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Home My WebLink About2012-00872 -addn/remodel/repair ` �' CITY OF ORONO 2750 KELLEY PARKWAY * z 0 1 2 - P1 0 B 7 2 * DATE ISSUED: 09/12/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 2172 SHADYWOOD RD PIN : 17-117-23-42-0010 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 000 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 1,350.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) RECONFIGURE GARAGE DOOR *ALL ILLEGAL HARDCOVER RE D AND AN AS BUILT SURVEY AND HARDCOVER CALCUALTIONS TO BE SUBMITTED BEFORE SEPTEMBER 15,2012. INITIAL APPLICANT pERMIT FEE SCHEDULE 54.25 TRUE NORTH HOMES INC STATE SURCHARGE(VALUATION) 0.68 410 LAKEVIEW AVENUE TONKA BAY,MN 55331- TOTAL 54.93 (612)281-2540 Minnesota State License#:20636839 OWNER DORE,STEVEN 6530 CABRIDGE ST MINNEAPOLIS,MN 55426- 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 pertnission 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 revoked at y ti e d 'ause. � � � � � / �?1-�Z Ap �cant rmitee Signature Date Iss e y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � r� �3� , , � �o I Z- City of Orono Building Permit Application for New Structures or Additions �`�-�3 — Mailing Address: Permit number: — �g 7�j 0 PO Box 66 � � Crystal Bay, MN 55323-0066 Date received: — — �� \ ,�� 5 �� ,I� ��,��_ �I I StreetAddress:� Received by: � �`�',�,��r,,��j�,�� Gti' 2750 Kelley Parkway Plan review fee: .3.5• � �g �$'<= g,�.-%' Orono, MN 55356 ��9. �s�o ao�a -�D 8�3 _= Total Fee: Main: 952-249-4600 Fax: 952-249-4616 This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: �i �2 Sha��wr�� a C 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 un/ess applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT I FORMATION: Name: i?ve �� - �►'�i�- � l NC State License# (�C E 3( g 3 q Expiration Date: 3 � / Phone: office � -- - �� C� cell Mailing Address: (p ,E�.�;�� Cit : jorv� I(�« ZIP: .SS�3 Contact Person: �,q Crt, �,t�P��1.�•� Applicant is: ontractor- / omeowner (Circle One) Email and/or Fax: �u� �pvs�b�� I�P�t (`� Rv1.Ct��1 PROPERTY OWNER INFORMATION: Name: S;r�� /;.�2� Phone(day): 2- � _ 2 Address: 2(7Z S��a� ..,� i,�r>oo �� City: ��,cJC ZIP: 55��( Email and/or Fax 5�'eve� c� iNG��IC'U.�e:�'►'1 ARCHITECT/ENGINEER INFORMATION: Name: �,�5 Phone(day): Address: f 0135 �(7 �' i�e• City: � �yv�a�� ZIP: S54-yZ Email and/or Fax: Rsm r�ie n ��€�r�CaS,—:her PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal & Water Supply ❑ New Construction �Single Family with �,Residence ❑Addition attached garage ❑Garage/Accessory Bldg. `� Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑Office/Commercial ❑ Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage � Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (speCify) 18202 Minnetonka B�vd ��-r„ �Y''1�� Deephaven,MN 55391 T� Phone: 952-471-0590 Fax: 952-471-0682 Estimated Construction Valuation (excluding land) � �� ,�SG. O O STRUCTURE INFORMATION: 1.Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame b.Width (ft.)= Number of garage stalls: ❑ Masonry Areas in square feet Attached= ❑ Metal ❑ Pole Bidg. c. Basement= Detached = ❑ ICF d. 15f Story = ❑On-site Prefab e. 2rd Story= ❑Off-site Prefab f. '/z Story = ❑ Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ ❑ Permit A lication ❑ ❑ Pro osed Buildin Plans ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ ❑ Surve meetin all re uirements ❑ ❑ Stormwater Pollution Prevention Plan ❑ ❑ Hardcover Calculation s ❑ ❑ Se tic S stem Site Evaluation Re ort ❑ ❑ Access Permit ❑ ❑ Wetland Buffer Im rovement Plan ❑ ❑ En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ Other: 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$500; • 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 $10,000 escrow to ensure completion of the as-built survey and all site improvements. ApplicanYs Signature: � Date: q'-y -(Z � , t Owner's Signature: � �` Date: � �� Z- , , • , Plan Review Checklist for New Structures / Additions Address/PID/ Legal: Z 2 S1-\P� o o� Description of work: I�C�N �G; ��2 i�U s, ��/�6�. ��2 Septic review by: Date Approved: Zoning review by: 1,�� Date Approved: � • �' �Z--• Building review by: Date Approved: `�^!D � t 2.— Grading review by: �,J� Date Approved: Zoning File#: Resolution#: Resolution Date: Zonin District Fire De artment Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: 0 Yes � Date of Survey: / Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Building Defined Height: Building Peak Height: FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START the distance between the basement floor/ START the distance between the slab and the WITH crawl space floor and the highest roof peak, WITH highest roof peak, the top of the cornice the top of the cornice of a flat roof eck of a flat roof, the deck line of a m ard line of a mansard roof, or the ermost roof, or the uppermost n a round or oint on a round or oth rch-t e roof other arch-t e r ' SUBTRACT half the distance een the highest SUBTRACT half the di ce between the highest window and � est roof peak of a pitched wind and highest roof peak of a . roof ed roof SUBTRACT the ' tance between the basement floor/ ADD the distance between the slab and the awl space floor and the highest existing highest existing grade within the grade within the foundation or 10 feet, foundation whichever is less. EQUALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: �� SF ��_% Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff � Yes 0 No � Yes 0 No 0 N/A p Yes 0 No � N/A � Yes 0 No Permit Number: Setback: Hardcover Zones � Existin ' Pro osed Variance Re uired CUP Re uired 0-75' 0 Yes � No � Yes 0 No 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): Updated: 07/01/2009 z:\forms�plan review checklist.docx , J i Fees to be Char ed YES NO `P�rmi# Plan Review �ta�+e�ur.�a . e Investi ation Fee S�kC-;�Alu�riber of��4C-ll�i� Sewer Connection ��G��a�ibn Park Fee . �itE�1ns :ect�on Other s eci a'�tisc�lla�ec�s f�ea Calculated B : UBC: Construction Type: S uare Foota e $ er S uare Foota e Basement X = $ 1 Floor X = $ 2" FIOOr X = $ Gara e X = $ Estimated Construction Value: $ 1 , 3�� Orono Insoections Required Work Reauirinq Seqarate Permits Required State Permits � Site 0 Plumbing � Grading/ Filling � Well � Hardcover Removal 0 Mechanical 0 Fire 0 Electrical G Footing 0 Septic 0 Water Connection 0 F undation Survey � Fireplace � Sewer Connection _.Framing � Masonry � Lawn Irrigation � Insulation � G Mfg. O Wall Board 0 Other(specify) �As-Built Survey Final Other s eci REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES 0 NO New: � YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) � � � re.... �2. ►� Updated: 07/01/2009 z:\forms�plan review checklist.dorac t2ECEtVED City of Orono ,;��oNo,, Hardcover Calculation Worksheet ocT 22 20�3 I,�,`� ^) PropertyAddress: 2i.�� .y�,oy�Ga� �OdQ C1D�0'R�,� C�OFORONO ''�\�_=.,_M,,�`u'` Prepared by: Date: GRo�vBFR F � A1'I'oci,�rc-r i.vc . �0-7_/.3 Stormwater Quality Overlay District Tier: {Circle one) Tier Tier 2 Tier 3 Tier 4 Tier 5 Step 1: EXISTING HARDCOVER In the following table identify all items af existing hardcover on the prope�ty, keyed by letter to Cert�cate of Riivey(survey must accompany this form}. Use as many lines as necessaiy to accurately depict existing hardcover status of the properry. For Tier 1 properties,identify any features by letter which are split at the 75' setback line and calculate hardcover square footage separately for each portion. Key to Hardcover Item {Describe) Length x Width Total Surve S uare Feet Exam le Gara e 24'x 30' 720S.F. A � o�t 6o S.F. B / S.F. C S.F. d S.F. E 6 S.F. F S.F. G 1 / S.F. H ' Ca1/�'R E !O 8 S.F. � S.F. � S.F. K S.F. � S.F. M S.F. N S.F. � S.F. P S.F. Q S.F. R S.F. S S.F. T S.F. � S.F. U S.F. W S.F. X S.F. Y ' S.F. Z S.F. _�__Total Existin� Hardcover yT 7 S.F. Excludable Hardeover See Cit Code Sec 78 1s6$4 : __._�._._._ �at�GU �c o rti • � 0-7 ' F'o S.F. _._..._.._.._..___--�-- ----- S.F. --- ___._.. ._. . S.F. _..__.....__._ ��_._...__.______ S.F. _ _---r-------._ __.__.._..._.---_—L- S.F. 2 Total Excludable Hardcover S.F. _i3} Net Existin Hardcover Subtract line{2 from line 1 S.F. (4Z_Total Lot Area � /8 S.F. Existing Hardcover Percentage [(3){(4j ] 2,5',00 % (Praposed Hardcover next page} January 8,ZOi3 � - - � _ \�� _ ____ _ _. _ UPPER FLOOR� __ __�� EL. III'-� US' MAIN T.D_ f� EL. IIm'-I I/8' � �XS FRIEZE BD. �, �� 2 X T IM � �—; _ ' i � 2X T �� C� �� ; � _ MAIN FLOOR � EL_ Im0'-m' � � GARAGE SLAB � � � I I I I EL_ 99'-6' . ,. ,....: .,_ ,.. � � __ l ; I >, . ,::-.: � - - - - - - - - - - - - - - - - - - - - -�-r - - - - - - - - - - - - - � � — - - -�� — — — — — — — — — — — — — — — — — — — — — — — — — — — — — -1 — — — — — — — — — — — — — — �— — — — — — — — J 2 FRONT ELE'��TIO�N (I�O�DSIDE) 3 ��4■ _ ��-0■ �ooR r�. ' 1X4 FF2AMING W/1/1' EXT_PLYWOOD I/7' INTERIOR GYP_B . 9ilb' pOOR JAMB AIR OF 1'-6' X 8'-0'FLUSN DOORS W'OFFSET TNRpUJ NINGES FLUSH BOLT THI$DOOR XISTIt�Ks TX TRIM EXISTING ZXb TRI f IX TRIM TO I'1ATGN OvERNEAD � DOORS � , �� 3/8' vERTICAL PANELING T �'� ((�J � ��' � 1�� MATGN OvERNEAD DOOR5 I TRIM APpLIED 70 DOOR � WALL �/� 1 ��y.,j SHEATHING �i� ��_��'��' ��.:��'��E�f►�� f'LAN CHECKED 3"_ __ (�2�-- CATE_ -1�_� � �ECEt�ED GARAGE SER'1/'ICE DOC)R PLAN � �� AUG � 1 ��12 � ''�{:� � 3 �■ _ ��-0■ �� . � cITY O� oRONo �I-1 � �'lG�,