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Home My WebLink About2014-00088 - addn/remodel/repair e „ CITY OF ORONO * z 0 1 4 - 0 0 0 8 B * 2750 KELLEY PARKWAY DATE ISSUED: OZ/07/2014 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 380 LEAF ST PIN : 04-117-23-23-0027 LEGAL DESC : AUDITOR'S SUBD.NO.230 : LOT 026 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALLTATION : $ 15,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) 2ND FLOOR REMODEL APPLICANT PERMIT FEE SCHEDULE 265.50 PLAN REVIEW 172.58 THOMAS BREN HOMES STATE SURCHARGE(VALUATION) 7.50 2073 WAYZATA BLVD. W.#50 WAYZATA,MN 55391 TOTAL 445.58 (952)475-6777 Payment(s) Minnesota State License#: BUIL-BC128144 CHECK 14350 445.58 OWNER BURKE,FORREST&RENEE 380 LEAF ST 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 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 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 in conformance with the State Building Code.This permit may be revoked at any time for due cause. �- ? / i/ Applicant Pe ee Signature te Issu By Signature Date � � - City of Orono i�35� � Building Permit Application for Maintenance / Replacement / Renovation � � (No structural expansion. Only windows, doors, siding, re-roof, e c.) � � � Mailin�g�Bd�dre�s�s: Permit number: �� p � � � �0 Crystal Bay, MN 55323-0066 Date received: �ao� ' :�: � Street Address: Received by: �� , � 2750 Kelley Parkway Plan review fee: � �,�' Orono, MN 55356 ,t: `'�kFSHo� �� 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: � �'��% ��- S"� . � Will this be a Parade of Homes, Remodelers Showcase Home or other Display 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/APPLICANT INFORMATION: Name: -�-��n1vt�-3-5 �S�:ct�l �:✓L (�z S , 111�C�- � State License# j�C� �� c..�.�..� Expiration Date: 3--�( _ j ,.f � Lead Certification Number: �� Expiration Date: � �(for work on homes that were constructed prior to 1978 ; Phone: (cell) (p I Z- ��°j- �-j�( U (office) Cj�� - �-f 75 -(��7�7 � Mailing Address: �v � �,}!f- ,q-r/� �.',� �-„� �S'` City: �o � �� ZIP: �'S j� � r:i Contact Person: �� a� . �'� �y Applicant is: ontracto / Homeowner (Circle One) � Email and/or Fax: / T� — '� �h/��d � ��Afy7�r� 5 /J/"t>� i"[a�?PS. L��/h � PROPERTY OWNER INFORMATION: � Name: ��1��YC_ � �/�,?rz s � j Gt��- � Phone (day): ` i� Address: ?�(� L�-,¢�- �j_ City: G;;�p,,�M� ZIP: c�� 7� (� � Email and/or Fax: ��Z,�� 2 G �5N� GD/�- � z; �: PROJECT INFORMATION: Overall pro"ect description: ;� Type of Project: Any earth movement may also require ' ❑ Door(s) ❑ Remodel MCWD review&permits: ❑ Fire Damage � P1�' Minnehaha Creek Watershed District(MCWD) � ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage � 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.orq �s, Estimated Construction Valuation of Project(excluding land) $ /`S ,L2'��G �' � � ,;, �- 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 � �;y solely responsible for submitting a comptete 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 govemmental agencies required by law. If � ?� ou refuse to su I the i tio ,.the a ication ma not be issued. � ��± ApplicanYs Signature: � Date: �� "-/j� � #�� / �'�� Owner's Signature: U Date: �� Last Updated:03/06/2013 ' ��, � �'?� k_ _ _ �.,�a �� F �� Ad�fresslPermi�{�umber: � � _ ��"'��= � Descriptio�of v�ork: L a� � ' � �: (�� i�,l�^^3�'J l-;C� Septtc review by: _fV/� Date Approved• Zoning review by: hJ /i _ Date Appcovecl: _ Builc�� review�by: " Date Approved: /-z�i - t Grading review by: N/�` Date Approved: Zoning District: Zoning Fife#: Reso#: Resa Dat : . 2onin • Lot Area: SF i AC 1Ntdth: Lot Coverage: SF % Survey Su itted: Q Yes � No Date of Survey: Revi da#e? : Pro osed Setb ks: Front(Lake) R�ar(Stree�) � � S E W ) { N S E 1R� j pt Builclings IM�tland Sicte Side Deftned Height: �ak Heigfit: ��E: FFE nus 6 feet= (Exi�ting Contou� Perimef�er(linear feet)_ `�0"/0= #of S rie�s Ok? Ct YES � FOR A BUILDING WITH A BASEMENT OR CRAWL SPA : The distance between the i � A BUJLfliMG ON A SLAB FOUNDATION:` START WITH � proposed floor(of the basement or ` wl space)and the highest poinE ofthe STAR7 WITH T�distan�bet�reen the top of slab and It ou have a..: the highest,point of the roof. Y If you have 8... • t3ABLE OR HIWPED BOOF(nb . GABI,E ORHIPPEp ROOF(no windows): Subtract half the windows): Subtract half the tlistanc distance between fhe highest pciM between the highest paiit of the roc of the rooi to 1he low point of the SWBTRACTION corresponding gabie orhipped ° ��A�Pant of the�mespondirn ' SUBTR�CTION gable or hipped roof, ��D ON ROOF G,qBL�OR HIPPED ROOF � (SASED ON . fl�ABI:E i7R HIPF��p 1?OOR(with • windows): Subtrad half ` ROOF TYPE) windoNrs): Su.btract h�H the distanc distance between the of the _ befinree�l the top of the highest h�hest window and highes� wirxlow and the highest poiM of Me point of the roof roof • ALL OTHER R TYP£S(flat; - • ` ALL QfiHEft ROOF TYPES(flat, �me�nsard,etc): o subtradlon. mansard et�:No subtract�n. ADDRION Add fhe distanc�DetweBn.tMs Wp of alab Subtrad fhe dis between the - SUBTRACTtON t '� (BASED ON and l41e hlgtlest e�dsUng grade edjacent U (BASED ON EXISTiNG �s�^y� Pace floor and the EXISTING the foundation.' GRADES) highestexisti 9radeadjacenttothe� GRADES , : .. ,, toundation 10 feet(whichever is less). EQUALS netl buiWing hetght EQUAL$ -0etined iiding height _ Shoreland D�strict fiACWD Permit Recei�iec! Avera e Lakeshore Setback Met? tuff `_ L7 Yes G7 No : t'� N/A : L� Yes n No G Yes � ' ' G Yes Q No � N/A Perm�t Number. � Setback: Stormwater a[ity Existing I�ropo$ed �ariance Required CllP Required Overla Distr ct Tier Ftardcover Hardcover t� Yes [7 No Q Yes t� No ' TYpe�s)� TYPe(S)� Updated: January 2013 v:\formslplan review checklist 2013.docx � � ��`6�� REF�IARKS(in-house): Fees to be Char ed YES IV� Permlt :+/ Plan Review State Surcharge � - ---------�-- nves iga on ee---- ----- --- --- --�----- SAC-Number of SAC Units Other(spectfy} - S uare Foota e $ er S uare foota e Basement X = $ 1s1 Floor X - � 2nd Floor X - $ Garage x - $ Estimated Construction Value: S /��'� Orono Inspections Required ItVork Requiring Separate�ermits Required State Permits G Site ,p�Plumbing � Grading/Filling L7 Well O Hardcover Removal �Mechanicai G Fire ll�lecfica) . 0 footing 0 Septic � Water Connection � Poured Wall G Fireplace 0 Sewer Connection G foundation Sunrey O Masonry G Lawn Irrigation � Radon Rock Bed G Mfg. �'Framing [] Other(specify) f�'Insulation L1 As-BuiitSuwey ,�'Finai G Wefland B�ffer G Other(specifY) REMARKS (in-house): Other Review: Reviewed by: Date ApproVed: Access: Existing: � YES t1 NO New: 13 YES C7 NO OFFICIAI REMARKS-TO BE NOTED ON PERMIT AND 1NITtALLED Updated: January 2013 v:lformslplan review checklist 2013.docx � � Q�� DATE TIME � CITY OF ORONO CALLED IN - INSPECTION NOTICE HEDULED /O.' d-� PERMIT NO. � �� LETED ADDRESS OWNER TE PHONE N �"� -3 CONTRACTOR — � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z �NSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP = 0 DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI O SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � -�o� U. / ✓ e ►�.t.a�P�! a _��,5k l�a w - 0 2- ��' �var�s - /� -38 � c� >�l,�s � �. / . _ ��c � � - !/Q.OQ �' /7a r r' � �r- O n � - �.. G r! s �.�Eco:cs - 5 et <a� - W � Q z D !� �— C'l�v� ✓ W � W � j W./'�.�BfGRKSATiSFACTORY:PROCEED ❑ PROJECT COMPLETE � � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-460� Ownerl tractor on sit • �f�o� Inspector. � White Copyflnspector's File Canary CopylSite Notice � � / c� DATE TIME V CITY OF ORONO CALLED IN Z I � INSPECTION NOTIC SCHEDULED - / : PERMIT NO -�� COMPL ED ADDRESS � L-� ��✓�� OWNER TELEP NE NO.�°1-�39 l$�3 CONTRACTOR � � ��Y�- � DESCRIPTION � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y O FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL ZO INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SIAB O WATER HOOK-UP ❑ PROGRESS � 0 FINAL ❑ SEWER HOOK-UP O COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v � PLUMBING RI O SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YiOU:_YES_NO c� COMMENTS: � a j 0 � 0 W � Q � 2 � W � j d W� KSATISFACTORY:PROCEED ❑PROJECT COMPLETE W CORRECT WORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ RRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952) 249-4600 OwnedContractor on site: Inspector: White Copyllnspector's File Canary CopylSite Notfee �e� � DATE TIME CITY OF ORONO CALLED IN a.7 INSPECTION N TI SCHEDULED - �D.'On PERMIT NO. �� r'��COMPLETED ADDRESS �� " � OWNER TELEPHO NO.�P�a g3'�l I S�D�J CONTRACTOR � DESCRIPTION ��'� �` � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FIWNG Q ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB O WATER HOOK-UP ❑ PROGRESS � FINAL ❑ SEWER HOOK-UP ❑ COMPUUNT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i � DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVEH REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERfCONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: UD�c '� �c V�-( �'¢rK a�( a Sw��.s - 6� j Eq��.fS �l� O � �'�{��f•�� .� ,,,�� - 7-/�r -�4 ° � t( w or 1` c d,...e l-��,r W � Q � W � W � j � ❑WORKSATISFACTORY:PROCEED �OJECT COMPLEfE � ❑CORRECT W'ORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COA/ERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for ion 2�ours in advance. (g52) 249-4600 ctor on � Inspector: Whits Copyllnspector's File Canary CopylSfte Notfes