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Home My WebLink About2013-00520 - addn/remodel/repair . � CITY OF ORONO * 2 0 1 3 - 0 0 5 2 0 * 2750 KELLEY PARKWAY DATE ISSUED: 07/02/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 2216 SHADYWOOD RD PIN : 17-117-23-42-0004 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT O11 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 18,000.00 NOTE: STEP AND WALKWAY REPLACEMENT NOTE: PROVIDE EROSION CONTROL (INITIAL) APPLICANT pERMIT FEE SCHEDULE 309.75 LUKE BUSKER MASONRY PLAN REVIEW 201.34 P O BOX 180 ROBERTS,MN 54023- STATE SURCHARGE(VALUATION) 9.00 (612)490-1037 TOTAL 520.09 PAID WITH CC# 1045 OWNER SHABAZ,REBECCA L 2216 SHADYWOOD RD WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be perfortned 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 permiu. All provisions of laws and ordinances goveming this rype 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � �2 � 13 7 � � J Apphcant Ynitee Signature Date Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. "�� -� � -�� CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �O�O Mailing Address: Permit number: o��J�-��j�� PO Box 66 /�, Crystal Bay, MN 55323-0066 Date received: [�� '/,� StreetAddress:' Received by: y � 2750 Kelley Parkway Plan review fee: � G t Orono, MN 55356 �kFSH�� [/� O� Total Fee: 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 returned. (Please print) GENERAL INFORMATION: Job Site Address: ,�I(� �� v �oQ� Q� Will this be a Parade of Homes, Remodeler Showcase Home or other Display Home? ❑ Yes �No If yes, a special event permit is required with Police Department and City Council approva/60 days prior to the event. Shuttle bus service will be requrred unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �� i1 S iC�(� MA�So I�f �R.Y State License# Expiration Date: Phone: (cell) �f a -y�j !� - /4'�'� (office) Mailing Address: Cit : �('��1 ZIP: Contact Person: �U K Applicant is: ontrac or / Homeowner �c��cie o�e> Email and/or Fax: � usl� f n� �.t,n•� PROPERTY OWNER INFORMATION: Name: Phone(day): Address: City: ZIP: Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZI P: Email and/or Fax: PROJECT INFORMATION: Description of project: 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 also require ❑ Commercial �Other(specify) MCWD review 8�permits. ❑ Industrial co1�fi S�Dp ❑ Private Well Minnehaha Creek Watershed District(MCWD) � Other: (speCify) 18202 Minnetonka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (exctuding land) $ ��,��,�� _ ._... , � _� . _�. ,. . , _ . 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 Bldg. c. Basement= Detached= ❑ �CF d. 15t Story = ❑ On-site Prefab e.2"d Story= ❑ Off-site Prefab f. Y 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 ❑ ❑ Application Escrow&Agreement ❑ ❑ 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: (� '� �� `� f� Owner's Signature: Date: f�� . � . . . . . . � . . . - . . , . � . � • r PLAN REVIEW CHECKLIST FOR NEW STRUCTURES l ADDITIONS Address/Permit Number: Z Z I(o .S�`��!`�4 W UOd (�A� Description of work: S'C�C'P �N� W�U�w Au ��P`�c.}�C.P l'Y�iC►�.�`t— 1 J n� k.t N�O) Septic review by: /�� Date Approved: Zoning review by: N Date Approved: Building review by: Date Approved: � - /9 — ��3 Grading review by: N l✓� Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zonin Lot Area: SF/AC Width: Lot Coverage: SF _%a Survey Su itted: 0 Yes 0 No Date of Survey: Revised da Pro osed Set cks: Front(Lake) Rear(Street) { .N S f W ) ( N S E W ) Other iidings Wetland Side Side Defir�ed Height: eak Height: FFE: FFE mi s 6#eet= (Existing Contour) Perimeter(IinearYeet)= 50%_ #af Sto es Ok? G YES FOR A BUILDING WITH A BASEMENT OR CRAWL PACE: The distance between lowest f O A BUILDING ON A SLAB FOUNDATION: START WITH proposed floor(of the b ent or crawl space)and the highest poin f the roof. START WITH The distance between the top of slab and If you have a... the highest poirtt of the roof. if you have a... • GABLE OR HIPPED ROOF o . GABLE OR HIPPED RDOF(no windows): Subtract half the windows): 5ubtract half the distance distance between the highest poi between the highest poirrt of ihe roof of the roof to the low point of the to the low point of the corresponding SUBTRACTION correspontling gable or hipp of SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR'HIPPED ROO wRh (BASED ON . GABLE OR HIPPED ROOF(with T�'PE) windows): Subtract half e ROOF TYPE) windows): Subtract<hatf the tlistance distance between the p of the between the top of the highest highest window an e highest window and the'highest point of the point of the roof � • ALL OTHER ROOF TYPES(flat, • ALL OTHER OF TYPES{flat, mansard,etc:No subtraction: mansard, :No subtraction. ADDITION Add the distance belween the top of slab SUBTRACTION Subtract the tance between the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenU wl space floor and the EXISTING the foundatiom. GRADES) highest 'sting grade adjacent to the GRADES foun 'on OR 10 feet{whichever is less). UALS Defined buildtng helght EQUALS ned building height Shoreland D' 'ct MCWD Per�nit Received Avera e Lakeshore Set ck Met7 Bluff -G Yes "G No � N/A � Yes 0 No G Yes � No � Yes 0 No G Permit Number: Setback: St water Quality Existing Proposed Variance Required CUP R uired O erla District Tier Hardcover Hardcover ' '� Yes � No � Yes � No Type(s): Type(s): Updated: January 2013 v:\formslplan review checklist 2013.dopc �1 , � REMARKS (in-house): Fees to be Cha ed '" rv��_ . Plan Review Investigation Fee Other(specify) S uane Foota e $ er S uare Foota e Basement X = � 1°t Floor X = $ 2"d Floor X = $ Garage X = $ Estimated Construction Value: E I �,t�o O �� Orono Inspections Required Work Requiring Separate Permits Required State Permits G Site � Plurttbing 0 Grading/Filling � Well O Hardcover Removal G Mechanical 0 Fire � Electrical ooting O Septic � Water Connection � Poured Wall � Fireplace � Sewer Connection G Foundation Survey G Masonry � Lawn Irrigation G Radon Rock Bed 0 Mfg. G Framing O Other(specify) G Insulation G /1s-Built Survey �Final G Wetland Buffer O Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES G NO New: G YES G NO OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED ��,�.� L.SYt�S ti o� �'''�T�O�-- Updated: January 2013 v:\fortnslplan review chedclist 2013.doac DATE TI E ✓ CCITY OF ORONO CALLED IN r�O�� _�� INSPECTION OTICE SCHEDULED � 6 PERMIT NO. v -- �S� COMPLETED ADDRESS 2 Z I � . S�U U�1 OWNER S��a-s TELEPHONE NO. L��- �-1_r�� 103� CONTRACTOR �- U � I'YZC"Sct-'"'a'r� � DE��B1e,TION �� FOOTI ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q URED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIFiEPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP � ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ P�UMBING RI ❑ SEPTIC FINAL O FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO ��., COMMENTS: � W C o .-�� a -� c�-c�rv��-c�T- � t_� � •�-c� --ocs -�� 0 � W � Q � 2 W � W � � d W �GRKSATISFACTORY:PROCEED O PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR W4lL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnerlContractor on si : Inspector. White Copyllnspector's file Canary CopyfSite Notice DATE TI E CITY OF ORONO �`�"� CALLED IN INSPECTION NOTICE�Sac SCHEDULED PERMIT NO.�Q/3-�i� COMPLETED � - ��/� ADDRESS �� -s�fx4wo� �� OWNER TELEPHONE NO. CONTRACTOR �� .�i5'�!" ��S. � DESCRIPTION s�P "� �� ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q FINAL ❑ WATER HOOK-UP '"FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: � /"e�,,,, :-t .jol�/� ►- �,�� 7� l� /� .�✓ d ��iC or! �� '.., '' � � ..t�t �C:..� re..o� � �!0-/3 -D,� - wGC�i � 0 � W L Q �D Q/�t /(�N'lG " z /�lr�S� ��,�-a� o�o.w c,�� t�- W -��.1� � -��1, �� -��:., ar � � �,� �� ,`� , �a t� � a �—� W ❑WORKSATISFACTORY:PROCEED G PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED 'INSPECTION REQUIRED.C Call for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site: Inspector. 4 . �-- White CopyAnspector's File Canary CopylSfte Notice