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Home My WebLink About2012-01270 - addn/remodel/repair CITY OF ORONO * 2 0 1 2 - 0 1 z 7 0 * � 2750 KELLEY PARKWAY DATE ISSUED: OUO2/2013 , ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1205 NORTH ARM DR PIN : 07-117-23-41-0013 LEGAL DESC : SAGA HILL REVISED : LOT 001 BLOCK 004 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 4,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) REMODEL ADV.PLAN REVIEW COLLECTED$67.11 2012-01269 APPLICANT pERMIT FEE SCHEDULE 103.25 THARALDSON,BREVIK STATE SURCHARGE(VALUATION) 2.00 1205 NORTH ARM DR MOUND,MN 55364- TOTAL 105.25 OWNER THARALDSON,BREVIK 1205 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 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. - / / 2. / /3 / / ermitee Signature Date Issued By Si ure Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A E. �; � i�,Z�, �� . �� f ��a . 8��6�ing Pe�m�� A�ap6i�a�iQr� �ar t�adr��er�a�ce / F�e�Q�a�ica� �. 2� �* �, (winaovNs, d�ors, siding, r�-ro�f, e�c.) �D Mailrng Address: _� �� PO Box 66 ' Permit number. a�0(o� ��Z7� �� ,, 0\ Crystai Bay, MN 55323-0066 Date received: 1 Z - Z I - �� ,a � '�, �, � Street Address: Receivetl by: � ` ��c, d'�� 2750 Kelle Parkwa � �.. o Y Y Plan reviewfee: (p7. l � ��'�,�rEs'�o4"� Orono, MN 55356 020�o� �� l a(p G1 ' �' Total Fee: `' Main: 952-249-4600 Fax: 952-249-4016 www.ci.orono.mn.us �' This applicaiion form must be completed in full and all required information must be submitted. � incompiete appfica4ions will be returnecl. (Please print) �° GEN�RA� INFORMATIOf�: �, � r Job Site Address: ` ; �j ��-( � -�� ` Will this be a Parade of Homes, Remodeiers Showcase Home or other Display Home? U Yes No `�' _ ❑ �� If yes, a spec�al event permif is required with Po(ice Department and City Council approval 60 days pnor to the event. Snuttie bus service wil!be � s� ., . required unless app/icanf demonstrates sufr`rcienf on-site parking is available. Non-permitted events wil/not be allowed. "� 4ajW t�' i� CONTRACTOR/APP CANT INFORMATIOI�: � "° Name: ��/� � ��f�'��'�� State License# ,t� �� '. �>4 �xpiration Qate: ,� �' ' Lead CertiTication Number: Expiration Date: � �� (for work on homes fhat were constructed prior fo 1978 � YeY: �� Phone: %a--�c�-O-__ �}� �� (ofiice) (cell) � N'�aifing Address: �E..� � j� �Z City: �; ZJ�J� ZIP: _-� '� � , Contact Person: � �J� � ' }��.,�ppficant is: Contractor�,�rfieowner �Circfe One) � � Email and/or Fax: '� _-c' r- � t� PROPERTY OWN�R INFORMATION: Name: �.. . ,�1.'�k l f�'`'�"(...i�� -./ _� �.--'� Phone da - . �� Y)� f5:�-�� " y , ) � � Address: l�S ��-T�-�- �}-K�y''� '�!L CitY� l �''D�� ZIP: iS �bT :�� Email and/or Fax �C'�-�(�1..�� S )7 ;�,: , � � PROJ`C� INFORMATIOI�: �� ; Type of Project: I I i �� Any earth movement rray require �° Door(s) �odel � g MCWD review&permits: � � ❑ Fire Qama e I Ninnehaha Creek Watershed District(MCWD) ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvo � � ❑ Re-roof, cec3ar ❑ Restoration ❑Water Damage Deephaven, MN 55391 � � Phone: 952-471-Q590 � g � ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) � Far.: 952-471-Oo82 x� www.minnehahacreek.orq ``°' �indow(s) � ,:� ..:; Overall Project Des�riptioR: ��:' �$; _ Esfirrzated Construcfion �lafuaiion of Project (excfuciing fand) � — `��, �r APPLICAMT ACKNOWLCD�`McI�E�': �; • Aarees to provide all informafion required or requested by the Building Department; I � • Certifies that the information supplied is true and correct to the best o� his/her knowledge. Tne applicant recognizes that they � � are sofely responsible for submitfing a complete appfication being aware that upon failure to do so, tne staff has no alternative ,� but to reject it until it is�ompfete; • Some or all of the inrormafion that you are asked to provide on this application is classified by State law as either private or �'�? confidential. Private data is informaiion wnich generaliy cannot be given to the pubfic but can be given to the subiect of the �� data. Confidenfial data is information which generalfy cannof be giver to eitner the pubiic or the subiec't of tne data. Our �� purpose and intended use of this information is to annually update our recoras and records of other qovernmen,al agencies I ,�� reauired by law. If ou refuse to suppfv tne information the aopfication rrav not be issu�d � / �: AppficanYs Signature: _.,�/ Daie: f��"� p� �`�; Last Updated: OP-a9-2011 �� , � l _ ..�:', . Plan ��view Checkiist for New Structures / Additions Address/PID/Legal; l Z� S N U(ZT1�} /�R{M �2 . Description of work: 1�=✓�A��:-Z Septic r,e�iew by: 1'V �A Date Approvetl: Zoning revieanrby: N Date Approared: Building review by: Date Approved: ' 12�27- /Z : ° Graciing review by: N//� Date Approved; Zoning File#: Resolufion#: Resolution Qate: Zonin 'District 'Fire'De actment Post Office Scho.ol Dis �ct Zoning: Lot`Area: SF/AC V1/idth: Dep . Survey Subrnitt : ��Yes 0 No Date Df'Survey: Pro osed Setbacks: _ :Front (Lake) ar�5tre�t) � 'N S E °1N ) ;( 'N S �E W ) -Ot rBuildings Wetlar�d Side Side Building Defined Height: `` Building:Peak Height: #of.S#ories�k?: � 1�ES FOR A$UICDING'tiVITH'�B�4SEMENT OR C SPACE: ' FOR=A BUIL NG ON A SLx►B FOUN[594T10N: START WITH :the.distance between the ba ment floor/�crawl START the distance'between°the slab and>the highest space floocand the highest ro eak,the top of Wll'. roof peak,the top of the comice Af a filat coof, the:cornice flf a'flat roof;the.deek ' e of a the deck`line of a mansard-ropf,or;the mansard•noof,or'the uppermos#.poi on a round uppermosi:point on a round or other arch-type or other arch= e roof roof SUBTRACT half the dis#ance:befinreen.the highest wi auv and SUBTF�ACT half.the distance between#he highest window `hi hest ro�f eak of a itched roof ;antl hi hest roof; eak of a itchetl roof SUBTRACT the distance between the basement'floor/-cra ADD the tlistance between'#he:slab and the highest ' spa�ce floor and the highest existing gratle withi existin rade withinthe foundation the foundation or 10 feet,�whichever is less. EQUALS DefiAed,buiJtlin ,hei ht EQUALS Defined:buildin ;hei ht � Lot`Covsrage: : %o Sharelantl'-District �M.C.�A1D•Per it•Received �►v�er� e.Lakeshore:Setback :Blu�f 0 Yes No 0 N/A ; � Yes � N� � Yes � -No � Yes No � N/A Permi . umber. Setback: Hardcover:Zanes xistin P�ro osetl Uariance Re ' ed CUP:Re uired D-75' � Yes :0 '0 Yes 0 :No 75-250� Type(s): TYpe(s): 250-5D0' 500- 00' REMX�RK (in-hocrse): N o C tf�N 6 ' Uptlated: 09/19/2009 . z:lformslpfan review checklistdoac Fees to be Char ed �'fS :�10: _ , ,_ _ . . ,_.� ,_ _ _ .. _ .:.. : . Plan Review - --�,.,F, . .,, . ,. .. ,� .._ _ . _ investigation Fee . u �. :,,� , a .._ : 'Sewer�Connection .Paek fee :Other(specifiy) �a�culated:By; ; S uare Foota e �$ er uare Foo�ta e Basement X ': _ � , 1�:Floor X = � ��a Floor , �, _ � Garage; � � � Estima#ed`Construc�ion Value: � M n�o = Orono'inspections R+equired ` �llork�2equirin�Separate Permits Requiretl State Permi�Es ' � Site ' Rlumbing � ,Grading!Filling :� Well C :Hardcover Removal Mechanical n Fire �''Electrical � Footing , . `� SePtic ; � V1later Connection G Poured UVall � Fireplaae :'q Sewer�onnectinn "0 Fovndation:Survey � 'Masnnry a Lawn Irrigation ' 0`Radon Rock Bed p Mfg. ;�Framing � Dther(specify) ,�inswlation ' :� ;As-Built Survey fr3�Final ` ;0 Dther�specifyj : REMARKS{in-house): . Dther R�e�ie�rr: ::Reviewed by. �ate�pprovetl: AccessExisting: .G 'YES fl -�O New: �� YES � NO REMARKS(TO:BE�1DTED t)N PERiVI1T A1�1D lN1TlALLED BY�Eh�.SDN PULLING'PERMIT) Updated: 09/11/2D09 z:lfom►s1plart:review checklist.docx �� D T TIME V CITY OF ORONO �D IN -- / INSPECTION TICE �7�LED d—��'-�3 y� a PERMIT NO.�`��D``��COMPLETED ADDRESS l�� l � ��/YYL-� '��''�.�C/�_ OWNER TEL PHONE NO.��2-7�� 1�� CONTRACTOR r � I � � DESCRIPTION � �'L � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ 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 COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEEf YOU:_YES_NO � COMMENTS: � W C � J O � � O � W � Q � Z W � W � � � }�'V�VORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE W ❑CORRECT WORK&PROCEED ❑ 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 ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�0 OwnedContractor on sit : Inspector. � � White Copyllnspector's File Canary Copy/Site Notice �-- DATE TIME � CITY OF ORONO CALLED IN a-7-�� INSPECTION TICE SCHEDULED c��_-,(3 � PERMIT NO. � � �a 7� COMPLETED ADDRESS �� S � //�?.'fi[�I/!_. �, /.� OWNER � eU�� LEPH NE NO.��z-��-D'LD�� CONTRACTOR � DESCRIPTION � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS 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 J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ WARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU�YES_NO v�, COMMENTS: � W a � J O a � O � W � Q � 2 W � W � � � �KSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 forthe next inspection 24 hours in advance. (g52) 249-4600 Owner/Coniractor on site: Inspector. White Copyllnspector's Ffle Canary CopylSNe Nodce J�C� �'�'�`" — ��ATE l TIME V CITY OF ORONO � � CALLEDIN ��7—IU /�.3 INSPECTION NOTICE .�. SCHEDULED 7�l1� �1�� PERMIT NO. •�--�i (� "C I--�7C COMPLEfED �` ADDRESS �/� (i �ZT/I, ,l�L ��-�.r l �i�' OWNER ��L� l. 1 I� TELEPHONE NO. �E l.� '-�).�(�-"lC�� CONTRACTOR ;� I � � DESCRIPTION I � � _. � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ IAKESHOREM/ETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ 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 COVER REMOVAL v ❑ PLUMBING RI ❑ SEP IC FINAL � FOUNDATION/REMOVAL 2 OWNE�RfCONTRACTOR TO MEET YOU:�YES_NO � COMMENTS:_Ti'�� (,� i I � �� /�(��1�� W C � O �. � O � W � Q � 2 W � W � � J j a W WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECdVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP OFDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice