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Home My WebLink About2017-00754 - addn/remodel/repair � � C�TY OF ORONO * 2 0 1 7 - a 0 7 5 4 * 2750 KELLEY PARKWAY DATE ISSUED: 07/07/2017 ORONO,MN 55356- (952) 249-#600 FAX: 952 249-4616 ADDRESS : 2500 SHADYWOOD I�iD PIN : 20-117-23-11-0034 LEGAL DESC : REG. LAND SURVEY NO. 1630 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMOD�EL/REPAIR PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 5,000.00 NOTE: SEPARATE PERMITS REQUIRED: MECHANICAL,ELECTRICAL(STATE) LJNIT#150 BUILDOUT APPLICANT PERMIT FEE SCHEDULE 123.87 STATE SURCHARGE(VALUATION) 2.50 Ugorets 8098 LLC TOTAL 126.37 410 11TH AVE S Payment(s) HOPKINS,MN 55343- CHECK 1694 12637 (952)769-7249 OWNER Ugorets 8098 LLC 410 11TH AVE S HOPKINS,MN 55343- AGREEMENT AND SWORN STATEMEN The work for which this permit is issued shall be performed accordFng to the approved plans and specifications,applicable City approvals,a►►d the State Building Code. This permit is for only the work described a�d does not grant permission for additional or related work which requires Separate permits. All provisions of laws and ordinances governing this typel 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 construc ion is suspended for a period of ISO days at any time after work has co enced. The applicant is responsible for assuring all required inspections e requested in conformance with the State Building Code.This pe it may be revoked at an time for due cause. .. � 7��/1 �� 7 � � � /,Z Applicant Permitee Si ature Date Issued By gnature Date * . � i r 1 �/""� � CITY OF ORONO �a�� BUILDINiG PERMIT APPLICATION FOR NEW S�'TRUCTURES OR ADDITIONS ,�O A,O Mailing Address: Permit number: � —� �V PO Bo�t 66 � CrystaliBay, MN 55323-0066 Date received: J�-�7 � Street Addr�ess:' ��(� �� Received by: 2T � y�, G'� 2750 K�elley Parkway ��"�,1,� Plan review fee: � � �,�k�SHo��, Orono,MN 55356 d�/7 �7�3 Main: 952-249-4600 Total Fee: Fax: 952-2149-4616 www.ci.orono.mn.us This appNcatlon fom�must be pleted in fuil and ail required informallon must be submitted. Incomple�ap Ifcations wiii be returned. (P/ease print) � GENERAL INFORMATION: Job Site Address: r SO� S �� Will this be a Parade of Homes, Remodele s Showcase Home or other Display Home? ❑ Yes �No If yes,a specia/event permit is required with Police Depa ent and City Council approval 60 days prior to the event. ShutHe bus service will be required unless applicant demonstrates s�cient on-site pdrking is available. Non Permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: l�c nc��s Sa9R L .�..L-- State License# �— � Expiration Date: Phone: cell office Mailing Address: o ��{'- u . Cit : � i ZIP: SS3�F3 Contact Person: Applicant is: ac Homeowner �ci►�i•o�� Email and/or Fax: �,�ex _ rv;►�j��sc . c�n. • PROPERTY OWNER INFORMATION: Name: U�nrQ.�-S f L.L.C_ Phone(day): L�1 0 -3��-_��a 1 , Address: y �t, 1��'- pk,� . .�a . City: �}�ak;�� ZIP: SS343 Email and/or Fax o�,l�x e n�i��.1un�.c I�cs . car� 0 ARCHITECT/ENGINEER INFORMATION: ' Name: C�.�► � �-}-e,��s Phone(day): S - 1 - Address: 1 Ni � Cit : o �, � z�P: ,55343 Email and/or Fax: d C,.,; c,o PROJECT INFORMATION: Descri tion o ro'ect: 1.Type of Project 2.Pr posed Use 3.Structure Type 4.Sewage Dlsposal 8� Water Supply ❑New Construction ❑S ngle Family with ❑Accessory Bldg./Garage ❑Addition ched garage ❑Deck �Public Sewer ❑Accessory Building ❑ ingle Family with �Office/Commercial ❑Relocation etached garage ❑Residence ❑Private Sewer �Other:(specify) I'�mc�d�\ ❑ ultiple Family/Condo ❑Retaining Wall(s) ❑ blic 4-feet or greater �Public Water **Any earth movement may also require mmercial ❑Storage MCWD review 8 permits. I dustrial ❑Warehouse ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ ther: (specify) ❑Other(speCify) 15320 Minnetonka Blvd Minnetonka,MN 55345 Phone: 952-471-0590 Fax: 952�71-0682 www.m in nehahacreek.or Estimated Construction Valuation (excluding and) � ,�_��• �� Last Updated: January 2016 � f � STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) a. Length (ft.)= Number of bedrooms= 2. Occupancy: � b.Width(ft.)= Number of garage stalls: /D 3. Occupant Load: � Areas in square feet Attached= c. Basement= Detached= 4. Type of Construction: � � d. 15'Story = �� • _�1.� e.2"d Story= 5. Code Edition: � f. YZ Story = g.Total Area= b GC� REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable O Buildin Permit Escrow A reement and Fees ❑ 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 survey 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 ❑ 81 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 5500; • 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 510,000 escrow to ensure completion of the as-built survey and all site improvements. ApplicanYs Signature: Date: � Owner's Signature: Date: Last Updated: January 2016 , • .. � � � 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 p�lrmit 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�nsure reimbursement to the City of its costs. NOW THEREFORE,THE PARTIES AGRE�AS FOLLOWS: 1. DEPOSIT OF ESCROW 'FUNDS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall deposit$2,5d0 with the City. All accrued interest, if any, shall be paid to the City to reimburse the City for its cost in administeri�g the escrow account. 2. PURPOSE OF ESCROW.iThe purpose of the escrow is to guarantee reimbursement to the City for all out-of-pocket costs the City has inqurred (including planning, en�►ineerin�r, in excess of 5500, or legal consultant review) or will incur in reviewi g the plan. Eligible expenses shall be consistent with expenses the Owners would be responsible for under a b Iding permit application.The escrow will also guarantee reimbursement to the City for all out-of-pocket costs the Ci has incurred to assure that the work is completed in accordance with the Stormwater Pollution Prevention Plan ahd the provisions of Orono City Code Chapter 79.The financial security may also be used by the City to eliminate lany hazardous conditions associated with the work and to repair any damage to public property or infrastructur$ that is caused by the work (including planning, engineering, or legal consultant review) associated with buildir►�g 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 fesponsible for payment to the City within 30 days of the Owners'receipt of bill. � 4. DISBURSEMENT FROM E�CROW ACCOUNT. In the event that the Owners do not make payment to the Ciry 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 f�om the escrow account without further approval of the Owners to reimburse the City for eligible expenses the Ciry has indurred. 5. CLOSING ESCROW. Th Balance on deposit in the escrow,if any,shall be returned to the Owners when all requirements related to the projec are complete. City Staff shall review the terms of this escrow agreement two times per year to determine whether he requirements of the project have been successfully completed and whether it is appropriate to return the fund . 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 CHAF�GES. 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 pr ert pursuant to Minn. Stat.§ 415.01 and 366.012. CITY• C F ORO OWNER: By: its: IM.r�,a�use o�ly: �ort�tna�� Mn9 �copr to Propsrer a� �coar to strwt Flk Last Updated: January 2016 � � � - I � Permit A licati n: Self-Checklist for Com leteness Please note, the applicant must initi I in the boxes below to acknowledge the minimum required information is included with the submittal. 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. Completed Applic�tion � I �(�, Plan Review Fee �a d � Signed Escrow A�reement & Escrow Payment Building Plans (tq scale) x2 � Certificate of Sur�ey (to scale) showing the proposed project & meeting all requi�ements x2 �� Hardcover Calcul tions (if applicable) I am aware that rono will not issue a building permit without a copy of MCWD p rmits (or documentation from the MCWD stating � the proposed pr ject does not trigger their permitting ` requirements). will contact the MCWD at 952-471-0590 reg this pr ' Signed by: � Address: Permit #: Last Updated: January 2016 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: ��i! � ��IIN(�(� (L- ��// Permit No.: �� `�� 7� � Description of work: Date Rec'd: Septic review by: , � � �l�P �Date Approved:m 1(� ` ��z`l� Zoning review by: --'" Date Approved: , Building review by: � �- Date Approved: Grading review by: Date Approved: Zoning District: Zoning File#: Resolution? Yes Reso#: � Reso Date: S,i ned: Yes No Resolution/NA � i Zoning: Lot Area: SF/AC Width: �� Structural Coverage: SF % Survey Submitted � Yes �Q No Date of S�ey: Revised date(?): Landscape plan submitted? � Yes Landsc per: i � No/None proposed � Pro osed Setbacks: � % Front(Lake) Rear(Street) ( N S E W � ( N S E W ) Other Buildings Wetland Si e / Side / , i Buildinq Heipht Analvsis: ', j i ; Distance Between First Floor��d defined Top of � � � Roof See "buildin hei hY' d,e inition : a First Floor Elevation from b�iil �'n lans : (b) Highest Existing ground level (p�r survey) or 10' �� above lowest round level, whiclnever is lower: Difference between b a d c : ' (d) DEFINED HEIGHT If highest eScisting grade is: �g� above FFE-Height is(a)-(d)/ below FFE-Height is(a)+(d) � Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? � Yes � No Permit Numb,er: 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 s % and s i 0 Yes � No 0 Yes � No 1 2 3 4 5 Type(s): Type(s): f , Updated: October 2016 , v:\forms�plan review checklist 10-2016.docx ' � , _. Fees to be Char ed YES NO Permit Plan Review ;�' St�te Surcharge (/" Investigation Fee ,. SAC—Number of SAC Units Other(specify) S uare Foota e $ er S uare Foota e Basement X = $ 1 St Floor X = $ 2nd Floo� X = $ Garage X = $ i, Estimated Construction Value: $ �O, Orono Inspections Required Work Requiring Separate Permits 0 Footing � Site � Plumbing � Grading/Filling 0 Poured Wall � Silt Fence/Erosion Control Mechanical � Fire � Foundation Survey 0 Hardcover Removal � Fireplace � Water Connection � Framing 0 Other(specify) 0 Masonry 0 Sewer Connection 0 Waterproofing/Drain tile � Mfg. 0 Lawn Irrigation � Foundation Waterproofing 0 Other(specify) � Landscaping �Framing O Insulation 0 As-Built Survey Final � Lathe Required State Permits � Other(specify) 0 Well Electrical REMARKS (in-house): OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: 0 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 2016 v:\forms�plan review checklist 10-2016.docx c�� DATE TIME CITY OF ORONO CALLED IN ZS-/;Z INSPECTION NO ICE HEDULED �-7/7 /O:�a PERMIT NO. � COMPLETED ADDRESS �� k�d�D� �� OWNER TELEPHONE NO. �� '��7� � CONTRACTOR LL � �S � DESCRIPTION �� Y�� 4� ❑ FOOTING ❑ DEMO-FINAL TIC 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 BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 01MNERICOlRRACTOR TO MEET Y�OU:_YE$_NO y COMMENTS: � � o /'G!�'t '�i ��-'�� U f' ��y � �R9rP 0 � Q � Ca�t�� -�l�<f✓'leu� /��d�C /m� �e,�mr� � �(�U �l�'!�G� W � W aC J / 4�j O'YVORK SATISFACTORY:PROCEED O PROJECT COMPLETE � RRECT WORK 6 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY W ❑ RECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CaVERINO PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p p�{OTO TAKEN INSPECTOR WFLL REfURN ❑GTATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952) 249-48�� OwnerlContra on site: Inspector: White CopyAnspector's File C��ry�PY��N�� er� � �/D _ TIME CITY OF ORONO CALLED IN � MISPECTION N � �DI�)�'y1 SCHEDULED -�'7-/7 _,�� PERMR NO. « `��COMPLETED --�— ADDRESS �� y Gc�ao� �� OMINER TELEPHONE NO�--3� CONTRACTOR � 0 � � i�� DESCAI�TION � � ly 0 FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADINGIFILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION � ❑ FRAMING ❑ MECHANICAL FINAL � ❑ RATED WALLS � ❑ INSULATION ❑WOOD BURNER/FIREPLAdE ❑ COMPLAINT � ❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL r ❑ DEMO-SfTE ❑ SEPTIC INSTALL 2 CWNBYCOIfTRACfOR TO MEET YOU:—Y68—NO � COMMENT� � � Qi(' �^rCQ' — � j 0 � �j Q` " -2q� G�'�� f/'i a r�t ' � � e — � -- -- W O WORK SATISFACTORY:PROCEED ECT COMPLETE � ❑OORRECT WOF�C 8 PROCEED CERTIFlCATE OF O(:CUPY►NCY � O CORRECT WOFIlC,CALL FOR REINSPECTION I �TEMPORARY V BEFORE CaVERiNa i pEqMpNENT ❑(bqqECT UNSAFE CONDITiON YYITHIN H��• pHpTO TAKEN INSPECTOR WILL RETURN ❑ST�ORDER POSTED.CALL INSPECTOR ��ATION ISSUED ❑INSPECTION HEOUIRED.CALL TO ARRAN(iE ACCESS. i ceb ta u�e next t�pection 2a nou�s��sdve�o.. (952) 249-4600 owne on site: , � M1hIN t�op�IMa�C1or's FlM Gmry Cop�I81a Notla