HomeMy WebLinkAbout2016-00929 - addn/remodel/repair � CITY OF ORONO * 2 0 1 6 - PJ 0 9 2 9 *
` 2750 KELLEY PARKWAY DATE ISSUED: 08/10/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1801 LAKEVIEW TER
PIN : 27-118-23-43-0004
LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN
: LOT 005 BLOCK 003
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 40,000.00
NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE)
INTERIOR REMODEL ONLY:KITCHEN/LIVING/DINING REMODEL
APPLICANT PERMIT FEE SCHEDULE 603.02
PLAN REVIEW 391.96
CORREA,ALFONSO STATE SURCHARGE(VALUATION) 20.00
1801 LAKEVIEW TER
LONG LAKE, MN 55356- TOTAL 1,014.98
Payment(s)
CREDIT CARD 1646 1,014.98
OWNER
CORREA,ALFONSO
1801 LAKEVIEW TER
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which Ihis 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 1 SO days at any time afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conf ce with the State Building Code.This permit may be
revo at any for ue cause. �
_ � C6 �c� � � , it� , ��6
Ap Permitee Signature D e Issued ignature Date
City of Orono
Buildir�g Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
O Mailing Address: Permit number: ��
�- �O PO Box 66
Crystal Bay, MN 55323-0066 Date received: � �
� � Street Address:
Received by: �
y G� 2750 Kelley Parkway Plan review fee: 6��-Ci (
`� �, Orono, MN 55356 U�
��'CES H 0� �C�:.
Total Fee: �✓
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us (�� �L�
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: 7 '>%,
Job Site Address: �SO � Ll��=.CVi�� � ��z. 2�NO ��� J�35 �
Will this be a Parade of Homes, Remodelers Showcase Home or other D�isplay Home? Yes o
If yes,a special event permit is required with Police Department and City Council approval 60 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/APP ICANT INFORMATION:
Name: �� j,,j�
State License# Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were construcfed prior to 1978
Phone: (cell) (office)
Mailing Address: City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNE INFORMATION:
Name: - ^�NS �i`�. RRc�
Phone (day): (o�Z '� '�.� l 3�
Address: � �p� L/1�,�V���� '"j�[2 City: ���(�0 ZIP: �/�.�
Email and/or Fax: 0.l �flc•sOC ac r � � l , �„�.
PROJECT INFORMATION: Overall project description: k-'��t��er� Z'��^� .�!��^ ��2�^a
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) www.minnehahacreek.ora
Estimated Construction Valuation of Project(excluding land) $ D DO
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 inform tion which generally cannot be given to either the public or the subject of the data. Our purpose and
intended use of this inform tion is to annually update our records and records of other governmental agencies required by law. If
ou refuse to su I e in rma ' n,the a lication ma not be issued.
Applicant's Signature: Date: (,J � �`�
Owner's Signature: Date: v �
Last Updated:January 2016 ��� � (� l��
l
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
�-
Address: � �i�J � L,u'�CC�i/'tG61i' l.-�'✓'�'u,c;� Permit No.: ���`� �%'C�y�`�
� �/� ,/' / �/� � �.������ i��t•��t,
Description of work: iP'JP_G�I�Q�� h ���{'1C1�, l/�����"t"' /ISc;L'�/ Date Rec'd:
Septic review by: ��'���%"� /<� �� Date Approved:
Zoning review by: Date Approved:
% �: �
Building review by:��;� 7 . , � `,� Date Approved: � c�
Grading review by: Date Approved:
Zoning District: Zo,�ing File#: Reso#: Reso Date:
Zoning: Lot Area: SF/AC ' Width: Lot Cove,rdge: SF %
Survey Submitted: 0 Yes � No Date of Survey: i�� Revised date(?):
Landscape plan submitted? 0 Yes 0 No Landscaper:
Proposed Setbacks:
Front(Lake) Rear(Street) ( 1� S E W ) ( ;IV S E W ) Other Buildings Wetland
Side Side
Defined Height: Peak Height: ��FE: FFE minus 6 feet= (Existing Contour)
Perimeter(linear feet) _ ; 50%� � L.F. below grade
}
Basement? � Yes � No, Stqrie��
�1�k.
FOR A BUILDING WITH A BASEMENT OR CRAWL SPA(Z"�: FOR A BUILDING ON A SLAB FOUNDATION:
The distance betwe�n th lowest proposed Slab at or above grade—
START WITH floor(of the basement or Grawl space)and measure from hiahest existina
the highest point o�the roqf. START WITH rq ade to the highest point of the
� roof even if fill was brought in to
elevate home.
If you have a.,.' `�
SUBTRACTION • GABLF OR HIPPED ROOF(no Slab below grade—measure
(BASED ON wind9Ws): Subtract hal the distance from highest existing grade to the
ROOF TYPE) beM/een the highest poi t of the roof hi hest oint of the roof.
to tre low point of the co responding If you have a...
ga61e or hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF
• (�ABLE OR HIPPED RO (with (BASED ON (no windows): Subtract half
windows): Subtract half th distance ROOF TYPE) the distance between the
'between the top of the high st highest point of the roof to
window and the highest poi t of the the low point of the
roof corresponding gable or
hipped roof
• ALL OTHER ROOF TYPES( at, . GABLE OR HIPPED ROOF
mansard,etc):No subtraction. (with windows): Subtract
SUBTRACTION 5ubtract the distance between the half the distance between
(BASED ON basemenUcrawl space floor and the the top of the highest
EXISTING highest existing grade adjacent to the window and the highest
point of the roof
GRADES) foundation OR 10 feet(whichever is I s). . ALL OTHER ROOF TYPES
(flat,mansard,etc):No
EQUALS Defined building height subtraction.
t Defined building height
EQUALS
Updated: October 2015 � j
z:\forms\plan review checklist 10-2015.docx � k
� �
Shoreland District MCWD Permit Average Lakeshore Setback 'Bluff
Met?
� Yes � No Permit Number: 0 Yes 0 No � N/A � Ye No �
� N/A—see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf % and sf
� Yes � No 0 Yes � No
1 2 3 4 5 Type(s): Type(s):
Fees to be Charged YES NO
Permit
Plan Review i,�
State Surcharge �/'
Investigation Fee �/
SAC— Number of SAC Units �/
Other(specify) �/'"
Square Footage $ per Square Footage
Basement X = $
1 S� Floor X = $
2nd Floo� X = $
Garage X = $
/�. ,,p :�
Estimated Construction Value: $ `7' 0��VG�
Orono Inspections Required Work Requiring Separate Permits
0 Footing � Site Plumbing � Grading/Filling
0 Poured Wall � Silt Fence/Erosion Control Mechanical � Fire
0 Foundation Survey � Hardcover Removal � Septic � Water Connection
� Foundation Waterproofing � Other(specify) � Fireplace � Sewer Connection
Framing . 0 Masonry 0 Lawn Irrigation
Insulation ❑ Mfg. 0 Landscaping
� As-Built Survey � Other(specify)
Final
� Lathe Required State Permits
� Other(specify)
0 Well Electrical
REMARKS (in-house):
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
� See Builder Acknowledgement Form
� Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved.
Updated: October 2015
�•\fnrmc\nlan rcvio�ei nc�rklict 1(1_9(115 rinrv
.
' Reviewed for Code
detector Compliance City of Orono
Carbon �Onoxide ft. of
required within 10
all sleepi�9 roo
ms. Dat�e � �
Reviewer �'vCR�
O�yhECTED TO A S�UND-
SM����CTOR C E�TOFt AUDIB�1N
IfvG 4E�'►CE O�',OTHE�D� �.��,�y q C Cl P 1�
S�EPIriG A�{�S•
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- D TIME V
CITY OF ORONO ���� CALLED IN �o� �
INSPECTION NO CE SCHEDULED /- -� /fo __1-'�
PERM�T NO. b`�—���� COMPLETE --�-�
ADDRESS I r�'O� (J l-t°i�liU l ��')',l.t GQ�
OWNER � �'��- TELEPHONE NO���a7��-3v7
CONTRACT
� DESCRIPTION ��`''��Yu�
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q � FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� �SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
� ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 dWNERlCONTRACTOR TO MEET YOU:�fES_NO °
� COMMENTS: C �ct. � "' /� 'f"dl.�,�.�1�
, o �
� n�� e I� �r•�, �✓�r,�c ca , �/ b� � �.�s�� </°
o /�Er���y'�%____--�_fcrf��.- a a�e � ..
� �•' �C � i,,,• � .O J�.? �sf.y9+st'
O
� /c�e r ;'v�SZ` , , t.o.��.� �.� �
Q � �i°'D�.�c � �S /i.�'1 i r15�� d �'r�.✓ E�_�
� �'.5 �- f�y. .� � /r'l���/a�
i �� !c� �t5���S�� ��. �'
w �� ��o'e ��c��_J.����L�i/l
; /,t�lle fr-k��� b e���,z �i��r�r� �1�c��
W O WORK SATISFACTORY:PROCEED �� ��5�L ❑PROJECT COMPLETE
� CORRECT WORK 6 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
0 ❑ RECT VII�RK,CALI FOR REINSPECTION TEMPORARY
V BEFORE CONERIN� PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHpTO TAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
Call for the next inspectlon 24 hours in advar�e. (952) 249-4600
pwnerlContractor on site:
Inspector: �� �`''`-� �
White CcPYAnspector's Fila Canary CoPYISits Notke
6�-1 S�
DATE TIME
CITY OF ORONO cnILED IN /— o�l�-/�
INSPECTION NOTICE /�j}� SCHEDULED /�3 -/7 _3.'ab
PERMIT NO. ����-"�� � COMPLETED
ADDRESS � � �
O'WNER �ELEPHONE NO.612 �°��—i3��
CONTRA
� DESCRIPTION � �'
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAVlGRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� �NSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
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Csp br tl�e next Mspection 24 hours in advanoe. (952) 249-4600
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Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLIN(3
�Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑tiADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q � FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� NSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
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❑INSPECTION RE�UIRED.CALL TO ARRAN(3E ACCESS.
CaN for the next inspection 24 hours in advanoe. (952) 249-4600
OwnedCqttractor on site:
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ly ❑ FOOTING OEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
�Q ❑ FOUNDATION WATERPROOF ❑ PLUMBINCa 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
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
� DEMO-SITE ❑ TIC INSTALL
2 OMIN KTRACTOR TO MEET Y�OIl:�YES_NO
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W ❑WORKSATISFACTORY:PROCEED ❑PROJECT COMPLETE
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V BEFORE CWERINO PERMANENT
O CORRECT UNSAFE CONDITION WRHIN HOURS. p p�{OTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �pTATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
CaM tor the next inspect%����advanoe. (952) 249-4600
OwnerlContractor on site: df
Inspector: �`^'
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