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HomeMy WebLinkAbout2012-00519-VOIDED ' � CITY OF ORONO * Z 0 1 2 — 0 fd 5 1 9 * , , 2750 KELLEY PARKWAY DATE ISSUED: 06/20/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1376 PARK DR PIN : 07-117-23-41-0096 LEGAL DESC : SAGA HILL REVISED, HENNEPIN C : LOT MB BLOCK 013 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAI ACTIVITY : 434-RESIDENTIAL VALUATION : $ 6,500.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMB G,MECHANICAL, EPLACE,ELE RICAL(STATE) 1N KIND REPLACEMENT OF WALKWAY A F NT STOOP * EXISTING ST'OOP IS 4'X 4' REPLACEME ST P CANNOT E ED 4'X APPLICANT pE IT FEE SC DULE 147.50 LARSON& TERESA, DAYTON PLA VIEW 95.88 1376 PARK DR MOUND, MN 55364- STATE GE(VALUATI 3.25 TO 246.63 PAID WITH CC# 4918 OWNER LARSON&TERESA,DAYTON 1376 PARK DR MOUND,MN 55364- 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}or 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 e State Building Code.This permit may be r ked at y time for due ca e. � ' �� � �j� Applic nf Permitee Signature ate �� � `� �� � Issue y S�gnature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . • . � City of Orono ��� �� � Building Permit Application for New Structures or Additions Mailing Address: Permit number: � l! — .S/ O��,�.0 PO Box 66 Crystal Bay, MN 55323-0066 Date received: �p/2�� �''`'"''�'"'= Received by: t a '�'-� ,, � Street Address:� � �� �,,�' 2750 Kelley Parkway Plan review fee: \lqgESHog� Orono, MN 55356 �=___.-- �-a��.�� - 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: � a % ^ ' ', Will this be a Parade of Homes, Remodelers Showcase Home or oth r Display Home? ❑ Yes No If yes,a special event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service wil be required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ; , ��. �O,S�/tl State License# Expiration Date: Phone: ��� � � „ �.�� (office) (cell) Mailing Address: �� Cit : � ,,ti • . 3� Contact Person: �,I�y r,,,t, ,�,��,:>.v Applicant is: Contractor / omeowner � �c���ie o�e� Email and/or Fax: ��T�,1�� �� 5`'� C^T�La r� � �6�,� PROPERTY OWNER INFORMATION�:� /� Name: ����iiiJ V•-I�.S��� Phone (day): �����=��'� Address: �� City: ZIP: Email and/or Fax -�� �- /n ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZI P: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal & Water Supply ❑ New Construction ❑ Single Family with ❑ Residence ❑Addition attached garage ❑ Garage/Accessory Bldg. �Public Sewer ❑ Accessory Building �' Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer �Other: (specify) s` ❑ Multiple Family/Condo ❑Warehouse ❑ Pubtic ❑ Storage ❑ Public Water '*Any earth movement may require ❑ Commercial �Other(g cify)� MCWD review&permits. ❑ Industrial � b3�y '�'Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other. (specify) �� ���/� 18202 Minnetonka Blvd �' 1 Deephaven,MN 55391 � Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ �- �, � (`��� �_ . � STRUCTURE INFORMATION: � 1.Structure Dimensions 1.Structure Dimensions (continued) 2.Type of Construction 0 �,� a. Length (ft.)= ��� Number of bedrooms= �Wood/Frame b.Width (ft.)= ����;;.•jP Number of garage stalls: ❑ Masonry Areas in square feet Attached = ❑ Metal ❑ Pole Bldg. c. Basement= Detached = ❑ ICF d. 15f Story = ❑ On-site Prefab e.2"d StOry= ❑ Off-site Prefab f. '/z Story = ❑ Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: N ot Enclosed A licable ❑ Permit A lication � ❑ Pro osed Buildin Plans ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ ❑ Surve meetin all re uirements ❑ ❑ Stormwater Pollution Prevention Plan ❑ ❑ Hardcover Calculation s ❑ Se tic S stem Site Evaluation Re ort ❑ Access Permit ❑ Wetland Buffer Im rovement Plan `M" ❑ En ineered Plans for Retainin Walls 4 feet or above ��� ❑ ❑ Plan Review Fee i'`". >`" ❑ ❑ Other: �:: �`'' APPLICANT/OWNER 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; • Understands 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. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. Applicant's Signature: Date: Owner's Signature: o- ` <— Date: . , � Plan �e�riew Checkfist for I��w S#rucfiures / Ad�ditions Address/ PID l iegat: l �?b �AaK D/L�..�Q Description of work: T nJ 1�-i�v�4 S��� ��,�A �W AvVL �,,a�,� : ��p��.Q ,�y�.e1,,T Septic r�view by: ___N/l� Date Approved: > Zoning review;by: 1,� Date Approared: Buifding review by: Dats Approvetl: 'f �7�-I 2 �ratling review by: !'v'(14 Date APProv�tl: Zoning Fil�#: ' Resolution#: ` Resolution:Date: Zonin District f-ire De artment 'Post OfiFce School ' trict Zoni : Lot�►rea: SF/:AC Ullitlth: epth: Survey ubrni�te�: �Yes 0 No . D.ate of Survey: _ Pro osed etbacks: <Frant<(L�a _ -Rear�5#re�et) � :M � � '�� ) { '� � E � <Other>'Buildings Wetlar�r! ;Sitle Sid Building Defin�d Height: Buildirrg Peak H ' ht: " #of Stories Ok?: 0 �'ES FOR A,BUICDINGWITH`ABASEM T OR'CRAWL SPACE: FOR A BWLDING ON A SLAB FOUND3K71AN: START WITH the�istance betar the basemer�t floor/� ST�#RT the distance between'the slab antl�the highest space floor:and'the h. hest roof peak,'the p of 1NITH roof peak,the top of the comice�f a�lai roof, #he comice ofi a"flat roo, F�e.deck line a 'the deck lirje�f a:mansacd roof,or°#he mansard,rpof,;or'the uppe o$t;poi n a round uppermost point on�round or other arch-type or otherarch- e roof raof SUBTRf#CT half the riistance between the ' hest.window antl SUBTRACT half the distance befin+een the highest uvintlow . hi hest roof eak of a itche roo antl hi hest roof. eak of a, itched roof SUBTRACT the distance between_the sement or/crawl ADD the distance between:the:slab and the highest space'floor and the'hig st existing,gr e<within existin ratle.within tMe fiounda#ion the foundation or 10 et,;whicheveris fe EQUALS Defined:buildin :hei ht EQUALS Defined.builtlin . i ht . Lot Coverage: �F .% .Shnr�land':Distci �:M,C�IIID Permit Receivetl v�ra e:Lake�hore:Setback ' BIu�F - � Yes D No 0 N/A fl 1'�s D :No � Yes No � � No � N/A Permit Number. Setback: Harr! �er:Zones Existin Pr osed 1Lariance e uiced �UP Re �ired 0-75' ;� Yes ;No 0 Xes ;� No 75-250�. Ty.pe(s): TYPejs): 250-.500' : 5D0-1000� . F�EMAR�KS:(in-house): /��l� C�'��6'e Updated: U9/11/2009 . z:lformslplan reuiew checkfist.doac s Fees to be Charged YES NO . -Pecmit _ � ._.���� � , 1;; . , , , .,,;, � s. Plan Review � .Sfat@`�U�CflalCg@ I r ��vw.K tir�rA�,��' i'i� Investigation Fee -"SAC �f��rt�ber=of.'S`AC�U�its ���,R�,� ��„!a �, x I � , r,. Sewer Connection :�llla�e����n�:c�imr���; r � � - , ,µ..,,,� 3 ls k _�,..,��. �-�` .����,�+�,��e;���.���s��:'��; Park Fee �� 1 9 __ � .)..... ^ . . . -.� �_:'? � ji..n �.. n._w.... • • . • : . � , F.N].i... . ar...r;,T'i.�ri „9f�t+^���.jeJ.�+ �i �' .... Yh. ��...,. .nt. �.. , 1����t .@��1011& R r. . . . ,_ .._, ...� .;; v _. . ...z .�.� Other(specify) ;�IlYlisc�7lara��.�s��ee�s`� �r:� �'� '���x�.�wF`�'�,� ��,_� � .�r.< _�-' � . �. � Fp,�..,,_,:.r'k w b.�.�, S ,�'v1 'Srt14. �3? Calcutated By: Square Foota e $ per Square Foota e Basement X = � 15t Floor X = $ 2nd FIOOr X = � Garage X = $ Estimated Construction Value: $ �, 5`�� �� Orono fnspections Required Work Requiring Separate Permits Required State Permits ❑ Site � Plumbing ❑ Grading ! Filling ❑ Well � Hardcover Removal 0 Mechanical ❑ Fire ❑ Electrical Footing ❑ Septic 0 Water Connection ❑ Poured Wall 0 Fireplace ❑ Sewer Connection ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigation 0 Radon Rock Bed ❑ Mfg. �'Framing � Other(specify) 0 Insulation � As-Built Survey Final 0 Other(specify) REMARKS (in-house): . Other Re iew: Revie ed by: Date Approved: Access:Existing: 0 YES 0 NO New: ❑ YES � NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) � X�S i�N�, S7—'D o l � �( � � ���ti1 C�VV��au� — `� <-r-il o D c�;-� v�o � �� cs� L-( `x y , Updated: 09/11/2009 z:\formslplan review checklist.docx T!{ 7�iy F: - e�.'��� ��' ��{C lr, . � + ,E,;. .-6:' " M � i+*�'������ ��• DAYTON F LARSON � 1376 PARK DR � , � � ORONO,MN 55364-9608 �'� �� / t� ' ' ( �°'' '� � G `' w � . � �`\�►" ) Boise Cascade Great products are only the beginning: �� Boise Building Materials Distribution ' _.._. .__ �/ t� ' ; ,: � �' . _ -- ° � � � ; , ;_ _ __ �� ..�:.. ., : . _ _ __ ._ : ;_ 4 . . . . ' ': _ . .._ . . ; : '. , � � . _._.. _.. , __ . ,_. .:.. ,._.. 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