The URL can be used to link to this page

Home My WebLink About2017-00461 - addn/remodel/repair �' CITY OF ORONO 2750 KELLEY PARKWAY * � 0 1 7 - PJ 0 4 6 1 * DATE ISSUED: OS/1 U2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2500 SHADYWOOD RD PIN : 20-117-23-11-0034 LEGAL DESC : REG. LAND SURVEY NO. 1630 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL- BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUAT[ON : $ 20,000.00 NOTE: REMODEL UNITS: 500-555 NO SAC DUE,PER LETTER FROM MET COUNCIL DATED 10/13/16 APPLICANT PERM[T FEE SCHEDULE 356.22 STATE SURCHARGE(VALUATION) 10.00 Ugorets 8098 LLC TOTAL 366.22 410 11TH AVE S Payment(s) HOPKINS,MN 55343- CHECK 1606 366.22 (952)769-7249 OWNER Ugorets 8098 LLC 410 11TH AVE S HOPKINS, MN 55343- AGREEMENT AND SWORN STATEMEIYT 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 does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances governing 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 180 days at any time afrer 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 revoked at any time for due cause. k j) '� ` � � li 1 ` �� , - ��'C��'�..-.� � ��_� f�`_�,c__ -' / / Applicant Permitee Signature Date Issued By Signature Date I , ��.CEIVED CITY OF ORONO MAY U �2n�7 BUILDING PERMIT APPLICATION C�T`( OF ORONO FOR NEW STRUCTURES OR ADDITIONS �O�O MailingAddress: Permitnumber: ��17—� PO Box 66 �� / Crystal Bay, MN 55323-0066 Date received: StreetAddress:' ------ �eceLed by: �� ----_.___ y�, G� 2750 Kelley Parkway % Plan review fee: � �. 5 �'� t�kESHO�� Orono,MN 55356 �- -- -----_ �/7'��i � Main: 952-249-4600 Total Fee:� Fax: 952-249-4616 www.ci.orono.mn.us s' �f,(L, , 2 2- This application form must be completed in full and all required information must be submitted. ��,� ��,� Incomplete applications will be return�d. Please print) �-�'' GENERAL INFORMATION: ��? �G'1G��.-r�vL� iris,�?�� Job Site Address: r�� ,,��c�: 1�:.s�,�».i� Cs�,,�� ,k-� �CC'� - `�5.� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No If yes,a specia/event permif is required with Police Department and City Council approva/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: 1��;N�-S �C:ti� L.L.C. . State License# Expiration Date: Phone: (cell) (�1 � -�i(c,,5 -• 3�� (office) Mailing Address: �I�a i�t'' fj-o�,Sc � Cit : p k-,n� ZIP: S�_3�!3 Contact Person: �1��c ljc - � Applicant is: ntr�to� / Homeowner (Circle One) Email and/or Fax: C:.\c3.�,cQ id lo.�,dc;l�s.cc.�^'� PROPERTY OWNER INFORMATION: Name: l�«�:�s ��:9�s �.�..c'. . Phone (day): �,17�� -3�='3 -3_iFa� Address: �! lo li *" P}�� . S�; CitY: }-�o,k:,;,� ZIP: 5:.53� 3 Email and/or Fax c�..�F�c� �+-�;�l\�.�,�..�:1 � tc . c c�e�, ARCHITECT/ENGINEER INFORMATION: Name: �,v�11;�s ��.�;}-,�}y Phone (day): q,�� - �-�_; �-3[�S� Address � ,S it;;n}�. �}��. �3o City: j-}�,��;�S ZIP: S�,�f.3 Email and/or Fax: d j p��_i.,�;\koS c�c� . C��ti. � PROJECT INFORMATION: Description of project: 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Dispo::al& 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) C�r►,�h,�\ ❑ Multiple Family/Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater �.Public Water **Any earth movement may also require Q 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�71-0682 www.minnehahacreek.orq Estimated Construction Valuation (excluding land) $ a ��, ��<>�"> C'%�j Last Updated: January 2016 r STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continuedj a. Length(ft.)= Number of bedrooms= 2. Occupancy: �/ b.Width(ft.)= Number of garage stalls: / � 3. Occupant Load: (L� Areas in sQuare feet Attached= � c. Basement= Detached= 4. Type of Construction: d. 15'Story = .��.. �1--�-�p I ,✓ e.2"d Story= 5. Code Edition: ��J — /"�� f. '/�Story = g.Total Area= G� 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 ❑ Sl Plan Review Fee � ❑ Com leted A lication Form ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/2 x 11 set ❑ � Minnesota State Ener Code Calculations and Mechanical Code Re uirements ❑ � Surve —2 full size,to scale meetin ALL surve requirements ❑ � Hardcover Calculations ❑ Se tic S stem Certification ❑ � Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD statin no ermit is re uired ❑ 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 a500; • 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 afl 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 generalty 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: L Date: � � Owner's Signature: Date: Last Updated: January 2016 ^ PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIO� - �f c � � �J �j ,- Address: � G y�v��e ��PermitTl� � Description of work: Date Rec'd: Septic review by: Date Approved: 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 �1lidth: Lot Coverage: SF % 3 1 Survey Submitted: 0 Yes � No ? Date of Survey: Revised date ? : i Landscape plan submitted? � Yes d No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N S; E W ) N S E W ) Other Buildings Wetland Si e Side ; Defined Height: Peak Height: � FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50 0 = L.F. below grade Basement? � Yes 0 No, Sto ies � FOR A BUILDING WITH A BASEMENT OR CRAWL ACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance b tween the lowest pro osed Slab at or above grade— START WITH floor(of the b sement or crawl space) nd measure from hiqhest existinq the highest oint of the roof. START WITH rq ade to the highest point of the roof even if fill was brought in to elevate home. If you h e a... SUBTRACTION • ABLE OR HIPPED ROOF(no Slab below grade—measure (BASED ON indows): Subtract half the distance from highest existing grade to the ROOF TYPE) between the highest point of the roof hi hest oint of the roof. to the low point of the corresponding If you have a... gable or hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF GABLE OR HIPPED ROOF(with (BASED ON (no windows): Subtract half windows): Subtract half the distance ROOF TYPE) the distance between the between 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 SUBTRACT N Subtract the distance between the half the distance between (BASED O basemenUcrawl space floor and the the top of the highest EXISTIN 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 Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? 0 Yes 0 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 j/'� State Surcharge �j— Investigation Fee i/ SAC—Number of SAC Units '� Other(specify) � Square Foota e $ per Square Footage Basement X = $ 15i Floor X = $ 2nd Flool' X = $ Garage X = $ Estimated Construction Value: $ � �r V�U Orono Inspections Required Work Requiring Separate Permits � Footing 0 Site � Plumbing 0 Grading/Filling 0 Poured Wall � Silt Fence/Erosion Control �,Mechanical � Fire 0 Foundation Survey � Hardcover Removal 0 Septic 0 Water Connection � Foundation Waterproofing 0 Other(specify) 0 Fireplace � Sewer Connection �Framing � Masonry � Lawn Irrigation � Insulation � Mfg. 0 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: � See Builder Acknowledgement Form 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 ��\fnrmc\nlan rcvia�ni rhar41ic4 1f1_7(11F rinrr Permit A�plicatior,�: Self-Checklist for Completeness Please note, the applicant must initial;in the boxes below to acknowledge the minimum required information is included with the subrr�ittal. If not, the application will NOT be accepted. Call 952.249.4620 to schedule a meeting with staff if you have questions on application submittal requirements. i� Completed Applic�tion � Plan Review Fee �aid ��. Signed Escrow Agreement & Escrow Payment i ,Q� Building Plans (td scale) x2 Certificate of Su�vey (to scale) showing the proposed project & � meeting all requirements x2 � Hardcover Calcu;lations (if applicable) I am aware tha� Orono will not issue a building permit without a copy of MCWD �ermits (or documentation from the MCWD stating C,P. the proposed pr�oject does not trigger their permitting requirements). ;I will contact the MCWD at 952-471-0590 re 'ng this plroj� � Signed by: � � Address: � �c��_' ��` �� ermit �: -� Last Updated: January 2016 i � BUILDING PERMIT ESCROW AGREEMENT Orono Building Permit# AGREEMENT made this day of , 20_, by and between the CITY OF ORONO, a Minnesota municipal corporation ("Cit�') ("Owners"). Recitals 1. A building permit application has been filed a located at the ("Subject Propert�'), legally described as 2. Owners request the City to review this application. 3. The City will commence its review of the application and incur costs associated with said review only if the Owner establishes an escrow 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 has incurred (including planning, ensrineerin_a. in excess of 3500, or legal consultant review) or will incur in reviewing 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 the 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 eliminate any hazardous conditions associated with the work and to repair any damage to public property or infrastructure 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 shall be responsible for payment to the City within 30 days of the Owners'receipt of bill. 4. DISBURSEMENT FROM 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 draw from the escrow account without further approval of the Owners to reimburse the City for eligible expenses the City has incurred. 5. CLOSING ESCROW. The Balance on deposit in the escrow,if any,shall be returned to the Owners when all requirements related to the project are complete. City Staff shall review the terms of this escrow agreement two times per year to determine whether the requirements of the project have been successfully completed and whether it is appropriate to return the funds. 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 in 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 O E By: L its: k�bmai Uss Onl�►: t�Oripinsl b f�lanning �Copy to ProMrty Kt�rn�r O Copy to Strest Fl1e Last Updated: January 2016 I c�- --_ _-.- . / � , � � DATE TIME CITY OF ORONO c�aLLED IN I INSPECTION TIC SCHEDULED �r�— PERMR NO. "� COMPLETED �� ir� ADDRESS � GS OWNER TELEPH�NE NO. CONTRACTOR � DESCRIPTION ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI , ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL i ❑ TREE REMOVAL Z ❑ ADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q FRAMING ❑ MECHANICAL FINAL I ❑ RATED WALLS _ ❑ ULATION ❑ WOOD BURNER/FIRE�LACE ❑ COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP i ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET Y�OU:_YES_NO i y COMMENTS: � W � o � o r,[ �— �0�� I � o ��r� Qt C mu.c�,.f��.� f..� ��'��.l a� /�t 1 vl c��,�mvPs � �� t�+^P C��er �rt� i � w � j W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE �� RRECT WORK 3 PROCEED I ❑ ISSUE CERTIFICATE OF OCCUPANCY RECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANEN7 ❑CORRECT UNSAFE CONDITION WRHIN HOURS.i p pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR I �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. I Cail for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site• � Inspector: White Copyflnspector's Flle Cenery CopylSite Notke