HomeMy WebLinkAbout2016-01080 - deck attached � CITY OF ORONO * 2 0 1 s - 0 1 0 8 0 *
2750 KELLEY PARKWAY DATE ISSUED: 09/09/2016
ORONO,MN 55356-
(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/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DECK ATTACHED
VALUATION : $ 2,500.00
NOTE: REPLACE DECK/PORCH WOOD POST FOOTING
APPLICANT PERMIT FEE SCHEDULE 92.89
PLAN REVIEW 60.38
GIRARD,SANDRA&BRIAN STATE SURCHARGE(VALUATION) 1.25
680 NORTH ARM DR
MOUND,MN 55364- TOTAL 154.52
Payment(s)
CHECK 10717 154.52
OWNER
GIRARD,SANDRA&BRIAN
680 NORTH ARM DR
MOLJND,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 Ciry approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permiu. AII provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.l'his 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. `�
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Applicant Permitee Signature Date Issued By Signature Date
City of Orono �
Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
(i.e. windows; doors, siding, re-roof, etc. — Nt3 STRUGTURAL EXPAt�����}
-' � Mailing Address: Permit number. �� l� —" �� ��
� �-0���'�, PO Box 66 p
Crystal Bay, MN 55323-006 Date received: -!— �p "
�� � Street Address: �$'�� Received by:
` �� � ��I 2750 Kelley Parkw q Plan review fee:
���t�� �`�'� C�rono, MN 55356
\ kP�t�v��.-' ��.J�i � �
- Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 vvv�^J.ci.crono.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: ��0_,�. RRIh �Q . �fZOA1b 1/�� �536�
Will this be a Parade of Homes, Remodelers Showcase ome or other isplay ome? ❑ Yes �'No
/f yes,a special event permit is required with Police Department and City Counci/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/APPLICANT INFORMATION: �
Name:
State License # Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) (office)
Mailing Address: � City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Emaif and/or Fax:
PROPERTY OWNER INFORMATION:
Name: _ �L�_�� ---
Phone (day): ,. Z/
Address: gp ,� �ie City: �,��,n/D ZIP: s�3,�� _
Email and/or Fax: �..�ah Q j��..t��p,�o����� �� __
PROJECT INFORMATION: Overall project description: Ce ]�K e�� � DS� �+IKq
� Type of Project: Any earth movement may also require ',
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: I
Minnehaha Creek Watershed District(MCWDj �'
, ❑ Re-roof,asphalt [�Repair ❑ Storm Damage I
15320 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345
i ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
� ❑Window(s) ��^r.lr,�✓_minnehanacreFk_:_oro
Estimated Construction Valuation of Project(excluding land) $ d�
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 I
�, reject it until it is complete; ;
� • 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. I
Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and I,
� 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� Ip ication may not be issued. ___.j
----
— _ - —
�lpplicant's Signature: ���� /� -� Date: ����'�.
�Jwner's Signature: ���u-.��� ��� Date: 7� ���
Last Updated:January 2016
� PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
� �� � ���
Address: C?.�CO('/ �/. �/"`� �Y/l/�(i Permit No.: l �(/�
Description of work: �����5 P L° rtiC `� Date Rec'd:
Septic review by: 1 V � a't�'' ��'1�� Date Approved:
Zoning review by: Date Approved:
Building review by: � � Date Approved: � � �
Grading review by: Date Anproved:
Zoning District: Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: SF/AC Width: Lot Coverage: SF %
Survey Submitted: � Yes 0 No Date of Survey: Revised date ? :
Landscape plan submitt�d? 0 Yes 0 No Landscaper:
Proposed Setbacks:
ti,
Front(Lake) Rear(Streetj ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Defined Height: ,, eak Height:� FFE:� FFE minus 6 feet= (Existing Contour)
_ � ° = L.F. below rade
Perimeter(linear feet) � 50/o g
Basement? 0 Yes � No, ��Stories
�
�
FOR A BUILDING WITH A BASEMENT OR CIRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distar�ce between the lowest proposed Slab at or above grade—
floor(of th�basement or crawl space)and measure from hiqhest existinq
START WITH the highestWoint of the roof. rp ade to the highest point of the
l START WITH roof even if fill was brought in to
� elevate home.
If you have a'`1.
SUBTRACTION • GABLE cpR HIPPED ROOF(no Slab below grade—measure
(BASED ON windows)��Subtract half the distance from highest existing grade to the
ROOF TYPE) between t highest point of the roof hi hest oint of the roof.
to the low p int of the corresponding If you have a...
gable or hip d roof SUBTRACTION ' GABLE OR HIPPED ROOF
• GABLE OR H PED ROOF(with (BASED ON (no windows): Subtract half
windows): Sub ract half the distance ROOF TYPE) the distance between the
between the top f the highest highest point of the roof to
window and the h hest point of the the low point of the
roof corresponding gable or
hipped roof
• ALL OTHER ROOF YPES(flat, • GABLE OR HIPPED ROOF
mansard,etc):No su raction. (with windows): Subtract
SUBTRACTION SubVact the distance betwee the half the distance between
(BASED ON basemenUcrawl space floor an the the top of the highest
EXISTING highest existing grade adjacent t the window and the highest
point of the roof
GRADES) fo�ndation OR 10 feet(whichever less). . ALL OTHER ROOF TYPES
t
' (flat,mansard,etc):No
EQUALS efined building height subtraction.
• Defined building height
EQUALS
Updated: October 2015
z:\forms\plan review checklist 10-2015.docx
Average Lakeshore Setback —�
Shoreland District MCWD Permit Met? Bluff
0 Yes � No Permit Number: � Yes 0 No 0 N/A � Ye No �
� N/A—see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf % and sf
0 Yes 0 No ❑ Yes � No
1 2 3 4 5 Type(s): Type(s):
Fees to be Char ed YES NO
Permit
Plan Review
State Surcharge
Investigation Fee
SAC— Number of SAC Units
Other(specify)
Square Footage $ per Square Foota e
Basement X = $
15t Floor X = $
2nd Floo� X = $
Garage X = $
Estimated Construction Value: $ ����
Orono Inspections Required Work Requiring Separate Permits
Footing 0 Site ❑ Plumbing � Grading/Filling
❑ Poured Wall ❑ Silt Fence/Erosion Control 0 Mechanical � Fire
� Foundation Survey � Hardcover Removal 0 Septic � Water Connection
� Foundation Waterproofing � Other(specify) 0 Fireplace 0 Sewer Connection
�Framing � Masonry ❑ Lawn Irrigation
� Insulation 0 Mfg. 0 Landscaping
� As-Built Survey � Other(specify)
1�Final
�0 Lathe Required State Permits
� Other(specify)
❑ Well ❑ Electrical
REMARKS (in-house):
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
0 See Builder Acknowledgement Form
0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved.
Updated: October 2015
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� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
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Owner/Contractor on site:
Inspector.
White CoovlInsoector's File Canary Copy/Site Notice