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Home My WebLink About2017-01420 - addn/remodel/repair . , CITY OF ORONO * 2 0 1 7 - e 1 4 2 0 * 2750 KELLEY PARKWAY DATE ISSUED: 1UO2/2017 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 1680 SHADYWOOD RD PIN : 17-117-23-21-0016 LEGAL DESC : SHADY-WOOD : LOT 009 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 4,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) PERMIT FOR WINDOW FRAMING ONLY FINAL CAN BE SIGNED OFF AT FRAMING INSPECTION. APPLICANT PERMIT FEE SCHEDULE 108.38 CROSSROADS REMODELING LLC STATE SURCHARGE(VALUATION) 2.00 7256 MACIVER AVE NE TOTAL 110.38 ALBERTVILLE,MN 55301- Payment(s) (952)217-0148 CREDIT CARD 2936 11038 Minnesota State License#:BUIL-BC 721767 OWNER DOLEMAN,JOHN 1680 SHADYWOOD 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 dces not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.l'his permit will expire and become null and void if construction authorized is not commenced within l80 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 confortnance with the State Building Code.This permit may be revoked at any time for due cause. � / .Z � // i 0 a�i / � Appli ant Permitee Signature te ssued By gnature 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: ��,�� G�/�� f YO PO Box 66 Permit number: � Crystal Bay, MN 55323-0066 Date received: /�� 7 � � Street Address: Received by: B y�, G� 2750 Kelley Parkway Plan review fee: �('. �qk�SHO��, Orono, MN 55356 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: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No lf 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: _ [. (c�SS�i�o.�s Q�/Y�c l.�, � �L- State License# �f� 7�� 7 t� 7 Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were consfructed prior to 1978 Phone: (cell) �5�- �,►7-�/Y� (office) Mailing Address: �7��GA I'%��c:ver /�� 1L'� City: �}/��;-�-Y,��jf ZIP: 5'S'�3�/' Contact Person: {)�S�„ �'��-i�.;, Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: d�-F�:,, �Lf'C�S i'GC,�y�a a�;-��.i/�c:o�-- PROPERTY OWNER INFORMATION: Name: _��- �� '�- Ih �n � ��'� ►� Phone (day): Address: _ (�c �t' S�i�� w�c�� City: �-�6�o�QCa�-}�� ZIP: ��-'.5�.3�1 � Email and/or Fax: PROJECT INFORMATION: Overall pro�ect description: Type of Project: Any earth movement may also require ❑ Door s MCWD review 8� ermits: ( ) emodel ❑ Fire Damage p ❑ Re-roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) ❑ Re-roof,cedar 15320 Minnetonka Blvd ❑ 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 ora Estimated Construction Valuation of Project(excluding land) $ �/,aaG 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 ou refuse to su I t e informa 'on,the a lication ma not be issued. ApplicanYs Signature: � --S� Date: / ^ 1 � 7 Owner's Signature: Date: Last Updated:January 2016 . . PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS rr� �/ Address: � �v t� (� , Permit No.:_C,�� - �l�l� _ J /., Description of work: I Q� i�1 �/ T(�d' `�Z GV� Date Rec'd: Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: � � Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Cov ge: SF % Survey Submitted: � Yes �`No Date of Survey: Revised date ? : \ � Landscape plan submitted? � Yes `� 0 No Landscaper: ... Proposed Setbacks: �� Front (Lake) Rear(Street) ( N S E W ) ( S E W ) Other Buildings Wetland Si Side Defined Height: Peak Height: F E: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% = L.F. below grade Basement? 0 Yes 0 No, Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between th lowest propos d Slab at or above grade— floor(of the basement crawl space)an measure from hiqhest existing START WITH the highest point of th roof. rq ade to the highest point of the START WITH roof even if fill was brought in to elevate home. If you have a... SUBTRACTION • GABLE O IPPED ROOF(no Slab below grade—measure (BASED ON windows): Subtract half the distance from highest existing grade to the ROOF TYPE) between e highest point of the roof hi hest oint of the roof. to the lo point of the corresponding If you have a... gable hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF GAB OR HIPPED ROOF(with (BASED ON (no windows): Subtract half • win ws): Subtract half the distance ROOF TYPE) the distance between the bet een the top of the highest highest point of the roof to wi dow and the highest point of the the low point of the r f corresponding gable or hipped roof • LL OTHER ROOF TYPES(flat, • GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION Su ract the distance between the half the distance between (BASED ON ba emenUcrawl space floor and the the top of the highest EXISTING hi hest existing grade adjacent to the window and the highest GRADES) f undation OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined building height subtraction. Defined building height EQUALS Updated: October 2015 � z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback Bluff . M et? 0 Yes � No Permit Number: � Yes 0 No 0 N/A � Ye No � � N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf � Yes � No 0 Yes 0 No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit Plan Review State Surcharge Investigation Fee SAC—Number of SAC Units Other(specify) Square Footage $ per Square Footage Basement X = $ 1 S� Floor X = $ 2nd Floot' X = $ Garage X = $ Estimated Construction Value: $ ��D�D � � Orono Inspections Required Work Requiring Separate Permits � Footing � Site 0 Plumbing 0 Grading/Filling 0 Poured Wall � Silt Fence/Erosion Control ❑ Mechanical � Fire � Foundation Survey � Hardcover Removal 0 Septic 0 Water Connection � Foundation Waterproofing � Other(specify) 0 Fireplace 0 Sewer Connection Framing ❑ Masonry � Lawn Irrigation � Insulation 0 Mfg. 0 Landscaping � As-Built Survey 0 Other(specify) Final 0 Lathe Required State Permits � Other(specify) � Well 0 Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: 0 See Builder Acknowledgement Form � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. !'�r a�I �l� `�' �l :'�OI � ��i 72r �vr�t e -�'c� c� �Li r� �v'.9i1 i i^�d�! � n l� Updated: October 2015 �•\fnrmc\nlan ravia�u rhorklict 1(1_9f11F rinrv C- $ -= � o�r� n�e CITY OF ORONO cnLLED IN //- 3 -17 iN8PECTION TICE &CHEDULED /,f- lo- /7 __� PERMR NO. V l I COMPLETED a�uREss � �- p� OMINER TEL PH E NO. -��7"0� o CONTRAC'TOR �D�S � DESCRIPTION ��-��Y� {y ❑ FOOTING ❑ DEN�-FINAL ❑ SEPTIC FINAL a ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADIN(i/FILLIN(i O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q i�FRAMIN(3 ❑ MECHANICAL FINAL ❑ RATED WALLS � ��ISULATION ❑WOOD BURNER/FIREPIACE 0 COMPLAINT � ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP W ❑AS BUtLT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL ? TO MEET lfOlh._1fE8_NC � COMMENT� �l�c. /2-�� S/� 4 �D/�G � P��e✓ - � o , � ��ha,K r 0 �� ,� ,►t �ar,� � �� _ _P � � W W � /fi�4,•,tic..�i ��'lk� J � `�I�ORKSATISFACTORY:PROCEED �i?JECf COMPLETE W��O OORRECT WiORK 8 PROCEED O ISSUE CEATIFK'•ATE OF O(xl1PD1NCY � ❑OORRECT 11MORK.CALL WR f�INSPECTION TEMPORARY V BEFORE COVEipNO pERIMANBdT ❑ppi#�C'T UNSAFE ppND1'TION VYRHIN fKK1�• O PHOTO TAKEN INSPECTOR WILL RETI/HN O STOP ORDER PO�TED.CALL INSPECTOR ❑aTATION ISSUED O IM3PEC'TION REQIIIRED.CALL TO ARRAN(iE ACCESS. csa ror n�e next Mspecaon 24 no�rs�n ad+►ano.. (952) 249-4600 on site: �� 'r' Whib OoVY��b►'�� C�mry Cop�ISN�Notlo�