HomeMy WebLinkAbout2016-00428 - land alteration ' . ' CITY OF ORONO * 2 0 1 6 - 0 0 4 2 8 *
, 2750 KELLEY PARKWAY DATE ISSUED: OS/02/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 1890 SHADYWOOD RD
PIN : 17-117-23-24-0019
LEGAL DESC : SHADY-WOOD
: LOT 000 BLOCK 000
PERMIT TYPE : Z01�1ING PERMIT
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS)
NOTE: $2,000 SB COLLECTED IN ESCROW FEE
ACTUAL ESCROW FEE AMOUNT COLLECTED $2,000
HOW DID THEY PAY? CK#5323
ESCROW PERMIT#:(DON'T FORGET TO ENTER) 20162016-00467
FRONT SIDEWALK BEING REPLACED PER PLAN-N/C PER ZONING
APPLICANT MINOR LAND ALTERATION 0.00
TOTAL 0.00
STEVE ATKINSON
4350 CTY RD 50
DELANO,MN 55328-
(612)735-6292
Minnesota State License#:BUIL-20638420
OWNER
LUNDBERG,MIKE&ANGELA
1890 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 hereia 1'his 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 aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
�( 5'�-�I�o / ��� J� i
� C�� � � � /�o
Appli���tee Signature Date Issued By Signa Date
�
� � � City of Orono
� Zoning Permit Application
Mailing Address: Permit number: -�.11 � y �O
�Q�O PO Box 66 Date received: �(D �
Crystal Bay, MN 55323-0066
Escrow#and
Street Address: amount:
2750 Kelley Parkway � /�
�y� � Orono, MN 55356 Permit Fee: �.T
L
`�kE S N v�� Fax: 952-249-4616 Approved by: � ��, j � � r
Main: 952-249-4600 Notes:
www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted. (P/ease print.)
Job Site Address: �g q 0 S�p d v w o dGr R�
T
CONTRACTOR I APPLICANT INFORMATION:
Name: /Yl�ke F ���Pl�.. L�no�6o�a
Phone: 9SZ- oo- B�LSo Fax:
Address: l6 90 S�adv woo l � City: p,a�,o ZIP: S�3 9/
Contact Person: ContacYs phone number
Email Applicant is: Contractor Homeowner (Circle One)
PROPERTY OWNER INFORMATION:
Name: Su rn e,
Phone(day):
Mailing Address: ZIP:
Email and/or Fax
Overall Project Description: Si c�►wa�kS "' Stt ���P�N�c�
Boxk TYPE OF PERMIT collected whenE ermit is issued
Dock, Commercial $50+engineering review costs
Escrow for erosion control and engineerin review costs $2,000
Dock, Residential - Permanent dock on any lake or initial seasonal dock not on Lake $50+engineering review costs
Minnetonka ermanent dock re uires CUP
`/ Hardcover Permit: Driveway, Patio, Sidewalk,etc.(New or Replacement) No charge
]� Also requires is a Minor or Ma'or Land Alteration Permit
Land Alteration, Major (grading, filling, or excavating) of more than 500 cubic yards $50
beyond the lakeshore setback OR more than 50 cubic yards within the lakeshore setback
(also requires Conditional Use Permit)
(Reference: Citv Code Sections 78-967. 78-1247 and 78-12861
Escrow for erosion control and engineering review costs As determined b CUP
Land Alteration, Minor(grading, filling or excavating)of 51 to 500 cubic yards beyond the $50 +engineering review costs
lakeshore setback OR 50 cubic yards or less within the lakeshore setback
lReference: Citv Code Sections 78-967. 78-1247 and 78-12861
Escrow for erosion control and engineering review costs $2,000
Retaining Walls which exceed two feet in height above existing grade; or result in more $50+engineering review costs
than 20 cubic yards of imported fill; or are located less than flve feet from the property line.
Escrow for erosion control and engineering review costs $2,500
lReference: Citv Code Section 78-1405(5.1)1
Retaining Walls which measure more than four feet(from bottom of footings to top of wall)
require a building permit. Tiered retaining walls are considered one wall unless the walls
are se arated b twice the hei ht of the lower wall.
Stairway or Lifts to Lake(New or Replacement) lReference: Citv Code Sections 78-12821 $50+engineering review costs
Escrow for erosion control and engineering review costs $2,000
Structure Permit for other structures 200 sf or less not requiring a building permit but $50+engineering review costs
regulated by the zoning code lReference: Citv Code Section 86-661
Escrow for erosion control and engineering review costs $2,500
Tree Removal or other vegetation removal within 75 feet of lakes No charge.
lReference: Citv Code Section 78-12851 Pre-inspection required.
Tempora Construction OfficelTrailer(associated with buildin permit) $30
Updated May 2015
�
APPLICANTIOWNER ACKNOWLEDGEMENT:
• ApplicanUOwner agrees to provide all information required or requested by the Planning Department;
• Owner agrees to pay the City of Orono for engineering consultant review costs where applicable;
• ApplicanUOwner 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;
• Applicant acknowledges the attached Escrow Agreement is completed and signed by Owner;
• ApplicanUOwner understands their project may require an initial andlor as-built survey per City Code Section 86-68.
• 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 the information,the a lication ma not be issued.
The undersigned certify that the information supplied is true and correct to the best of their knowledge.
ApplicanYs Signature: Date:
Property Owner's Signature: Date: �/�ZS�Ib
SUBMISSION REQUIREMENTS: Exc t for tree removal permits, all permits require a completed
TYPE OF PERMIT: application form, escrow agreement (signed by the property owner) and escrow check from owner,
two copies of each,where applicable, plans,landscape plans,grading plans,surveys or site plans.
DOCk,CommerCial 1. Structural plans for the dock
2. Survey/site plan showing the proposed location of the dock
3. Copy of LMCD permit
Dock, Residential Seasonal Dock—survey showing proposed dock
Permanent Dock—plans as approved by CUP and copy of LMCD permit(if applicable)
HardCover Pe�mit 1. All Minor or Major Land Alteration Permit requirements apply as appropriate
2. Hardcover calculations,existing and proposed
3. Survey
Land Alteration, Major 1. Survey/grading plan including existing and proposed contours as approved by Conditional Use Permit
2. Erosion control plan.
3. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
buildin ermit without information from the MCWD.
Land Alteration, Minor 1. Survey/grading plan including existing and proposed contours
2. Amount of fill to be imported and/or exported and haul route
3. Amount of earth to be moved around on site
4. Erosion control plan.
5. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
building permit without information from the MCWD.
Retaining Wall 1. Plans for wall(s)
2. Unless repair or exact replacement of existing wall,submit an updated survey with grading plan including existing and
proposed contours
3. Hardcover calculation worksheets if in shoreland district
4. Erosion control plan
5. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
buildin permit without information from the MCWD.
Stairway oP Lifts to 1. Construction plans for stairway or lift,including footings
Lake 2. Topographical survey of property with proposed stairs or tift shown
3. Erosion control plan
4. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
building permit without information from the MCWD.
StruCture Permit 1. Construction plans.
2. Survey/site plan of property with proposed structure shown and with setbacks to property lines,other structures on
property and the septic system indicated.The general location of any sewer and water services should be shown if
applicable.
3. Grading plan if grading is proposed.
4. Hardcover calculation worksheets
5. Erosion control plan.
6. A copy of Minnehaha Creek Watershed District(MCWD)permits or documentation from the MCWD stating the
proposed project does not trigger any of their permitting requirements. Please note,the City will not issue a
buildin ermit without information from the MCWD.
Tree Removal Call: 952-249-4600 to schedule an inspection for removal of an individual tree(s). A re-planting plan I erosion control I
mana ement lan ma be re uired for clear cuttin ,buckthorn or other intensive ve etation removal.
Updated: May 2015
' PLAN REVIEW CHECKLIST FOR ZONING PERMIT APPLICATIONS
Ad d ress: V
�
Description of work:
Type of permit:
Zoning review by: 1�\ Date Approved: `TT�7' �YJ
Grading review by: N� Date Approved: —
Other Review, Reviewed by: Date Approved:
Zonin Information:
Zoning File#: Resolution#: Resolution Date:
Lot Area: SF/AC Width: Depth:
Survey Submitted. es 0 No Date of Survey: Revision date:
Existin Setbacks:
Front (Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Proposed Setbacks:
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Shoreland District MCWD Permit Received Average Lakeshore Setback Met? Bluff
0 Yes 0 No � N/A 0 Yes No
Yes � No � Yes 0 No �N/A
Permit Number: Setback:
Stormwater Quality Existing Proposed Variance Required CUP Required
Overla District Tier Hardcover Hardcover
0 Yes � No 0 Yes 0 No
' (� �� Type(s): Type(s):
File# File#
_
Updated:January 2013
z:\forms\old stuff�plan review checklist for zoning permit applications 2013.docx
Earth Movement- Cubic Yards
In Out Total
Haul Route? ? 0 Yes 0 No
Explain haul route in detail:
Fees to be Charged Amount Orono Inspections Required
Permit Fee Amount �
0 Site
Escrow Amount 0 Hardcover Removal
� Footing
Escrow Agreement received? � Poured Wall
0 As-Built Survey
0 Yes � No 0 Planting Plan
� Wetland Buffer
Escrow Money received? Final
�ther s ecif
� Yes 0 No � p y�
Engineering review needed?
0 Yes � No
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
Updated:January 2013
z:\forms\old stufflplan review checklist for zoning permit applications 2013.docx
Mike &An ela Lundber ONO COPY
g g O�
1890 Shadywood RD
Existin�Structure
A- Rock-over fabric, no hardcover 0
B- Brick walk—5 feet wide x 17.4 feet long 87 (5 x 17.4)
C- Rock—over fabric, no hardcover 0
D- Brick Walk—3.1 feet wide x 19.8 feet wide 61 (3.1 x 19.8)
E- Brick Walk—approximate triangle 3.1 wide x 1.3 high 2 (3.1 x 1.3/2)
F—Rock over p�astic- 4 feet wide x 18.1 feet long 72 (4 x 18.1)
G—Rock over plastic-7 feet wide x 3 feet long 21 (7 x 3)
Total existing 243
Proposed Structure
Construct a Y shaped sidewalk approximately 6.5 feet wide and a separate walkway near the garage
approximately 2.5 feet wide. Extend turf area. Replace rock near garage with new rock over fabric.
1—Sidewalk 6.5 feet wide x 17.7 feet long 113 (6.5 x 17.7)
2—Remove from 1 two triangles 3 feet wide x 4 feet long (12) (3 x 4)/2 * 2
3—Sidewalk triangle 7 feet wide x 11 feet long 38.5 (7 x 11)/2
4—Sidewalk triangle 7 feet wide x 11 feet long 38.5 (7 x 11)/2
5—Sidewalk 2.5 feet wide x 21 feet lorg 52.5 (2.5 x 21)
Total proposed 230.5
Note 1: Proposed plan represents current intentions. Final design may vary, depending on how
concrete forms lay out and final walkthrough. However, total square footage of hardcover in the overall
project area will not exceed the 243 square feet existing.
Note 2: The existing site is fairly level and we do not anticipate bringing in any dirt. Minor grading will
be necessary due to removal of existing material.The work area is approximately 20 feet by 40 feet.
Over this square footage, a depth of 20 inches over the entire area would be necessary to equate to 50
cubic yards. Any dirt or grading requirements will be well below that threshold.
Note 3: The project will include resurfacing or replacing the existing porch floor,which is under a roof.
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DATE T���'
CITY OF ORONO / —CA�LLED IN -3 ��
INSPECTION�IyS?TICE CL�/�%f�GHEDULED a�--/� !!.� G�C�
PERMIT NO. '�-'! S- ��t3 co P�ErE�
ADDRESS �� � ��� u'��
OWNER � � �r TELEP ONE NO.S�l�'7�5�'a5�
CONTRAC �
� DESCRIPTION � '� ��'�'��
l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED ROJECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECTVYORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 urs in advan . 2 9-46�0
OwnerlContractor on site:
Inspector.
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