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Home My WebLink About2011-00609 - land alteration f • CITY OF ORONO PERMIT NO.: 2011-00609 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUEn: 07/14/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2256 SHADYWOOD RD PIN : 17-117-23-43-0125 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 006 BLOCK 001 PERMIT TYPE : ZONING PERMIT PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : LAND ALTERATION(0-500 CU YDS) NOTE: AS-BUILT PLAN SHOULD BE SHOWN ON AS-BUILT SURVEY REQUIRED FOR PERMIT#20 1 1-0002 1. MINOR LAND ALTERATION AND RETAINING WALL PERMIT. APPLICANT MINOR LAND ALTERATION 50.00 KEENAN&SVEIVEN,INC. RETAINING WALL<4' S0.00 15119 MINNETONKA BLVD. TOTAL 100.00 MINNETONKA,MN 55345 (952)475-1229 Minnesota State License#: 7252 OWNER BURKE,FORREST&RENEE 2256 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 not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming 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 sponsible for assuring all required inspections are requested in c formance with the te Building Code.This permit may be revoked t �me for due c 7/ � / 7i�[1i / Appli t Pe ' Si ature Date T Issu By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � .. - City of Orono 'I�►� i( Zoning Permit Application Mailing Address: Permit number: ��l-"��(o� �Q J�,, PO Box 66 Date received: 7 � �� `r Crystal Bay, MN 55323-0066 Q � Escrow#and "1 fi�?:� ' Street Address: amount: � 7/� �'�`� '�°'�Y`�� - ' � ` ;��> � I 2750 Kelley Parkway Permit Fee: � �� p Orono, MN 55356 � . t�kESHO�'� Approved by: q �.�: Fax: 952-249-4616 Notes: � Main: 952-249-4600 �•ci.orono.mn.us This application form must be completed in full and all required information must be submitted. (Please print.) GENERAL INFORMATION: Job Site Address: �2.5l0 57il�t,��,�/od CONTRACTOR/APPLICANT IN�ORMATIO • Name: 6 �j✓�i✓�,y� � YLG • Phone: - `?S- l"L Fax: - S'� /�(p Address: n Cif : ZIP: 3� Contact Person: ContacYs phone z..- 6 �,,� Email � � Q,y(,{.t G�p�plicant is: 'Contractor Homeowner (Circle One) �._ PROPERTY OWNER INFORMATION: Name: /'re��'" P2. ��2i Phone (day): e�.- � Mailing Address: 3 y�.2 Oho ZIP: s-3 Email and/or Fax Overall Project Description: �Gc✓ �� v�,wet,.�, �k�n/6�,,,� A,y�� t�awo� �51�-Or2 �t�T�e� !�1 olti^C. IZ'ML�t-I • Check TYPE OF PERMIT Box COST* Dock, Residential- Permanent dock on any lake or initial seasonal dock not on $30 + engineering review costs Lake Minnetonka ermanent dock requires CUP Dock, Commercial $50+ engineering review costs Escrow for erosion control and en ineerin review costs $2,000 Driveway Permit(New or Replacement) No charge Also re uired is a Minor or Ma�or Land Alteration Permit Land Alteration, Major(grading, filling, or excavating) more 500 cubic yards or $30 more than 10 cubic yards in lakeshore setback (also requires CUP) Escrow for erosion control and en ineerin review costs As determined b CUP xLand Alteration, Minor(grading, filling or excavating)-500 or less cubic yards $50+ engineering review costs outside of lakeshore setback or less than 10 yards in lakeshore setback Escrow for erosion control and en ineerin review costs $2,000 Retaining Wall measuring under four feet require a zoning permit. $50+ engineering review costs � Retaining walls measuring more than four feet (from bottom of footings to top of wall) require a building permit. (Tiered retaining walls are considered one wall unless the walls are separated by twice the height of the lower wall.) Escrow for erosion control and en ineerin review costs $2,500 Stairway to Lake (New or Replacement) $50+ engineering review costs Escrow for erosion control and engineering review costs $2,000 Structure Permit for other structures not requiring a building permit but $50+ engineering review costs regulated by the zoning code (including, but not limited to accessory building of less than 120 square feet, detached deck or platform and sport court) Escrow for erosion control and en ineerin review costs $2,500 Tree Removal or intensive ve etation removal in 0 to 75 foot zone No char e. (over) *Permit fee will be collected at the time the permit is issued. APPLICANT/OWNER ACKNOWLEDGEMENT: ' .—= • Applicant agrees to provide all information required or requested by the Planning Department; • Owner agrees to pay the City of Orono for engineering consultant review costs where applicable; • Applicant 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; • Applicant acknowledges the attached Escrow Agreement is completed and signed by Owner; • 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. The undersigned certify that th � ormation�lied is true and correct to the best of their knowledge. Applicant's Signature: Date: � ` � Property Owner's Signature: ?�o� .,�� Date: � � 1 SUBMISSION REQUIREMENTS: Except for tree removal permits, all permits TYPE OF PERMIT: require a completed application form, escrow agreement (signed by the property owner) and escrow check from owner, two copies of all plans, and three copies of all grading plans or surveys/site plans Dock, Residential Seasonal Dock–survey showing proposed dock Permanent Dock- plans as approved by CUP and copy of LMCD permit Dock, Commercial 1. Structural plans for the dock 2. Survey showing the proposed location of the dock , 3. Copy of LMCD permit Driveway Permit 1. All Minor or Major Land Alteration Permit requirements 2. Hardcover calculations, existing and proposed 3. Driveway plans Land Alteration, Major 1. Plans as approved by Conditional Use Permit 2. Erosion control plan or copy of MCWD Erosion Control Permit Land Alteration, Minor 1. Grading plan including existing and proposed contours (Less than 10 cu.yds. within 75' of 2. Amount of fill to be imported and/or exported and haul route lake or less than 501 cu.yds 3. Amount of earth to be moved around on site elsewhere.) 4. Erosion control plan or copy of MCWD Erosion Control Permit Retaining Wall 1. Plans for wall(s) 2. Unless repair or exact replacement of existing wall, submit an updated survey with grading plan including existing and proposed contours 3. Hardcover calculation worksheets if in shoreland district 4. Erosion control lan or co of MCWD Erosion Control Permit Stairway to Lake 1. Construction plans for stairway, including footings 2. Topographical survey of property with proposed stairs shown 3. Erosion control plan or copy of MCWD Erosion Control Permit Structure Permit 1. Plans for structure. 2. Survey of property with proposed structure shown and with setbacks to property lines, other structures on property and the septic system indicated. The general location of any sewer and water services should be shown if applicable. 3. Grading plan if grading is required 4. Hardcover calculation worksheets if in shoretand district 5. Erosion control lan or co of MCWD Erosion Control Permit Tree Removal Call: 952-249-4600 to schedule inspection. Last Updated: April, 2011 � . , Plan Review Checklist for Zoning Permit Applications Address: (�� Description of work: �1.0�s L Type of permit: �l/�� I'• l�u�" Zoning review by: Date Approved: � � 2 �) Grading review by: �� Date Approved: Other Review, Reviewed by: Date Approved: Zonin : Zoning File#: Resolution#: Resolution Date: Lot Area: SF/AC Width: Depth: Survey Submitte ? Yes o Date of Survey: Existin Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Pro osed Setbacks: y� � Front(Lake) Rear(Street) ( N S E W ) ( N S �N ) Other Buildings Wetland Side ide Sh eland District MCWD Permit Received Average Lakeshore Setback Met? Blu � Yes � No 0 N/A 0 Yes No es � No 0 Yes � No N/A Permit Number: Setback: Hardcover Zones Existin Pro osed Variance u' ed CUP Re ire 0-75' �(�� g.ln � Yes No 0 Yes No � ��b 75-250' GJC,�� D Type(s): Type(s): 25Q-500' � Oj4% �a� Zoning File#: Zoning File#: D 6v 500-1000' Resolution #: Resolution #: �� Created: March 29,2011 z:\forms\plan review checklist for zoning permit applications.docx . . ► Planning Review Checklist for Zoning Permit Applications Page 2 of2 Cubic Yards In Out Total Haul Route? ? 0 Yes 0 No Explain haul route in detail: Fees to be Charged Amount Orono Inspections Required Permit Amount ��„ � S ite Escrow Amount 0 ardcover Removal Il� Footing �y (/�r-�c.�,� — ��`� � ured Wall Signed escrow received? As-Built Survey � Yes � No 0 P anting Plan 0 Wetland Escrow amount received? � Final 0 Yes 0 No � Other(specify) Engineering review needed? � Yes No REMARKS (in-house): Other Review: Reviewed by: Date Approved: ; 6 r i � REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) �✓�� '�' `�a" �1'� �� -�- b 1 -- ODD 1 Created: March 29,2011 z:\forms\plan review checklist for zoning permit applications.docx DATE TIME V CITY OF ORONO CALLED IN INSPECTIONnNOTICE / C SCHEDULED 'Z —� � PERMIT NO.;C Ul I— ��{p(Z ( COMPLETED ADDRESS � � �� L� � � �'�. L'-'�� - OWNER �<<�S � �uI��ELEPHONE NO. CONTRACTOR � �'�'--�� %�� : DESCRIPTIO �� ( �J�� ` L�� r �T�� S � �lL� FOOTING C �� ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ 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 J ❑ PLUMBING RI O SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o �nr� �in� 1T� (�P� �(/�� a � 0 � W � Q ti 2 W � W � � GW�\WO� RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED � INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on si e: Inspector. -� � ��C White Copyllnspector's File Canary CopylSite Notice W 0 A 0 00 00 I I 6 z O �mIj N AUJ I>cn� m� D. A� nm {m D�Uj 70Cm m rq O Nrn-nrn � -4 UJ m m)0- -I m D - 8„ I4T. VARIES 3'-0" MIAX NT. —� BURIED 5,45E COUR5E I'- M M porn N:K n m00 O(P m m rM)DO do OX 4-4 �m \ < n �m Ui �r lA � 3� zp U4 M -I m =n ' O 3 X L -- - 4 d � w r r zI z �mIj N AUJ I>cn� m� D. A� nm {m D�Uj 70Cm m rq O Nrn-nrn � -4 UJ m m)0- -I m D - 8„ I4T. VARIES 3'-0" MIAX NT. —� BURIED 5,45E COUR5E I'- M M porn N:K n m00 O(P m m rM)DO do OX 4-4 �m \ < n �m Ui �r lA � 3� zp U4 M -I m =n ' O 3 X L D O � ON �m�� o 4 I N m -4 m � r z o 0 UOU i r 3 v,v,OItoci 1�)X u►v►00 �A( N O N N N V A-�0 ��iUz ��X1D Cl 0�3mmo 030 03pz 030(, � z NEW W 0 W QNB (�I7Ur0N OLoLv -4 �o w N 011 91 cn � o � Ze6 E ,'a3g -- - c � w - 0 I 33 <. 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