HomeMy WebLinkAbout2009-00348 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2009-00348
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 06/29/2009
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 795 OLD CRYSTAL BAY RD N
PIN : 28-118-23-34-0003
LEGAL DESC : UNPLATTED 28 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : INSTITUTIONAL-SCHOOL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 326-SCHOOLS AND OTHER EDUCATIONAL
VALUATION : $ 7,000.00
NOTE: SHOWER ADDITION IN EXISTING SPACE.
WORK REQUIRES ADDITIONAL PERMITS: PLUMBING PERMIT REQUIRED.
APPLICANT PERMIT FEE SCHEDULE 147.50
M.CARSON CONSTRUCTION STATE SURCHARGE(VALUATION) 3.50
3311 VALE CIRCLE SW
PRIOR LAKE,MN 55372- TOTAL 151.00
(952)226-2699
Minnesota State License#:20264722
OWNER
278,ORONO SCHOOL DIST NO.
795 OLD CRYSTAL BAY RD N
LONG LAKE,MN 55356-
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 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 period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any tirry or du cause.
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Applicant Permitee Signature Date Iss/By Signature Date .&9
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
% nO Box 88Mailt Address:
!ermit number. i 9-'O 35'���y4.° Crystal Bay, MN 55323-0068 Date received: (,A 2/oq
Received by:
,�i'i� ,r Street Address:��` 2750 Kelley Parkway Plan review fee:' N; 4��' Orono, MN 55356
TotalFee: ://./A.
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Main: 952-249-4800 Fax: 952.249-4818 www.ci.orono.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: /O 7S O Icf Covs7/*/ BAy /00
W �, o214,5°.it this be a Parade of Homes, Remodelers Showcase Hbme or other Display Home? 0 Yes LJd'N
If yea,a special event permit is required with Police Department end City Council approval 60 days prior to the event. Shuttle.pus service will be
required unless applicant demonstrates sufficient onsite parking is available. Non-permitted events will not be elldwed.
CONTRACTOR/APPLICANT INFORMATION:
Name: Ale-SO eli Con,g4e.c. 111A,
State License# O Expiration Date: 3 3/ -
Phone: .1-.3- G - 2 91 (office) �77- 3C^ ..5Z 72 (cell)
Mailing Address: 3/l 49./-s co rJh S.4,4, Cl : . lire_ ZIP: ..s—s"3 7_2
Contact Person: /7)i Aes A v.. ori/ Applicant Is: ontractor I Homeowner (Circleone)
Email and/or Fax: /yrj s to-,.s. AA.M s n n 6) 7..,,o . ,.. 11 n.1.1
PROPERTY OWNER INFORMATION:
Name: arsO i Tc-€ t1r e iuA S+e u v. Ar 4 e( /77 Rti u 7 er.
Phone(day): - •- _0 "0
Address: /0., _c- o 1 d Cry s I SA?, AJ 4 City:6 trove c.) ZIP: de '"3sr
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review&permits
❑Door(s) ('Remodel 0 Water Damage
Minnehaha Creek Watershed District(MCWD)
❑Window(s) 0 Repair 0 Storm Damage 18202 Minnetonka Blvd
Deephaven,MN 55391
❑Siding 0 Restoration 0 Other:(specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Re-roof 0 Fire Damage www.minnepahacreek.orq
Overall Project Description: €
Estimated Construction Valuation of Project(excluding land) $ -AAA/, vet
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 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. 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. .
/-2Applicant's Signature: ,�f;4(0 ie Date: .06 /6 - .,70 O 7
Last Updated: 05-04-2009
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: 10Z5 t9c.€) C ¢,,sem ogur 11.43-4.0PID: t
DESCRIPTION OF WORK: SN=ov-e A od /& rx ,sT r 5Dr4 c.
ZONING REVIEW BY: NM ( DATEAPPROVED:
BUILDING REVIEW BY: cryg DATE APPROVED: e - .0 5
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes No ✓ SEWER CONNECTION
STATE SURCHARGE Yes ✓ No WATER CONNECTION
INVESTIGATION FEE Yes No t/ PARK FEE
SAC Yes No moi SITE INSPECTION
Number of SAC Units OTHER (spec) •
ZONING CHECK LIST Zoning District: 0
Fire Department: Post Office: School District:
Lot Area: Sq.ft. Acres kith Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front(Lake): Right Side:
Rear(Street): Left Side:
• Adjacent Structures: W=tland
Building Height. Def'Hgt. P •k Hgt.
Lot Coverage:
Grading: Staff Approval Date: By Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District: MCND Permit:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-'5'
75-250'
250-500'
500-1000'
Hardcover T.-at-tame Required: Yes No Date of Council Approval:
REMARKS(in house):
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BUILDING P 'Vi PLA.'< :-,iT.',"d
INSPECTOR _..__ . .
DATE b•2�'•6 Pr_r usT Pi;.. ._
/leAPP i?O ED AS SUESMI TTED
❑ APPROVED WITH CORRECTIONS AS NOTED
❑ NOT APPROVED --CORRECT& ic c,,vIT
These ccm^c,?s are far y;;.,:2r in0,1-4.1atiQu.ti:wtak sial be done
In full cornpiieno9 Ali el apVicri'; i)t,iid r-;) end m,irl code.
Rsc,::rame s i Ic:udinQ it;ns not sneclf:c3Hy.0ted in tn:s rsvieut.
Ick P T:-IIS PLAN SET O'N SITE AT ALL TIMES
I7UW22-2009 13:52 FROM: TO:9522494616 P.3
Orono Ice Arena M. Larson Construction
1025 Old Crystal Bay N. 3311 Vale Circle S.W.
Orono, Mn. 55356 Prior Lake, Mn. 55372
Manager Steve Kramph Office 952-226-2699
Phone 952-449-6090 Cell: 612-636-5672
DESCRI PTION:
Visiting team locker room add two more showers.
Frame up wall so new plumbing and shower valves can be installed.
Cover wall with dens shield wall covering.
Install liner on shower floor and pour concrete to slope to drain.
Add curb to hold water in shower area.
Tile, grout and seal floors and walls in shower area. Tile about 7 ft. high on walls
Disposal of all building materials used for this job will be hauled away.
All work listed above will be done and completed in a professional manner.