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HomeMy WebLinkAbout2017-00775 - addn/remodel/repair 11 • CITY OF ORONOi' ''� �' �' 1 ' * 2750 KELLEY PARKWAY * 2 0 1 7 - 0 0 7 5 DATE ISSUED: 07/10/22 017 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 • ADDRESS : 615 ORCHARD PARK RD PIN : 31-118-23-11-0006 LEGAL DESC : UNPLATTED 31 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 22,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) BATHROOM REMODEL APPLICANT PERMIT FEE SCHEDULE 387.20 PLAN REVIEW 251.68 D B RASKOB CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 11.00 2864 ARDMORE AVE MAPLE PLAIN,MN 55359- TOTAL 649.88 (763)479-1393 Payment(s) Minnesota State License#:BUIL-3481 CREDIT CARD 9975 649.88 OWNER • LANG,MR&MRS KEVIN 615 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 date of issuance,or if construction is 11191 suspended for a period of 180 days at any time after work has commenced. The applicant is ..ns .le for assuring all required inspections are requested in•.nforman• with the State Building Co . is permit may be / revoked: any time fo due cause! 141 �� sem' air: A:• ' • 'ermitee Signature Date • ssued By Signa re Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) t V Mailing Address: Permit number: �j/7D-07?S` W PO Box 66 Crystal Bay, MN 55323-0Q{fi61 Date received: /`4,_) 7 Street Address: �'� Received by: —J y� L� 2750 Kelley Parkway 1/ Plan review fee: `AESHO�� Orono, MN 55356 /"/ 8.5Total Fee: 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: ,7 Job Site Address: �' ��i"Cf1' �� 7 c`( /e - c � 21 ; /L (l-�� s w Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? E Yes 1 JVo 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/APPLICANTIN ORMATION: Name: 2e3 /t J if-ci4, i fI iict,7'7cO-i LLc— State License# ?4�/ Expiration Date: . Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) (Pla — 1'6,5-- 960 '7 (office) 76,3- 4i79 -/3 j 3 Mailing Address: y^ G - , City:/1//e ZIP: 75-8 Contact Person: / ' ko L Applicant is: t.n racto / Homeowner (Circle One) Email and/or Fax: ah/A.3/c_e,, & 60 /nc- cf PROPERTY OWNER INFORMATION: Name: e v c �. ¢ , 4 L Phone (day): 40/:2 - 96. cf - 74, 4L(74 Address: 6,t6- dj-ch1z-i; t-(_ ,a.4-- , CE. City: - -z ZIP: SS � 5-Z. Email and/or Fax: /1/, PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) emodelMCWD review&permits: 0 Fire Damage ❑ Re-roof,asphalt El Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) El Re-roof, cedar 15320 Minnetonka Blvd ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof, other(specify) ElSiding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ j d 2C) 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 t - 'nfo ation,the application may not be issued. RECEIVED 7 Applicant's Signatur-: ` Date: 7/i)�,/ JUL 0670at .1/. Owners Signature: Last Updated:January 2016 CITY OF ORONO PLAN REVIEW CHECKLIST/ FOR NEW STRUCTURES / ADDITIONS Address: 7(5 ®/'C/'f Qrcr %v" Permit No.:Z0(7' 00 7 7,� Description of work: gc.rkA 490 fn. / #Z LJ / Date Rec'd: 7/Ce//7 Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: Gl�,l( / Date Approved: 7//0//7 Grading review by: dd �• Date Approved: Zoning District: Zoning File#: Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution /NA Zoning: Lot Area: SF/ 'C Width: Structural 'overage: SF ok Survey Submitted: D Yes 0 No Date of Survey: Revised date(?): Landscape plan submitted? 0 Ye. Landscaper: 0 No/ None proposed Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N E W ) Other Buildings Wetland Side -ide Building Height Analysis: Distance Between First Floor and define. Top of Roof* (See "building hei!ht" definition): (a) First Floor Elevation (fro building pla s): (b) Highest Existing ground l;vel (per su ey) or 10' (C) above lowest ground level, whicheve is lower: Difference between (b) an• (c): (d) DEFINED HEIGHT If highest e,sting gr de is: (e) C above FFE-Height is(a)-(d) — below FFE-Height is(a)+(d) Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? Permit Number: 0 Yes 0 No 0 N/A 0 Yes 0 D Yes D No No 0 N/A—see attached i Setback: I Stormwater Quality Existing : -roposed Overlay District Tier Hardcover i =rdcover Variance Required CUP Required (circle one) (% and sf) (°. and sf) _ D Yes D No D Yes D No 1 2 3 4 5 Type(s): Type(s): Updated: October 2016 v:\forms\plan review checklist 10-2016.docx ; Fees to be Charged YES NO Permit t/` Plan Review State Surcharge Investigation Fee /' SAC—Number of SAC Units C/' Other(specify) l� Square Footage $ per Square Footage Basement X = $ 151 Floor X = $ 2nd Floor X = $ Garage X = $ CPO Estimated Construction Value: $ 2- Q 62t Orono Inspections Required Work Requiring Separate Permits ❑ Footing 0 Site Plumbing 0 Grading/Filling ❑ Poured Wall 0 Silt Fence/Erosion Control Mechanical 0 Fire ❑ Foundation Survey 0 Hardcover Removal 0 Fireplace 0 Water Connection O Framing 0 Other(specify) 0 Masonry 0 Sewer Connection O Waterproofing/Drain tile 0 Mfg. 0 Lawn Irrigation ❑ Foundation Waterproofing 0 Other(specify) 0 Landscaping Framing Insulation ❑ As-Built Survey Final ❑ Lathe Required State Permits ❑ Other(specify) 0 Well 'Electrical REMARKS (in-house): / OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: ❑ See Builder Acknowledgement Form ❑ Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. 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I '�- DATE TIME J CITY OF ORONO 0 7g' ALLED IN 7a ��-/7 INSPECTION N qT�CE f�7__SCHEDULED p`�Tr'!�`-, PERMIT NO. ov 7- /J COMPLETED 7-.2., -/ 7 1/,' c-i) ADDRESS 4'e5 6V 1W OWNER �TELEPHONE NO. /Z s 4A'7 CONTRACTOR 4' Z. ti DESCRIPTION / l b Lu ❑ FOOTING 0 DEMO-Fli L 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING 'I) 0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS • ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL .t ❑ DEMO-SITE 0 SEPTIC INSTALL 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO (,)• COMMENTS: C 2 ?'n S���v��o n W CC W)(WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE • ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY C ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.I' BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. iB White Copy/Inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICF�-� i- j SCHEDULED V1717 C-%( •Cj' PERMIT NO. u �/ COMPLETED C�' ADDRESS P LES- Cf -t(K OWNER TELEPHONE NO. (Of GI J`bb C L007 CONTRACTOR Rcz-kwh -"r,� � wry E DESCRIPTION Ftr f -104' ` , - VY��°-c- W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING • ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION • 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS • ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT FINAL 0 WATER HOOK-UP 0 FOLLOW-UP ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL ..t ❑ DEMO-SITE 0 SEPTIC INSTALL • OWNERICONTRACTOR TO MEET YOU:_YES_NO Fril COMMENTS: fir,0A,4; S 4" kr? 0/c 9ILC © k Td ak 1 cc0 0 W O: O: W 0 WORK SATISFACTORY:PROCEED ``Q PROJECT COMPLETE CC0 CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY c.) BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED 0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours In advance. (952) 249-4600 Owner/Contractor on site: Inspector: &"--45"..3-1 Cad White Copyfnepector's FIN Canary CopylSIts Notice