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Home My WebLink About2009-00631 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2009-00631 � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuED: 10/05/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 3438 LYRIC AVE PIN : 17-117-23-43-0077 LEGAL DESC : NAVARRE HEIGHTS : LOT 023 BLOCK 005 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DECK ATTACHED ACTIVITY : 434-RESIDENTIAL VALUATION : $ 6,500.00 NOTG: HANDICAP RAMP APPLICANT pERMIT FEE SCHEDULE 147.50 S B CONSTRUCTION STATE SURCHARGE(VALUATION) 3.25 49 7TH AVE S TOTAL 150.75 HOPKINS, MN 55343- (612)251-6256 PAID WITH CASH 150.75 Minnesota State License#: 20630224 OWNER HUDLOW, LOIS 3438 LYRIC 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 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 da[e of issuance,or if consVuction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in contormance with the State Buyl�ing Code.This permit may be revoked at any tima'for du�cause. �� =� ;%i' /� 'j / / �%�' '� � ��.. . � - l�� Q5�0 �p ant Y�rmi't—'S g ature Date Iss e y Signature Date SEPARATE PERM[TS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � ' ' �E�EIVED �o� City of Orono SEP 2 4 2009 �� Buildin Permit A lication ��-�rY caF oRot�n J pp for New Structures or Additions Mailing Address: Permit number: �(� — d 1 �,0,j� PO Box 66 O O 1 Crystal Bay, MN 55323-0066 Date received: � � � � ,� � '�� Received by: ' .��,� �, ; StreetAddress:' '$'�,c, '��::0_ �ti� 2750 Kelfey Parkway Plan review fee: , '�� F��4� Orono, MN 55356 aQ _ ,;� � kE5H� 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 prrnt) GENERAL INFORMATION: Job Site Address: �_�/�g L yric �-,r e Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [�No If yes, a specia/event permit rs required with Police Department and City Council approva/60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates suffcient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �I��.,P �«�r��,F State License# � o.v o Z 2�� Expiration Date: Phone: z - -6 2 S� office cell Mailing Address: y 1h S Cit : �, �, ZIP: S — z Contact Person: Applicant is: ontrac / Homeowner (Circle One) Email and/or Fax: ,�i S�( _ ,,� y�,G ,`o„ �g �j G,/hR,'f..Go�1 PROPERTY OWNER INFORMAT4ON: Name: �o i 5 ��,d�e c� Phone (day): Address: �Ll�g L�,y;G �,�, City: (jro.�cu ZIP: �S ��i / Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3. Structure 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) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water "`'`Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (Specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Vafuation (excluding land) $ � SOU Last Updated: 6/22/2009 - 19 - STRUCTURE INFORMATION: 1. Structure Dimensions 1.Structure Dimensions (continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame ❑ Masonry b.Width (ft.)= Number of garage stalls: ❑ Metal Attached= ❑ Pole Bldg. Areas in spuare feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 15t Story = ❑ Other(please specify): e. 2"d Story= f. '/Story = g. Total Area= � REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: N ot Enclosed Ap licable � ❑ Permit A lication � ❑ Pro osed Buildin Plans � ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form � � i Surve meetin all re uirements � ❑ Stormwater Foilution Prevention Plan � ❑ Hardcover Calculation s � ❑ I Se tic S stem Site Evaluation Re ort � ❑ Access Permit � ❑ Wetland Buffer Im rovement Plan � � En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee � ❑ ❑ Other APPLICANT 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 complete 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; • 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 generalfy cannot be given to either the public or the s�bject 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. r;� C� Applicant's Signature: Date: ( — �Ll U 9 Last Updated: 6/22/2009 -20 - Plan Review Checklist for New Structures / Additions ,..e Address/ PID/ Legal: � �� L, Description of work: Septic review by: � Date Approved: `�',� ;� —� `�j Zoning review by: Date Approved: Building review by: ��%� Date Approved: l C-' ' 0 '��( Grading review by: Date Approved: Zoning File#: Resolution#: Resolution Date: Zonin District Fire Department Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: 0 Yes 0 No Date of Survey: Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Building Defined Height: Building Peak Height: #of Stories Ok?: � YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl START the distance between the slab and the highest space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line of a the deck line of a mansard roof,or the mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type or other arch-t e roof roof SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest window hi hest roof eak of a itched roof and hi hest roof eak of a itched roof SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet, whichever is less. EQUALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: SF % Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff � Yes ❑ No � N/A 0 Yes � No � Yes 0 No 0 Yes 0 No 0 N/A Permit Number: Setback: Hardcover Zones Existin Proposed Variance Re uired CUP Re uired 0-75' � Yes ❑ No � Yes ❑ No 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Char ed YES NO � Permit Plan Review State'Surcharge : Investigation Fee SAC-.Number of SAC:l�nits Sewer Connection Water-Connection < Park Fee Site Inspection,� Other(specify) Miscefianeous Fees Calculated By: S uare Foota e $ er S uare Foota e Basement X = $ 1 gt Floor X = � 2nd Floo►' X = $ Garage X = $ Estimated Construction Value: $ Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing � Grading/ Filling � Well � Hardcover Removal 0 Mechanical C Fire � Electrical 0 Footing 0 Septic 0 Water Connection � Poured Wall � Fireplace � Sewer Connection � Foundation Survey 0 Masonry 0 Lawn Irrigation 0 Radon Rock Bed 0 Mfg. 0 Framing � Other(specify) � Insulation 0 As-Built Survey 0 Final � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES 0 NO New: 0 YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\formslplan review checklist.docac � � <T�' TIME � CITY OF ORONO CAL� �� /� ��- INSPECTION �1IO��'i� �6 L�/ SCHEDULED Q O7 '"d�.7� PERMIT NO.�J �/ COMPLETED ADDRESS ,Q OWNER CONTR. cS rCJ (�L� AK TELEPHONENO. P� - a`5/ - �dS� � � � D,ESCRIPTION �O� � ��FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOFi TO MEET YOU:_YES_NO � COMMENTS: � W a � J O a� /�I�.�—��.—�f'�] �.� O � W � Q � 2 W � W � � � d WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETItRN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTIONREQUIRED.CALLTOARRANGEACCESS. Call forthe next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor ite: Inspector. ,h, White Copyllnspector's File Canary CopylSite Notice �— D TIME � CITY OF ORONO CALLED IN '�� INSPECTION NOTI E SCHEDULED ' -�� PERMIT NO. AO ' rv3 � COMPLETED ADDRESS OWNER CONTR. � TELEPHONE NO. ��Z T7 Z �-f�7��Z � DESCRIPTION FI. � � ❑ FOOTING ❑ MECHANICAL RI EXCAV/GRA ING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT v ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: s W a � � O � � O � W � Q � Z W � W � � � � ❑WORK SATISFACTORY:PROCEED �RROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTiON TEMPORARY V BEFOREC�/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL tNSPECTOR ❑ CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/ConUactor on site: r Inspector. White Copyllnspector's File Canary Copy/Site Notice