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Home My WebLink About2017-01317 - addn/remodel/repair � CITY O�' O�ONO *� _ 0 1 3 1 7 * 2750 KELLEY PARKWAY DATE ISSUED: 10/19/2017 ORONO, MN 55356- 952 249-4600 F�X: 952 249-4616 ADDRESS : 2178 SHADYWOOD RD PIN : 17-117-23-42-0009 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 017 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTNITY : 434-RESIDENTIAL VALUATION : $ 9,000.00 NOTE: SEPARATE PERMITS REQUIRED: ELECTRICAL(STATE) CHANGE OUT 3 SKYLIGHTS IN SAME LOCATION REMOVE PATIO DOORS AND INSTALL 3 WINDOWS APPLICANT PERMIT FEE SCHEDULE 185.83 PLAN REVIEW 120.79 EDGEWORK DESIGN BUILD STATE SURCHARGE(VALUATION) 4.50 7210 GALPIN BLVD EXCELSIOR,MN 55331- TOTAL 311.12 (612)328-0944 Payment(s) Minnesota State License#: BUIL-3681 CREDIT CARD 3099 311.12 OWNER ANDERSON,MR.&MRS.CURTIS 2178 SHADYWOOD RD WAYZATA, MN 55391- 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 no[grant permission for additional or related work which requices 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 S[ate Building Code.This permit may be revoked at any time for due cause. � � / / Appl ant Permit e Signa Date Issued By Signature Date � � _ `� �' � � �: �� ;� - City of Orono 8uiiding Permit Appiication fo� Maintenance f Replaceme�nt/Remodel —Reaidential Ol+tLY (i.�. windows, c400rs, siding, re-ranfi, �tc. -- �"�� STRUC7URAl. E�i�s+��:;tf3r`!; __._.�_ 1 ,t', MaiJing Address: Permit number ��7'� � PO 8ox 68 �/ � �'�:�O;VQ'�' Crystal Bay,MN 55323-Ob66 / � daie received. ��_l----� � Q l� ReCeived by: �� Stret�t AAdre&s: ,p �� 5 � 2750 Keikey Parkvray � 'b� Pian eeview tee F V \`��KESNe?��` CNo�o.MN 55�56 / /• / � ) j Total Fee: f ( vl.� I Main: 952-249�460� Fax_ 852-249-A6t6 Ww'N Gl,orono mn,us � This appGcatian farm must be completed in fuil and aU required infatmaGon must be submftted. Incomplete applications will be retumed• (Please print) GENERAI INFtJRMATIQN: } � Job Site Address: �c'�� `"��.�, .,,,a�� ^> c�\ '��.r�,�E� �lll��'..: � Will this be a Rarade of Homes,Remodelers Showtase Nome or other Dlsplay Home? Yes No !f yes.a spe�craf over�t pwrrur rs req�u�ea wim Pofice DeFartmerrr ar�e c�ry Coun�xl approval so days pna ro rhe ovenr. stumra tws sFxv�ce w�fr be remnrncf unless appficarrf demvnstrates suK�crent on-srte p:ukrig+s aualabfe. lVort-permitted evenls w�not b9 a/bwed. Ct)NTRACTOR/APPLIC4INT INFORMATIOM• (� Name: r-.r.t�t�.��`� �`'4.� t�� State License# � Expiration Date: '� lead Cartification Number. �;.�- � �� o c f�"-� Expiration Dat�: � (for worlr on homea fhat wer�constructed prlor ta 1D78 Phone: (ceti} "" ;�,,.- ��.y�u-- � (office) —�.______�—__ ��_ n�-- �ZIP: Maiiing Address: _ p ��,� ;,� ` Gity: o $S '3 :� Contact Person ��.�, �, __�/ __r�., APPlicant is� rrtractor f omeowner �circ�e ons} _�_ - ��_ Emailand/orFax: __ �:,L.c��-`' 9;.��-c��s�a:� �Jk:� •T�-+�-� PROPERTY OWNER INFORMATION: Name: �Cs r� �rn �'-Pl'5�,� Phone(day}- �F'j;�- �F?,� � Qgr 5 P+ddress `�-a 7 Sf 5i�n ck�1c�,,�,� �.a� City: �.�t-f'�/u'� 21P: Email andlpr Fax� PROJECT INFORMATION: t�verall r 'ect descri tion: S� : n�� 5-�..ne ioc�-}�v.� ��;�- rTYPe oi Praject: y rth movement may atso require �� I � � I-1 nnor(s) �Ramrxie! ❑Fire damage �CWD revlew&permits: �'� � . . •-- .- IIA:,•• _�••r r _„-�.�.n�..._� � n�._._._.,un�e.n� � ❑Re•root.a�N��o�, cJ nc�,... v.., . , � ' _. ,,( ��'. . . u _. . .�... _ ,. i . .. ....,. .. : . `,:".VC1 �..+.[j'N�4(I - .. � .._,... � . . � l.{K� . , . ...� , 'rCi , . . i � _ �� a w�• �� v�minnehahacreek.ora � �~ � . : " e � a� �s�l�-�e.. �.' . . 'IT. � . . ' � � . . .. . '111, ��l�.�L� 4 <. .f . �� . ne � waE� � � .. � ..l . � . . �. � '�. s , r . . , ,.. . °X.,y ,'�W��ff . . ,,. , ,.� ,., _ , _�._ _ . ...-,. .,, . ., . p i "s'�" r" ��".`t" ,,r1. r; � . � . . .,.-� . _ .. ..�,._ . . .,...-_�.... _,�.., ..yo .. �.- ,� , � , u .. �.. . . . � " + ' .. ' ... . .;C . . . .. - w � � � I��,�,, _ ra � / � . . . � . % :w , .._ �. _ _ : � .. u �t� �. .�. �� PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: � � �� Permit No.: �-�"` �`` Q ��/ �— 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#: Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution/NA Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % Survey Submitted: � Yes 0 No Date of Survey: Revised date(?): Landscape plan submitted? � Yes Landscaper: � No/ None proposed Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Buildin Hei ht Anal sis: Distance Between First Floor and defined Top of Roof*(See"building heighY' �a� � definition : First Floor Elevation from buildin lans : (b) Highest Existing ground level (per survey)or 10' above lowest ground level, �� whichever is lower: Difference befinreen b and c *: (d) DEFINED HEIGHT *If highest existing adjacent grade is above FFE-Height is(a)-(d): (e) *If hi hest existin ad'acent rade is be/ow FFE-Hei ht is a + d Shoreland District MCWD Permit Average Lakeshore Setback g�uff Met? O Yes � No Permit Number: 0 Yes � No � N/A � Yes � No � N/A–see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and s % and s � Yes 0 No 0 Yes 0 No 1 2 3 4 5 Type(s): Type(s): , � Updated: June 2017 � z:\forms�plan review checklist 06-2017.docx i � . i � Fees to be Char ed YES NO Permit Plan Review State Surcharge Investigation Fee SAC—ldumber of SAC Units Other(specify) S uare Foota e $ er S uare Foota e Basement X = $ 15' Floor X = $ 2nd FIoO(' X = $ Garage X = $ Estimated Construction Value: $ /� �� Orono Inspections Required Work Requiring Separate Permits � Footing � Site 0 Plumbing � Grading/Filling � Poured Wall � Silt Fence/Erosion Control 0 Mechanical � Fire O Foundation Survey O Hardcover Removal � Fireplace � Water Connection 0 Framing � Other(specify) 0 Masonry � Sewer Connection � Waterproofing/Drain tile 0 Mfg. � Lawn Irrigation � Foundation Waterproofing � Other(specify) 0 Landscaping Framing � Septic Insulation 0 As-Built Survey Final 0 Lathe Required State Permits 0 Other(specify) � Well Electrical 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. � �, 1. . Updated: June 2017 z:\fortns\plan review checklist 06-2017.docx �,-� � DATE TIME �ITY OF ORONO CALLED IN �NSPECTION NOTICE SCHEDULED �(�� AERMR NO. a'd �d � COMPL ED ADDRESS 7 S f.�00� �NNER TELEPHONE O. �r�-3a$�OQ�f�L; CONTRACTOR � � � DESCRIPTION �� , ty ❑ FOOTING ❑ DEMO-FINA ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING VS ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL � RADON SLAB ❑ MECHANICAL RI Z ❑ ❑ SITE INSPECTION Q�FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS 1=. .�INSULATION ❑ WOOD BURNER/FIREPIACE ❑ COMPLAINT v Q FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP Q W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL Q OWNERlCOKTRACTOR TO MEET Y�OU:_YES_NO � COMMENT'� ��• Q-L �"�y � �� 3 W��v�w,s r�p��c,�s 3 �vy�r oW �Nd�t+�.s ��s�iK� �1ca��' - v�. ' � � ° ��5�. - !�t f �Mrc�� !/.g. - � Q i l5lC ' .� Lavc ✓ � W � j ��1y,'QRK SATISFACTORY:PROCEED ❑PROJECT COMPLETE W CQ CORRECT W'ORK R PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERIN(3 PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WILL RETURN CI STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED q INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. CaY for the next inspectfon 24 hours in advar�e. (952) 249-4600 OwnerlContractor on sits- Iltspector: �/ A/l White CopyAnapecto�'s Flle C�nary CopylSNa Nahx �� < i � A C v X � I N ! < I D m/ � � � m �' � �� I_mOZ m � � � ' � � = n a / tn rn w , A �. 7c / D ; Z � ! 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O � � 3 3 ,:,.:,..,.,, �'° � N N �T �� a— �N _.. .. .. ._ � License#3681 Owner: � D � Est.1976 SUE �NDER50N � .Ri.+ cQ edgework designbuild.com z � cD � 2178 5hadywood Road � � � � / 0:952-401-3900 0 � � F:612-822-0258 Orono MN 55391 m N 7210 Galpin Btvd• Excetsior, MN 55331 '�