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Home My WebLink About2016-00280 - addn/remodel/repair ' CITY OF ORONO * 2 0 1 6 - 0 0 z s e * 2750 KELLEY PARKWAY DATE ISSUED: 04/1U2016 ORONO, MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 2420 SHADYWOOD RD PIN : 20-117-23-11-0002 LEGAL DESC : LJNPLATTED 20 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 9,750.00 NOTE: CABINETSBQ NOTE: VERIFY ADA REQUIREMENTS AT FINAL INSPECTION. INITIAL: APPLICANT PERMIT FEE SCHEDULE 201.32 PLAN REVIEW 130.86 Holiday Companies STATE SURCHARGE(VALUATION) 4.88 GLEASON,NICK P.O. BOX 1224 TOTAL 337.06 MINNEAPOLIS,MN 55440- Payment(s) (800)745-7411 CHECK 1017252 337.06 OWNER Holiday Companies GLEASON,MCK P.O. BOX 1224 MINNEAPOLIS, MN 55440- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry approvals,and thz 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 specified herein.This permit will expire and become null and void if construction authorized is not commenced wi[hin 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 any time for due cause. � �;�,, � � ��' �f � /! � I,b Applican ermitee Signature -" Date ssu B ignature Date � � CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �O�O Mailing Address: Permit number: 2-�� Zg� PO Box 66 , �� o Crystal Bay, MN 55323-006 �- Date received: � 25 / ��V Z� A(�� Received by: �, �� Street Address:' a �� " 2750 Kelley Parkway 'JI� Plan review fee: � �qK��o��" Orono, MN 55356 Main: 952-249-4600 Total Fee: �37, Q� 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: f��2°�� Job Site Address: �� }�pt(��pp� �, ��Ilf��'�.�� t�ltJ S53�t2- _ Will this be a Parade of Homes, Remodelers howcase 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 unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFO/�M�ATION: Name: �'OL\��/ I..OM�tJ\� State License# Expiration Date: Phone: _(cell) (office) �--a� -$(oa0 Mailing Address: Cit : ZIP: Contact Person: �(,�. �J Applicant is: Contractor / Homeown (CircleOne) Email and/or Fax: n IG1�-.qleG�.SO'�l `CI'l 0�,��G�.V COM�GL,y�tGS• G�Yv'l PROPERTY OWNER INFORMATIO�: Name: �pL.1DKk�/ b'S�)LL1V�4tJ�S Phone (day): Address: City: ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Description of pro ect: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply ❑ New Construction ❑ Single Family with ❑Accessory Bldg. /Garage ❑Addition attached garage ❑Qeck �blic Sewer ❑Accessory Building ❑ Single Family with �"Office/Commercial ❑,�elocation n�_ detached garage ❑ Residence ❑ Private Sewer � Other: (specify) U'�ilt�£� E . ❑ Multiple Family/Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater Public Water ""Any earth movement may also require [�Commercial ❑ Storage MCWD review 8�permits. ❑ Industrial ❑Warehouse ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ Other(speCify) 15320 Minnetonka Blvd Minnetonka, MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ l� `� Last Updated: January 2016 f �` STRUCTURE INFORMATION: 1. Structure Dimensions 1.Structure Dimensions(continued) a. Length (ft.)= Number of bedrooms= 2. Occupancy: % b.Width (ft.)= Number of garage stalls: / � 3. Occupant Load: C� Areas in square feet Attached = c. Basement= Detached = 4. Type of Construction: d. 1S'Story = e. 2"d Story= 5. Code Edition: �� (� / /, �� f. '/z Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ ❑ Buildin Permit Escrow A reement and Fees ❑ ❑ Plan Review Fee ❑ ❑ Com leted Application Form ❑ ❑ Pro osed Buildin Plans—2 full size sets, to scale and 1 reduced 11 x 17 or 8 '/2 x 11 set ❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements ❑ ❑ Survey—2 full size, to scale(meeting ALL survey requirements) ❑ ❑ Hardcover Calculations ❑ ❑ Septic S stem Certification ❑ ❑ Minnehaha Creek Watershed District(MCWD) Permit or Documentation from MCWD statin no ermit is re uired ❑ ❑ Landsca e Walls and/or Retainin Wall Plans ❑ ❑ Stormwater Pollution Prevention Plan SWPPP ❑ ❑ Access Permit ❑ ❑ Data Privacy Advisory Form 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: � v� Owner's Signature: Date: Last Updated: January 201 f � � s e �� ,c�'Z:�2Z� .� �-� C (C� ��c�� G � p �� PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS -� �, r Address: �. :�..(i� Permit No.: �. � Description of work: ��; {�1 ��t ��' ,�� i� Date Rec'd: Septic review by: - Date Approved: Zoning review by: Date Approved: Building review by: - Date Approved: 7 � l' Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: 0 Yes � No Date of Survey: Revised date(?): Landscape plan submitted? ;��Yes � No Landscaper: Proposed Setbacks: \ � Front (Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland � Side Side Defined Height: Peak He��ht: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% = L.F. below grade Basement? � Yes ❑ No, Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: ' FOR A BUILDING ON A SLAB FOUNDATION: The distance betwee�the lowesT proposed Slab at or above grade— ' START WITH floor(of the basement or crawl space)and measure from highest existinp " the highest point of the roof, START WITH ra ade to the highest point of the roof even if fill was brought in to 9 �� elevate home. If you have a... / � SUBTRACTION • GABLE OR H�ED ROOF(no Slab below grade—measure (BASED ON windows): S tract half the distance from highest existing grade to the ROOF TYPE) between th�highest point of the roof hi hest point of the roof. +� to the low�Aoint of the corresponding If you have a... gable or hipped roof � SUBTRACTION ' GABLE OR HIPPED ROOF P • GABL�OR HIPPED ROOF(with (BASED ON (no windows): Subtract half windbws): Subtract half the distance ROOF TYPE) the distance between the betWeen the top of the highest �� highest point of the roof to w ndow and the highest point of the the low point of the �of � corresponding gable or ' hipped roof • �ALL OTHER ROOF TYPES(flat, � • GABLE OR HIPPED ROOF ' i mansard,etc):No subtraction. (with windows): Subtract E SUBTRACTION btract the distance between the half the distance between (BASED ON }�asemenUcrawl space floor and the the top of the highest EXISTING highest existing grade adjacent to the window and the highest GRADES) foundation OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined building height subtraction. \ Defined building height EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx � Shoreland District MCWD Permit Average Lakeshore Setback g�uff Met? Permit Number: ❑ Yes � No � N/A � Yes 0 � Yes ❑ No No � N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf � Yes 0 No 0 Yes 0 No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit t/ Plan Review V- State Surcharge �� ;'� "�`� " �.��.�� a�� °' �� Investigation Fee l/' �SAC—Number of SAC Unit� �t�s� _: "'�� `�,� Other(specify) �-. Square Foota e $ per Square Foota e Basement X = $ 1 St Floor X = $ 2nd Floo� X = $ Garage X = $ � r �^� Estimated Construction Value: $ !, ��U Orono Inspections Required Work Requiring Separate Permits � Footing � Site � Plumbing � Grading/Filling � Poured Wall � Silt Fence/Erosion Control 0 Mechanical � Fire 0 Foundation Survey � Hardcover Removal 0 Septic � Water Connection � Foundation Waterproofing � Other(specify) � Fireplace � Sewer Connection 0 Framing 0 Masonry � Lawn Irrigation 0 Insulation � Mfg. � Landscaping 0 As-Built Survey � Other(specify) Final � athe 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 ardcover c Iculations must be submitted and approved. l2�'I � � /' � I/'' l�lit, �1.� ' '�/( � Updated: October 2015 r\fnrme\nlan rcvic�ei rhar4lief 1(1_9M 5 rinev DATE TIME J� CITY OF ORONO CALLED IN V INSPECTION NOTICE SCHEDULED PERMIT NO.'�� _Q�� COMPLEfED �'� ADDRESS Z� C� � waQ� � OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION �'�2 i �'1 C'LS `td� �d(� �ed' v'�Cl 4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECT�ON Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS _ ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP � ❑ AS BUILT-SUFiVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL r ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTMCTOR TO MEET 11�U:_YES_NO v�i COMMENTS: � � � o �� o � r � ° �. CG( 7�' W � Q � 2 � W � � J � ❑W�ORKSATISFACTORY:PROCEED PROJECT COMPLETE w O CORRECT WORK 3 PROCEED ❑I UE CERTIFICATE OF OCCUPANCY � �CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORECdVERING PERMANENT ❑CORRECTUNSAFECONOITIONWRHIN HWRS. p pHOTOTAKEN INSPECTOR NfILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. 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