HomeMy WebLinkAbout1995-007568 - addition PERMIT
�,�;ITY OF ORONO PERMIT TYPE: _ .
' 2750 Kelley Parkway- P.O. Box 66 i'� ��c�
Permit Number. � ��°:=ti���
Crystal Bay, Minnesota 55323 - ' -`'� .
(612)473-7357 Date Issued: -
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SITE ADDRESS:
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: `=��� � .: � OWNER:
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APPLI PERMITEE ATURE ISSUED BY:SIGNATURE
f` • �
� T�tal Fee: $ „�;�`�7, '7/ DateReceived: �'� . � - ��5�
�`�� Date Approved:
Entered By: �-��� Permit#: '���• ;�� �
CITY OF ORONO - BUILDING PERNIIT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BESTARTED
THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ��U �}0�1,�1JF� �-�v� Z�: 5��I
NAME OF OWNER: �'DM � P�1U� �DIX�U�t�� PHONE: (home) G�'�fo-2�iS1
(work) �23�5��
MAILING ADDRESS: 1�bo St�oRS,�p�1�.. CITY: f� ZIP:�'�1
CONTRACTOR: I,�j,[.E COUI�t(�-`1 P�I��'gS � �NG. PHONE: ���'1�'l.�
MOBII.E PHONE/PAGER:
vIAILINGADDRESS: `�`� �EGdND �('(1.E'E'C CITY: �C�S�b�- ZIP:���_
STATE LICENSE: # Z2�
ARCHI'TECT/ENGINEER: N.R• PHOi�1E:
NTAILING ADDRESS: CITY: ZIP:
��,�; REGISTRATION #
TYPE OF WORK: New Addition x Accessory Structure
Move Remodel/Alteration X Lanci Alteration
PROPOSED WORK,(describe indetail): a � 3 D " � W�f� �
r Yl?�v,► �'i'kP�vl �Il�r✓►�t� 1� R �t auI �l� ' rl'WI
STORIES: � SQ. FEET OF EACH FLOOR: `�100 SF(�.)Ew�
NO. OF BEDROOMS: -$ GARAGE STALLS: ATT. � DET. —
ESTINiATED CONSTRUCTION VALUATION(excludingland): $ ��5,UD0.00
I hereby apply for a building permit and I acknowledge that the information above is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City
and with the State Building Code; that I understand this is not a permit and work is not to start
without a permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE: I I I I� '�1 r'�'
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
9
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�kESII�g'�" ,
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to
inform you that your request for a permit or license from the City of Orono or any of its
departments may require you to furnish certain private or conf'idential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the
permit or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the
permit or license.
3. The information may be shared with other local, state or federal agencies to the
exter�t necessary to p:ocess the permit or license.
4. If your requested permit or license requires Council action to approve, some
information may become puolic.
5. You have certain ri�hts under M.S. 13.04 (see followin� paae) to review private
data on yourself.
6. Your full name is required to process this application or permit.
PLEASE PRINT
�tor�y l� I.�� �'�a-)
First NSiddle I.ast
I,PI�Y-� GoVt�'L?�-� f�lufJ�S � u.1G •
'�l'� S�cnNO S'�P�
Address
��,�,sioa. M� ��31 N�4-�I�-1
City State Zip Phone
I understand my rights as stated above.
'�nature
TF'i.FPHO?VE-473-7357�FAX-473-0510
1�
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Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subdivision 1. Type of data. The rights of individual on whom the data is stored or
to be stored shall be as set forth in this section.
Subd. 2. Information required to be given individual. An individual asked to supply
private or confidential data concerning himself shall be informed of: (a) the purpose and
intended use of the requested data within the collecting state agency, political subdivision, or
statewide system; (b) whether he may refuse or is legally required to supply the requested data;
(c) any known consequence arising from his supplying or refusing to supply private or
confidential data; and (d) the identity of other persons or entities authorized by state or federal
law to receive the data. This requirement shall not apply when an individual is asked to supply
investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement offcer.
The commissioner of revenue ma�nlace the notice required under this subdivision in the
individual income tax or property tax refund instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority, an
individual shall be informed whether he is the subject of stored data on individuals, and whether
it is classified as public, private or confidential. Upon his further request, an individual who
is the subject of stored private or public data on individuals shall be shown the data without any
charge to him and, if he desires, shall be informed of the content and meaning of that data.
After an individual has been shown the private.data and informed of its meaning, the data need
not be disclosed to him for six months thereafter unless a dispute or action pursuant to this
section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the
individual subject of the data. T'he responsible authority may require the requesting person to
pay the actual costs of making, certifying, and compiling the copies.
The responsible authority shall comply immediately, if possible, with any request made
pursuant to this subdivision, or within five days of the date of the request, excluding Saturdays,
Sundays and legal holidays, if inunediate compliance is not possible. If he cannot comply with
the request within that time, he shall so inform the individual, and may have an additional five
days within which to comply with the request, excluding Saturdays, Sundays and legal holidays.
Subd. 4. Procedure when data is not accurate or complete. An individual may
contest the accuracy or completeness of public or private data concerning himself. To exercise
this right, an individual shall notify in writing the responsible authority describing the nature of
the disagreement. The responsible authority shall within 30 days either: (a) correct the data
found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or
incomplete data, including recipients named by the individual; or (b) notify the individual that
he believes the data to be correct. Data in dispute shall be disclosed only if the individual's
statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions
of the administrative procedure act relating to contested cases.
11
� HARDCOVER CALCULATION WORKSHEET
SETBACK ZONE: (CIRCLE ONE) 0-75' 75-250' 250-500' S00-10
EXISTING HARDCOVER IN ZONE
A. House x = S.F.
Length Width
R = S.F.
x = S.F.
R = S.F.
B. Garage x = S.F.
C. Driveway �2 x 1'� _ ��� S.F.
x = S.F.
D. Sidewalk x = S.F.
R = S.F.
E. Patio/Deck x = S.F.
R = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - �Ob S.F. A
TOTAL PROPERTY AREA IN ZONE - °15�'( S.F. B
A qD b — B �5�1 x 100 = °�•�(• %
PROPOSED HARDCOVER IN ZONE C� ��� �� ��
A. House x = S.F.
Length Width
R = S.F.
x — S.F.
x = S.F.
B. Garage x = S.F.
C. Driveway (Z x �S = ��O S.F.
R = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
R = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - QI�D S.F. A
TOTAL PROPERTY AREA IN ZONE - � S.F. B
A — B x 100 = �•�}'/• %
14
• HARDCOVER CALCULATI WORKSHEET �
SETBACK ZONE: (CIRCLE ONE) 0-75' S-250' 250-500' S00-1' 000'
�
EXISTING HARDCOVER IN ZONE
A. House x = S.F.
Length Width
x = S.F.
z = S.F.
R = S.F.
B. Garage x = S.F.
C. Driveway lrl- r 1'�S = 21DO S.F.
X = S.F.
D. Sidewalk x = S.F.
c = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - Z�DD S.F. A
TOTAL PROPERTY AREA IN ZONE - Z 2'1(o S.F. B
A 21�0 - B 22,2�b x ioo = �,y • • %
PROPOSED HA.RDCOVER IN ZONE ND (�P,,� 1"�� �tl�
� ►�•�v�_�
A. House x = S.F.
Length Width
X = S.F.
R = S.F.
X = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
X = S.F.
D. Sidewalk x = S.F.
X = S.F.
E. Patio/Deck x = S.F.
� = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - 'Z.�p(� S.F. A
TOTAL PROPERTY AREA IN ZONE - 22 2�� S.F. B
A — B x 100 = G�.�} ' • %
14
� HARDCOVER CALCULATION WORKS
' SETBACK ZONE: (CIRCLE ONE) 0-75' 75-250' 250-500' �-1000'
EXISTING HARDCOVER IN ZONE
A. House 52 x �1 = ��{D�} S.F.
Length Width
x = � S.F.
R = S.F.
x = S.F.
B. Garage 22.. x 2d =
���4o s.F.
C. Driveway Y�O c �y = ��ZO S.F.
?•o x ly = 2�bo s.F.
D. Sidewaik �. x �p = �6� S.F.
4 e s4n = l bo s.F.
E. Patio/Deck 2�j x `Ld = 5Do S.F.
x = S.F.
F. Landscape �j0 x 3b 'Z = �SO S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Ot�he�r �2 x 2�j = 2�0 S.F.
TOTAL HARDCOVER IN ZONE - ��1'��'I S.F. A
TOTAL PROPERTY AREA IN ZONE - �jl�p�Z,� S.F. B
A 4"154 — s 3l i �23 X ioo = Iy.q •/• �
PROPOSED HARDCOVER IN ZONE ��
A. House �Z x 27 = f D S.F.
Length W id th
�'L X 2� = 32`� s.F.
R = S.F.
X = S.F.
B. Garage 2?i x �.O = L�.�D S.F.
C. Driveway Q�D x �y = ��Zb S.F.
?_b X f�1 = ��p S.F.
D. Sidewalk L� x (oD = �� S.F.
—� x 4n = /��_ s.F.
E. Patio/Deck �� x Zo = �b S.F.
� = S.F.
F. Landscape `J,p x �j 0"2 = �7D S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other , �2 x 2U = ��a S.F.
���
TOTAL HARDCOVER IN ZONE - ��$ S.F. A
TOTAL PROPERTY AREA IN ZONE - 31 � 2�6 3 S.F. B
� 5t5'6 - B 31, �23 x ioo = i�.�- �
14
� HARDCOVER CALCULATION WORKSH�ET [�,p
� SETBACK ZONE: (CIRCL� ONE) 0-75' 75-250' 250-500' S00-1000' � ���'
EXISTING HARDCOVF,R IN ZONE
A. House x = S.F.
LenB� Width
X = S.F.
z = S.F.
x = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
X = S.F.
D. Sidewalk x = S.F.
x = S.F.
E. Patio/Deck x = S.F.
x = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic e = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - -8- S.F. A
TOTAL PROPERTY AREA IN ZONE - /'7,G/�r-/ S.F. B
A — B x 100 = ..6-- %
PROPOSED HARDCOVER IN "LONE � �(��
A. House x = S.F.
Length Width
X = S.F.
R = S.F.
X = S.F.
B. Garage x = S.F.
C. Driveway x = S.F.
X = S.F.
D. Sidewalk � = S.F.
X = S.F.
E. Patio/Deck x = S.F.
e = S.F.
F. Landscape x = S.F.
Underlain x = S.F.
By Plastic x = S.F.
Or Fabric
G. Other x = S.F.
TOTAL HARDCOVER IN ZONE - S.F. A
TOTAL PROPERTY AREA IN ZONE - f 7��f7 S.F. B
A — B x 100 = �g, %
14
EXTERIOR ENVELOPE ENERGY CODE COMPUTATION WORKSHEET
To Determine Compliance with the Minnesota Energy Code
(Section 502 of the State Amended 1983 Model Energy Code)
Project Title �nil����►j'IY11J � ����.1��
-,.
Site Address ���p� `,�'p�1�1�G bQ1�G b�Ol�
I. EXPOSED WALL CALCULATIONS
AREA "U" VALUE AREA x "U"
A. Opaque Wall
1. Mas nry/Concrete t � a• ' _ , Z���
a. _���R
b. � /uw At.t . x O�— _ '7.0 •f"!
C. R =
2. Foundation Wa 1 (Above Grade)
a. 1 C V d � z =
b. R =
3. Wood Frame Wall
a. Insulated Area �y�S R �•�y = � '�iD
b. Framing Area (Ave. 15% at 16" oc) Z � x o•nq = Z2 �5
c. Framing Area (Ave. 10% at 24" oc) x =
4. Peripheral Floor Edge/Rim Joist
a. � w► 2� x o•a 4� = ( ��"310
b. x =
B. Glazing
1. WindowsNl�h� •,�2 _ �60,4y
a. (,�pV�?E w��q•r-� 5�2 x
b. x =
2. Doors � �' �R • 7 = •1
C. Doors
1. Wood
a. Solid R =
b. With storm door x =
2. Metal 3 �x ��1 = '
3. Overhead R =
4. Other R =
D. TOTAL WALL AREA, sq. ft. �Uu
E. TOTAL OF AREA z "U" ��� ��
II. ROOF/CEILING CALCULATIONS
A. Roof/Ceiling Insulated Area 2 0 (D z n�0� _ �� �
B. Roof/Ceiling Framing (Ave. 15% at 16" oc) z =
C. Roof/Ceiling Framing (Ave. 10% at 24" oc) �x d�n I�__
D. Skylight � ��!) R —
E. TOTAL ROOF/CEILING AREA sq. ft. Z��
F. TOTAL OF AREA z "U" ��! I
15
III. BUII.,DING ENVELOPE REQUIREMENTS
TOTAL REQUIRED ALLOWABLE
AREA "U"
(From I.D&II.E) (From V.) (Area z "U")
A. Exposed Wall: "f W x ��� = 0'v�
B. Roof/Ceiling: 21 x . 02�'_ �
C. TOTAL ALLOWABLE BUILDING ENVELOPE(Total df A&B above) � ► � _
IV. ACTUAL BUII.DING ENVELOPE
ACTUAL
(Area x "U")
A. Exposed Wall (From I.E) �`�
B. Roof/Ceiling (From II.F) S ��
C. TOTAL ACTUAL BUILDING ENVELOPE (Total of A & B) �' ��
*(Meets code requirements if less than III.C) v�J�
�
V. REQiJIItED "U" VALUES
WALLS ROOF/CEILING
Detached one and two family dwellings .11 :026
*Multi-Family Residential Buildings .238 .033
(3 stories of less in height)
*All other Construction Types (3 stories or less) .238 .06
*All Other Construction Types (More than 3 stories) .28 .06
*Based on 8007 heating degree days (Mpls/St. Paup
Adjust "U" values accordingly for other locations
CERTIFICATION
I hereby certify that I have completed the above information and that it complies with the Minnesota State Energy
Code.
I�IZ1S�
Signature Date
BCSD 3-89
CC/SM6574
16
ENERGY CODE DESIGN BY ACCEPTABLE PRACTICE
To Determine Compliance with the Minnesota Energy Code
(Section 602 of the State Amended 1983 Model Energy Code)
This form is only applicable to detached one-and two-family dwellings. The requirements herein are based on Table
No. 6-11 in lieu of the criteria specified in Sections 602.2.1, .2 and .3.
Building Address ���O S►fioREU�E n(L-1� b�N O
Cont ctor r Owner L� Cp�l�'(Q�"� �jUL�'�(�i, �N� • `.l� #�Z��o
BuildinQ Element "R" Values Area (s4 ft) % of Ext. Walls
Ceilings Design 3� Req'd 38
Walls (exterior) Design 2 r7 Req'd 20 2��' .
(w/o fdn)
Floors (over unheated spaces) Design �� Req'd 20
`�
*Windows (in bldgs w/o ��Z' Design ��•�O �Req'd 12
sliding glass door) (glass)
*Windows (in bldgs with a Design Req'd 10
sliding glass door) (glass)
Foundation Walls Design �� Req'd 5 (when insulating full depth of foundation wall)
Design � � Req'd 10 (when insulating only to frost depth and
, footings extend below)
Slab-on-grade floors Design N� Req'd _ (See Figure No. 3)
**Doors (1-3/4" metal faced) Design �� Req'd 3
* All windows shall be double glazed or have storm windows
** Conventional doors other than metal require a storm door
CERTIFICATION
I hereby certify that I have completed the above information and that it complies with the Minnesota State Energy
Code.
Signature
Date 1��Zl�r
BCSD 3-89
CC/SM/6593
19
� -
. CHECK OFF LIST FOR ISSUAi�10E OF PERMITS
� FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ���?,,�,/ --�; z���.t. ��2- PID: /U-�1� -�? 3 YZ G�r o��
DESCRIPTION OF WORK: U,� G�ti.-;�
------------------------------
ZONING REVIEW BY: � DATE APPROVED: ��-��-�r s
BUILDING REVIEW BY: DATE APPROVED: t�- �3-5 s
---------- -
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes ✓ No
PLAN REVIEW Yes ✓' No SEWER CONNECTION
STATE SURCHARGE Yes v No WATER CONNECT'ION
INVESTIGATION FEE Yes No c� PARK FEE
SAC Yes No �� SITE INSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: G2-�� Shoreland District : ya5
Fire Department: �uqT2. Post Office: w��2 School District: plL�N�
Lot Area: Sq.ft. �Z,3b o Acres 1 •°t Width �27� �" Depth 7 od��
Survey Submitted: Yes �C _ No Date of Survey: �1• -� �
Proposed Setbacks:
Front (�ke): +� J� Right Side: S 3� � �
Rear (Strcet): Z G'd f Left Side: �S� � �'`!�
Adjacent Structures: Arr'►�1u+� Wetland: �u�
Building Height: Def. Hgt. U' .� Peak Hgt.
Avg. Setback: (9 , l� Bluff Setback: — Lot Coverage: —
E�sting Proposed
Hazdcover: 0-75' `l•`l S�`"�
�s-2so° Z.K q. `�
250-500' �y•`1 '`•2'
500-1000' � n
Hardcover Variance Required: Yes No �C Date of Council Approval:
Grading: Staff Approval Date: N({4 By: Council Approval Date:
Septic: Staff Approval Date: BY�
Zoning File: # Resolution: # Resolution Date:
REMARK,S (in house):
26
_ �
BUII,DING REVIEW CHECK LLST
UBC: �-S CONSTRUCTION TYPE: V�
Sq Footage � Per Sq Ftg
Basement x =
1 st Floor x =
2nd Floor x =
Garage X =
x =
TOTAL
Estimated Construction Value: $ (�S`�C900�
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Fire
Hardcover Removal _�l Mechanical Water Connection
�c Footing Septic Sewer Connection
_� Framing Fireplace Lawn Irrigation
�Insulation (Masonry) Other
) Wall Board (Mfg.) Well (State Permit)
_�Final Grading/Filling p�Electrical (State Pemut)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
REMARKS(TO BE NOTED ON PERMIT):
27
DACT�E (o � TIME
CITY OF ORONO CALLED IN I a/ - `� '3v �
INSPECTION NOTICE SCHEDULED /l'30-�� • � 3 d�
PERMIT NO. s� COMPLETED � a
ADDRESS ��
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y� FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
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� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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Call for the ne t inspection 24 hours in advance.473-7357
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White Copyllnspector's File Canary CopylSite Notice
AT TIME
CITY OF ORONO CALLED IN � �
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PERMIT N0. � COMPIETED
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Z 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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Call for the next i spection 24 hours in advance.473-7357
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Inspector.
White Copyllnspector's File Canary CopylSite Notice
pATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT CE SCHEDULED ����
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Inspector.
White Copyllnspector's ile Canary Copy/Site Notice
pATE TIME
CITY OF ORONO CALLED IN � i
INSPECTION NOTICE scHEou�E� � ' :'� " "�t
PERMIT NO. � 4 - :ti COMPLETED
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Inspector.
White Copyllnspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN 9-�
INSPECTION NOTICE SCHEDULED --� � �� �
PERMIT NO. COMPLETED G _t�_
ADDRE � •
OWNER � CONTR.
TELEPHONE NO. -
� DESCRIPTION .
� 01 FOOTINO 11 MECHANICAL HI 1B IXCAV/C3HADINO/FIWNO
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Call for the next i spection 24 hours in advance.473-7357
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White Copyllnspector's File Canary CopylSfle Notice
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FRANK R. CARDARELLE �� ; ��
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(612) 941 -3031 Eden Prairie, Mh1 5534�
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1860 Shoreline D�i.ve �3 ����
Orono, MN 55391
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Lot 3, Auditor 's Subdivision �o. 356,
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Thi� plan, specifieatic�n or report was prr_pared by me or und��r Qy direct super�faf.mn,
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thia 9th day af Nov�mber , 19g5 . ..----- •, --.
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