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Home My WebLink About2016-00368 - addn/remodel/repair CITY OF ORONO * 2 0 1 6 - 0 0 3 6 8 * ' 2750 KELLEY PARKWAY DATE ISSUED: 04/20/2016 � ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 2615 SHADYWOOD RD PIN : 21-117-23-23-0054 LEGAL DESC : PHEASANT LAWN : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 9,800.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING, ELECTRICAL(STATE) REMODEL KITCHEN,REPLACE 8 WINDOWS IN EXISTING OPENINGS,SIDING&GARAGE DOOR APPLICANT PERMIT FEE SCHEDULE 201.32 PLAN REVIEW 130.86 TODD REALTY,LLC STATE SURCHARGE(VALUATION) 4.90 206 N.CHESTNUT CHASKA,MN 55318- TOTAL 337.08 (952)345-3450 Payment(s) CHECK 12203 337.08 OWNER HUBER,THOMAS&NANCY 2615 SHADYWOOD RD EXCELSIOR,MN 55331- 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 dces 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 riod of 180 days at any time after work has commenced. The applicant is sponsible for assuring all required inspections are requested in c rmance with the State Building Code.This permit may be revoked at an i e for due cause. � I � � � ��- � U �/ a-c� � A ic Pe 'e / a Issued By Signature Date City of Orono , Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windaws, d�ars, s�ding, re-rc�of, et�. - NO STRUCTURAL EXPANSIONj j-�� Mailing Address: Permit number: °~ PO Box 66 i �� Crystal Bay, MN 55323-00 Date received: — �- , i � � � � Street Address: 7 �� / � Received by: \�� 1� 2750 Kelley Parkwa� ��Lj � Plan review fee: LrB-�-�-t �`�i �� ' Orono, MN 55356 ��Kr.s r�o�; Total Fee: ��/ i1 (� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us � U O 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: � � �� ' �= K�-� - Will this be a Parade of Homes, Remodelers Show se Home or other Display Home? ❑Yes ❑ No If yes, a special event permit is required with Police Department and City Counci/approval 60 days pnor 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/APP�ANT I�IF0J�IAATI/ON: Name: ` ! •'�� `�.�� iJ-�-- State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) �(Z ='�,c%_ ` -�p` (office) , Mailing Address: , City: IP: S" (`j Contact Person: � ; , Applicant is: Contractor / Homeowner° �c��ie one� Email and/or Fax: � "�� .� j - � PROPERTY OWNE�. FOR AT1pN: Name: -. ;L% �.1..,L Phone (day): ' � Address: 6 � City: ZIP: �S` /� Email and/or Fax: �� ) . � � ` ` � tcx,.J, PROJECT INFORMATION: Overall pro�ect descripti�d�i �Lt.dL� ��l�,�- � � Type of Project: A y earth movement may also require ❑ Door(s) ['�Remodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof, asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ , APPLICANT ACKNOWLEDGEMENT: . Agrees to provide all information required or requested by the Building Department; • 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; • 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 ou refuse to su the i formation,the a lication ma not be issued. ,a "',�• y Applicant's Signature:� �� ' ' ' ��- Date: � %L �C> �i � �� Date: � /L �, Owner's Signature: ' Last Updated:January 2016 ��!�� K �� G,% � � � / PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: ��( � � �(D � Permit No.: ��/�L/i` �� Description of work: Date Rec'd: rt Septic review by: Date Approved: Zoning review by: Date Approved: � Building review by: Date Approved: Grading review by: Date Approved: t Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: 0 Yes 0 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 Height: FFE: FFE minus 6 feet = (Existing Contour) Perimeter(linear feet) = 50% = L.F. below grade Basement? 0 Yes 0 No, Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lowest proposed Slab at or above grade- floor(of the basement or crawl space)and measure from hiqhest existinq START WITH the highest point of the roof. rq ade to the highest point of the START WITH roof even if fill was brought in to elevate home. If you have a... SUBTRACTION • GABLE OR HIPPED ROOF(no Slab below grade—measure (BASED ON windows): Subtract half the distance from highest existing grade to the ROOF TYPE) between the highest point of the roof hi hest oint of the roof. to the low point of the corresponding If you have a... gable or hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE OR HIPPED ROOF(with (BASED ON (no windows): Subtract half a windows): Subtract half the distance ROOF TYPE) the distance between the between the top of the highest highest point of the roof to window and the highest point of the the low point of the roof corresponding gable or hipped roof • ALL OTHER ROOF TYPES(flat, • GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract the distance between the half the distance between (BASED ON basemenUcrawl 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 s Average Lakeshore Setback Shoreland District MCWD Permit Met? Bluff � � Yes � No Permit Number: � Yes � No � N/A � Ye 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 0 Yes � No 0 Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit (/' Plan Review V` State Surcharge V' Investigation Fee f/' SAC—Number of SAC Units (� F Other(specify) Square Footage $ per Square Footage Basement X = $ 1 S' Floor X = $ 2"d FIo01' X = $ Garage X = $ Estimated Construction Value: $ /, tI/�� Orono Inspections Required Work Requiring Separate Permits ❑ Footing ❑ Site Plumbing ❑ Grading/Filling � Poured Wall 0 Silt Fence/Erosion Control � Mechanical 0 Fire ❑ Foundation Survey 0 Hardcover Removal � Septic ❑ Water Connection � Foundation Waterproofing � Other(specify) � Fireplace 0 Sewer Connection Framing � Masonry � Lawn Irrigation � Insulation � Mfg. � Landscaping 0 As-Built Survey 0 Other(specify) Final � Lathe Required State Permits � Other(specify) � Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: � See Builder Acknowledgement Form 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 ��\fnrmc\nlan rovio�ni nc��41ic4 1 fl_9(19 F rin�r �� j • / ' DATE TIME CITY OF ORONO CALLED IN � ==�c� INSPECTION NOTIC� SCHEDULED PERMIT NO. �i(�1�(�� -(��f7�coMP��eo ADDRESS �+ � � J�«� �C� OWNER TELEPHONE NO 3 CON7'RACTOR '�'�� L ��-Z 1- � � �. � DESCRIPTION � ly ❑ FOOTING DEMO-FINAL ❑ SEPTIC FINAL IK� Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLINCy�j�� y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FO�LOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ PTIC INSTALL 2 OWNER/CONTRACTOR TO MEET YOU: IYES_NO c�., COMMENTS: 'Cc,�- ��-�'`�- //2S�Zt%�c� � � ��-L'-Gt.�' s�� /TY1 � J O / � � O � W � Q � 2 � W � W � � J d W ❑WORKSATISFACTORY:PROCEED ROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CARRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CAIL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. .-'". Cail for the next inspection 24 ho rs in advan ) 249-46�� OwnedContractor on site: Inspector. 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