The URL can be used to link to this page

Home My WebLink About2017-01097 - addn/remodel/repair # „ CITY OF ORONO * z 0 1 7 - 0 1 0 9 7 * 2750 KELLEY PARKWAY DATE ISSUED: 09/20/2017 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 PERM[T TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL- BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 30,000.00 NOTE: INTERIOR REMODEL SUITE#400 APPLICANT PERMIT FEE SCHEDULE 490.12 Ugorets 8098 LLC PLAN REVIEW 318.58 410 11TH AVE S STATE SURCHARGE(VALUATION) 15.00 HOPKINS,MN 55343- TOTAL 823.70 (952)769-7249 Payment(s) CHECK 1701 823.70 OWNER Ugorets 8098 LLC 410 11TH AVE S HOPKINS,MN 55343- AGREEMENT AND SWORN STATEMENT The work for which this permi[is issued shall be performed according to Ihe 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 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 revoke�/�t any time f9r du�cause. /'' ! �, rf / . ��a. / / ' (. � 7/� j�� '/�`� l (� � �� y� �� /i �r A�p cant Pern�itee$ignature Date ,�' Issued B gnature Date � � " ` City of Orono Building Permit Application for Maintenance / Replacement/ Remodel - Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O�O Mailing Address: Permit number: ��"��d�' PO Box 66 Crystal Bay, MN 55323-0066 Date received: 9//—/ Streef Address: Received by: ��"/ '� y � 2750 Kelley Parkway Plan review fee: `�t L Orono,MN 55356 z �j�\ 1KFSHo�`�` Total Fee: ��J• / �` Main: 952-249�600 Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. Incomplete applications will be retur ed. (PI ase print) GENERAL INFORMATION: Job Site Address: ''� � �vD t�' � /� � � �� Will this be a Parade of Homes, Remo elers Show ase Home or other Displ y Home? Yes o If yes,a special event permit is required with Po/ice Department and City Council approva/60 days prior to the event. Shuttle bus s ice will be required unless applicant demonstrates s�cient on-site parking is avai/ab/e. Non permitted events will not be allow . CONTRACTOR/APPLI ANT I,�NFO�R�M;ATIO : p Name: -!�j OI« � � �D�J d L-L � State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes thaf were consbucted prior to 1978 Phone: (cell) _ � r 3 2 (office) ��Z — ��p �j � 3 Mailing Address: � (/�' City: � �/` ZIP: ''j Contact Person: Ap licant is: Contrac r omeowner ci«�o�� Email and/or Fax: � ' �t ' PROPERTY OWNER IN ORMATION: � � � Name: � � '' � Phone(day): .. — ?' Z � Address: � �Q City: � � ZIP: �3 � Email and/or Fax: PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) emodel ❑ Fire Damage MCWD review 8 permits: ❑Re-roof,asphalt Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑Siding ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • 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; • 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�nnot be given to either the public or9he subject of��,rQuj�urpy se and intended use of this information is to annual u ate our records and records of other overnmental a ��f� law. If ou refuse to su I f rmation,t ication ma t be issued. ApplicanYs Signature: � Date: j` /� 1 � �u�/ Owner's Signature: Date: F ORONO Last Updated:January 20 r . PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: G�"�l/ �j`jGtIGS<t.1/�l�iT7�aL �T Permit No.: �f7'D�L��7 Description of work: �Q�Qt�� Date Rec'd: ��l� Septic review by: L/ 4�� Q l � Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: Grading review by: Date Approved: l l / Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: � Yes � No Date of Survey: evised date ? : Landscape plan submitted? � Yes 0 o Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S W ) Other Buildings Wetland Side 'de Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% = L.F. below grade Basement? 0 Yes � No, Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lowe t propos d Slab at or above grade— floor(of the basement or craw space)an measure from hiqhest existinq START WITH the highest point of the roof. ra ade to the highest point of the START WITH roof even if fill was brought in to elevate home. If you have a... SUBTRACTION • GABLE OR HIPP ROOF(no Slab below grade—measure (BASED ON windows): Subtr ct half the distance from highest existing grade to the ROOF TYPE) between the hig est point of the roof hi hest oint of the roof. to the low poin of the corresponding If you have a... gable or hippe roof SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE OR IPPED ROOF(with (BASED ON (no windows): Subtract half windows): ubtract half the distance ROOF TYPE) the distance between the between th top of the highest highest point of the roof to window a d 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 mansar ,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract the distance between the half the distance between (BASED ON basemenU awl space floor and the the top of the highest EXISTING highest exi ting grade adjacent to the window and the highest GRADES) foundatio OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined uilding height subtraction. Defined building height EQUALS 1 Updated: October 2015 z:\forms\plan review checklist 10-2015.docx : � Average Lakeshore Setback Shoreland District MCWD Permit Met? Bluff � Yes 0 No Permit Number. � Yes 0 No � 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 0 No 0 Yes 0 No 1 2 3 4 5 Type(s): • Type(s): Fees to be Char ed YES NO Permit Plan Review //" State Surcharge � Investigation Fee �/` SAC—Number of SAC Units �' Other(specify) v Square Footage $ per Square Footage Basement X = $ 1 St Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ ��(�/,��17 —/ .��. Orono Inspections Required Work Requiring Separate Permits �,Footing 0 Site 0 Plumbing 0 Grading/Filling � Poured Wall 0 Silt Fence/Erosion Control �Mechanical 0 Fire � Foundation Survey 0 Hardcover Removal � Septic 0 Water Connection � Foundation Waterproofing 0 Other(specify) 0 Fireplace � Sewer Connection Framing 0 Masonry � Lawn Irrigation 0 Insulation � Mfg. � Landscaping � As-Built Survey � Other(specify) Final � Lathe Required State Permits � Other(specify) ❑ Well Electrica� 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 r\fnrmclnlan ravic�u rharklicf 1 h_9M F rinrv �� v DATE TIME CITY OF ORONO CALLED IN INSPECTION 1�QTICE SCHEDULED �� PERMff NO. rU4�7 " �� COMPLETE ADDRESS o` � � d OWNER ��-��r� TELEPHONE 0.�� 33�� CONTRACTOR �,� � DESCRIPTION �� tV FOOTING ❑ DEM -FINAL ❑ SEPTIC FINAL � ❑ URED 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 _ ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTRACTOR TO MEET 1'�U:_YES_NO y COMME TS: � / C ►" � ,.�s�e��ac� 0 ° �o�`(� " �o�� C��m � W ( aC Q � W �� — /d�tc��y� a�ct�«t W � J W WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK 3 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C4MERING PERMANENT ❑CORRECTUNSAFECONDITIONWfTHIN HOURS_ ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 2a hours in advance. (952) 249-46�0 OwnerlCon on site: Inspector. ite CopyAnspector's Flle Cenary CopylSite Notice