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Home My WebLink About2016-01291 - addn/remodel/repair �, , CIfiY OF ORONO * z 0 1 6 - 0 1 z 9 1 * � 2750 I�ELLEY PARKWAY DATE ISSUED: 11/02/2016 OItONO,MN 55356- (952)249-4 00 FAX: (952)249-4616 ADDRESS : 2500 SHADYWOOD PIN : 20-117-23-11-0034 I LEGAL DESC : REG.LAND SURVEY 1�10. 1630 : LOT 000 BLOCK OQO PERMIT TYPE : ADDITION/REMODE�,/REPAIR PROPERTY TYPE : COMMERCIAL-BUSIIVESS CONSTRUCTION TYPE : ADDN/REMODEL/R�PAIR ACTNITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 20,000.00 , NOTE: SEPARATE PERMIT REQUIRED: PLUMBING,MEC$IANICAL,ELECTRICAL(STATE) INTERIOR REMODEL � SAC PAID 10/13/2016-SEE SAC LETTER ATTACHED APPLICANT PERMIT FEE SCHEDULE 356.22 Ugorets 8098 LLC ' STATE SURCHARGE(VALUATION) 10.00 410 11TH AVE S i TOTAL 366.22 HOPKINS,MN 55343- Payment(s) (952)769-7249 CHECK 1523 366.22 OWNER Ugorets 8098 LLC 410 11TH AVE S HOPKINS,MN 55343- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to ' the approved plans and specifications,applicable Ciry 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.This permit will expire and become null and void if wnstruction 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. "fhe applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may revoked at any time for due cause. � r � 11 I� � � � i l� �G� Applicant Permitee Signature Date Issued By ignature Date t '� ��}�� , � , , l � � � � � � . � City of Orono ��_ Building Permit Application for New Structures or Additions MailiPO Bo�r66� Permit number. (,��U "'C�� O�v0 Crystal Bay, MN 55323-0066 Date received: ti�l� Street Address:' ��.., ceived by: y� ,� `�� 2750 Kelley Parkway �p/(p --�� lan review fee: �" . � c.` � Orono, MN 55356 t�'�ES H�� Mai n: 952-249-4600 Fax: 952-249-4616 w�a��l..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: � S�c� Sl� ,��,� ��,�,�,, Will this be a Parade of Homes, Remodeler Showcase Home or other Display Home? ❑ Yes No If yes, a special event permit is required with Police Department and City Council approva/60 days prior to the event. Shutt/e 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: L�qo��s 8c�� L�� State License# Expiration Date: Phone: (cell) (o�� -_3��_33a1 (office) Mailing Address: •�- „�, Cit : ZIP: S�3 3 Contact Person: p��e,� UT��S Applicant is: act r Homeowner (Circle One) Email and/or Fax: �\�..Xp _�,��a,r,�, ,��,,�5 c.�,�.� PROPERTY OWNER WFORMATION: Name: A�Q Phone (day): (o� - Address: '-�110 1��"' r�� .So _ City: No,k:,�s ZIP: .5�3y Email and/or Fax G..\�� -i',��„�. _��< �oo-. ARCHITECT/ ENGINEER INFORMATION: Name: (�.S;�k�s rRra:,��t Phone (daY): qS� -�y i -k(„�� Address: /S ,t.�;,,.�,,� �,,Q �n City: /��k,,,� ZIP' �5"S3y' Email and/or Fax: �r — �j�, e_ ��{�,� PROJECT INFORMATION: Description of project: =�-�-C�-tv ��/L �<<i�<�� 1. Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal & Water Supply ❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck �Public Sewer ❑Accessory Building ❑ Single Family with Office/Commercial ❑ Relocation detached garage �] Residence ❑ Private Sewer � Other.(specify) I��r�1�\ ❑ Multiple Family/Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater � Public Water *'Any earth movement may require Commercial ❑ Storage MCWD review&permits. Industrial ❑Warehouse ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) ❑ Other(SpeCify) 15320 Minnetonka Blvd Minnetonka, MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ o�D,o� , d� n��n�c� Packet Lasf Updated: August 2015 CITY OF ORONO Page 21 STRUCTURE INFORMATION: 1. Structure Dimensions � 1. Structure Dimensions (continued) 2. Type of Construction --� t a. Length (ft.)= Number of bedrooms= � � � ❑Wood/Frame � b.Width (ft.)= Number of garage stalls: ❑ Masonry Areas in sauare feet Attached= �(Metai �CG(��Gt�T L � � ❑ Pole Bldg. , �U�� O c. Basement= Detached = ❑ ICF t% e�� d. 15'Story = nd ❑ On-site Prefab n s1� �� m� e.2 Story= ��'�� `''�'T ❑ Off-site Prefab �f1�y., �,�C f. '/�Story = �Other(please specify): sh�#<ock- g.Total Area= o��q� REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ Buildin Permit Escrow A reement and Fees O Plan Review Fee - �..ar�.� ", � ❑ Com leted A lication Form ❑ Pro osed Buildin Plans-2 full size sets,to scale and 1 reduced 11 x 17 or 8'h x 11 set ❑ k7 Minnesota State Ener Code Calculations and Mechanical Code Re uirements �7 � Surve -2 full size,to scale meetin ALL surve re uirements -� S m,�� ❑ Hardcover Calculations ❑ � Se tic S stem Certification � ❑ Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD statin no ermit is re uired -u-�� s��-�� ❑ �I Landsca e Walls and/or Retainin Wall Plans ❑ Stormwater Pollution Prevention Plan SWPPP ❑ k7 Access Permit k� ❑ Data Privac Adviso Form - �,\��- ,, -, � 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 pubtic 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. � ApplicanYs Signature: � Date: �d ��/�/� , Owner's Signature: � Date: � � �� Packet Lasf Updated: August 2015 Page 22 � � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: ��- 7 �� jG� � �i(�� Permit No.: Description of work: Date Rec'd: � ,�/ �,/� C� Septic review by: ,�L►�/('� Y' U��L�E/ �/�� ate A pro ev d: �� Zoning review by: Date Approved: Building review by: / Date Approved: �� L `-/(�, Grading review by: Date Approved: ,� Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Covera�e: SF % Survey Submitted: 0 Yes � No Date of Survey: Revised date ? : Landscape plan submitted? � es � No Landscaper: , Proposed Setbacks: ; Front (Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak Hei t: F E: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% = L.F. below grade Basement? � Yes 0 No, St ries FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE' FOR A BUILDING ON A SLAB FOUNDATION: The distance between t e lo st proposed Slab at or above grade— START WITH floor(of the basement r cr�wl pace)and measure from hiqhest existinq the highest point of t roof. START WITH rq ade to the highest point of the roof even if fill was brought in to elevate home. If you have a... I SUBTRACTION • GABLE HIPPED ROOF(no Slab below grade—measure (BASED ON windowg: Subtract half the dista ce from highest existing grade to the ROOF TYPE) betwee,�the highest point of the r f hi hest oint of the roof. to the 1ow point of the correspondin If you have a... gable or hipped roof • GABLE OR HIPPED ROOF SUBTRACTION (no windows): Subtract half • GABLE OR HIPPED ROOF(with (BASED ON the distance between the wmdows): Subtract half the distance ROOF TYPE) 4etween the top of the highest highest point of the roof to Noindow and the highest point of the the low point of the 'roof corresponding gable or hipped roof • r' ALL OTHER ROOF TYPES(flat, • GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract the distance between the half the distance between (BASED ON basemenUcrawl space floor and the the top of the highest EXISTING highest existing grade adjacent to the window and the highest GRADES) foundation 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 1 EQUALS �� ' Updated: October 2015 z:\forms\plan review checklist 10-2015.docx � 1 � . � Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? 0 Yes 0 No Permit Number: � Yes � 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 0 Yes 0 No � Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit Plan Review ✓ State Surcharge V Investigation Fee SAC—Number of SAC Units Other(specify) �� Square Footage $ per Square Foota e Basement X = $ 1 S' Floor X = $ 2"d Floo� X = $ Garage X = $ Estimated Construction Value: Orono Inspections Required Work Requiring Separate Permits 0 Footing 0 Site �Plumbing 0 Grading/Filling 0 Poured Wall 0 Silt Fence/Erosion Control Mechanical � Fire ❑ Foundation Survey 0 Hardcover Removal � Septic 0 Water Connection � Foundation Waterproofing � Other(specify) � Fireplace 0 Sewer Connection Framing � Masonry 0 Lawn Irrigation , Insulation � Mfg. � Landscaping � As-Built Survey � Other(specify) �Final 0 Lathe Required State Permits ❑ Other(specify) � Well 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. Updated: October 2015 �•\fnrmc\nlan ravie�ei rharlrlief 1f1_9(11F rinrv DATE TIME CtTY OF ORONO cnLLED IN l,�-� /l0 1 . � INSPECTION NOTICE SCHEDULED /�-�/ - /[� PERMR NO.�,�1/� 'D/��// C PLErED ADDRESS v,�� =��L'/�� OWNER �TELEPHONE NO.y —��-�� CONTRACTOR � DESCRIPTION � � �y ❑ FOOTING ❑ DEMO-FINAI ❑ 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 � I SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP �4 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ � ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 O'WNERICOIfTMCTOR TO MEET V�OU:_YES_NO � COM f ENT'� � W� � 2�� „��-'�L�� U% �/� � �� 0 � , _ ° ��;�- -- ��w��'/.� � � ✓ ��o�,� � -{%.�� Q � � W � _ � W ❑WOFiK SATISFACTORY:PROCEED ❑ PRW ECT COMPLEfE � ❑CORRECT W'ORK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY W O ❑CORRECTVYORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERINO PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pMOTO TAKEN INSPECTOR WILL RETURN ❑GTATION ISSUED ❑STOP ORDEH POSTED.CALL INSPECTOH ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Call for the next inspectfon 24 hours in advanoe. (g52) 249-4600 Owne�ICorrtraa�r on site: �'' Inspector:.' /� � WMb CoprAnsp�ctor's FIN Canary CoprlSib Nofia l.� � _�1X� Y DATE TIME CITY OF ORONO CALLED IN �3 —/ —/ 7 INSPECTION N TICE _D�z y SCHEDULED ��Z a •' PERMfT NO. /COMPLET D ADDRESS OWNER SEPHONE O.�-�o ' 7� `l"7a�L� CONTRACTOR � DESCRIPTION c�Z� � • O • �y ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING �Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BUANER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL i OWMERICOPfTRACT R MEET YW:_YES_NO � ll y COMM T5: �ovl�� 7�/`u�tS'i f/mh Gar 7�0 �i l��6�v It1� / � � �� U� � � �"� � "i �i r o .� � �i ct � C� � s- � �,'�� . -0 � � � . ° 7 / !%�G�t� / �c��^!�ly Y' ��"`�" �� ' � � �� ,�t�� t�rt�'� ll Q , . � � , _ ,, Z � .. W _ , .:. � � : - - , , . • ._. �- �_ � �� 0 P v� ��t /� 4' cf � W K�T S ACTORY`.P�D ❑PROJECT COMPLEfE � ❑CORRECT WORK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY W O RRECT VI�RI CALL FOR REtNSPECTION TEMPORARY PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WlLL RETURN ❑STOP OROER POSTED.CALL INSPECTOR �aTATION ISSUED O INSPECTION REW IRED.CALL TO ARRANGE ACCESS_ Cafl forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlContrac#or on sRe• � � Inspector:47�,_t.��1�..'��- White CopYflnspector's FOa Canary CopYlSita Notks