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Home My WebLink About2012-00253 - addn/remodel/repair . � CITY OF ORONO * 2 0 1 Z - 0 0 2 5 3 * 2750 KELLEY PARKWAY DATE ISSUED: 04/09/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 679 MINNETONKA HGLD LA PIN : 06-117-23-44-0008 LEGAL DESC : MINNETONKA HIGHLANDS ESTATES : LOT 004 BLOCK 002 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 10,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING, ELECTRICAL(STATE) BATH ROOM REMODEL APPLICANT pERMIT FEE SCHEDULE 191.75 NELSON,ROBERT&VICKY STATE SURCHARGE(VALUATION) 5.00 679 MINNETONKA HGLD LA TOTAL 196.75 LONG LAKE,MN 55356- OWNER NELSON,ROBERT&VICKY 679 MINNETONKA HGLD LA 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 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 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 at any time for due cause. s�P`��. � 9 � /� � 9� /� Applicant Permitee Signature � Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. - , ��v� �.� �`�S r�Z--� City of Orono Building Permit Application for Maintenance / Renovatio (windows, doors, siding, re-roof, etc.) /��•�S - Mailing Address: Permit number: apl�-DO� O��,�.0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: - -� �� "�, ,� � ��-�, �, Street Address: Received by: �.5 '�, �' A �..�' 2750 Kelley Parkway Plan review fee: �� -�O"�J �"' 19,�E$H�g'� Orono, MN 55356 �� _- Total Fee: Main: 952-249-4600 Fax: 952-249-4616 . � 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: �l�-]y }'�� i,�r��'�s��!�c� �ic�j�v��:� L�v�c� �%T�%%`�c:�,d�l� S-=�� Will this be a Parade of Homes, Remodelers Showcase Home r other Display Home? ❑Yes �No /f yes,a specia/event permit is required with Po/ice Department and City Counci/approva/60 days prior to the event. Shutt/e bus serv�c wi//be required un/ess applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events wil!not be allowed. CONTRACTOR/APPLICANT INFORMATION: \ Name: _�r�'ic'i�.-F /�F=� =c%��.J ✓) E�r'� State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: �S Z_�S-_f�,S�Z (o�ce) ��SZ ZI S-(�?�� (cell) Mailing Address: �— = ,� y - y. �- City: -� -� ZIP: � �� , Contact Person: �16��, �,�- �.�,��, ,.� Applicant is: Contractor / omeowrier �c�.�ie o�e� Email and/or Fax: �� }�a � �,�,�� ,r,��,� PROPERTY OWNER IN�RMATION: Name: r:J �r�'{' �� J�✓) Phone(day): �� Z-�f ZC�•-,l �{�Z Address: /,.,7`� i�'l i ,�►��-�o,�kct �-�'��.n d ��i z C�tY�C'}�;t�v ZIP: �S``��(c� Email and/or Fax b�+ k m i- k c� a� �Nl �h�!„�u�� PROJECT INFORMATION: Type of Project: Any earth movement may require ❑Door(s) Remodel ❑ Fire Damage MCWD review 8�permits: � Minnehaha Creek Watershed District(MCWD) ❑Re-roof,asphalt ❑Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑Re-roof,cedar ❑Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ❑Re-roof,other(specify) ❑Siding ❑Other: (specify) Fau: 952-471-0682 ❑Window(s) '"`�"�N- -, ��'i , ee�,,ra Overall Project Description: �� , E: �. � �3 Estimated Construction Valuation of Project(excluding land) S �Q, C�C�� 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 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; • Some or all of the information that you are asked to provide on this application is Gassified 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 r uired b law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYsSignature: � � /��i�-�, Date: ��f�/� T Last Updated: 08-09-2011 Pian Review Checklist for New Structures / Additions Address/PIDiLegal: �1q M�NN�'r'ONic,A NIbN�-�NrJ t�4N2. Description of work: '(5�q�� a,�.� (Z,�ry�,a d� Septic review by: N I A� Date Approved: Zoning review by: N I� Date Approved: Buiiding review by; �T Date Approved: �/�"5— �' �'Z_. Grading review by: i�l//1- Date Appcoved: Zoning File#: Resolution#: >Resolution Date: Zonin District Fire De artment Post Office S ooI District Zoning; Lot Area: SF'/AC Width; Depth: Survey Submitted: 0 Yes � No Date of Survey: Pro osed Setbacks Front{Lake) Rear reet) ( N S E W ) ( N S E W 0ther`Buildings Wetland �� Side Side ` � Building Defined Height: Building Peak Height: #of Stories Ok�: 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPA : R A BUILDING ON A SLAB fOUNDATION: START WITH the distance between the basement flo cravvl START the distance beiween the slab and the highest space floor and the highest roof,peak,the p 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 uppermo5t point on a rou uppermost point on a round or other arch-type or other arch- e roof roof SllBTRACT half the distance between the highest wind and SUBTRACT half the distance between the highest window hi hest roof eak of a itched roof ` and fii hest roof eak of a itched roof SUBTRACT the distance between the basement fl r/crawl D the.distance between the slab and the highest space floor and the highest existing rade within existin rade within the-foundation the#oundation or 10 feet,whichev r is less. EQU S Defined buildin hei ht EGIUALS Defined buildin hei ht Lot Coverage: SF % Shoreland District M D Permit Received Avera e Lakesho Setback Bluff es � No � N/A � Yes � No � Yes � No ' '� Yes 0 No /A ermit Number. Setback: Hardcover Zones Existin Pro osed Yariance Re uired UP Re uired 0-75' � Yes 0 No G � No 75-250' TYPe{s): TYPe�S): 250 00' 0-1000' � �, REMARKS (in-house): N� C l��'�G � Updated: 09/11/2009 z:\formslplan review checklist.doac Fees to be Char ed YES :NO . �Kac».� :' , i�LL.,�f�. �,.� �_,,. #,�s. ' ��s�+,"� ..,�a+ ,;� y� .�.-5. .-..._.�-� - r.. t- �R xr fi�,. ��.?�y„e��,.',�.r4'�'� .-.n5�._�: Plan Review _ _ �_ = W,� p.._„ t.� �, . ;,_ .. , . . ,. ., _.,. .. . - - __ . ,,,._ .a. _ ,.. _ .. ,� r,:... Investigation Fee � _, � � , � , . - _ „��r>�,� �?� . . .: .. _: -� _ _ _.�.., � _. . . T Sewer Connection . , _ ,.,. _,., , . _ . - - Park Fee . _�_ .... _ - - _. _ _.. _. . ... Other:(specify) _ _ . . ,. . Calculated By: S uare Foota e `$ er S uare Foota e - Basement X = $ 1�Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ � l��OCaf� �= Orono inspections Required Wark Requiring Separate Permits Required State Permits G Site Plumbing .G Grading /Filling � Well G Hardcover Removal G Mechanical � Fire �Electrical � Footing � Septic G Water Connection � Poured Wall � Fireplace � Sewer Connection G Foundation Survey 0 ,Masonry 0 Lawn Irrigation � Radon Rock Bed 0 Mfg. Framing G Other(specify) � Insulation �s-6uilt Survey Final 0 Other{specify) REMARKS (in-house): Other Review: Reviewed by: �ate Approved: Access:Existing: '� YES � NO New: � YES � NO REMARKS(TO BE NOTED ON PERMIT AND INITIALLED BY PfRSON PULLING PERMIT) Updated: 09/11/2009 z:\formstplan review checklist.docx