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Home My WebLink About2010-00192 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2010-00192 - 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEn: 04/13/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2200 SHADYWOOD RD PIN : 17-117-23-42-0006 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 013 BLOCK 001 PERMIT TYPE : ADDIT[ON/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 15,000.00 NOTE: SEPERATE PERMITS REQUIRED: ELECTRICAL(STATF,) CONVERTING AN EXISTING PORCH IN"I'O A SCREEN PORCH ADVANCED PLAN REVIEW PAID ON PERMIT#2010-00193 WITH VISA APPLICANT PERMIT FEE SCHEDULE 265.50 SHORELINE BUILDERS STATE SURCHARGE(VALUAT[ON) 7.50 2184 SHADYWOOD RD TOTAL 273.00 WAYZATA,MN 55391- (763)506-0629 Minnesota State License#: 20630814 OWNER SWANSON, KARI &ZACK 2200 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 specitications,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 specitied herein.This permit will expire and become null and void if consUuction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of I 80 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 at any ti for due cause. � l� i l� �� Applicant Per itee Signature Date / / Issued By gnature Date SEPARATE PERMITS REQUIRED FOR WORK OTHE THAN DESCRIBED A O Cit of Orono �`��° Y Building Permit Application for New Structures or Additions Mailing Address: ,.�; � 'g.+�.� PO Box 66 Permit number: � �—L;/ C --�;�' �? Q h\ Q Crystal Bay, MN 55323-0066 Date received: � (o � �� :��. �� Street Address:� Received by: �� c�� i�� i 2750 Kelley Parkway Jd (/i SI4 g/G �'7 , �r"j' �'��' ` t �` � Orono, MN 55356 / Plan review fee: 2. � - , �c� kESH�4 Total Fee: � � � �� n Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us ,��1 This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (P/ease print) GENERAL INFORMATION: /� Job Site Address: �,�� S �, Will this be a Parade of Homes, Remodelers Sh case Home or other Display Home? ❑ Yes ❑ No If yes, a specral event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION:�` � � " Name: State License# E piration Date: Phone: o ice ' - Z�j' cell) Mailing Address: Q ` Cit � .� � ZIP: C{' Contact Person: Appl�can i : ontractor / Homeowner (Cirde One) Email and/or Fax: � PROPERTY OWNER INFORMATION: ,{� �1 � Name: /` I'�7�-� SW�t/LS��I Phone (day): Address: _ City� ZIP� Email and/or Fax ARCHfTECT/ENGINEER INFORMATION: Name: Phone (day): Address: City� Z�p� Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal 8� Water Supply ❑ New Construction ❑ Single Family with ❑ Residence ❑Addition � �,�4}'V`�� attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building�,�E��E r � .��-�� c ❑ Single Family with Deck ❑ Relocation �c � ck�;tc detached garage ]�ffice/Commercial ❑ Other: (specify) � ❑ Multi le Famil /Condo ❑ Private Sewer P y ❑Warehouse ❑ Public ❑ Storage ❑ Public Water "'`Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Wel� Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or � a Estimated Construction Valuation (excluding land) $ Last Updated: 9/29/2009 - 17 - r:" STRUCTURE INFORMATIOfV: . � 1. Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction a. Length (ft.)= � % Number of bedrooms = �ood/Frame b. Width ft. _ �� L J Masonry ( ) Number of garage stails: ❑ Metal Attached = ❑ Pole Bidg. Areas in square feet Detached = ❑ ICF c. Basement= ❑ On-site Prefab ❑ Off-site Prefab d. 15f Story = ❑ Other(please specify): e. 2"d Story= f. '/2 Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A plicable � ❑ Permit Ap 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 � 0 Hardcover Calculatio�(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 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; • 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. f/ / `J � n � Applicant's Signature: Date: �' Last Updated: 9/29/2009 - 18 - : 1 � �. , �;= ' ; ' � � . Plan Review Checklist for New Structures / Additions � Address/ PID/ LegaL � � �� S�� R C�"� � UC� � (� � Description of work: � �y�;,�� : Fr��i . �"��'� (,c.i�Z C'�PC�� C.:%�a �G '� Cu�iY e'?>vs r�r� c?'�?� Septic review by: (�J� Date Approved: L�� CP' l (� Zoning review by: � � Date Approved: �_ Cr—� Building review by: Date Approved: �- � � / (� Grading review by: /V � I/} Date Approved: Zoning File#: Resolution #: Resolution Date: Zonin District Fire Department Post Office School District � �� - lC; Zoning: Lot Area: G SF/AC ` Width: �'�GZ ( Depth: � � Survey Submitted: [�es 0 No Date of Survey: l�/� I�GZ C/-�5 h��'�� c�y Pro osed Setbacks: '��'X°= t ��K��,� Front(Lake) Rear(Street) ( N S E W ) ( N S E W ► Other Buildings Wetland Side Side i�c� ��(�h�� f� /.► rr c� C6��z�i��_ �� G;.�� Building Defined Height: (�� Building Peak Height: #of Stories Ok?: ❑ YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl START the distance between the slab and the highest space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type or other arch-t e roof roof SUBTRACT half the distance between the highest window and SUBTRACT half the distance between the highest window hi hest roof eak of a itched roof and hi hest roof eak of a itched roof SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet, whichever is less. EQUALS Defined buildin hei ht EQUALS Defined buildin hei ht Lot Covera e: in _Sd"r'�C�F�Y.�-( C��.t��.� �— c�ec l� t s �=a f r�_�:��j2:�{w%�1 g l�� C�I'I�ki'� SF % Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff ❑ Yes o ❑ N/A /� ❑ Yes o ❑ Yes 0 No &d��'es ❑ No ❑ N/A Permit Number: Setback: Hardcover Zones Existin Proposed Variance Required CUP Required 0-75' 0 Yes 0 No ❑ Yes � No 75-250' • �,� Type(s): Type(s): 250-500' � i� C,� �c:�(�'� G��- 500-1000' 7� �� G/ - Z7 REMARKS (in-house):_ �C� (�/�C✓,CL'� /�J�C�<={/�;i=�'y��C'G�,1i ��5 �'�1�Z1 ��'�"7 C%yl �'C�.:�r1�� I)lrr�5 C��lZ�` �'�-G��S Updated: 09/11/2009 z:\forms�plan review checklist.docx Fees to be Charged YES NO Permit j ' Plan Review �/ • State Surcharge � Investigation Fee SAC—Number of SAC Units Sewer Connection Water Connection Park Fee Site lnspection Other(specify) Miscellaneous Fees Calculated By: Square Foota e $ per S uare Foota e Basement X = $ 1 S` Floor � X = $ 2nd FIoOI' X = $ Garage X = $ Estimated Construction Value: $ I��DOt� °= Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site ❑ Ptumbing 0 Grading / Filling ❑ Well ❑ Hardcover Removal � Mechanical ❑ Fire Electrical � Footing � Septic ❑ Water Connection ❑ Poured Wall ❑ Fireplace ❑ Sewer Connection ❑ Foundation Survey 0 Masonry � Lawn Irrigation ❑ Radon Rock Bed � Mfg. �Framing � Other(specify) ❑ Insulation ❑�4s-Built Survey �f Final 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES � NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.docx