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Home My WebLink About2017-00352 - addn/remodel/repair , . r _� . " CIT{Y OF ORONO * 2 0 1 7 - 0 0 3 5 2 * 2750 KLLLEY PARKWAY DATE ISSUED: 04/17/2017 OR(�NO, MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 2500 SHADYWOOD RD PIN : 20-117-23-I1-0034 LEGAL DESC : REG.LAND SURVEY N�. 1630 : LOT 000 BLOCK 000' PERMIT TYPE : ADDITION/REMODEL J,REPAIR PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REP',AIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 5,000.00 NOTE: SEPERATE PERMITS REQUIRED:MECHANICAL&EI�ECTRICAL(STATE) REMODEL OF SUITE#100 NO SAC DUE,PART OF CONTINUED REMODEL AND SAC DETERMINATION FROM MET COUNCIL LETTER DATED 10/13/16 APPLICANT , PERMIT FEE SCHEDULE 123.87 � PLAN REVIEW 80.52 Ugorets 8098 LLC STATE SURCHARGE(VALUATION) 2.50 410 i 1TH AVE S HOPKINS,MN 55343- TOTAL 206.89 (952)769-7249 Payment(s) ' CHECK 1604 206.89 OWNER U orets 8098 LLC g 410 11TH AVE S HOPKINS,MN 55343- , AGREEMENT AND SWORN STATEMENT i The work for which this permit is issued shall be performed according to I the approved plans and specifications,applicable Ciry approvals,and the State Building Code. This permit is for onty the work described and dces not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing this type of work shail be compied with whether or not specified herein.This permit will expire and become null and void if construction suthorized 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 aIl required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. N �7 O 1 /� L / App icant Permitee Signature Date Issued B ignature Date '� • �� CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRl1CTURES OR ADDITIONS �O� Mailing Address: Permit number: � �/ � � �-C]� � O PO Box 66 � Crystal Bay, MN 55323-0066 Date received: � /� - ��r_ —,-- � Received by: _...._. -%� ` a ,, Street Address:' -- ��%F v 2750 Kelley Parkway Plan review fee:�� ' � ' j \��4kfsiio�`` Orono, MN 55356 ��.__ ' �.;. Main: 952-249-4600 / -- __ __ __--- --� Total Fee: Fax: 952-249-4616 www.ci.orono.mn.us �(�;� t � �� This application form must be completed in full and all required information must be submitted. ,,� 1 Incomplete applications will be returned. (Please print) � �� J � �I GENERAL INFORMATION: 3"��'�- # �� Job Site Address: �re.s�wo�-�_��Sines3 �-n'�C �.Sad J�o�d woo� �, . 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. 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�rQ.�__�p98 L.L,C . - --- State License# _ __ __ Expiration Date: _ _ Phone: (cell) �ia -_3�3 - 33a� (office) MailingAddress: y/o // '` Aue. S,• Cit : k;,,s __ ZIP: ,fS3`l3 Contact Person: A 1 ex Q. Applicant is: Contract r / Homeowner (Circle One) Email and/or Fax: o,.\e.X J f►�,dland.G�a�,cor� . __ _ I PROPERTY OWNER INFORMATION: Name: O L.�..�'-. Phone (day): (o -3� -- 3�1 Address: y Io �1°` �Hue. Sd- City: F-�oa k,ni ZIP: ,SS3y 3 Email and/or Fax ��e x ��;��p�a. 4la.sS. �or� ARCHITECT/ENGINEER INFORMATION: Name: (�-�� ku s �c��ke�atS Phone (day): q$d - 9�i ( - ��p Address: /$ Nin�l. A�o. IUo, City: {-�p�k��s ZIP: �53�}�_ Email and/or Fax: d� p � W; ��«, Qr� , cor� _ _ � ��„�,� �;iz � �' � i:t% PROJECT INFORMATION: Description of project: � 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 detached garage ❑ Residence ❑ Private Sewer � Other: (specify) �a(+')m�.� ❑ 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) � 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) S �pd Last Updated: January 2016 .k , STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structuire Dimensions(continued) � a. Length(ft.)= Number of bedrooms= 2. Occupancy: b.Width(ft.)= Number of garage stalis: 3. Occupant Load: �� Areas in sguare feet Attached= c. Basement= Detached� 4. Type of Construction: �J � d. 1 S�Story = /� e.2"d Story= 5. Code Edition: �!��/"�� f. YZ Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted ir� order for your application to be processed: Not Enclosed A licable �[ ❑ Buildin Permit Escrow A reement and Fees � ❑ Plan Revi�w Fee � ❑ Com lete A lication Form 8I ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/:x 11 set ❑ J� Minnesotal State Ener Code Calculations and Mechanical Code Re uirements ❑ � Surve —2 full size,to scale meetin ALL surve re uirements O � Hardcover Calculations ❑ �C Septic S stem Certification ❑ �1 Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD statin no ermit is re uired ❑ Landsca Walls and/or Retainin Wall Plans ❑ � Stormwat r Pollution Prevention Plan SWPPP ❑ � Access P rmit � � Data Priv�cy Advisory Form APPLICANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required pr 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 trwe 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 informatian that you are asked to provide on this application is classified by State law as either private or confidential. Private data is infotmation 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 r other conditionsprevent the completlon 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 'uilt survey and all site improvements. ApplicanYs Signature: Date: / i Owner's Signature: � Date: /� / , Last Updated: January 2016 � � . � P rmit A lication: Self-Checklist for Com letenes Please note, the applicant must initial in the boxes below to acknowledge the minimum required inforrriation is included with the submitt I. If not, the a�plication will NOT be acc�ted. Call 952.249.4620 to schedule a meeting wi staff if you have questions on application submittal requirements. Completed Application �� . Plan Review Fee Pai� A� , Signed Escrow Agre�menfi & Escrow Payment �J, Building Plans (to sc�le) x2 Certificate of Survey (to scale) showing the proposed project & �v- meeting all requirements x2 Hardcover Calculatiojns (if applicable) I am aware that Oroino will not issue a building permit without a copy of MCWD permits (or documentation from the MCWD stating � the proposed projec� does not trigger their permitting requirements). I will contact the MCWD at 952-471-0590 re rding this ro'e t. Si ned b ��—�� 9 Y• 1 Address: �` � -��' - �� I' ��/�f�-, Permit #: ��. , -� Last Updated: January 2016 . � _, , I . �- � • I � BU�LDING PERMIT ESCROW AGREEMENT Or no Building Permit# AGREEMENT made this day of , 20 , by and between the CITY OF ORONO, a Minnesota municipal corporation Gity") ("Owners"). Recitals 1. A building permit application has been filed a 5�'►h-�- � loo located at aSoo S�cb_yw+o� {�., the ("Subject Property"), legally described as F.�as),w�� "��L�,,, C'.�� 2. Owners request the City to review this application. 3. The City will commer�ce its review of the application and incur costs associated with said review only if the Owner establishes an escro�uv to ensure reimbursement to the City of its costs. NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS: 1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall deposit$2,500 with the City. All accrued interest, if any, shall be paid to the City to reimburse the City for its cost in administering the escrow account. 2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City for all out-of-pocket costs the City ha� incurred (including planning, enpineerinq,�in excess of $500, or legal consultant review) or will incur in rev�ewing the plan. Eligible expenses shall be consistent with expenses the Owners would be responsible for under a building permit application.The escrow will also guarantee reimbursement to the City for all out-of-pocket costs th�e City has incurred to assure that the work is completed in accordance with the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79.The financial security may also be used by the City to elimirhate any hazardous conditions associated with the work and to repair any damage to public property or infrastru�ture that is caused by the work (including planning, engineering, or legal consultant review) associated with building permit # if compliance with the approved building permit is not accomplished. 3. MONTHLY BILLING. As the City receives consultant bills for incurred costs, the City will in turn send a bill to the Owners. Owners shalllbe responsible for payment to the City within 30 days of the Owners'receipt of bill. 4. DISBURSEMENT FROI� ESCROW ACCOUNT. In the event that the Owners do not make payment to the City within the timeframe outlined in #3 above, shall issue a Stop Work Order until the Owners pay all expenses invoiced pursuant to#3. The City may dr�w from the escrow account without further approval of the Owners to reimburse the City for eligible expenses the City has incurred. 5. CLOSING ESCROW. �'he Balance on deposit in the escrow, if any,shall be returned to the Owners when all requirements related to the proj�ct are complete. City Staff shall review the terms of this escrow agreement two times per year to determine wheth r the requirements of the project have been successfully completed and whether it is appropriate to return the fu�ds. Owner may also request the release of the funds,and such funds shall be released upon City Staff receiving the appropriate verification that all requirements of the project have been successfully completed. 6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses incurred by the City exceed the amount iin escrow, the City shall have the right to certify the unpaid balance to the subject property pursuant to Minn. Stat.�§§415.01 and 366.012. CITY: CITY OF ORONO OW ;' gy: � �ts: ,� � Internal Use Only: ;�Originat t�Pfianning' G Copy#o Property Owner ` 'Q Cnpyta S�reef File Last Updated: January 2016 i r . � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: 'U' �OD Permit No.:7��7"��✓`�� Description of work: Date Rec'd: � � � _ Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: � � r Grading review by: Date Approved: Zoning District: Zoning File#: Res Reso Date: Zoning: Lot Area: SF/AC Width: L t Coverage: SF % Survey Submitted: 0 Yes � No Date of Surve . Revised date(?): Landscape plan submitted? � Yes 0 No Landscape . Proposed Setbacks: Front (Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50° L.F. below grade Basement? � Yes 0 No, Storie FOR A BUILDING WITH A BASEMENT OR CRAWL SPAC : FOR A BUILDING ON A SLAB FOUNDATION: The distance betwee he lowest pro osed Slab at or above grade— START WITH floor(of the baseme or crawl space and measure from hiahest existina the highest point of e 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... SUBTRACTION • GABLE R HIPPED ROOF(no Slab below grade—measure . (BASED ON window ): Subtract half the distance from highest existing grade to the ROOF TYPE) betwe n the highest point of the roof hi hest oint of the roof. to th low point of the corresponding If you have a... gab or hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF • G BLE OR HIPPED ROOF(with (BASED ON (no windows): Subtract half ndows): Subtract half the distance ROOF TYPE) the distance between the etween the top of the highest highest point of the roof to window and the highest point of the the low point of the roof corresponding gable or hipped roof • 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 EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx I _ r � Shoreland District MCWD Permit Average Lakeshore Setback g�uff Met? 0 Yes 0 No Permit Number: 0 Yes � No 0 N/A � Ye No � 0 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 � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Perm it l/ Plan Review (/' State Surcharge V— Investigation Fee (�' SAC—Number of SAC Units Other(specify) �' Square Footage $ per Square Footage Basement X = $ 1 S' Floor X = $ 2nd FlOor X = $ Garage X = $ f Estimated Construction Value: $ �,� v Orono Inspections Required Work Requiring Separate Permits ❑ Footing 0 Site � Plumbing 0 Grading/Filling 0 Poured Wall � Silt Fence/Erosion Control Mechanical 0 Fire � Foundation Survey � Hardcover Removal � Septic 0 Water Connection 0 Foundation Waterproofing � Other(specify) 0 Fireplace ❑ Sewer Connection Framing 0 Masonry � Lawn Irrigation 0 Insulation 0 Mfg. � Landscaping � As-Built Survey 0 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 r\fnrmc\nlan ravic�ei rharklict'I fl_9(11 F rinrv � / U DATE TIME CITY OF ORONO CALLED IN �S' 9 -I 7 INSPECTION OTI �j SCHEDULED � /o= D�z� PERMIT NO.�� ' ✓� CO PLETED �— ADDRESS v U�'�-� �� - OWNER 4ELEPH NE N0.9S�� -�Z�� CONTRACTOR �� DESCRIPTION `�' � �' �� l� �y ❑ FOOTING ❑ DEMO-FINA ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING Rt ❑ EXCAV/GRADING/FILLINO 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 � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ � ❑ DEMO-SITE ❑ SEPTIC INSTALL ? OINN�NTRACTOR TO MEET YOU:_YES_NO � COMMENT'� � �/��r�'r� ��aacr�� ,�`�f�� j � ` U� � �i � 0 Q �c�"c 7 (`j _�! � W W � � � ❑YMORK SATI.SFACTORY:PFWCEED `PROJ�CT COMPLETE W ❑CORRECT WORK�PROCEED �ISSUE CERTIFlCATE OF OCCUPJINCY O ❑OORRECT VMORK,CALL FOR REINSPECTION TEMPORARY V BEFORECdVERIN� PERIiAANENT O OORRECT UN3AFE CONDITION WITHIN HWRS. p pHpTO TAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED ❑INSPECTION REOUIRED.CALL TO ARRAN(iE ACCESS. CaN tor the next inspectlon 24 taurs in adnanoe. (952) 249-4600 on site: � Inspector: " % � WMte CopyAnsp�eMr's Fih Canary CoppfSib Notia