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Home My WebLink About2016-01069 - addn/remodel/repair , " CITY OF ORONO * 2 0 1 s - 0 1 0 s 9 * 2750 KELLEY PARKWAY DATE ISSUED: 09/13/2016 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 285 LEAF ST PIN : OS-117-23-14-0001 LEGAL DESC : AUDITOR'S SUBD.NO.203 : LOT 009 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 6,000.00 NOTE: SEPARATE PERMITS REQUIRED: ELECTRICAL(STATE) APPLICANT PERMIT FEE SCHEDULE 13936 PLAN REVIEW 90.58 PARSICON CONSTRUCTION STATE SURCHARGE(VALUATION) 3.00 285 LEAF STREET LONG LAKE,MN 55356- TOTAL 232.94 Payment(s) CREDIT CARD 1839 232.94 OWNER DAIVARI,KHOSROW 285 LEAF ST LONG LAKE,MN 55356- AGREEMENT AND SWORl�1 STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry approvals,and the State Building Code. This permit is for only the work described and dces not grant permission for additionai or related work which requires separate permits. 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 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 re uired inspections aze requested in conformance with the State Bu' ing Code.This permit may be revoked at any time for due cause. � l� �� - fsz � / % �� -� � �/ Applicant Pe ee Signature Date Issued By Signature Date � City of Orono � Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O� Mailing Address: Permit number: p7d/ —(� � (o O PO Box 66 Crystal Bay, MN 55323-00 6 �/'n Date received: 1—� ��,. � � Street Address: �$ Received by: m ti�, G� 2750 Kelley Parkway� � Plan review fee: �q �, Orono, MN 55356 �� /� kEs H ot� 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 returne . (Please print) GENERAL INFORMATION: Job Site Address: � G.��.� �• �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If yes, a special event permit is requi�ed 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/AP�LICAI�T INFORMATION: -J � Name: j �� iG��7 �c��!'1�-r��I�(/1 CT� �??�"L State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) ' r Z— ' �� Z (office) Mailing Address: Z� �, �� r��. City: � ZIP: �s� -� � 5 � S Contact Person: �� (,� Applicant is: Contract r / Homeowner (Circle One) Email and/or Fax: � � '� �'r.+..� ..0✓1 �i�.r S i C ro c � �,q,�n.c�� PROPERTY OWNER INFOR ATION: � o ., Name: � �7 YG �� /�i�Y� i Phone (day): Z — �- � ��-- �� Address: Z�2 � l,�r.v� 1 ��, i�� , S � City:�y��,�f��ZIP: �-�j��l � Email and/or Fax: �-�^ ` `�� , r ,� z, PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review& permits: �.Re-roof,as halt Re air Minnehaha Creek Watershed District MCWD p �. p ❑ Storm Damage 15320 Minnetonka Blvd ( ) ❑ Re-roof,cedar ❑ Restoration �Water Damage Minnetonka, MN 55345 0 Re-roof,other(specify) �(J Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 �Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project (excluding land) $ G��J,--- 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 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 ou refuse to su I the info ation, a licatiom m �ot be issued. ApplicanYs Signature: > - , Date: � /7 � /� �� Owner's Signature: Date: Last Updated:January 2016 � � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: �—�``' � �Ciu� /7�'�� Permit No.: Description of work: �� L��2 �' �� /� Date Rec'd: � t !G Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: � '�� " > Date Approved: C�� _ G • Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: 0 Yes '�; � No Date of Survey: Revised date(?): Landscape plan submitted? � Y�s 0 No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 0% = L.F. below grade Basement? � Yes � No, Stori � FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: F A BUILDING ON A SLAB FOUNDATION: � The distance between the lowest roposed Slab at or above grade— START WITH floor(of the basement or crawl spa e)and measure from hiqhest existinq the highest point of the roof. 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 • GABLE OR HIPPED ROOF(p'o Slab befow grade—measure (BASED ON windows): Subtract half the�istance from highest existing grade to the ROOF TYPE) between the highest point,bf the roof hi hest oint of the roof. to the low point of the co esponding If you have a... gable or hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF GABLE OR HIPPED f�00F(with (BASED ON (no windows): Subtract half • windows): Subtract,�alf the distance ROOF TYPE) the distance between the between the top ofhhe highest highest point of the roof to window and the I�i�ghest point of the the low point of the roof corresponding gable or / hipped roof • ALL OTHER IjOOF TYPES(flat, . GABLE OR HIPPED ROOF mansard,etc)'No subtraction. (with windows): Subtract SUBTRACTION Subtract the distaCce between the half the distance between (BASED ON basemenUcrawl 9pace floor and the the top of the highest EXISTING highest existing grade adjacent to the window and the highest GRADES) foundation OR]0 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined buil�ing height subtraction. Defined building height EQUALS , � Updated: October 2015 `, z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? � Yes 0 No Permit Number: � Yes � No ❑ N/A � Ye No � 0 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 0 No � Yes 0 No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit Plan Review State Surcharge Investigation Fee SAC— Number of SAC Units Other(specify) Square Foota e $ per Square Foota e Basement X = $ 1 St Floor X = $ 2nd FIOo� X = $ Garage X = $ Estimated Construction Value: $ [�(i ��v�_ Orono Inspections Required Work Requiring Separate Permits � Footing � Site ❑ Plumbing � Grading/Filling � Poured Wall � Silt Fence/Erosion Control 0 Mechanical O Fire 0 Foundation Survey 0 Hardcover Removal � Septic 0 Water Connection 0 Foundation Waterproofing � Other(specify) � Fireplace � Sewer Connection Framing � Masonry � Lawn Irrigation Insulation 0 Mfg. 0 Landscaping . � As-Built Survey � Other(specify) Final 0 La he Required State Permits 0 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. 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"�e: �� :.. -. �s, �� ✓ � � DATE TIME CITY OF ORONO cnLLED IN -�� INSPECTION OTJCE lO�g SCHEDULED PERMIT NO. � COMPLETED ADDRESS a � � OWNER HONE NO. � f � . � CONTRACTOR l � DESCRIPTION �� / ' ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL 2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ S TIC INSTALL 2 dWNERICOidTRACTOR TO MEET YCU:�YES_NO � COMMENTS: � ` �r�'f'r'Q.��ti� n� �i�TP� S'�0�1/c�/� /J1+o7b S' j _c /� , / . // / 0 U7 7"�n nn.n A a` ..�n-.C'/i�dro i.r�/� i..i..,�le� 7i5 GL7 � ,w�e� �:.s-�o.�I w�r��o .�c��' m��e� r_r� � ^,��c.r c�oo� W � Q l Zb� 7�i �'ti�1 .r�/ts ../s�-Z � W o� j ll �/ �'�RK SATISFACTORY:PROCE� PROJECT COMPLETE w��CORRECT WORK 3 PROCEED ISSUE CERTIFICATE OF OCCl1P11NCY O� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERINO PERIiAANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHpTO TAKEN INSPECTOR W{LL RETURN ❑STOP OROER POSTED.CAIL INSPECTOR ��TATION ISSUED ❑INSPEC710N REQUIRED.CALL TO ARRAN(3E ACCESS. CaN for the next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: ��«: ��c�,�l- White CaPYMnapecta's Fil� Gnary Cop�dSlb NoNa