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Home My WebLink About2017-00353 - addn/remodel/repair � �, ' CITY OF ORONO 2750 KE�,LEY PARKWAY * Z 0 1 7 - 0 0 3 5 3 * DATE ISSUED: 04/17/2017 ORO O,MN 55356- (952)249-460 FAX: (952) 249-4616 - ADDRESS : 2500 SHADYWOOD RD PIN : 20-117-23-11-0034 LEGAL DESC : REG. LAND SURVEY NQ. 1630 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/IREPAIR PROPERTY TYPE : COMMERCIAL-BUSIN�SS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 10,000.00 NOTE: ADDITIONAL PERMIT REQUIRED:ELECTRICAT,(STATE) [NTERIOR REMODEL OF DOOR NO SAC DUE,PART OF CONTINUED REMODEL AND SAC DETERMINATION FROM MET COUNCIL LETTER DATED 10/13/16 APPLICANT PERMIT FEE SCHEDULE 20132 PLAN REVIEW 130.86 Ugorets 8098 LLC STATE SURCHARGE(VALUATION) 5.00 410 11TH AVE S HOPKINS,MN 55343- TOTAL 337.18 (952)769-7249 Payment(s) CHECK 1604 337.18 OWNER Ugorets 8098 LLC 410 11TH AVE S HOPKINS,MN 55343- AGREEMENT AND SWORN STATEMENT The work for which this pertnit 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.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 l80 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 i revoked at any time for due cause. � �11� o "�1 O � i�� l� 7 / �� - /a � Applicant Permitee Signature Date Issued B ignature Date � , � CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �A, Mailing Address: Permit number: �� L'�`�� `VO PO Box 66 Crystal Bay, MN 55323-0066 Date received: � - /2 - � � .� y StreetAddress:' Received by: � � ; /-: y�, G� 2750 Kelley Parkway Plan review fee: , " ` '' '�eI ;� • , ��. l ��kfsHo�� Orono, MN 55356 � Main: 952-249-4600 Total Fee: � � Fax: 952-249-4616 www.ci.orono.mn.us �� 7 � �� This application form must be completed in full and all required information must be submitted. � ��.ss i�-i - Incomplete applications will be returned. (Please print) � GENERAL INFORMATION: Job Site Address: {��„�a�e� �s�nes5 ��C - o� SaC� �hc.�vwoo� 1�, Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? � Yes �No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shutt/e bus se�vice will be required unless applicant demonstrates sufficient on-site parking is available. Non-pemritted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: l�ocQ.ats �D�iB L.L.C.. State License# Expiration Date: Phone: (cell) (ola -3�3-33a► (office) Mailing Address: y t o )fi'- �,�, So. Cit : k' 1 Z�P: Contact Person: �� Applicant is: on ractor'�,4 Homeowner (Clrcle One) Email and/or Fax: w��X� ',d\�.� c.1�ss . ca �r • PROPERTY OWNER INFORMATION: Name: L.�. CC . Phone (day): � Address: H Ic� �\ � {��, So City: �!�{opk,ns z�P: 5"S3y 3 Email and/or Fax �� \ tG. , v, ARCHITECT/ENGINEER INFORMATI�N: Name: (��.\�C�s r�,'.^�c�ts Phone (day): 9�a- 9�i 1 � 8!v fo D Address: /S Ni��+L A.��. N, City: /-/n�k;,,. z�P: .�S3y3 Email and/or Fax: ��_�,a; ��cul a,r�l., �v,.. �— �(�'.`�, � � PROJECT INFORMATION: Description of pro'ect:�� '� !''�� I �� k. 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8� Water Supply �New Construction ❑Single Family with ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck ❑ Public Sewer ❑Accessory Building ❑ Single Family with Office/Commercial ❑ Relocation �I�, detached garage Residence ❑ Private Sewer �,Other: (specify) ❑Multiple Family/Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater ❑ Public Water **Any earth movement may also require ,�Commercial ❑ Storage MCWD review 8 permits. ❑ Industrial ❑Warehouse ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑pther:(speCify) �Other(specify) 15320 Minnetonka Blvd �� Minnetonka,MN 55345 �Tf�r7' Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ , � �� Od a, �p Last Updated: January 2016 � � . STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) � a. Length(ft.)= '7�� Number of bedrooms= 2. Occupancy: b.Width (ft.)= �-' Number of garage stalls: /� 3. Occupant Load: lJ D�J Areas in sauare feet Attached= c. Basement= Detached = 4. Type of Construction: .�L- — � d. 1 S'Story = e.2nd Story= 5. Code Edition: ��1� �� f. 'h Story = g.Total Area= ti 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 L�7 ❑ Plan Review Fee �'sl ❑ Com leted A lication Form ,9 ❑ Pro osed Buildin Plans-2 full size sets,to scale and 1 reduced 11 x 17 or 8'/z x 11 set ❑ ,� Minnesota State Ener Code Calculations and Mechanical Code Re uirements ❑ (t� Surve -2 full size,to scale meetin ALL surve re uirements ❑ ,� Hardcover Calculations ❑ R7 Se tic S stem Certification �, ❑ Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD statin no ermit is re uired .ine.lu�ed %n C,d,P, c. /;�1,� ❑ fa. Landsca e Walls and/or Retainin Wall Plans ❑ � Stormwater Pollution Prevention Plan SWPPP ❑ ,� Access Permit ❑ �$ Data Privacy Advisory 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 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. ApplicanYs Signature: y Date: � � i � �Z � Owner's Signature: /" � Date: Last Updated: January 2016 . � � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: � � Permit No.: �� 7�' �7j_�� Description of work: �(6. `(�}�/7`� 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 Coverage: SF % Survey Submitted: � Yes � No Date of Survey: Revised date ? : Landscape plan submitted? � Yes � No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S W ) Other Buildings Wetland Side S' e Defined Height: Peak Hei ht: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50%= L.F. below grade Basement? 0 Yes 0 No, St ries FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lo st roposed Slab at or above grade— START W ITH floor(of the basement or craw ace)and measure from hi�c hest existina the highest point of the roof. START WITH rp ade to the highest point of the roof even if fill was brought in to elevate home. If you have a... SUBTRACTION • GABLE OR HIPPE ROOF(no Slab below grade—measure (BASED ON windows): Subtra half the dista ce from highest existing grade to the ROOF TYPE) between the high st point of the ro f hi hest oint of the roof. to the low point the correspondin If you have a... gable or hippe roof SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE OR PPED ROOF(with (BASED ON (no windows): Subtract half windows): btract half the distance ROOF TYPE) the distance between the between th top of the highest highest point of the roof to window a the highest point of the the low point of the roof corresponding gable or hipped roof • ALL OT ER ROOF TYPES(flat, • GABLE OR HIPPED ROOF mansa ,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract the�distance between the half the distance between (BASED ON basemenUQrawl space floor and the the top of the highest EXISTING highest e�lsting 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 EQUALS il � / Updated: October 2015 � z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback Bluff � Met? 0 Yes � No Permit Number: 0 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 0 Yes � No � Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit Plan Review (�~ State Surcharge t� Investigation Fee w SAC—Number of SAC Units 1i- Other(specify) v Square Footage $ per Square Footage Basement X = $ 1 St Floor X = $ 2nd FIOo� X = $ Garage X = $ Estimated Construction Value: $ �V, �� Orono Inspections Required Work Requiring Separate Permits 0 Footing � Site � Plumbing ❑ Grading/Filling ❑ Poured Wall 0 Silt Fence/Erosion Control � Mechanical 0 Fire 0 Foundation Survey ❑ Hardcover Removal � Septic ❑ Water Connection � Foundation Waterproofing 0 Other(specify) � Fireplace 0 Sewer Connection Framing � Masonry � Lawn Irrigation 0 Insulation � Mfg. � Landscaping 0 As-Built Survey 0 Other(specify) Final � Lathe Required State Permits 0 Other(specify) � Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: � 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 ravic�u rharklich'I fl_9f19 F rinrv _ _ T <\ _ �— �.r -�-- DATE TIME CITY OF ORONO cnLLED IN S� � —1� iNSPECTION N TICE,�,�� SCHEDULED —� t � /D•. C.� PERMIT NO. � � ��M��/lR � � ADDRESS �"� OWNER � TELEPHON NO. ' �S-7� � CONTRACTOR`�� S r� '�-� '' DESCRIPTiON �� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLINO Q ❑ 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 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL i dINNEAICOKTRACTOR TO MEET Y�U:_YE$_NO � COMMENTS: � o �,� �'�i'�ar� C l��'c t�'� c� �' , �t�o �. o� ° c��z / � �� W � Q � W W � J W ❑VYORK SATISFACTORY:PFiOCEED �CT COMPLETE � ❑OORRECT VMORK R PROCEED O I E CERTIFICATE OF OCa1PANCY W O O CORRECT WORIC,CALL FOR REINSPECTION TEMPOMRY V BEFORE COVERINf3 PEFiIiAANENT ❑OORRECT UNSAFE CONDITION WRHIN H��- ❑p►�pTO TAKEN INSPECTOR YVILL RETURN O STOP ORDER POSTED.CALL INSPECTOR �pTATION ISSUED ❑INSPECTiON REQUIRED.CALL TO ARRANf3E ACCESS. CaN for the next inspectfon 24 hours in advsnce. (952) 249-4600 Owne�iContra on site: I�spactor: ' , , wn�a c.ovrn�sPector.Fl�. c■�.ry cav�rist�woeie.