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Home My WebLink About2014-00829 - addn/remodel/repair CITY OF ORONO �Z 0 1 4 - 0 0 8 z 9 * . � 2750 KELLEY PARKWAY DATE ISSUED: 08/OS/2014 ORONO,MN 55356- (952) 249-4600 FAX: 952) 249-4616 ADDRESS : 145 MANOR CIR PIN : 04-117-23-11-0024 LEGAL DESC : COUNTRYSIDE MANOR 3RD ADDITION : LOT 1 BLOCK 1 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 90,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) KITCHEN REMODEL APPLICANT PERMIT FEE SCHEDULE 981.75 WILLETTE BUILDING CO. PLAN REVIEW 638.14 6074 COUNTY RD 6 STATE SURCHARGE(VALUATION) 45.00 MAPLE PLAIN,MN 55359- TOTAL 1,664.89 (952)472-4332 Payment(s) Minnesota State License#: BUIL-1804 CHECK 12431 1,664.89 OWNER NAFSTAD,ADAM&KRISTIN 145 MANOR CIR 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 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 in conformance with the State Building Code.This permit may be revoked any time for due cause. ��" / / A p�can ermitee Signature Date Issued By Si ure Date � Z �� CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS O Mailing Address: Permit number: � � �O PO Box 66 Crystal Bay, MN 55323-0066 Date received: !�' —�� Street Address:� Received by: �y� G� 2750 Kelley Parkway L�� Plan review fee: Orono, MN 55356 � (� �` `qkFSHO�� l/�� I• v� Totai 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: 'U U �/L�' f��' Will this be a Parade of Homes, Remodelers Showcase Home o other Dis�t y Home? ❑ Yes No 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/APPL�I,�ANT INFORMA ION: � ►vame: �t/� �� t`� ��, /cQ�N State License# 'Ub (7 Expiration Date: �D Phone: cell — J -y �C� office —� l D-- 5� c7 Mailing Address: (�D (p Cit :/Yl/� � � rJZIP: �-�"S35 }` Contact Person: r /l �?'h Te Applicant is: ontrac / Homeowner (Circle One) Email and/or Fax: �� ,� � i`[ C�-t'fe f,c-i f ce�'i✓Y , C D`�' v PROPERTY OWNE I FORMATIO�►`�: Name: �a�r�'y� /1/'A I=S-t'f�-D Phone (day): l Z—.3��-- O�`57 � Address: j�S y}'1 �N�1� r Rc,I'E' City�7/1Jq � � /�(� ZIP: �� Email and/or Fax �� ARCHITECT/ENGINEER INFORMATION: >� Name: �� Phone (day): `,� Address: City: ZI P: Email and/or Fax: � ,' PROJECT INFORMATION: Description of project: 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & Water Supply P�;; ❑ New Construction �(Single Family with �Residence ' ❑ Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ?:;';� ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation �� M v � �> detached garage ❑ Office/Commercial �Private Sewer ��Other: (specify) 1 ❑ 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: (specify) 18202 Minnetonka Blvd `'� Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ Q�� C�OC� � 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 Bldg. c. Basement= Detached = ❑ ICF d. 1 St Story = ❑ On-site Prefab e.2"d Story= ❑ Off-site Prefab f. '/z Story = ❑ Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ Permit A lication �d ❑ 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 ❑ L� Wetland Buffer Im rovement Plan ❑ � En ineered Plans for Retainin Walls 4 feet or above ❑ j ❑ Plan Review Fee ❑ �1 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 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; • 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. ApplicanYs Signature: �-��• �^ � Date: ��f �l � Owner's Signature: Date: ��.� �� '�� d�cesslPerrn�t t��rnb�r:_ �� -r�.� Descrb�afion of�r�rk: ��C'�-P�i�J �1..�^O t,�.t.� Septic cevieHr i�y: �/S� D�te�►pprmv�d: Zor�ing eevi�w bY: � � Date Qpproved: Building e�view b�►: Date Approved. �'��'?�/y Gr�cliRg reviev�►by: �/� Dat�ApprovecE- Z in� Dpstrict: ZoRing F�{�#: Reso#: Resa Date: Zonin�: /�rea: SF/AC �'icith: �Qt Coverage: F _% S�rvey�ubrni C�Yes E� No Date ofi Sunr+�y: Revise ate ? ; Pra osec� Setback�: Frcnt(Lake) R� (Street) � � � � � � ( � S E � ) Qt e�Bt�Eldings We�tand �id� Sit�e aefin�c! F�eEght: P�ak ight: FFE: FF minu� 6 fe�t= (Existing Contou P�rirn�t�r(firtear teet)= 5a°o- # Stor�es Ok? �YES FOR A BUILDIkG WITH A BI4SEIIfiEkT OR CRkYVL SPACE: The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATtON: START WITH proposed floor(of tMe basement or apace)and the fiighest poinf of the roof. The distanee between the top of siab an START WRH �e highest poiM of the roof. If you have a... If you have a... • GABLE OR HIPPED ROOF(no . GABLE OR HIPPEb ROOF(no windows): SubUad hatF the windows): Subtract half the distan distance between the highest p nt between the hi hest of the roof to the low point of e 9 point of the rc SUBTRACTION corcesponding gable or hip d roof to the Iow point of the correspondii SUBTRACTION gable or hipped toof (BASED ON RbOF . (',qg4E OR HIPPED R F(with (BASED ON . GABLEOR HIPPED:ROOF(with TYPE) windows); SvbtracYh the ROOF TYPE) windows): Subtract helf the distan distance between t top of the between the top of the bighest highest window a tfie highest window and the highest peint of th point of ihe roof. ruof ALL OTHER OF TYPES(flat, • ALL OTHER ROOF TYPES(flat; � mansard etc:No subt[adion. mansard,e :No subtracFron. qD ION Add the distance between the top of sia' SUBTRACT�ON Subfract the di nce between the (BASE ON and the hiphest ex�s6ng grade adj8cant (BASED ON EXISTING �S°�� space floor and the EXISTIN fhe found5tion. GRADES) highest eb ng grade adjacent to the GRADES foundatio OR 10 feet(whichever is less). EQUAIS Defined bullding heigM EGUALS 13efin buiiding heigM Shor�l�ncf t3istr�ct t�iCIMD Perm��Receivecl Aver� e Lakeshore Setback Niet? Bluff t� Yes � t�o C3 �/A Yes C! N� � Yes No � Yes E� Na 0 N/A Permit Number: Setba • St�rr��ra r(��airt�r ` ExcsYi�n� �ro�o�ec� �ariar�ce Requicecf CUP �ec{�ired ��erta istrict Tier i��rdcQder liardcov�e 0 Yes C] No !� Yes E1 No Type(s): Type(s): Updated� January 2013 v:\formslplan review checklist 2013.docx REf►��FtKS (in-house): fees to b� Char ed YE� 1�� . gea'rrnt� . Plan RevieHr St�#��ut�ch��e a�" Investigation Fee SAG-N�t�3er tt€�R�t��ts Qth�r(specify) 1/� S uare Foota e S er S uare Foota e Basement X ' � 1$`Fioor X = $ 2"d Floor X ' � Garage � - $ Est�mated Construction V�lue: ��,,f�,!' �l��' Oro�o Inspections Required� l�Ilock Requiring Separafe Permits Required State Permits C� Site Plumbing C7 Grading/Filiing � e8 � Hardcover Removal Mechanical 0 Fire Electrical t� Footing f� Septic {� Water Connection Q Poured Wail Q Fireplace � Sewer Connection [1 Foe�nciation Survey Q Masonry Q Lawn irrigation t� Radon Rock Bed � �f9• Framing 0 Other(specify) Insulafion C� As-�uiit Survey . Final O Wettand Buffer [7 Other(specify) I�E�AaRKS (in-house): Othec Reviev�: Review�d by: Date�►p�sroved: Acce�s: Existing: t� YES � I�O l�ew: Q YES t� NO OFFiCtAL t�Efit�tAmRK� -T�BE h4TEd Ot� E�E�ft�{T ANQ thl1TlA�L�Q Updated� January 2013 v:\forms�plan review checklist 2013.docx �� E � Y CITY OF ORONO CALLED IN ��I �� INSPECTION TI E SCHEDULED � � PERMIT NO. � � ZQ COMPLETED ADDRESS �� r ,�,/� OWNER , TELEPHONE NO. � 2'�`�� CONTRACTOR ��1 �� Cd � DESCRIPTION I`"rGt r"`a.'`3 � � ❑ FOOTING ❑ PLUMBING FINAL O EXCAV/GRADtNG/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWEfLANDS y FRAMIN ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB � WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP � ❑ DEMO-FtNAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMM ENTS:� .�•f-C�� re�e.aQ�.L ' � a - /I Gcc� w�K�o WS '� � /►e w ��.�e� oQ��o Boa r - /��.� ��,E,,t - � C-/��f��c�c �� — ��C �_ � ' /D Ir/l!llba+�J I�t,O�+tt.•r�.i.�� - S`�M t s�Lc. - Q Stwte Sty�� — ��4�'ti �2u��. r�d/,�tc.�t�� - l�•�.� fl�s��K �arn��v- cafC✓tav 54/C s•�i��. � �/iS�s`� ' Dl�. � �h.�s�(. I/.f-�Or ,b•Err�e,. �' jCt�i�G G/�iw�'*�/�✓�vl4�d � ��t� �LG�/a✓ W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � /'�QARECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O��O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the n xt inspection 2a hours in advance. (952) 249-46�� Ow ontractor on site• � Inspect . �� White Copyllnspector's Flle Canary CopyfSite Notice � DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO.'n/�r- �d So"t9 COMPLETED o� '�'�b ADDRESS �� 4�0�'' C,� � OWNER _ TELEPHONE NO. CONTRACTOR wi/�� Q�s . � � � DESCRIPTION �.'��n ��'+'�� I~a� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q �FINAL ❑ WATER HOOK-UP ��OLLOW-UP 4! ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEEf YOU:_YES_NO y COMMENTS: ��'•w�t 11 J r�e� �..�7�•.A Z� c t�r � ' a .�� ,y�••�t.E� /✓�v/deG�ia.-i o �/c. F..�G - /a � �� /� L�/��.F..a. � '' �O d vl¢— �s-.�.� . � � 0 � W Q �e44iS G G'a,/C D/o�C� C r�c� �t 4 �� 1'� .scii�.Ptil�e a ��iL i�s�e�a� a W LL. � � �f �il� � C`fZt� .liG B.S-- -�G�'f•S - W � � � d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOfi �CITATION ISSUED INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (952) 249-4600 OwnerlContractor on site: Inspecto �� ^-� � ° White Copyllnspector's File Canary CopylSite Notice