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Home My WebLink About2009-00508 - addn/remodel/repair " CITY OF ORONO PERMIT NO.: 2009-00508 ' � 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISSUEn: 08/26/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 680 NORTH ARM DR PIN : 06-117-23-43-0002 LEGAL DESC : AUDITOR'S SUBD.NO. 362 : LOT 001 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPA[R PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 30,000.00 NOTE: SEPERATE PERMITS REQUIRED: ELECTRICAL(STATE) PORCH&DECK REPLACEMENT PERMIT#2009-00507 IS FOR ADVANCED PLAN REVIEW OF$30339-PAID W/CREDIT CARD APPLICANT PERMIT FEE SCHEDULE 466.75 PLEKKENPOL BUILDERS STATE SURCHARGE(VALUATION) 15.00 401 E 78TH ST TOTAL 481.75 BLOOMINGTON, MN 55420- (952)888-2225 Minnesota State License#: 1797 OWNER WATSON, DOUGLAS 680 NORTH ARM DR MOUND,MN 55364 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 permi[s. 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 perio�f 180 days at any time after work has commenced. The applican[is respons ble for assuring all required inspections are requested in confo an wi the te Building Code.This permit may be revoked at any tim�fo cause. C 1 /"?�� -lC�) > � � -� �,` Y_ � ; /.. U 7 "'� �✓�� / ! � �� l.� l"'Ut j�.l': � Applicant e itee �gnatufe Date Issued By Sig ture Date SEPARATE PERMITS�REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. * � V ' City of Orono $� Building Permit Application for New Structures or Additions Mailing Address: � Permit number: �U9" �,�`� ��, PO Box 66 � / � /O 0,;, Crystal Bay, MN 55323-0066 Date received: ' e��"� � I; � Received by: G{' �,,� ``��,��,�, ,,; StreetAddress:' '�,F,r � � �+^ ��ti�� 2750 Kelley Parkway Plan review fee: ��L�.3. � — �Q' RxE3H0¢ Orono, MN 55356 pSQ�' Total Fee: � Q � Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us D� �lj This application form must be completed in full and ail required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION:� � / /� Job Site Address: CvF� /V vz�N /`�tcz.� 1�,-z, ��f Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No /f yes, a special event permit rs required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates su�cient on-site parking rs available. Non-permitted events will not be allowed. CONTRACTOR I APPLICANT INFORMATIOI�J:, Name: J-�� 1�.�<v�,�.��.-. 15�iLD[�''/L$ ...�nic. State License# i �� ' � Expiration Date: ,�,�. Zoid Phone: �jSZ.. $'�8'-2z2S (office) (cell) Mailing Address: D/ �'�_ �8"L" ST: Cit : T3�.,�b��v ZIP: Ssy2� Contact Person: T,�,,�- p,,,NGd a,t c��►�« Applicant is: ontractor Homeowner (CircleOne) Email and/or Fax: �'�+sT'�"��^' PROPERTY OWNER INFORMATION: Name: 1`��.�-- t SH�rz�K�- l�/�--rSa.r` Phone (day): `�SZ- �-l�z - �-g3g Address: (r�8'D e,.1ire A,�„1 . „�� City. �2o.vv ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1. Type of Project I 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8� Water Supply ❑ New Construction ❑ Single Family with ❑ Residence i ❑ Addition attached garage ❑ Garage/Accessory Bldg. �Public Sewer ❑Accessory Building ❑ Single Family with �Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer ' �Other: (specify) �'s'3u�� °r ❑ Multiple Family/Condo ❑Warehouse ; �2cr+ $-'Dc��K ❑ Public ❑ Storage i ❑ Public Water i "*Any earth movement may require ❑ Commercial �Other(specify) j MCWD review 8� permits. ❑ Industrial F'o��+ � Private Well I Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) I 18202 Minnetonka Blvd � Deephaven, MN 55391 ' � Phone: 952-471-0590 � I Fax: 952-471-0682 I www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ 3 � �"�.� Last Updated: 6/22/2009 - 19 - ,�, ,,�. . � � STRUCTURE INFORMATION: , 1. Structure Dimensions L Structure Dimensions(continued) i 2.Type of Construction i � a. Length (ft.)= 2 S I Number of bedrooms= ',� �Wood/Frame � � ❑ Masonry b.Width (ft.)= J3 I Number of garage stalls: ❑ Metal � Attached = ❑ Pofe Bldg. Areas in square feet i Detached = ❑ ICF � ❑ On-site Prefab c. Basement= � I ❑ Off-site Prefab d. 1S`Story = I � ❑ Other(please specify)� e. 2ntl Story= � i f. '/z Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not I Enclosed Ap licable ❑ ' Permit A lication � R[ ❑ � Pro osed Buildin Plans � ❑ � I MN State Ener Code Calculations and Mechanical Code Re uirements Form ' ❑ : Surve meetin all re uirements ❑ 1� ' Stormwater Pollution Prevention Plan ❑ Hardcover Calculation(s) ❑ I Se tic S stem Site Evaluation Re ort ❑ I Access Permit ❑ Wetland Buffer Im rovement Plan i � I En ineered Plans for Retainin Walls 4 feet or above L ❑ ❑ , Plan Review Fee i ❑ ❑ � 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 i 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. I If you refuse to supply the information, the application may not be issued. � i Applicant's Signature: Date: � � � �1 Last Updated: 6/22/2009 -20 - r , ' � • Plan Review Checklist for New Structures / Additions Address/ PID/ Legai: b �� NOCtTN f�(ZVt� n(Z, . Description of work: PoRct� Ar►O Or2.�� '�Ulc�'i.n�.�n/7� Septic review by: �"- Date Approved: Zoning review by: — Date Approved: Building review by: Date Approved: f�-Z y- oq Grading review by: �— Date Approved: Zoni File#: Resolution#: Resolu�i n Date: Zo ' District Fire De artment Post Office School District Zoning: Lo rea: SF/AC Width: Depth: Survey Submitted: Yes � No Date of Surve . Pro osed Setbacks: Front(Lake) Rear( reet) ( N S E W ) ( N S E W ) Other Buildings Wetland Side ide Building Defined Height: Buildin eak Height: FOR A BUILDING WITH A BASEMENT OR CRAWL ACE: FOR A BUILDING ON A SLAB FOUNDATION: START the distance between the base ent floor/ START the distance between the slab and the WITH crawl space floor and the highes oof p k, WITH highest roof peak, the top of the cornice the top of the cornice of a flat roof, eck of a flat roof, the deck line of a mansard line of a mansard roof, or the upper o roof, or the uppermost point on a round or oint on a round or other arch-t roof other arch-t e roof SUBTRACT half the distance between the hi est SUBTRACT half the distance between the highest window and highest roof peak a pitched window and highest roof peak of a roof itched roof SUBTRACT the distance between the b sement floor/ D the distance between the slab and the crawl space floor and the ighest existing highest existing grade within the grade within the founda on or 10 feet, foundation whichever is less. EQUALS Defined buildin hei ht EQUALS Defined buildin hei t Lot Coverage: SF % Shoreland District MCWD Permit Received Avera e Lakeshore Se ack Bluff � Yes � No � Yes � No 0 N/A p Yes � No p N � Yes � No Permit Number: Setback: Hardcover Zone Existin Pro osed Variance Re uired UP Re uired 0-75' � Yes � No � Yes � No 75-250' Type(s): Type(s): 250-50 ' 500-1000' REMARKS (in-house): Updated: 07/01/2009 z:\forms�plan review checklist.docx . ^ Fees to be Char ed YES NO , . � P+�rmit _ . „'' Plan Review ,/ q,� �tat��r.c�aa, s � ✓ Investi ation Fee 'S�►C-:N��bero#5AC Units Sewer Connection �11��er�iCn�r�ecfi�on ; /' Park Fee 5ite�l�s �c#�on ' Other s eci � ��I'lliscellar�en�s�Fees , , Calculated B : UBC: Construction Type: S uare Foota e $ er S uare Foota e Basement X = $ 1 S Floor X = $ - 2" FIOOr X - $ Gara e X = $ Estimated Construction Value: � Orono Insaections Required Work Requirinu Separate Permits Required State Permits � Site 0 Plumbing � Grading /,,Filling � Well � Hardcover Removal 0 Mechanical � Fire ,0'Electrical „0" Footing � Septic � Water Connection 0 Foundation Survey 0 Fireplace 0 Sewer Connection �Framing 0 Masonry � Lawn Irrigation . �'Insulation � Mfg. � Wall Board G Other(specify) ,: �s-Built Survey Final 0 Other s eci REMARKS (in-house): � Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES �� NO New: � YES � NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) �' Updated: 07/01/2009 z:\forms�plan review checklist.docx � �� C�/ ' DA TIME CITY OF ORONO CALLED IN �d Z o9 INSPECTION NOTICE SCHEDULED � '�1, � PERMIT NO.�D�JD�{ COMPLETED ADDRESS �� -��-�� OWNER CONTR,�� `12�1� /f-J TELEPHONE NO. /-� — �lT�S.�8'"�3(�S � DESCRIPTION ��/�G� �� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING � MECHANICAL FINAL ❑ LAKESHORENVEfLANDS y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL Z ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q�INAL ❑ SEWER HOOK-UP ❑ PROGRESS � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: � W a o �7r : �� p,� r� �e f—),A,. 2r ,�,•, f�� Q.., :�� . � 0 � W � Q � z W � W � � � d W ❑WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W ��CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT �CORRECTUNSAFECONDiTIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Ca11 tor the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: , inspector. � � White Copyltnspector's File Canary Copy/Site Notice �_ qDATE TIME � CITY OF ORONO CALLED IN /�L INSPECTION NOTICE p- SCHEDULED � � PERMIT NO.��D9—DD�DO COMPLETED ADDRESS a� 6�� N�''� �Y/�'t D/" - OWNER CONTR. � �, TELEPHONE NO. �Jl Z 3Z-� �3�� DESCRIPTION ��a�'��'7 � ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/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 i ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL J ❑ PIUMBING FINAL ❑ FOUNDAT�ON/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a O /�'� / � �� V �. � O � W � Q � Z W � W � � d KSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W RRECT WORK&PROCEED r ISSUE CERTIFICATE OF OCCUPANCY 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETURN �STOP ORDER POSTED.CALL INSPECTOR '� CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�� Owner/Contractor on site: ' Inspector. White Copyllnspector's File Canary Copy/Site Notice , ATE TIME � CI�O ORONO D INSPECTION OTIC SCHEDULED a o9�� PERMIT NO ^ -�� COMPL � ADDRESS � OWNER OONTR. TELEPHONE NO. — Z� �� DESCRIPTION �� ❑ FOOTING ❑ MECHANICAL RI ❑ EXCAV/GR L Q ❑ FRAMING ❑ MECHANICAL FINA� ❑ LAKESHORENVETLAND y ❑ INSULATION ❑ WOOD BURNER/FIREPLACE p TREE REMOVAL ;` Z ❑ WAL . ❑ WATER HOOK-UP ❑ SITE INSPECTION �j� = AL ❑ SEWER HOOK-UP ❑ PROGRESS <</'' � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT �,� � ❑ DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP � _ ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL � ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. � J O � � O � W � Q � Z W � W � � d W� �WORKSATISFACTORY:PROCEED PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN {NSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on sit�: Inspector. `� �` � White Copyllnspector's Flle Canary Copy/Slte Notice