The URL can be used to link to this page

Home My WebLink About2013-00694 - addn/remodel/repair „� CITY OF ORONO * Z 0 1 3 - PJ 0 6 9 4 * / 2750 KELLEY PARKWAY DATE ISSUED: 07/30/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3670 LIVINGSTON AVE PIN : 17-117-23-34-0031 LEGAL DESC : NAVARRO : LOT 009 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTNITY : 434-RESIDENTIAL VALUATION : $ 2,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) REPLACE PORCH IN KIND APPLICANT pERMIT FEE SCHEDULE 73.75 LARSON,MICHEAL&DEBRA STATE SURCHARGE(VALUATION) 1.00 3670 LIVINGSTON AVE WAYZATA,MN 55391- TOTAL 74.75 OWNER LARSON,MICHEAL&DEBRA 3670 LIVINGSTON AVE WAYZATA,MN 55391- 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 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 revoke t any time for ue se. 4 � ��O� � � � Applicant Permitee i nature Date Issued y S' ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED AB J�3y CITY OF ORONO ' BUILDING PERMIT APPLICATION �� , �S � FOR NEW STRUCTURES OR ADDITIONS O Mailing Address: Permit number: c� !3—��9� � �O PO Box 66 Crystal Bay, MN 55323-0066 Date received: 7-22 '�� StreetAddress:' � Received by: y�, G�' 2750 Kelley Parkwa ��j/ Plan review fee: $ �7� ! � t�kESHO�� Orono, MN 55356 �I ��3 ,�6 � 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: �Q �v i �539� Will this �e a Parade of Homes, Remodeler Showcase Home or other Dis I Home? ❑ Yes No lf yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus servic ill b required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/AP LICANT INFORM TION: Name: ��,�� ,t�'�0 iC� State License# Expiration Date: Phone: � (cell) (p/- O " N,� office S 2 - / ��Z f�-Qyrt F Mailing Address: ,�� Cit : Contact Person: Applicant is: Contractor / HOmeoW� (�irc�e one) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: `�' " � � �.�� -_��'�'_�2� Phone (day): '�=" c�Z 7 Address: � "� '� - � � Cit : � , ZIP: �- �� Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Description of project: ��'�..� 1.Type of Project 2. Proposed Use 3.Str t 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) CG� �� ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water ''"`Any earth movement may also require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeClfy) 18202 Minnetonka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $��0� , �� 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 Bidg. • c. Basement= Detached= ❑ ICF d. 15t Story = ❑ On-site Prefab e.2"d Story= ❑ Off-site Prefab �j'�:� �/�� f. '/Z Story = '�Other(please specify): / �� J7�'"� g.Total Area= r� ' REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not 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 ❑ ❑ Engineered Plans for Retaininc�Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ Application Escrow&Agreement ❑ ❑ 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 comptete application being aware that upon failure to 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 the as-built survey and all site improvements. Applicant's Signature: G'f �' Date: � /� Owner's Signature: Date: • PLAN REVIEW CHEC�CLIST FOR NEW STRUCTURES / ADD(TIONS r AddresslPermit Number: �(�� (_,.1�(1J�( 6 ST�N ��J� Description of work: �N 1G 1 N d l�Y�J i�2-�t Q t��Z.� (�-C�Nt�-�1N1�,_7'V J Septic review by: N/ A Date Approved: Zoning review by: • (�• Date Approved: Building review by: Date Approved: 7' Z-5 "' ��3 Grading review by: N(A Date Approved: oning District: Zoning File#: Reso#: Reso Date: Zoni : Lot Area: SF/AC Width: Lot Coverage: SF /o Survey mitted: � Yes � No Date of Survey: Revised date ? : Pro osed Se acks: .�'� Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Bui ngs Wetland Side Side m Defined Height: Peak Height: FFE: FFE mip�is 6 feet= (Existing Contour) �'' Perimeter(linear feet) = 50% _ #of St �es Ok? 0 YES ,�` FOR A BUILDING WITH A BASEMENT OR CRA SPACE: The distance betwee the lowest F A BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the b ement or crawl space)and the highest po t of the roof. START WITH The distance between the top of slab and If you have a... / the highest point of the roof. If you have a... • GABLE OR HIPPED ROO o . GABLE OR HIPPED ROOF(no windows): Subtract half the windows): Subtract half the distance distance between the highest poi between the highest point of the roof of the roof to the low point of th to the low point of the corresponding SUBTRACTION corresponding gable or hippe roof SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR HIPPED ROO (with (BASED ON • GABLE OR HIPPED ROOF(with TYPE) windows): Subtract hal e ROOF TYPE) windows): Subtract half the distance distance between the p of the between the top of the highest highest window an he highest window and the highest point of the point of the roof roof • ALL OTHER ROOF TYPES(flat, • ALL OTHER OOF TYPES(flat, mansard,etc:No subtraction. mansard, c):No subtraction. ADDITION Add the distance between the top of slab SUBTRACTION Subtract the stance between the BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemen rawl space floor and the STING the foundation. GRADES) highes xisting grade adjacent to the G ES foun tion OR 10 feet(whichever is less). EQUAL Defined building height EQUALS D ined building height \ Shoreland Dis ct MCWD Permit Received Avera e Lakeshore Setback t? Bluff 0 Yes 0 No 0 N/A 0 Yes � No � Yes � No � Yes 0 No � N/A Permit Number: S ack: Stor ater Quality Existing Proposed Variance Required CUP Required Ov la District Tier Hardcover Hardcover � 0 Yes � No � Yes � Type(s): Type(s): Updated: January 2013 /J I`� �' ��jU�(�S v:\forms�plan review checklist 2013.docx � v v � REMARKS (in-house): Fees to be Charged YES NO Permit � Plan Review . State Surcharge �'' ��';,;; Investigation Fee SAC—Number of SAC Units �' ' ' '` Other(specify) S uare Foota e $ er S uare Foota e Basement X = $ 15t Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ "Z,00� �� Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing � Grading/ Filling 0 Well ❑ Hardcover Removal � Mechanical 0 Fire fi 0 Electrical � Footing 0 Septic 0 Water Connection � Poured Wall � Fireplace � Sewer Connection � Foundation Survey � Masonry � Lawn Irrigation � Radon Rock Bed 0 Mfg. �Framing 0 Other(specify) � Insulation D,As-Built Survey � Final � Wet{and Buffer O Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES � NO New: � YES � NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 . v:\forms�plan review checklist 2013.docx � / � DAT � TIME � CITY OF ORONO � CA�LED IN �� —� INSPECTION�I�i _� ^,/SCHEDULED ��"�'"I_� o<, vv PERMIT NO. � �1S��CO PLETED ADDRESS � �� — OWNER c �LEP NE NO��d��"7�-.�Z-�7 CONTRACTOR � DESCRIPTION ��[�'� �� ❑ FOOTtNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERICONTAACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: � W � o _ l��v�O�I� �QC �k � c� 5!��. � v� � 1��7J�i� S S .4�.� ° ' �/'i.�/' �-' W 2 Q � �5-��9--r�' c.��-u �!'e.� � � �Jn,G.tl� �'r�Gc� zfl �a�.d�lcn�S j � � �� C� � �� /' -- GCvMM��flc�+ �v�� ❑WORKSATISFACTORY:PROCEED ROJE C PC /� w O CORRECT WORK 8 PROCEED ❑ 13TSUE CERTIFICA E O O UP NC� Y� O ❑CORRECT WORK,CALI FOR REtNSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 2a hours in advance. (952) 249-4600 OwneNContractor on site: Inspector. l� �� White Copyflnspector's File Canary CopylSite Notice