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Home My WebLink About2009-00507 - rebuild porch and deck CITY OF ORONO PERMIT NO.: 2009-0050� 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 08/2U2009 952 249-4600 FAX: 952 249-4616 AD�ESS : 680 NORTH ARM DR PIN : 06-117-23-43-0002 LEGAL DESC : AUDITOR'S SUBD.NO. 362 : LOT 001 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$30,000 TYPE OF PERMIT THIS PAYMENT IS FOR: REBUILD PORCH AND DECK PERMIT#THIS PRE-PAYMENT IS TIED TO: BUILDING PERMIT#2009-00508 APPLICANT ADVANCED PLAN REVIEW 303.39 PLEKKENPOL BUILDERS TOTAL 303.39 401 E 78TH ST BLOOMINGTON,MN 55420- PAID WITH CC# 6675 (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 pertnit 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 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 at any time for due cause. / / / / Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Ci f � � 0 ty o Orono � , - � Buiiding Permit App[ication for New Structures or Additions Mailing Address: Permit number: �Ug- �� PO Box 66 � � � j Q O`,, Crystal Bay, MN 55323-0066 Date received: � �=`�"' I�' 'i Received b �,� �' �,� Sfreet Address:' y� �� 's',�c, � "`�� / 2750 Keliey Parkway Plan review fee: ��GG�.�. � — Q%' t � � OronO, MN 55356 �Sar '�kEsxo4`' � Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �� lj This applicatio� form must be completed in full and all required information must be submitted. fncomplete applications will be returned. (Please print) GENERAL INFORMATION: _ /� /� Job Site Address: Ca� /V vz�N ��t� 17,-Z, �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No If yes, a specral event permit is required with Police Department and City Council approva/60 days prior to the event. Shuttle bus service wil!be required unless applicant demonstrates su�cient on-site parking rs avai/able. Non-penrrrtted events will not be allowed. CONTRACTOR/APPLICANT INF�RMATIOy,� Name: J�-L C�IG1�L-�.✓��.- /5�.c�t.�c��s ��.c. State License# i��t fi Expiration Date: ,��. 2oio Phone: �jS2. g��-2z2S (office) (cell) Mailing Address: c�/ �,�,-_ �8�" S,—_ Cit : 73i,�s—��v ZtP: Ssy2c� Contact Person: TsH,,�- Q�,,NGg 4,� cr-n+ Applicant is: ontractor / Homeowner (CircfeOne) Email and/or Fax: ��s�^'S6'�^' PROPERTY OWNER INFORMATION: Name: ��-�- t S1Hn 2�+�-^- (�/.�,-.So.r� Phone (day): 9�Z- 4f"�2 - �-�3 Address: Cr� 8'J �.2zrc A,�,,,t ,z,s d' City: �i�r,�v ZIP: 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 8� Water Supply ❑ New Construction ❑ Single Family with ❑ Residence ❑ Addition attached garage ❑ Garage/Accessory Bldg. �Public Sewer ❑ Accessory Building ❑ Single Family with Q Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer �Other. (specify) �6'3�� r ❑ Multiple Family/Condo ❑Warehouse �2�N- �-a��C ❑ Public ❑ Storage ❑ Public Water ""Any earth movement may require ❑ Commercial �Other(specify) MCWD review& permits. ❑ Industrial F'v�r+ � Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other. (specify) I 18202 Minnetonka Blvd Deephaven, MN 55391 � Phone: 952-471-0590 Fax: 952-471-0682 I www.minnehahacreek.or I Estimated Construction Valuation (excluding land) $ 3 � �O.o� Last Updated: 6l22/2009 - 19 - STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction ` a. Length (ft.)= 2 S Number of bedrooms= �Wood/Frame � ❑ Masonry b.Width(ft.)= f3 Number of garage stalls: ❑ Metal Attached= ❑ Pole Bidg. Areas in sauare feet Detached= ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1 gt 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: Not Enclosed A ficable ❑ Permit A lication �[ ❑ Pro osed Buildin Plans ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ Surve meetin all re uirements ❑ Stormwater Pollution Prevention Plan 0 Hardcover Calculation s ❑ 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 al! 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. , . � Applicant s Signature: Date. � � 1 Last Updated: 6/22/2009 -20 -