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Home My WebLink About2014-00018 - addn/remodel/repair CITY OF ORONO * z 0 1 4 - 0 0 P1 1 B * 2750 KELLEY PARKWAY DATE ISSUED: OU2l/2014 � ' ORONO, MN 55356- 952 249-4600 FAX: (952) 249-4616 ADDRESS : 2610 MAPLERIDGE LA PIN : 21-117-23-21-0009 LEGAL DESC : REG. LAND SURVEY NO. 1468 ; LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 24,740.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,ELECTRICAL(STATE) BATHROOM REMODEL APPLICANT PERMIT FEE SCHEDULE 413.00 DOUG DZURIK CONSTRUCTION STATE SURCHARGE(VALUATION) 12.37 1700 NIAGARA LN N TOTAL 425.37 PLYMOUTH,MN 55447 Payment(s) (612)221-2431 �� 7104 425.37 GC_ Minnesota State License#: BUIL-BC062372 OWNER FESLER&JANE ZELETES, DANIEL 2610 MAPLERIDGE LA EXCELSIOR,MN 55331- 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 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 I80 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. � . ;� � / / App i n erm' Signatur Date Issued B gnature Date Cit of Orono � `��-s�7 Y Building Permit Application for Maintenance / Replacement / Renovation � - (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O� Mailing Address:-�y � � Permit number. pZ0/�- dU� �!� �` O PO Box 66 i..1 b -t� ,�' Crystal Bay, MN 55323-0066 Date received: �` 7—�J'C Street Address: Received by: � �� y � 2750 Kelley Parkway Plan review fee: � �ow � F �, lqkFSH��, Orono, MN 55356 ��-�/-7 � o2D � �� 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: -�t�•��^ 4� �� - � (�i/�ti�!`G � Will this be a Parade of Homes, Remodele Showc� e Home or other Display 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/AP LICANT NFORMATION: "� �q Name: � {� �Z/i�'� �Dr S� _ � C �i � 1 ir�e r ro�'l s.k� State License# �� 3� Expiration Date: �-� -�p� R� Lead Certification Number: ,� i - � Expiration Date: � �f� - (for work on homes that were construc e prior to 1978 � Phone: (cell) (p�a -��J �� (office) �� .� Mailing Address: / a 3 � � c�ty: z�P: ssy �_; Contact Person: , Applicant is� ontra or / Homeowner (Circle One) �`� Email and/or Fax: � . �:� _ � PROPERTY OWNER NFORMATION: Name: .�Qh c2h ��vl� t�S�� Phone (day): � Address: ��f � � l �_ City: ��'�-r� ZIP: �� Email and/or Fax: � � ��: ;�� PROJECT INFORMATION: Overall project description: � �.; Type of Project: Any earth movement may also require ;� ❑ Door(s) �"Remodel ❑ Fire Damage MCWD review&permits "� ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) �; E�` 18202 Minnetonka Blvd � ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 � Phone: 952-471-0590 �� ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) �� Fax: 952-471-0682 • ❑Window(s) www.minnehahacreek.orq � .;� Estimated Construction Valuation of Project(excluding land) $ ` � � � ::� APPLICANT ACKNOWLEDGEMENT: ':� • Agrees to provide all information required or requested by the Building Department; �f,�� • 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; �i • 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 information, the a lication ma ot be issued. ApplicanYs Signature: � � Date: I Owner's Signature: Date: - Last Updated:03/06/2013 -rr.-"a . _ _ �u�a4 ��t�,� �� e 6`��E� �� E ��`t�� Adc�ee��IPer�nt�i�c�mber:_ Zbl � M i'�tPLCfZ��a�= �¢-�t'C:+r Q�scription ofi wrark: -___ ds.�fr7�!-s �t.o o� 1,�� eptic review lay: /U//� Qate apprav�d: Zoning ceviev�by: �l/}' Da��ApprovecE: Buiidi�g review by: Qate ARpro�eed:_d : �a �2of� Gradi�eg review by: �//-� Date l�pproved: Zo 'r�g Dis#rict: Z�ning Fife#: Reso�: Reso Date: Zdr�[n . ot/�rea: SF/AC lMfc�th: Lot Ccv�t^�ge: SF _% Surv�y Su Ittecl: Q Yes Q No aate of Survey: Revise date? : I�ro o�ed Seth s• Front(tak�) Rear(Stre�t} ( � S E lh� ) ( 6V S E 1tN ) Qthe ulic�ir�g� �'et�ar�d Sicf� Sicie �e�e�ed i�et�ht: ak Ft�ight: FFE: fFE rni s&f�et= (ExEstin� Contoui Perirr�eter(Einear feetj= 4%_ #of�to es Ok� !�YES FORA BUILDING WITH A BABEMENT OR�RAWL SP E: The distance between ttlei t �OR BUILDING ONt A SLAB FOUt�DATl01�: START 1NITH propoaed floor(of the baseme r crawl . space)and the highest point ofth t. ` The distance beiween the top of slab and S�ART WRH �e hiphest point of the root If you Mave a... B you have a... • GABLE QR HIPPED ROOF(no . ; GABLE OR HIPPED ROOF(no w(ndows): Subtract fiaB the • windows): SubVact half the distanc distance between the highest poiM between the highest point of the roi of the roof to the low point of the ko the lOw po1M af the correspondin SUBTRACTION. corresponding gable or hipped SWBTRACTION gable or hipped roof (BASEd ON ROOF . GABLE QR HIPPED ROOF( ' {BASED ON . GAgLE OR HIPPED ROOF(with TYPE) windows): SubVact half the ROOF TYPE) windows): Subtract hatt the dtstanc di9tence between the!op the between the top ofthe highest higfiestwindow and th ighest window and the highest point of the point of the ioof r�of • ALL OTHER R TYPfS(flat, • ALL OTiiER ROOF TYPES{flat. mansard etc): o subtraction. mansard etc:No subtracdon. ' DITION Add the diata�e between the top of siab SUBTRACTION Subtract the dis ce between the ' ( SED ON and the hl�hest existing grade adjacent t (BASED ONfXISTING basemenUcxa space floor and the fXi ING the foundation. ' GRADES) hi9hest exi ' g.grade atljacent to the GRAD foundatio OR 10 feet(whichever is less). EQUAL Defined buliding height EfdUALS De8 building height Shorel�r�c� Distric h�Clh�D Reren�ti Recelvec� A�er� e L�keshore Setback et? Biu�f ' C] Yes ` Ci No C] N/A � Yes 0 Nc � Yes h!o � Yes � No t] N/A Permit t�umber. etback: Storm ter(�u�tifry Exis��ng �ropos�d ��,riance Rec�uired CUP Requirec! �vecl Qistrict Tier Hardcover Harcicover � Yes C3 I�o f� Yes � No TYPe�s)� TYpe(S)� Updated: January 2013 � C �NG�� v�\forms�plan review checklist 2013.docx D RE�►�.RK� (in-house): . Fees to b�Char �d YES �� P�rttzi� Plan Review State&urcha�rgs l�� ` � nve� igation Fee___ 3kC—Number of SJ4C ilnits . Qther(�peclf�� S uare Foota e 3 er S uare Foota e Basement X ' $ 1`�Floor � _ $ 2"d Floor X - � Garage X ' $ Estlmated Construction Value: � 2-`"r�`'�� Qrono Insp�clions R�quir�ecE Work Requ€ring Sepacate Permits Req�ired State P�rmjts � Site Piumbing Q Gracling/Fiiling � Well � Hardcover Removai L1 �lechanical � Fire Electrical i� Footing G Septic Q Wa4er Connection � � Poured Vlrall G Fireplace t] Sewer Conr�ection � � Founclatiort Survey 0 Masonry G Lawn lrrigation : Q Radon Rock Bed a Mfg. ,;�Framing C� Other(specify) �insulation �s-Buift Survey _ � �inal 13 Wetland Buffer , i7 Other'{specify) RENiARKS(rn-house): Other Revie�rv: Rev�ewed b�r: Date Approved: Acce�s: Existing: E1 YES � NO t�ew: L7 YES E3 NO OFFiC1AL REI4RARKS-TO 6E NOTE�OhE RERt�ET�.N�ft�!'CiALLE� Updated� January 2013 v;\forms�plan review checklist 2013.docx DATE TIME �J CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED /� PERMIT NO..�.?L'S/ � �� COMPLE7ED ��- l�' i 7 \'� -'--yt ADDRESS �G�D �4,0/s ri��G L�. OWNER TELEPHONE NO. CONTRACTOR �� rZ.,� �e.c�s�. � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS AMING ❑ MECHANICAL FINAL �/�R ❑ TREE REMOVAL Z 0 INSULATION O WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v O PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDAl10N/REMOVAL 2 OWNERICONTRACTOR TO MEET YiOU:_YES_NO � COMMENTS: � F/��. �2 L�-O/c' � J O '' _5�.c l ,�'G� . t �/�7 r^�c � L �s � ° - ,Or � � i.'. L.�. e%� � � /� Q .fl�A�oo..� oS .��s c��`�+�^ ZCrj r r Vi1�- �- d� 7� CO�/�� . � '� �/'/1?. ,6r I� �• L�/�— c5'�-Ll Q�/'�G't! j ��5 ��!'• �P��i��e7�ioi�c+ �i�1�•.• Gl�r,t� � ❑WORKSATISFACTORY:PROCEED ❑PRpJECT Cp�qpLCEfE , �CO�iRECT WORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O��CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOYERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN O CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION RE(]UIRED.CALL TO ARRANGE ACCESS. Call br the next inspection 24 hours in advance. (952) 249-460� OwnerlContractoronsite: ��.c Inspector:___��(� I� — White Copyllnapector's File Canary CopylSite Notics �— G jl � �� bTE –'b�JU`g E� V CJ CITY OF ORONO ED IN d—7—� INSPECTION NOTIC HEDULED `<O -/ � _ '� PERMIT NO - cOMPLETED --�— ADDRESS OWNER T EPHONE N . a�� -3I CONTRACTOR l, � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE O SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL 2 OWNERfCONTFiACTOR TO MEET YOU:_YES_NO c��, COMMENTS: � W a � J O �. o� O � W 2 Q � 2 W � w 2 J d � ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WOFK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN O CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-4600 OwneNContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice � �` D DAT TIME � CITY OF ORONO CALLED IN INSPECTION NOT �,/ ��eHEDULED lp � — '� PERMIT NO. 'T� ��COMPLETED ADDRESS �� l/�%�� OWNER TELEPHONE NO.�P��a�—a _3S CONTRACTOR � [ —� � DESCRIPTION � � ❑ FOOTING ❑ PLUMBIN F AL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWEfLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z O 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-FINAL ❑ SEPTIC INSTALL ❑ HARD COVEfi REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: � , , � � 1^D v/`1.� �G 2/m G�c�o�S 4i�fiE�.,, � /� ` a� 4�l 6��•-eo�s o � � , � o v �l r2 b r �', �� '6 V' 8 lG�/` s c�lGr Q G fi lG! �a'1� W � �� Q -�4 •t� �e�� c.��a r � .., ��!'l.c�t✓ �7�e�-S( � z W � W � � d � OYVORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � �OOFTRECT WORK,CALL FOR REINSPECTION TEMPORARY �� BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca inspection 24 hours in advance. (952� 249-4600 � Owne ontractor on site• v►'� Inspector White Copyflnspector's File Canary CopylSfte Notice �-�, � '� DATE TIME CITY OF ORONO C ED IN / — '/ . INSPECTIO SCHEDULED � — � PERMIT N . � � COMPLETED _ ADDRESS �� OWNER TE EPHONE NO —�� / CONTRACTOR � DESCRIPTION �—,�� r � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORFJWETLANDS y 0 FRAMI ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INS ATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ DON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � INAL ❑ SEWER HOOK-UP ❑ COMPLAINT � D MO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL � FOUNDATION/REMOVAL 2 OYVNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W � j �O � O � W � Q � W � W OC j W ❑WORK SATISFACTORY:PROCEED ROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ I E CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECWERING PERMANENT O CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hou in advance. 9-460� OwnerlContractor on site: Inspector: White Copyllnspector's Ffle Canary CopylSke Notke