HomeMy WebLinkAbout2015-00633 - addn/remodel/repair CITY OF ORONO * 2 0 1 5 - 0 0 6 3 3 *
-- 2750 KELLEY PARKWAY DATE ISSUED: 06✓03/2015
. ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 4175 NORTH SHORE DR
PIN : 07-117-23-44-0093
LEGAL DESC : HIGHWOOD LAKE MTKA
: LOT MB BLOCK MB
PERMTT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 2,350.00
NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,I�CHANICAL,FIREPLACE,ELECTRICAL(STATE)
(EXTERIOR RADON SYSTEII�
APPLICANT PERNIIT FEE SCHEDLTLE 92.93
PLAN REVIEW 60.40
COMPLETE BASEMENT SYSTEMS STATE SURCHARGE(VALUATIOI� 1.18
54004 LOREN DRIVE
MANKATO,MN 56001- TOTAL 154.51
(50'n 387-0500 Payment(s)
Minnesota State License#:BUIL-143377 CREDIT CARD 5821 154.51
OWNER
SAVAGE,ANNE B&WILLIAM C
4175 NORTH SHORE DR
MOLJND,MN 55364
AGREEMENT AND SWORN STATEMENT
The work for which this pennit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. 1'his permit is for only the work described and dces
not grant permission for addidonal or related work which requires separate
pemuts. All provisions of laws and ordinances governing this type of work
shall be wmpied with whether or not specified herein.This permit will
eacpire and become null and void if construction suthorized 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 are
requested in confom►ance with the State Building Code.This permit may be
revoked at any time for due cause.
' � o � � lQ � I� � �.S—
,
Applicant Permitee ignature Date Issued Sign Date
Jul 13 14 02: 47a Nate Barke 507-345-5817 p. 2
CITY OF ORONO
BUILDING PERMIT APPLICATlON
FOR NEW STRUCTURES OR ADDITIONS
�O�O� Marlrng Address' -(`�Q(�; 3 .
PO Box 66 Permit number:
� Crystal Bay, MN 55323-0066 Date received: 5�
1
� 5treetAddress:' Received by:
�y� � �;1 2750 Kelley Parkway � Plan review fee:
� ' Orono, MN 55356 I
l�Kksr�o��" `� ��7 �(
Total Fee:
Main: 952-249-460Q Fax: 952-249-4616 avww.ci.orono.mn.us
This application form must be completed in full and all required information must b itted. '
{ncomplete applications will be returned. {Please print) � � Q �.� • ��;��_
GENERAL INFORMATION:
Job 5ite Address: '����'J � UY�'1n �`rLcSv2� �Y
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? —�
!f yes,a specia!event permit is required with Police Department and City Counci!approva160 days prror to the evenL Shuttle bus service wd!be
requi�d unless applicant demonstrates sutficient on-srte parking is avai7able. Non-permitted events will not be aUowed.
CONTRACTOR 1 APPLICANT INFORMATION:
Name: � �C. �<�G-Y_V��" yS�'GW�S
State �icense# 1 3311 Expiration Date: 3� �_
Phone: (cell) (afFce D?'��?�OSDp
Mailing Address: u � VL y Cit : ____ZEP: _ (p p c�
Contact Person: �vt � Yt�i {�- Applicant is: ontractor / Momeowner (CircleOne)
Email andlor Fax; �,J�j vt�{-U�k�� hn��;�v��v l,e.�t_�oa.S�WLeivi�• CCSYv� pr so?� (925�33�-I 3
PROPERTY OWNER INFOR ATION:
Name: � ti� a,�/
Phone (day): �p�2. -�l l,F � 1 53 , (
Address: �il"15 Nov� 11aYt �0� City: (�vby1 U ZIP: S�3 LP`�T
Email andlor Fax
ARCHITECT i ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
Email and/ar Fax:
PROJECT INFORMATION: Descri tion oi ro'ect:
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 Sidg. ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
❑ Relocation detached yarage ❑ OfficelCommercial ❑ Private Sewer
�] Other:(specify) �X�,YI�' �� ❑ Multiple Family/Condo ❑Warehouse
SYSf� ❑ Public ❑ Storage ❑ Public Water
*`Any earth movement may also require ❑ Commercial ! ❑Other(specify)
MCWD review&permits. ❑ Industrial ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other:(5pedfy)
i
18202 Minnetonka Blvd
Deephaven,MN 553�1 �
Phone: 9521i71-0590
Fax; 952-471-0682
www.minnei�ahacreek,or
Estimated Construction Valuation (excluding land) $ Z� "�JD • b�
�ul 13 14 02: 47a Nate Harke 507-345-5817 p, 3
.
� STRUC7URE INFORMATION:
' 1.Structure Dimensions 1,Structure Dimenslons(continued) 2.Type of Construction
a.Length(ft.)= Number of bedrooms=
❑Wood!Frame
b.Width(ft.)= Number of garage stalis: ❑Masonry
Areas in sauare feet Attached= ❑Metal
❑Pole Bldg.
c.Basement= Detached=
d. 1 S`Story =
❑ICF
e.2"�Story= ❑On-site Prefab
f. %:Story = �.Off-site Prefab
❑Other(pfease speciiy):
g.Total Area=
REQUIRED SUBMITTALS:
Alf of the information must be submitted in order for our a lication to be processed:
Not
Encfosed A Iicable
C7 C7 Permit A llcation
0 ❑ Pro sed Buildin Plans
� ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
� ❑ Surve meeGn alf re ulrements
0 O Stormwater Polluiion Preventian Plan
� O Hardcove�Calculation s)
� � Se tic S tem Site Evaluatian Re ar!
d 0 Access Permit
� D Wetland Suffer Irn rovement Plan
� ❑ En ineered Plans for Retainin Walls 4 feet or above
� �7 Minnehaha Creek Watershed District Permit(s
� � Plan Re�iew Fee
� ❑ Application Escrow 8�Agreement
� 0 Qther:
APPLICANT/OWNER 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 irue and correct to the besl of hislher knowledge. The applicant recognizes ihat they
are solely responsible for submitting a complete appllcation 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;
• Understands same or al!of the information thai you are asked to provide on this application is classified by State law as efther
private or confidential. Private daia is i►rformafion which generally cannot be given to the public but can be given to ihe 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 infended use of lhis 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.
• Agrees that In the ev�nt that weather or other conditions prevent the completlon of an as-bullt survey at tha ttme the
C�rtiflcate of Qccupancy is requested, a temporary Certificate of Qccupancy may be issued upon receipt of a$10,000
escrow to ensure completion of the as-built survey and all slte improvements.
t
ApplicanYs Signafure: �l!'G Date: 5��1�5
Owner's Signature: Date:
u�� ��� ��
I.� L� nJ t�� i1 a�'�'��/1 � u.,�t,y► � 1�> ?rr.� Y�
l J/
Gf L�7,271�Irf I> '� �� '.t'��S'�j�' 7� 1 �
'� � -� �
S� ✓�o��n5' u��✓,�a�` � Q1 � Q
�,,� ,��� � �m�s�� �9' ll ��� ���
�� �
�o�v� ���'`' ,, �1 � � �n vt� l U � 1r,.�
� 2� �u ��� a�- �� �'��' �✓ �
�
� 31�F1 £3 C�3X�3H� NtfEd
3���i"f'��s�li�� ���� ��� �����,�3��
� `
��U o�J'U� .
� .
, •Ju: ,�13 14 02: 48a Nate Barke 507-345-5817 p. 4
r� .
' � , ,�'
� PROPOSAL �; , y✓' . - "~
BID DATE: INSTALLATI N DATE: �
. � � �� l i • • � �`1(i0f B11ke�S �� �
�imPlete (�ja.aement
� ��'lJ75
License#BC143377
���- . • � . . .�� � � �� :�� . . � - - - - .
CUSTOMER NAME � � L��=-��y� PHONE �,� ` �f I S
�r.i, 1 �I �� j�
ADDRESS `t p � I�+�r�'� �I1�`�, {.✓�. PHONE
{,�r�,�l� , �� J��� EMAI�
CI7Y,STATE AN�ZIP CODE
Job Notes
�-''�,5��'a.�l �)C•�Ci�:)� I`�Z•') �y�:.5'}�;+'1 1 tl �;C'-ti S�C�'✓l 1-1 (.fi!'�i,w�'�/ � �iii.�,y
�C: -,� f } j�-� 'f � J� /
.,:=1 � `J ��� `�`i:�r�1 SL��'� Ll/t'--I t : IC�[lG 1 �u:'� •�-c� !,�X�4 v S`{- �(-S'�` C�l�S�?v•�
/ � + i
�U�Iv�e'J`t" T�'"'� ��1'1�. 1.�5 "fG r.c.G"l`cl,✓ur� Ir�CL�,C-tU!\ 'Tv'' .'F4'.\ ��r ��� 7- L � � /1G(
�•� l•'v� �:�+'�� r•'1 �i:: 2c � 1 R1,7
I i • �
� '- - - WaterGuard� 7herrnax7°
' � � I
' i -' � --I � i j i ' TripleSafe� PowerBrace-"
� ' + � (,_ ' �C,� °�1 ' SuperSump p �ehumidifier
' � UltraSump� Basement Wintlow
--- _ ' I ;
� � � � - - - -- -- -- - - -� WaterWalch�Alarm SunHouse'""
i � IceGuard� RockWell TM
'--i .�i . _' � :
� � � I - -- - LawnScape� WellDuc�r"
_ I I � � LawnScape�Basket ThermalDry^"Floor
_ .. ..�_. ._-- �-_, i � i
---- -_� i -� _ . _ F , ._ � r . _.I.-.+ _-� Debris F CfeanSpace TM
� iller
.. ._ - :_ : i I-- -- J
' 1 1/7'Pipe SmariJack'"
._ _ . :_' ' . ..._. I _..._. ; __._ _._ __ _ _. _ _ _ 4"Pipe SmartJack Header,""
I � i� i i-_
_.�.�_ oodcn �
, - �_� ek,M
F� ' C
---,-_ _ � � ` .U •-.
- - - - ---- _. __ _
-�-- - - - -- -�._ _ . __ ._ I � I FloodRing rM � � .
_ _..._ _ �-- - _ __ _..__ - .
� - FlexiSpan""
-- _�_ � _ . _._ _ --• -- - + CleanSpace'"Wall , .�
i
_ � _, ____ ThermalDryTM'Wall
-- - - 4;� _ ; _ . I _� SoFast �ti G
� i _ I.., In (
- " - 7ype of Wail: Type of Wall finish
� - - —j_ _! . ':-. --- .._. _�_ _ � � - -; �l8bck ❑Stone ❑Plain ❑Over Studs
__
i
- -� ; ; ❑Poured ConCrete ❑Paneling ❑Firring _
--- �-a-- � �-- __ . .__ _ _ _� ❑Other ❑Sheetrock �(Other. C�
� - -- -;--- -- .. _ _1 _. __ ._ . ._�_ _ Systemtodraininto:J�J� TypeofFloorFinish: —
L � � ❑SuperSump o-New �Cancrele ❑Tile
' -- -- 1-- ❑TripleSafe� ❑Carpeting
�
� � ❑Existing Sump O Other
� � / V+ �^, ' /� /� i - ❑Other
The contraGor's iepresentative has fuly explainetl the me�its of the waterp�oofing system.i understand a WaterGuard�,DryTrak�or DrainTrak�system will rempdy the problem wdh water involving the waus
antl the joints where the floors and walis meet.I fuJy untlersLand antl accepc the Iransferable warranty�vh�ch cOve�s onty ihe areas of the oasement atltlressed.There will be no charge for service calis which
are�eaks in the sysfem covered under warranty.Aservice charge wJl he imposed for any service calls involvirtg leaks in the systam,or leaks lrom aamage or abuse.Partial perimeter systems carry a hmited
warranty Sump p�mps ere wvered under a separa;e manufadcrer warranty which doesnY include laoor for pump service Installation of Dry7�ak�alone will not eliminate seepage Gom floor crecks.Installation
of syslem doea not include painting,firtished carpenlry,e�ctendmg discharge iine,eleclrical work,or replacement of floor tiles o�carpMing uNess speci5ad,Corlrac[or is not responsiDle forfrozen discharge lines
wilhout an IceGuard4�i,condensation,water once pumped from house,window well flooding,or fuel tanks or lines.Homeowner to provltle 4-5 workmg area away trom wall for installal�on.DUST SHOULD BE
EXPECTED FROM OUR WpRK.Paymem to be matle in Tull upon complation.A service charpe witl be imposetl if any check is reWmed for non-sutiicient fvnds.
W,�e�pose lo f nish material anp labor--omplete m accorC ce w h abov sp�ci5calions,for th sum f �' ,���� !�j
_! �./� ��v�.�..tcl . �F�rr• �7���'rC� �+�� 4�� Fx%c,�s doua�ss
2 ` =-v 7`` "� 1 r.v
Deposit Required S J�� � Deposit Paid$ ,7 C..�� Balance Oue Upon Instaitation g o[,�?��!
All matenal i5 g�arenteed as speafied.All worY.to he caaFleled acco�ding lo I�e standartl praclicas Any alteralion o�tleviaUon Irom abo�e quthorized�
speci(ications involving exlra costs will be exeadetl only uoon wntien orde�s,antl w�ll become an eztra charge over anC above the esnmafe Ali 5�9� � ,��� �
agreemenis contingent upon strikes accldem5 or delays beyond our�nimi.Our workers are fully coveretl by Workers Compensatron
Insurencc Homeowner assumes all resporsibillty for damages due lo hreakage of any hidden fueVc6liry sernce Imes,though we wiH d0 our bes[ Note.This proposal may be -
lo avoid s�ch damage.Ail proposals based primariiy on homeowners descnption o`prohlem wilhdrawn Gy us if r.ot acceptetl within ' pays.
Acceptance of Proposal-The above pnces,specifications and conditions are satisfactory and are hereby accep[ed.You j
are authorized to cio tnre�vor as sp �hed.Payment will be made as outlined above S�gnature x
Da(e of,acceptence �J � 1� ❑ qFULL PERIAIETER SYS7EM WAS RECOMMENDED Sgnawre �/
DATE TIME�
CITY OF ORONO CALLED IN
INSPECTION TICE SCHEDULED � �L �� `����%`�^
PERMIT NO � � %���3 3 COMPLETED
ADDRESS c
\ � �.��r�\- _ ��e,�� �Z
t�lAp�ER ��«� TELEPHONE NO. ���' ���� ��` �-
CONTRACT�A y t���ti�c�<� . �C���i�_�.-��>�y`a��x�r�
�; DESCRIPTION
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z 0 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 O SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOFi TO MEE?YOU:_YES_NO
� COMMENTS:
� - ��
W �
a
� ,
� i '-'�i:
O
�.
�
O
�
W
�
Q
�
2
W
�C
W
�
J
W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOYERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN
INSPECTOR WILL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in advan . 9 2) 249-4600
OwnerlContractor on site:
�
Inspector. �
White Copyllnspector's File Canary CopylSite Notice