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HomeMy WebLinkAbout2017-01147 - addn/remodel/repair CITY OF ORONO I* 2 0 1 1 7 i� 0 1'' 1 41I 7 II* 2750 KELLEY PARKWAY DATE ISSUED: 10/05/2017 ORONO,MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 490 OLD LONG LAKE RD PIN : 36-118-23-34-0010 LEGAL DESC : SUMMIT STATION : LOT 003 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 100,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) INTERIOR REMODEL APPLICANT PERMIT FEE SCHEDULE 1,109.92 DESTINY HOMES STATE SURCHARGE(VALUATION) 50.00 4201 SUNSET DRIVE TOTAL 1,159.92 SPRING PARK,MN 55384- Payment(s) (612)554-5476 CHECK 34251 1,159.92 Minnesota State License#:BUIL-BC5300986 OWNER LITSEY,CAL&CHRISTINE 490 OLD LONG LAKE RD WAYZATA,MN 55391- 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 info ance with the State Building Code.This permit may be revoked at an time for due cause. `` Applicant Permitee Si ture l I Date Issuqu Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel - Residential ONLY (i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) A, Mailing Address: 97 �Oi VO PO Box 66 Permit number: 010/7-0// ] 1 Crystal Bay, MN 55 3-0066 Date received: 9- J 8/7 i" Street Address: / /�," q Received by: ti� L� 2750 Kelley Parkw y / /✓ /' / Plan review fee: �[//rt7// y� `AkESHOv-� Orono, MN 55356 Total Fee: tfp 7,11. V5-_,‘L Main: 952-249-4600 Fax: 952-249-4616 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: 4C 10 (1) . �ti(, L-41-- b Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bu rvice will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: - --rj j- .L +4M ---- State License# -fit S 0°1 -^ Expiration Date: __ 12 rel' Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell 6 92)C? - S(1 �' (office) C012_- SSS-c -7(._49 Mailing Address: 42 b\ Sly(vS ET City: -I c,WLIP: `SSS g L/ Contact Person: , �-� Applicant is: t\Contractor Homeowner (Circle One) Email and/or Fax: GICr -}-0 -r-T� — -f--CM L27 . C PROPERTY OWNER I FORMATION: , Name: :/ C �] Pi � Phone(day): Address: 4 0 cni \Q1l/1- (.4 --;'r- t) City: (4%_OM) ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) emodel 0 Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) 0 Re-roof,asphalt ❑ Repair ❑Storm Damage 15320 Minnetonka Blvd ❑ Re-roof,cedar 0 Restoration 0 Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) 0 Siding 0 Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 0 Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ L ni (_ 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 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 ca .. be given to either the public or the subject of the data. Our purpose and intended use of this information is to a al u.,. - .ur -cords and records of other governmental agencies required by law. If you refuse to supply the in ormation, e app ion :y not ,- •- ued. Applicant's Signature: 1 Date: etard. Owner's Signature: Date: Last Updated:January 2016 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: #40 9t Ltvt9 ,'6k IL Permit No.:Z i &1(* 7 Description of work: .. fiery o K /L e edki ! Date Rec'd: Septic review by: ,P /el'm 9k WA"( Date Approved: Zoning review by: Date Approved: ,{� ` Building review by: - � .ii,(..)e 4 Date Approved: 7U' �! ` 7 Grading review by: Date Approved: Zoning District: Zoning File#: Resolution? Yes Reso#: Re Date: Signed: Yes No Resolution/NA Zoning: Lot Area: SF/AC idth: Structural C C. erage: SF ok Survey Submitted: D Yes 0 No Date of Survey: Revised date(?): Landscape plan submitted? 0 Yes Landsca er: 0 No/ None proposed Proposed Setbacks: Front(Lake) Rear(Street) ( N 5 = W ) ( N E W ) Other Buildings Wetland Side Side Building Height Analysis: Distance Between First Floor and defined Top of -oo° (See"building height" (a) definition): First Floor Elevation (from building plans): (b) Highest Existing ground level (per survey) or 1 e a'ove lowest ground level, (c) whichever is lower: Difference between (b) and (c)*: (d) DEFINED HEIGHT *If highest existing adjacent grade is abov• FFE-Height . (a)-(d): (e) *If highest existing adjacent grade is bel• FFE-Height i (a) +(d) Shoreland District M D Permit Average Lakeshore Setback Bluff Met? D Yes D No Permit Num,,er: 0 Yes 0 No 0 N/A 0 Yes 0 No 0 N/A— -e attached Setback: Stormwater Quality Existing Pro sed Overlay District Tier Hardcover Hard ver Variance Required CUP Required (circle one) (% and sf) (% an sf) 0 Yes 0 No 0 Yes 0 No 1 2 3 4 5 Type(s): Type(s): Updated: June 2017 z:\forms\plan review checklist 06-2017.docx Fees to be Charged YES NO Plan Review V Sties Surcharge t,"- Investigation Fee SAC—Number of SAC Units 1.7 Other(specify) Square Footage $ per Square Footage Basement X = $ 1st Floor X = $ 2nd Floor X = $ Garage X = $ A Estimated Construction Value: $ I&©� g©U Orono Inspections Required Work Requiring Separate Permits O Footing 0 Site Plumbing O Grading/Filling O Poured Wall 0 Silt Fence/Erosion ControlMechanical 0 Fire O Foundation Survey 0 Hardcover Removal Fireplace 0 Water Connection O Framing 0 Other(specify) 0 Masonry 0 Sewer Connection O Waterproofing/Drain tile 1Nfg. 0 Lawn Irrigation O Foundation Waterproofing 0 Other(specify) 0 Landscaping Framing 0 Septic Insulation 0 As-Built Survey Final O Lathe Required State Permits O Other(specify) 0 Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: O See Builder Acknowledgement Form O Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. 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Cal&Christine Litsey zs+a IRRe Roa W "� �R C T WootlNrb,MN 55391 490 Old Long Lake Road Wayzata.MN 55391 V \, ..7", DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE , SCHEDULED IO'�7 +�.e0 PERMIT NO.2-0/1 -01/1 � COMPLETED ADDRESS `-1 ?o alb( Long Lz,e ,2A / OWNER TELEPHONE NO.OP-55�/_s_1.7 2 CONTRACTOR 5,t.17 �)//te5 J d DESCRIPTION rra__,,,,,,,i_s ,i- _1 4 S W 0 FOOTING 0 DEMO-FINAV 0 SEPTIC FINAL A ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING 0 0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION • RAMING 0 MECHANICAL FINAL 0 RATED WALLS I. ULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT -"I FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W 0 AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL ✓• ❑ DEMO-SITE 0 SEPTIC INSTALL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO R COMMENTS: cc /�� 4 Com- /.� C-1-41-_0 5-4SWA.-rte1tA/G 51--/ tf.,/% 14 it o V At E ' ' " fiax.5 P74-e'k- vj25i1-5 e! . i (de._ (,-L/ n,,,5,.‹.v. tc,,,-/-,z64,1- , „, j `. 'reC Ia�S /�� � /lac¢ D��ws� E 614_--- -.a • 0 WORK SATISFACTORY:PROCEED 0 PROJECT COMPLETE IIAA% WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR 0 CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forth. - • • ' • 24 hours (952) 249-4600 Owner/Contractor . site: woe•, upsilons FIM Canary Copy/MM Notlo. KD E TIME CITY OF ORONO CALLED IN e INSPECTIONICE „ )7 SCHEDULED /0 / /O•. ) . PERMIT NO. pSl// ' T COMPLETED ADDRESS d Oi i h_ OWNER 4�JZJI T EPHONE NO. 7 / v3 CONTRACTOR /1/Le /,yriy 6//4 1 DESCRIPTION - I Or / W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL 5E ❑ POURED WALL 0 PLUMBING RI ❑ EXCAV/GRADING/FILLING 0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL Q ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS 1, ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL v ❑ DEMO-SITE 0 SEPTIC INSTALL IC Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO yCOMMENTS: IX IL `r e4kG /r464a✓Ote,eC) V n eC..-.3 Q. CC o o - d rt f GQ,P d- Gas/ bear-05 pow,be — W cc Q z dK Go�c W z W cc d LAJ ( .WOflKSATISFACTORY:PROCEED 0 PROJECT COMPLETE CC W LICORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector. "-- -/,,"-- ?61' White Copyllnspector's File Canary Copy/Site Notice -\. ..5 DATE TIME Y CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED off,..I--1 R lO:00 PERMIT NO.49-01/ 7-6 I I Li- COMPLETED , c� --Wrla_ ADDRESS `7 ! O O/ - �-- OWNER NO.9 gs�- * ' i \ CONTRACTOR 5 , 11 41,17eHONE s .JO A.- DESCRIPTION r71--A-') W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL 14. ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING C0 FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL Z ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS I, ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL r ❑ DEMO-SITE 0 SEPTIC INSTALL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO 2 COMMENTS: priPldta cka ��J'r)��,'4-a/ ,/sS5 dr. 1011/':a�w R dJyse.n1' 4"1-3 q % 4 o M tie‘r .6.,4-L. cc 0 W R Q W W j W 0 WORK SATISFACTORY:PROCEED 0 PROJECT COMPLETE CC• 0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY O \CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.1 EFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR 0 CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. 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