Yes � II �o G N/A � � .__ �' � �� Pemiit N�mber:- � � �� . 3etb�ck: ` : . , _ . . ' . , . � .. _ ; � � _� �. � � � , � � H�rdcoVe�Zones Existin Pro osed Vakiance� ' uire CUP R; uir.e�i . r � �-75' � � �� '�Yes �� No � Ci ��Yes ��'� . G �Nb �� , 75-250' _ Type(s): y�e�s); 25U= 0, 5 -1000' f�EM ; KS(in-house): �—nt P�1 iv Q '/��Co�t.t�ti7""' � � Updated: 09/11120U9 ` z:lforms�plan review checkiist.doac Fees to be Char ed- X�3 i�IO, .. . - , ; r . _~ ._ -�. � .. � ��. ��-, _ x�� _ .. . �'""., � Plan Review � $' � . tnvestigatian Fee - ��b�T�oi��ii':� � �^ �' r�.�=..-�- Sewer Connection �: •; ::: , : ��{�� y � +" �* t�ark�e� - � _ � � �� f� .+ - , .,, . , � � :_ ,: .; .� � � . � ., , ,k� ..�_ � r � ,� � Qt�i��{s,p��fy) � � : ;� ~ � r z a r `�' "��` '` t ,y� i Y � rR^ _ 1* Tv�� .��fe . . , r ?� � -�1'-'.. }�.. .i. x .,: .. -., -• -. � CaIcW�#ed By.:: � _� . , , . � _ _ , , �.� _ __ �. . , ;�� .:,. �.. �. ._ S_ uare Foota � :$ . r S uare Foota e. Basement . X - $ 1��Floor. X $ ;a ' �¢ � ' ��: X , � �P � �7Q�(,��. `� .X � � ,.�,,� � , . ; , - - . , , - . _. . ._.- . , ,� _ -, ... _ . . ,.� :,,: .. _ .�.�. �. ;. � ,:,' ,_ : �.=, . ' � � v `��1'C1e'1t�:C�C0�'1S`tiT�l,�#ib�T�a/��LI�'� �.� .��,��,�,� ' �:• ` L a' ,. � Su'.` i} � �' TZ �.k ._. ., , '. � .,.. .. ,�=, ... ''�,� .. � - ; �! .L �.;f �Y,� �-F r.q.�� Or�i lt�s�+�t�or�s Ret�u�r�ti Vilork i�e�'Iuiring.`��ara��Pei�p� -�E�q�i�� -` � � , , _ . ,_ _ .� ._ � � ,._ �, � , . . .,;. -. . . . . ;. • -: �.- - . .� � � �: r � � � . . , ,,. �� ,. _�=� Site� � G. �lumbing � � �1 C�radir�g`%�'iNi�� i "Il'�e�l ' �`� { .n.Aa° rdcover��nQv�1 - G °Me�h.�ni�a1 #�7 Fir� _ _ 1�7 �f��r��,��t �; �� ootir�� C� Septi� � iNa��EQn�e��n ��s L t `1� P�iarEd Vl�alt �i FireptaCe � 5ein/er C�n�i��an :;�� ' �G FQund�'��np$�rv.e�, - � Masonry C7 L`awr�irr%y�tr�� 3 - . r f :ry� �y MOj{�j��Vf1��1. . � �* � j # � �� j �� Q1_ �1 Y. . "� �� t � =�r�rr5�ng D:Oth�'(sp�c�fy) - � `� � � �� r��ul�tion� _ � a. _ ;, . ,. � , _ . . � �u��s��y . . � � .,-� �. . F , �� . �,. �� > � �, .r k , � , �ffn�t ='�' `;t�'�Other(s{�c�fy) ,.: k � � . , � `�2EM�IRKS (in-house): , . � : ` ,. ; , . Other Review: Reviewed by: Date Approved: Access�Existing: � YES � NO New: D YES G NO REM14RKS(TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMR) Updated: 09/11/2009 z:lfoRnslplan review checkfist.doac : C!J� � TIME ✓ CITY OF ORONO CALLED IN `t �' ��,�.-, INSPECTION CIOTICE SCHEDULED � -�-/a' ��— PERMIT NO. �r��—Od7�7 COMPLEfED ADDRESS a�SS ��ll/ vL L�GI G[.� OWNER ELEPHONE . ��g� � CONTRACTOR � - � DESCRIPTION �� `� � � ❑ 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 ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O � � O � W � Q � Z W � W � � � ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERiNG PERMANENT ❑CORRECTUNSAFECONDITIONWiTHIN HOURS. p pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. /I t 1 -� White Copyllnspector's File Canary CopylSite Notice