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HomeMy WebLinkAbout2015-00236 - addn/remodel/repair CITY OF ORONO I'Iih I * 2015 - 00236 * 2750 KELLEY PARKWAY DATE ISSUED: 02/25/2015 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 1389 ORONO LA PIN : 02-117-23-34-0005 LEGAL DESC : HOMES ON BROWNS BAY : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 20,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,ELECTRICAL(STATE) (FINISHING INTERIOR BEDROOM&BATH IN PEAK) APPLICANT PERMIT FEE SCHEDULE 356.26 STATE SURCHARGE(VALUATION) 10.00 KATHY HOLSCHUH(GENERAL) 3939 COTTAGE LA TOTAL 366.26 MINNETONKA,MN 55305- Payment(s) (612)990-8855 CREDIT CARD 0149 366.26 OWNER MACMILLAN, SALLY&CAM 1389 ORONO LA 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 in conformance with the State Building Code.This permit may be revoked at. y time for due cause. (Apa__ 2 7 6---//5- INN App icant liritee Signature Date Issued By Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel • (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) CoAMailing Address: Permit number: 1J3/ 5 — 60 2 5fe2 O PO Box 66 _ Crystal Bay, MN 55323-0066 Date received: / 5�/� Street Address: Received by: �� A G` 2750 Kelley Parkway Plan review fee: F t Orono, MN 55356 3 /,, �kESHO� lO( 2 c Total 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: Job Site Address: I ?6\ 0 r-0,1c3 L.-0.n 'E_r. Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? El Yeso If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus rvice will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 4<<{-4,L, {-4-0\S .J• State License# I Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) tv 1 Li e10 - S 3 (office) Mailing Address: 3131 co-t-fct,i e LQne— City: F'n-t--,,_ ZIP: ...,, 0 5 Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: korai 1 h0kelt„L.in co Liall,n_c0ri,1 PROPERTY OWNER INFORMATION: Name: :j<LI(y d Clam Il\&c. Vf; (Ickv) Phone (day): Address: 3 ri Oro r\o L--v—e._ City: (A)61.1.2_,.. tz. ZIP: 5`-5 3 5 i Email and/or Fax: PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) Remodel 1=1 Fire Damage MCWD review&permits: ❑ Re-roof, asphalt /❑ Repair I=1 Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project (excluding land) $ a°1 b O 0 . ' 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 information,the application may not be issued. Applicant's Signature: ' Date: V Owner's Signature: Date: Last Updated:January 2015 PLAN REVIEW CEIECKLIST FOR NEW STRUCTURES I ADDITIONS Address: t O?NO LAAJ Permit No.: Description of work: DTZ. -t l?a• r is -V Date Rec'd: SPAcr:c �J Pct►►T' zo v-1 Septic review by: N I A Date Approved: Zoning review by: N(A Date Approved: Building review by: )4n„--- Date Approved: Z-Z-C-e- Grading review by: N/(J Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: oning:Lot Area: SF/AC Width: Lot Coverage: SF % Su -y Submitted: Q Yes a No Date of Survey: _____ Revised date(?,. Propo Setbacks: Front(L- e) Rear(Street) ( N S E W ) ( N S E W ), 'Other Buil, ngs Wetland Side Side Defined Height: Peak Height: FFE: FFE mitlus ; eet-=. (Existing Contou Perimeter(linear feet)= 50%= L.F. below.grade #of Stories FOR A BUILDING WITRA BASEMENT 0- RAWL SPACE: FOR A BUILDIN r ON A SLAB FOUNDATION: The•istan. between the lowest proposed The distance between the top of START WITH floor(of the b-- .mentor'orawl space)and START WITH slaband the highest point of the the highest point the roof. roof. If you have a.. If YOU have a:.. + GABLE>OR HIPPED ROOF - • GABLE OR HIPP ROOF"(no (no windows);.Subtract half windows) Subtract' f the distance the.ttistencetetween the between the higheestpo of the mot =�htg`hest point,of-the roof to to the tow point of tire corn onding the towpointofthe SUBTRACTION gable or hipped roof corresgond4ng gap!or 18I'V D ON `�:�:. GABLE OR'HIPPED ROOF '�, ; )BTRACTIOt hipped roof 'ROOF TYPE) windows);-Subtract hairthe r (,-SED ON • "-�BLE"CR�kIIP�PfD ROOF. between the top of the hig ROOF nye) (with wrndow§} subtract window and the highest int of the 'halfthe lista a etween�` the ` ehlghest- ALL t�THE12. "o• TYPESMat. Wind➢owwend the hi`giest • mansard etc): subtraction . " Point ef'the roof • ALL OTHER ROOF TYPES SUBTRACTION Subtract the dis between the {flat ma isarci etc) No (BASED ON basement/cra space floor and the sub on E)LISI'ING, highest rade adjacent to (stance � g g. r DITION Addth6 distance between ttietop` GRADES) foundatio :•R 10 feet=(whicheverns less). • ED ON of slab and the highest existing EQUALS Dell budding height _ a •TING grade adjacent tothefoundafion. rT� eEsj .0 UA Dettieeti building height Average Lakesht Setback Shoreland District MCWD Permit `Buff l Met,s4 Permit Number:. D Yes 0 .No., 0 N/A " Yes 0 No DYes D o , CI N/A--see attached Setbalck: Sformwater Q ality Existing Hardcover Proposed Overlay D : rict o Hardcover Variance Required CUP Requir (/o andst) Tier(ci - one) (%and sf) Yes DNo D Yes CI No 1 2 3 4 5 Type(s): Type(s): Updated: January 2015 z:\forms\plan review checklist 2015.docx REMARKS (in-house): Fees to be Charged YES NO Pefluit Plan Review r/y State Surcharge Investigation Fee SAC—Number of SAC Units Other(specify) Square Footage $per Square Footage Basement X = • $ 1St Floor X _ $ 2"d Floor X = $ Garage X = $ Estimated Construction Value: $ Z f>,0c C7 Orono Inspections Required Work Requiring Separate Permits Required State Permits O SitePlumbing/21 17 Grading/Filling 0 Well O Silt Fence/Erosion Control 0 Mechanical 0 Fire tiff Electrical O Hardcover Removal 0 Septic D Water Connection O Footing 0 Fireplace 0 Sewer Connection O Poured Wall O Masonry a .Lawn Irrigation • Foundation Survey 0 Mfg.- a.Landscaping O Foundation Waterproofing 0 Other(specify) ® Radon Rock Bed © Framing insulation I3 As-Built Survey Final O Others ) REMARKS(in-house): Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES 0 NO New: 0 YES U NO OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2015 z:\forms\plan review checklist 2015.docx on) P-OstvG P r.a L16$e_-_i epi iii r to- IernA - _ -- c©� #+Rim-- 7Q '. 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