HomeMy WebLinkAbout2015-01420 - windows ' � ' CITY OF ORONO
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2750 KELLEY PARKWAY DATE [SSUED: 1U05/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2685 SHADYWOOD RD
PIN : 21-117-23-23-0050
LEGAL DESC : REG. LAND SURVEY NO. 1453
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING- UNDEFINED
VALUATION : $ 1,800.00
NO"I'E: MODIFY EXIST[NG WINDOW TO MEET CODE. -REPLACE ONE EXISTING WINDOW
APPLICANT PERMIT FEE SCHEDULE 70.58
PLAN REVIEW 45.88
GREENE CONSTRUCTION CIRCLE STATE SURCHARGE(VALUATION) 0.90
2233 HAMLINE AVE N#125
ROSEVILLE, MN 55113- TOTAL 117.36
(612)501-7954 Payment(s)
Minnesota State License#: BUIL-BC635870 CREDIT CARD 0662 11736
OWNER
BROWN, RICHARD W& MARION H
2685 SHADYWOOD RD
, 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 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 within 180 days of the date of issuance,or if consCruction is
suspended for a period of 180 days at any time afrer 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.
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Applicant Permitee Signature Da[e ssued� ignature Date
,
11/��015 08 : 21 T0: 19522494616 FROM:6123544154 Page: 3
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STRt�CTURE INFORNiATl�N:
1.Structure Dimensions � 1.Structure Dimensions(continued� I 2.Type of Constructian � j
i
' a� Length(ft.)- Number af bedrooms= �
� ( ❑�Nood I Frame �
� �I n.Width (ft.)= � Number of garage stalts: � ❑ Masonry !
� Are�s in square feet � Attached= ❑ Metal
❑ Pole Bldg. '
c. Basement= ; Detached= � ��F
ci. 1"Story = �
! ❑ On-site Prefab '
, e. 2��Story= (
❑ Off-site Prefab
f. 'i7 Story =
� � i ❑ Other{pleas�specify}: ��
', g Tot�l ar�a= ( t __
i
'�------______---�________ I
REG�IliRED SUBMITTAL�:
All of the information rnust be submitted in order for yaur application to be processed:
, _. r __ ---- - — --- --- -- - —
--- �_ _
� Not � �__.._. __�_ ._ --- --�
Enclased �Applicabie
�� ,_�.__ 0� ❑ �'� Permit Ap�ficatiort
� - ---.` _._..___ _ ----- ,�
� � � __. ' Proposed Building P(�ns - _ �
;_ � � � MN State Enerc,�Cade Calculations and Mechanical Code Requirements Form
L7 '� C) Survey(meetinq all requi��ements)
� d ��i �1 � Stormwater polEution Prevention Pl�n ��
--- _ _ _ —__ � �
� � � �� �, i-fardcover Calculatian�s)
� __ __.._._—�,�.... __ ____ -- ---_ _. _ - —__. . _-- —.._._.__ — ---- -- --.........
� C1 ' S�tic System Site Evaivatian Report _ ,
------- _ .. � -- _ ,
�� Cl ; C1 Access Permit ;
� �__ � _ � ❑ i Wefland�uffer imprc�ver��ent Plan �� � �� �
--- --- _
� � ��--- ❑ �fi Enqineered Plans tor R�taiiiinc�Walis 4 feet or above �
n
_�. _— --- ----�
� i ❑ �Min�ehaha Creek Watershed Oistrict Penr�it s
_� _� ._....___ ❑
___�.__ _ _. _.___ �_._ --- .____ _)__�.__�___. ....�.----.___�___�._.__�
_,_.. � � Plan Review Fee
� ! ❑ � Applicatian Escrow&Agreement Y � '
� -�- � _�__.. ---- -
� � Other.
� _ ,
APPLICA�6TICJWNEI4 AC6{t���lLEb���t1ENT:
—_____ �__._ ----^_.__ �__..._—_________ _____.
' • l�grees ta provide alI infiormation required oi�requestetl by the Buildiny Department; I
+ Agrees to pay the City of Qrono for engineering con5ultant review costs in excess of$50�;
i Certities that the ii�formation si�pplied is true �nd carr2ct to ihe best of his/her knowledge. The applicant recognizes that the;� �
are solely responsibie for subinitting a coi��plete application being aware that u�on failure to do so, the staff has na aiternatis�e
� l3ut to r�ject it unti(it is complete;
o Acknowiedges the Es�row Agreement is com�letetJ and signed; II
� Uncierstands some or ail of tf�e information thai ynu are asked to �rovicf� un this application is classified by 5tate law as either I
�rivate or confiden[ial. Private data is information which generally cannnt be given to fhe public but can be given to the subject
of the data. Conndential data is information which generaliy cannc�i be given to either tf7e public or the subject of the ciata. Oiu
purpose and intended use of this information is io annually upciatz our records and records of other governmental agencies I
re�uir�d by law. If you refuse to supply the iniormation, the applicatibn m�y nat be issued. �
�
• Agrees that in the�vent�hat weather�r other conditians prevent the completior� af an as-t�uilt survey at the time the !
Certi�cate of CJccupancy is reque$ted, a temporary��r�ificate of Occupancy may be issued upon re�eipt t�f� �1�1,OpQ �
�� escrow to ensure�ompfetian of the as-bailt survey and aIl site improvem�nfs.
i
___ __.._.. --__—_.__ _____--_ ___ .. __ _-----..--_ ---
__ —_____ __ ____T__-----)
�pp(ic�nt's Signature: Date: � _
C7wner's Signature: _ _.__�_�_ _._ Date:
11/ �,015 08 : 21 T0: 19522494616 FROM:6123544154 Page ; 2
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�UILC31Nt� P'EhMlI�' ,��F�L1�AT10�1
Ft�Ft �EIIV �TRUCTIJRE� C3R �1DDITIt�NS
�,r-� ;~ Mailing Flddr�ss: ��l S (� / � �
/ �1��� pQ go��� Permit number:
�� � Crystal Bay, MN 55323-0066 Date received: ����
' Street Address:' heceived by:
\� ' � 275U Kelley Parkway Pian review fee: /' 3
'``� � " Orono,MN 55356 ��
���est�a �` ToEal F��: �
�1
Main: 952-249-4600 Fax: 962-245-4616 vv4vwr.ci aronc r�n�us �
�� This application fiorm must b�con�rpiet4d in fuli and a(I re�uired informafio«�must be mitted. ��
lncomplete applicatiaits wilE be returneci. (Please prrnt} ������
GENERAL lNF�RMATIiJN. X
�� ��b Sit�Address� �,-��'�_��- ����-� .` �' - C�.
Vtfill rf�is be a Parade of Homes, Remo elers Sh�icase Home or other Display Nome? ❑ Ye� ��❑ Nc
if yes,a specia/event permit is��ryuired with Police Department and City Counci!apprcval 60 days prior to ihe everf. Shutfte bus service�ritt n�
required unless applicanf demonstrates suflicient on-site parkirr�is available. Non-Germitted evenfs wrfl aot be aAovied.
CCJNTRACI"OR 1 AP tC �1T INF , M�7It�N:
Name: _ �t�- ���1.__....�L�,.C...�-1 ___.. - --
State I�icense# Expiration Date:
-- — ---
Phane: _�c II � "���_ _� , office) �j� . (��--�-�.,�__.__
� Mailing Address: ` (�,� Cit . r' ZlP:
-- � �t�--- ��-��� - �__�._.._�a�..a}�_�.
Ccntact Person; _ ___�'���.�x, Applicant is: ra� / Homeowner {c�.���one2
Email andlor�ax: �(�,' �, _� ' � . ��1�f�:�1�'"►�Y�-_�C
. _C3.�---___, _�_ �____._
PRC}P�RTY OWNE INFORMAT ON: ,
Name: � � '(�G
� - �`�� ..��--- _ __--- __�___. --
__ — -- --- ...__._.
{'hone(day): _ �}�� _� � _
- -_� � ��_�
A�dress: _ .� --- '� - �=ir_'���C:i�'--=�`r„�.,e� ____ Crty�Ct�'j��---ZIP'���_�__
Email and/or Fax _����,_. irt����,�1�_La.l_4-�.
�aR�HITECT t ENGINEER INFORMATf�N:
N a n1e:
Phon�(day): _—. - ---.. —
�ctdr�ss: ------ --- ____ __ ___._. City: ZIP:
En�ail andlor Fax� �
! � � �, �� ` ` t�- d1�- �i
1�F�bJEC�' INFb AT 0���D ri Cion_oY"�ct�� .��'C�'� � . �', � G' IiL1 ' i'���
' 1.7ype of F'roject 2. P posed Use ', 3. Str ure Type i 4. wage Disposal& �
� ; Water Supply �
; �.1 New Cnnstruction Sit�gle�an�ily with , Residence i
j ❑Addifiot� atfached garaye I� ❑ Garage l Accessory Bidg, ❑ PubEic 5ewer �
� � ❑Acc ssory Building ❑ Single�amily wilh ; ❑ Deck I
❑ F2 �cation detached garage ' ❑ Office/Co�7unercial �' �
� ' t17�r: s ecif � ❑ Private��wer 1
; ( P Y) �V�`��� ❑ Multi��le Family(Condo ,' ❑ W�reftause
� ! ❑ Puk�iic ' �, Storage ❑ Pubiic UJafer '
� °'Any eartfi movement may also r�quire ; ❑Commercial ; ❑ Other(specify)
� i 1U9CWD review&permits. ( ❑ Industrial � ❑ Private Weli ��
�, AAinnehaha Creek�ldaiershed Districl(h1CWD) ❑ Oth�l': (SpeCffy) � '
' 18202 h5fnnetcnka Bfvd
� De2piiaven,��N 50391 — � �
i Pht�ne: 952-4?1-�590
' www.tg nn2ha O Seek.or; - --.__ . --- __ . __---- ----..__. � -s;�,� __. - _ ;
�.
Estimated Construction Valuatit�n (excl�lding land) � � �`� ���
__... __--�`-'__ _-----.....
' PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: � �_PC� � �h �C G'X�Q'a , �d� Permit No.:
Description of work: Date Rec'd:
Septic review by: 7 e w' ��^ � lit/O�`�eli' Date Approved:
Zoning review by: �-f- Date Approved:
/-i /--�
Building review by: Date Approved: �� / �j
�
Grading review by: Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
,.
Zoning: Lot Area: SF/AC Width: Lot Coverage: SF %
Survey Submitted: � Ye� � No ` Date of Survey: Revised date(?):
Landscape plan submitted? q Yes 0 No Landscaper:
Proposed Setbacks: �
Front(Lake) Rear(Street) �� N S E W ) ( N S E W ) Other Buildings Wetland
,\
Sid Side
�
Defined Height: Peak Height: � FFE: FFE minus 6 feet= (Existing Contour)
Perimeter(linear feet) = 50 = L.F. below grade
Basement? � Yes 0 No, Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: \ FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the I west propos d Slab at or above grade—
START W ITH floor(of the basement or cr wl space)an measure from hiqhest existina
the highest point of the roo. START WITH rA ade to the highest point of the
roof even if fill was brought in to 3
elevate home.
If you have a...
SUBTRACTION • GABLE OR HIPP ROOF(no Slab below grade—measure
(BASED ON windows): Subtr t half the distance from highest existing grade to the
ROOF TYPE) between the high st point of the roof hi hest oint of the roof.
to the low point the corresponding If you have a...
gable or hipped oof SUBTRACTION ' GABLE OR HIPPED ROOF
(no windows): Subtract half
• GABLE OR HI PED ROOF(with (BASED ON the distance between the
windows): Su tract half the distance ROOF TYPE) highest point of the roof to
between the t p of the highest
window and t e highest point of the the low point of the
roof corresponding gable or
hipped roof
• ALL OTHE ROOF TYPES(flat, • GABLE OR HIPPED ROOF
mansard,e ):No subtraction. (with windows): Subtract
SUBTRACTION Subtract the dist nce between the half the distance between
(BASED ON basemenUcrawl pace floor and the the top of the highest
EXISTING highest existing rade adjacent to the window and the highest
GRADES) foundation OR 1 feet(whichever is less). point of the roof
• ALL OTHER ROOF TYPES
(flat,mansard,etc):No
EQUALS Defined buildi height subtraction.
Defined building height
EQWALS
Updated: October 2015
z:\forms\plan review checklist 10-2015.docx
1
I •
Shoreland District MCWD Permit Average Lakeshore Setback g�uff
Met?
� Yes 0 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
� Yes � No � Yes � No
1 2 3 4 5 Type(s): Type(s):
Fees to be Char ed YES NO
Permit �
Plan Review (�
State Surcharge �
Investigation Fee
SAC—Number of SAC Units fj�
Other(specify) U
Square Footage $ per Square Footage
Basement X = $
15t Floor X = $
2"d Floo� X = $
Garage X = $
ma
Estimated Construction Value: $ � �� �
Orono Inspections Required Work Requiring Separate Permits
0 Footing 0 Site 0 Plumbing ❑ Grading/ Filling
0 Poured Wall � Silt Fence/Erosion Control 0 Mechanical ❑ Fire �
0 Foundation Survey ❑ Hardcover Removal ❑ Septic 0 Water Connection
❑ Foundation Waterproofing � Other(specify) ❑ Fireplace � Sewer Connection
r�Framing 0 Masonry O Lawn Irrigation
� Insulation 0 Mfg. 0 Landscaping
❑ As-Built Survey � Other(specify)
Final
0 Lathe Required State Permits
0 Other(specify)
0 Well 0 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 hardcover calculations must be submitted and approved.
}
Updated: October 2015
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11/4/2015 08 :21 T0: 19522494616 FROM:6123544154 Page: �
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a' � SMOKE DETECTOR CONNECTED TO A SOUND-
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� ; ��EEPING P,REAS.
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� Carbon monoxide detector
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� � �iquired within 10 ft. of
� block wall MAX 44" S��£p=ng roams.
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� �TO CLEAR AIR
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DATE E
CITY OF ORONO CALLED IN
IN8PECTION NOTICE SCHEDULED
PERMIT NO. 2�' 0/�- b/4o't0 COMPLETED �-e�a-1'7
ADDRESS ��`�� S�►�.v�� �,Q
p�WNER TELEPHONE NO.
CONTRACTOR G�-�-r nc � ?• G'.�t�c
� DESCRIPTION �� -dr.r.� 2ee/� -
ly ❑ FOOTIN(i ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q � POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADINGIFILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL
Z ❑ RADON SLAB ❑ MECNANICAL RI ❑$ITE INSPECTION
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
`��AL ❑WATER HOOK-UP ,�FOLLOW-UP
4Q1 ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATtON/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPT�C INSTALL
Z dINN�1ICOKTRACrOR TO MEET YOU:_Y68_NO
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� O WORIC SATISFACTORY:PFiOCEED ECT WMPLETE
� ❑OORRECT MIOFiK 3 PROCEED ❑1 �CERTIRCATE OF OCCUWINCY
C ❑CORRECTYMORIC,CALL FOR REtNSPECTION TEMPORARY
V BEFORECdVERINO pERMANENT
0 CaRRECT UNSAFE CONDITION WITHIN H��- p p�{pT0 TAKEN
INSPECTOR WILL RE7URN
O STOP ORDER P08TED.CALL INSPECTOR � O qTAT10N ISStJED
O INSPECTION REQUIRED.CALL TO ARRAN(iE ACCESS.
cs�roru�e�ext�spect�o�u nours�a�►ance. (952) 249-4600
on site:
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