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Home My WebLink About2017-01098 - addn/remodel/repair # 4 CITY OF ORONO * z0 17 — PJ 1098 * 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 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 20,000.00 NOTE: SEPARATE PERMIT REQUIRED: MECHANICAL,ELECTRICAL(STATE) APPLICANT PERMIT FEE SCHEDULE 356.22 PLAN REVIEW 231.54 Ugorets 8098 LLC STATE SURCHARGE(VALUATION) 10.00 410 11TH AVE S HOPKINS,MN 55343- TOTAL 597.76 (952)769-7249 Payment(s) CHECK 1701 597.76 OWNER Ugorets 8098 LLC 410 11TH AVE S HOPKINS,MN 55343- AGREEMENT AND SWORN STATEMENT 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 construc[ion 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. ' . � � , � Z � �0��ft , ) (' -�,� ; � 'J � � �'�. �"�c � �' , � l�L l� � ` � ,: Applicant P rmitee Signature te ssued By 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: �OJ�—��O PO Box 66 �s� Crystal Bay, MN 55323-0066 Date received: /l —/ Street Address: Received by: � � � 2750 Kelley Parkway Plan review fee: F �, `qkES H�� Orono, MN 55356 �{/�<��` � � Total Fee: f� Main: 952-249-4600 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: 4 � �� /�� f' � �� Job Site Address: � t:a /� q,�• 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 Police Department and City Council approval 60 days prior to the event. Shuttle bus s ice will be required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowe . CONTRACTOR/APPLI ANT INFORMATIO : Name: C.�` Q�� `�� [� � State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) _ � -- �'2�. Z � (office) ��Z — �� j -- �' � " Mailing Address: � (/ � City: � y/ ZIP: "� Contact Person: Ap licant is: Contrac r ��" omeowner �c��ie o�e� Email and/or Fax: � ' Ct,,� � � E PROPERTY OWNER IN ORMATION: Name: � �; '�' � � �: L � Phone(day): � — � ' � � Address: � �Q, � City: �� h ZIP: �� 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 cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annual update our records and records of other governmental agencies required by law. If ou refuse to su I f rmation,t lication ma t be issued. Applicant's Signature: �� Date: /� ' ��EtVf D Owner's Signature: � ' -- Date: C �� Z��1 Last Updated:January 20 C�T1(OF ORONO � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: �, D� ,� (��C�� Permit No.: �`7r" ��b� Description of work: Date Rec'd: Septic review by: � � Q /^� � �� /!� Date Approved: l 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 Width: Lot Coverage: SF % Survey Submitted: 0 Yes � No Date of Survey: Revised date(?): Landscape plan submitted? 0 Yes 0 No Landscaper: 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? 0 Yes 0 No, Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lowest proposed Slab at or above grade— floor(of the basement or crawl space)and measure from hiphest existina START WITH the highest point of the roof. rq 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 HIPPED ROOF(no Slab below grade—measure (BASED ON windows): 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 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 ' ' ! Average Lakeshore Setback Shoreland District MCWD Permit Met? Bluff � Yes � No Permit Number: � Yes 0 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 0 No 0 Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Charged YES NO Permit Plan Review State Surcharge Investigation Fee SAC– Number of SAC Units Other(specify) Square Footage $ per Square Footage Basement X = $ 1 S� Floor X = $ 2nd FIOOr X = $ Garage X = $ Estimated Construction Value: $ ��( �ly D �— Orono Inspections Required Work Requiring Separate Permits � Footing 0 Site ❑ Plumbing � Grading/ Filling � Poured Wall � Silt Fence/Erosion Control Mechanical 0 Fire 0 Foundation Survey 0 Hardcover Removal � Septic � Water Connection ❑ Foundation Waterproofing � Other(specify) � Fireplace � Sewer Connection �'Framing � Masonry � Lawn Irrigation � Insulation � Mfg. � Landscaping � As-Built Survey ❑ Other(specify) Final � 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 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 � �•\fnrmc\nlan ravio�ni nc�rklicf 1f1_9l11F rinrv � � �o� � � �,� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED � � � PERMIT NO.��OI -G I l�%�COMPLETED ADDRESS aSZ.� �5��/u�oC�f� � � 74� OWNER j��C��` TELEPHONE NO.�'��-3�L 3 3�� CONTRACTOR � �*� � � � DESCRIPTION ��`'��-�'�� ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED 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 _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET Y'OU:_YES_NO y COMMENTS: a� W � 0 9 v 1 /G'CC� � fi��f i �y � 0 � W Q .�e e v � — D� � z W � W � J d W ❑WORKSATISFACTORY:PROCEED ❑PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS_ p pHOTOTAKEN INSPECTOR WILI REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CAIL TO ARRANGE ACCESS. Ca11 for the next inspection 2a hours in advance. (952) 249-4600 r on site: Inspect White Copyflnspector's File Canary CopylSite Notice s�.� ✓ ��— DATE TIME CITY OF ORONO CALLED IN �a 7 INSPECTION TICE aZb �� SCHEDULED �"' -!7 /d'D'� PERMIT NO. ��b1 a�� OMPLETED ADDRESS � � � �"� OWNER TELEPHONE NO. CONTRACTOR 5 !�- $63 - � DESCRIPTION �� ul GGo 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAM�NG ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FiREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 4� ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: 4 / � ��C�2 ( f y o /'�u�l y /r�'l U (!� � fh '� n r c ll ��' � . ° ✓'e� !hf C � yt. Q �P/''�ti 2�9� �-O!0 �� W � W � J W ❑WORKSATISFACTORY:PROCEED ❑PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O RECT WORK,CALL FOR REINSPECTION TEMPORARY B ORECdVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 ror the next inspection 24 hours in advance. (952) 249-4600 OwnerlContra r on site: Inspector: White Copyllnspector's File Canary CopylSite Notfee