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HomeMy WebLinkAbout2010-00122 - addn/remodel/repair . . w CITY OF ORONO PERMIT NO.: 2010-00122 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 03/17/2010 (952)249-4600 FAX: (952) 249-4616 ADDRESS : 420 ORCHARD PARK RD PIN : 32-118-23-23-0006 LEGAL DESC : ORCHARD PARK : LOT 008 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 35,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) ADVANCE PLAN REVIEW FEE$338.33 PERMIT 2010-00121 APPLICANT PERMIT FEE SCHEDULE 520.50 FINISHED BASEMENT CO. STATE SURCHARGE(VALUATION) 17.50 1380 DUCKWOOD DRIVE TOTAL 538.00 EAGAN,MN 55123- (612)710-0391 Minnesota State License#:20460771 OWNER PETERSON, WILLIAM&LYNAE 420 ORCHARD PARK RD 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 d•to of issuance,or if construction is suspended f r a period of 180•ays any time after work has commenced. The applint is responsible as- ring all required inspections are re• ested n conformance State Building Code.This permit may be revo'-d a any time i • cau--. 1,4 � / / � / � / Applic. �t Permitee 'i� .t re Date ed By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. lb-3 g n AA° City of Orono Building Application A lication for New Structures or Additions Mailing Address: Permit number: &CYO COQ/c3...1....y_O� PO Box 66 0 Crystal Bay, MN 55323-0066 Date received: —�"/D Q��`" r- Received b I.e A `. "`�._:•, s. Street Address:' Y'_ , (�D IO " octal M,s,: 'A l' . j'i"�,N �� 2750 Kelley Parkway Plan review fee. 33�33 �kSHog� Orono, MN 55356 Total Fee: 553, Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us 7S.7 (o ,.5 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: c- 0 0(CA I 1?' vrft- K. (a U4,. -- 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 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: > '.AI )),-"-Ci- (ja3.4- e,. "- C nIAA H iL State License# ao kI4 C.-4:3-1 Expiration Date: 3 — DO l 0 Phone: [psa - a1 A. ete,P D, (office) (cell) Mailing Address: i I&G(a e4v.A-"itco vA .r Ci�Y r�� ZIP: 5 S 3�'JI Contact Person: pw, Mato t A licant is: Co ra for Homeowner i Email and/or Fax: . pp (Circle One PROPERTY OWNER INFORMATION: Name: L► wa{r q- 3<� cD �l'SDV� Phone (day): 01 -?.- c{ 4 — -C.SS Address: y?il ©Jclnar,� !�w`k— �2A City: atDIA,0 ZIP: 45-c-354,0 Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal & ❑ New Construction Single Family with Residence Water Supply Sin El Addition attached garage ❑ Garage/Accessory ❑ Accessory Building El Single Family with El Deck Bldg. El Public Sewer ❑ Relocation detached garage El Office/Commercial Private Sewer WOther: (specify) Zeis4AN4Ar ❑ Multiple Family/Condo ❑Warehouse w ❑ Public ❑ Storage ElPublic Water **Any earth movement may re uire ❑ Commercial ❑ Other(specify) MCWD review& permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) El Other: (specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.orq Estimated Construction Valuation (excluding land) $ 2J5 Last Updated: 9/29/2009 - 17 - I . • STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame ❑ Masonry b.Width (ft.)= Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1st Story = ❑ Other(please specify): e. 2nd Story-= f. 'h Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ ❑ Permit Application ❑ ❑ Proposed Building Plans ❑ 0 MN State Energy Code Calculations and Mechanical Code Requirements Form 0 ❑ Survey(meeting all requirements) O 0 Stormwater Pollution Prevention Plan ❑ 0 Hardcover Calculation(s) ❑ ❑ Septic System Site Evaluation Report ❑ 0 Access Permit O 0 Wetland Buffer Improvement Plan ❑ 0 Engineered Plans for Retaining Walls 4 feet or above ❑ 0 Plan Review Fee ❑ 0 Other APPLICANT 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 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; • Acknowledges the Escrow Agreement is completed and signed; • 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. Applicant's Signature: �' k SAA Date: cot6 w Last Updated: 9/29/2009 - 18 - . . . Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: (--(i C> U (c: l /1 / 0 P A (1 ' 1 ci Description of work: f3A SCZ b%'\t f •n.1 t S1- Septic review by: 1.0 (41-- Date Approved: — g- 1 CD Zoning review by: — Date Approved: Building review by: czP C".0.44."..-..— Date Approved: 3-ft — l 0 Grading review by: Date Approved: Zoning File#: Resolution#: Resolution Date: Zoning District Fire Department Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: ❑ Yes 0 No Date of Survey: Proposed Setbacks: Front(Lake) Rea Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Building Defined Height: Building Peak Height: #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL ' -ACE: FOR A BUILDING ON • SLAB FOUNDATION: START WITH the distance between the baseme't floor/crawl START he distance between the slab and the highest space floor and the highest roof pea the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line • a the deck line of a mansard roof, or the mansard roof, or the uppermost point on : round uppermost point on a round or other arch-type or other arch-type roof roof SUBTRACT half the distance between the highest window ,nd UBTRACT half the distance between the highest window highest roof peak of a pitched roof \ and highest roof peak of a pitched roof SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade withi• existing grade within the foundation the foundation or 10 feet, whichever is less. EQUALS Defined building height EQUALS Defined building height Lot Coverage: :F L 0,0 Shoreland District MCWD P• mit Received Averagetakeshore Setback Bluff 0 Yes 0 No 0 N/A 0 Yes 0 No 0 Yes 0 No ❑ Yes ❑ No 0 N/A — Per • t Number: Setback: Hardcover Zones Existing Proposed Variance Required CUP Required 0-75' 0 Yes 0 NN 0 Yes 0 No 75-250' Type(s): Type(s): 250-501 500- 000' REMA- 'S (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Charged YES NO Permit Plan Review t/ State Surcharge Investigation Fee SAC-Number of SAC Units Sewer Connection Water Connection Park Fee Site Inspection Other(specify) Miscellaneous Fees Calculated By: Square Footage $ per Square Footage Basement X = $ 1st Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ 3S;000 ';—" Orono Inspections Required Work Requiring Separate Permits Required State Permits O Site gr Plumbing 0 Grading / Filling 0 Well O Hardcover Removal Mechanical 0 Fire ArElectrical ❑ Footing 0 Septic 0 Water Connection O Poured Wall p'Fireplace 0 Sewer Connection O Foundation Survey 0 Masonry 0 Lawn Irrigation ❑ Radon Rock Bed ,121-"Mfg. %Framing 0 Other(specify) p' Insulation ❑ As-Built Survey incl ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES 0 NO New: ❑ YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.docx /3.— CD--- C e- TIME V D TE /O CITY OF ORONO CALLED IN INSPECTION NOTICE / SCHEDULED /? /d ,-Z:.3 a PERMIT NO. o{f�lhLY�f/3 , lCO�MPLETED /� (), ADDRESS TP OWNER TE PH NE NO.C�/�-M-�?-9l0/�-- CONTRACTOR M_1fl /� e0 " C71-4`" DESCRIPTION & U , 4---'cilt —,t6211.-et- Lg 0 FOOTING 0 PLUM ING FINAL ❑ EXCAV/GRADING/FILLING Q 0 POURED WALL MECH 0 LAKESHORE/WETLANDS Q`ei2FFRAMING 0 MECHANICAL FINAL IDTREE REMOVAL • 0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION Q 0 RADON SLAB 0 WATER HOOK-UP 0 PROGRESS • 0 FINAL 0 SEWER HOOK-UP 0 COMPLAINT v 0 DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP i ❑ DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL v -LUM:N,li 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL Z OW -.f ONTRA 0: '•MEETYOU?S YES_NO ti CO ENTS: LU • i 6/ 3,041 cc b, 01. t'-/I 4 10;/, . -�W1 0 cc 0 IM CC Q W Z W Cc 8 cc 440608 WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W RECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY OO ElCORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.1 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ElSTOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: gs Inspector. White Copyllnspector's File Canary Copy/Site Notice ..._A "5 ' ATE_ TIME CITY OF ORONO ----------- CALLED IN .�Ti /D INSPECTION NOTICE SCHEDULED _� 3, D PERMIT NO. ') COMPLETED /� ADDRESS 'Z'iDavxd-&t OWNER - T EP ONE NOb12) ' $' - di..0 irr CONTRACTOR %` 6G ��/14 — ,' >. DESCRIPTION -g K-ICS LAI ❑ FOOTING PLUMBING FINAL ❑ EXCAV/GRADING/FILLING 4. Q 0 POURED WALL ❑ elECHANICAL RI ❑ LAKESHORE/WETLANDS C1.3 0 FRAMING AI MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE 0 SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS FINAL 0 SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL v ElPLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: CC LiJ 4 I/ -- Re)/D - 0611 da5---4.1e 1 C Q. • P - cc � 6 ~ aom) - eo/�rvk ,ter cc ia� �o ld -Da 1/y� 0 Q Dir S C_ S SPd C < () , b.ec C-4-cyS Le) ; 4-1" 0 c_...) til e-re LJ CL-L3 e f' S 7 -+C c' 5 d tu cc T ri6' ( A(e C) - i LU ❑WORK SATISFACTORY:PROCEED \PROJECT COMPLETE CCW ❑CORRECT WORK&PROCEED El ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY CJ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ 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 Owner/Contractor on site: _ges Inspector. White Copy/Inspector's File Canary Copy/Site Notice