HomeMy WebLinkAbout2014-01321 - addn/remodel/repair e �
CITY OF ORONO * z 0 1 4 - 0 1 3 2 1 *
2750 KELLEY PARKWAY DATE ISSUED: 1U12/2014
ORONO, MN 55356-
952) 249-4600 FAX: 952 249-4616
ADDRESS : 1820 LAKEVIEW TER
PIN : 27-118-23-42-0012
LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN
: LOT 007 BLOCK 001
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 3,000.00
NOTE:
REMOVE WALLS AND ADD BEAM
APPLICANT PERMIT FEE SCHEDULE 88.50
STATE SURCHARGE(VALUATION) 1.50
RASKOB CONSTRUCTION LLC TOTAL 90.00
2864 ARDMORE AVE Payment(s)
MEDINA,MN 55340-
(612)865-9607 CHECK 16753 90.00
Minnesota State License#: BUIL-BC003481
OWNER
KOKESH,JAMIE
1820 LAKEVIEW TER
LONG LAKE, MN 55356-
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 dces
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 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested i rmance with the State Building Code.This permit may be
revok t any ti e for due use.
� -�.��l� /� //Z / /
pplicant Permitee Signature Date ssu By Signature Date
� City of Orono
Building Permit Appiication for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
�O�O Mailing Address: Permit number:
PO Box 66
Crystal Bay, MN 55323-0066 Date received:
Street Address: Received by:
y � 2750 Kelley Parkway Plan review fee:
`�t �,L Orono, MN 55356
`4KESH�� 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 prinf) �
GENERAL INFORMATION: , �� � A f� ,c U C�jl� �/�,�(r�,.� L G�/�.� �j,.,
Job Site Address: I �� ,lz �—SL�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �';No
!f yes,a specia!event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus s�rvrae wil!be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events wil!not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: L�R C�/ �'_� � �- ��i ��«�.� /.� � ��S�Gc�� �e�'=�,5 �_ � �-�,
State License# p� j ��� Expiration Date:
Lead Certification Number: Expiration Date:
(for work on i►omes that were constructed prior to ?978 l �
Phone: (cell) � —� ' - �' �� �7 (office) �/ �� — �
Maifing Address: � /, �,ti City: ,/►,�,, ZIP: ;� ��j �
Contact Person: �Q � r�i3 Applicant is: Contractor / Homeowner (CircleOne)
Email and/or Fax: � ��+ ��,-j� � [,� �;�� �,5 % . G C� j�✓')
PROPERTY OWNER I ORMATION: l
Name: �/a N ,l-,..� v►-� /►'� �-2_. l�. �l��j
Phone (daY): 7= `� .i " / �� � �J����.
Address: () �, 1� ,,� ��. City:Gl� ' L���ZIP:
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
'�ype 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)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.or
Estimated Construction Vafuation of Project(excfuding land) $
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 altemative 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 information which generally cannot be given to either the public or the subject of the data. Our purpose and
intended use of this infor ' n is to annually update: records and records of other governmental agencies required by law. If
ou refuse to su f th mfo ation,th`e licatio n be' sued.
Applicant's Signature: .cn-c � -� Date: � �� �-�
OwnAr's Signature: Date:
Last Upciated 03/06/2013
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de�cr@p�ian �f wark: �:vv�.� w�..�.S s'�n� ���.
SeptEc r�view bb: /�!/� Q�mt�f�pproved:
Zonir�g re�sie�w b�: N ( Daf��ppreved:
�uiic�ir�g eevievr��. �ate Approved: i I-�2- 7.c�/`j°
Grac#ing reviev�r by: /� //.l d�te Approvec�:
ZORI�ig DIStPICf: ZOt1iR� Fil@�: Reso#: �eso Date:
, ZonEro • Lat Rres: SF/AC �iclth: Lot Coverage: SF %
S�r�ey S mitted: E�Yes � No Da�te of Survey: Revised date(?1�
t�ro osed S�Y cks:
Front(L�ke) F�ear(Streetj f � � � � ) ! � S E � ) Ott�er��ildi��s �'etlan�f
S€tie Side
D�fEne� Hef�ht: eak HeEght: FFE: FFE mirrces 6 feet= (Existing Conto�
Perimeter(ti�ea�fee�j= s0%_ �ef Stoe€e� Ok? �YES
�OR A BUILDING!`dITH A BASEMEkT OR CRAViIL ACE:
The distance between west FO A BUI�QING ON A SLAB FOUNDATIONl:
START WITH proposed floor{of the base t or cranA
space)and the highest point roof. START WITH The distence between the top of slab arn
If you have a... the hf9hest Poirrt.of tlie roof.
• GABLE OR HIPPED ROOF(no 1f you have a...
windows): Subtract half the • �B�E OR HIPPED ROOF(no
winEows): Subtract half the dfstam
distanee between the highest point between the highest poiM of the ro
of the roof to the low point of the
SUBTRACTION aorresponding gable or hipped �t���PaM of the correspondir
(BASED ON ROOF SUBTRACTION gable or Mpped roof
TMPE� • GABLE OR HIPPED ROOF( (BASED ON . GABLE OR HIPPED ROOF(with
wfndows): Subtract halt th ROOF TYPE) windows): SubtraCt half the distarn
distance between the top the between tl�e top oi the hiphest
highest windowand th ighest window and the hi�hest poirrt of tt��
point of the roof roof , :
• ALl OTHER RO TYPES(flat. • ALL OTHER ROOF TYPES(ilat,
mansard,etc): subtraction. mansard etc:No subtracfion.
DITION Add the distanee between the�op of alat
SUBTRACTiON Subtracf the dista between tho D ON and the highest exfsdnp grade adjacerrt t
(BASED ON EXiSTING ��nUcra ace floor and the EX� G the foundatlon.
GRADES) h�H�ebsti grade adjacent to the GRADE
foundation 10 feet(whichever is iess). EQUALS Deflned building heigM
EQUALS Defined uilding height
Shoref�nc� district !'�CWD Pertnit Reaeivec� �,vera e:Lak�share Set@ack Met� B[ufF
Q Yes � No � R�/A 0 s � Nc
� Yes t] o C� Yes Q No 0 N/A
Permit Number. Setback:
Starr�v�at�r Q�altt� Exi�Yire� i�ropQsec� �r��xnc� Rec�uired CUP Rec�uised .
�verla District Ti�r Ft�a�coder Fiarelcaver
0 Yes Q f�o Q Yes � No
Type(s): Type(s):
Updated: January 2013
v:\forms�plan review checklist 2013.doac
REi,�ARKS (in-house):
F�es�o b�Ghar ecf �°�� ��'
����
���Ft ��4'L@Yi
�'ta���rc�as�e ,�
lnves�igation Fee
�AC—�tu�ber�Sa4C t���s
oth�r(specify)
S uare Foota� e $ r S u�re Foota e
Basement X - $
1�Floor X $
2"d Floor X = $
Garage X - $
Estirnated�Corestruction�alue: � �i,�v o �
Orono lnspect�orrs Required lAlork Requiring S�parate Permits Required State Permets
� Site � Plumbing E� Grading/Filling C3 Well
� Hardcover Removal � Mechanicai � Fire � Electrical
L7 Footing [7 Septic C7 Water Connection
O Poured Wall � Fireplace 0 Sewer Connection
� Foundatior�Surbey � Masonry � Lawn Irrigation
t� Radon Rock Bed E7 Mfg.
,�raming C� Other(specify)
Q Insulation
p As-Built Survey
.e!''Final
[7 Wetland Buffer
� Other(specify)
REA�ARKS (in-house):
Other Review: Revie�rred by: Date Appravecf:
Iff►ccess: Existing: Q YES 0 1�0 I�ew: � YES Cl NO
OFFiCIAL ftEAAAE�K�-TO BE [�OTED OEE RER[�iiT APlD iNlfTt1�LLED
Updated: January 2013
v:\forms�plzn review checklist 2013.docx
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CITY OF ORONO CALLED IN /� � ��.
INSPECTION O IC�/ SCHEDULED � �
PERMITN����`�-D`i�� COMPLETED
ADDRESS �d � LK���l���L l p
OWNER TEL PHONE NO. ` o S D
CONTRACTOR
�; DESCRIPTION f
�
ly ❑ FOOTING O PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ IAKESHORE/WETLANDS
�
Q�EBAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED ROJECT COMPLEfE
w ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca ' s ion 24 hours in advance. (952� 249-46��
Ownerl ontr or on site: • �
Inspector. '''�
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