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Home My WebLink About2010-00085 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2oia000gs � ' 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUEn: 02/22/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2056 SHORELINE DR PIN : 15-117-23-21-0002 LEGAL DESC : HARTWOOD : LOT 003 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 25,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,AND ELECTRICAL(STATE) ADVANCED PLAN REVIEW PERMIT-2010-00084-PAID WITH CHECK#1015 FOR$268.45 APPLICANT pERMIT FEE SCHEDULE 413.00 GREENWOOD DESIGN BUILDERS STATE SURCHARGE(VALUATION) 12.50 2370 BRIDLE CREEK CIRCLE CHANHASSEN,MN 55317- TOTAL 425.50 OWNER PATTY SILVA,MICKEY MAUDE 2056 SHORELINE DR 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 sepazate 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 responsible for assuring all required inspections are requested in conform ce with th State Building Code.This permit may be rev ti e r due cau e. �/� / / / Applicant Pe itee Si nature Date Issued By nature e SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABO �'� �`� � Cit of Orono � y � � , Buildin Permit A li � g pp cation for New Structures or Additions �—� Mailing Address: Permit number: � C� -d�(�� 4v�� PO Box 66 Q �,, � Crystal Bay, MN 55323-0066 Date received: � / �D/d .� �`��'�?,�4:::;,� s,) StreetAddress:' Receivedby: �'�n��.�,� oti�' 2750 Kelley Parkway Plan review feE;: �kESH 4� Orono, MN 55356 _ � Total Fee: �� ,�� Main: 952-249-4600 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. (P/ease print) GENERAL INFORMATION:�. /� Job Site Address: • J , ` Will this be a Parade of Homes, Remodelers Showcase 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 e repuired unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLI�`NT INFORMATIO�j Name: (7�1v�11 �,✓,,�-,.� U s;�/� !�� State License# ��t�` Expiration Date: �3 — ,�j�� Phone: office Mailin Address: � � U (cell 9 Cit : ZIP: Contact Person: A plicant is: Contr ctor / Homeowner (Circle One) Email and/or Fax: �4 - PROPERTY OWNER INFORMAT ON: �' Name: � � J` / Phone (day): — � Address: � Cit : ZIP: Email and/or Fax - � � ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: Cit � ZIP� Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal & ❑ New Construction Water Supply �Single Family with �Residence ❑Addition attached garage ❑ Gara e/Accesso Bld ❑ Accesso Buildin g rY 9• ❑ Public Sewer ry g ❑ Single Family with ❑ Deck ❑ Relocation L detached garage ❑ Office/Commercial �Private Sewer ,�Other: (specify) O� ❑ Multiple Family/Condo ❑Warehouse ❑ Public "*An earth movement ma re�� ❑ Commercial � Storage ❑ Public Water Y Y q ❑ Other(specify) MCWD review&permits. ❑ Industrial [�Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ � � ` Last Updated: 9/29/2009 - 17 - _ - _ � �. _ _. , , + STRUCTURE INFORMATION: 1. Structure Dimensions 1.Structure Dimensions (continued) 2. Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame ❑ Masonry b.Width (ft.)= Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet Detached = ❑ ICF i , ❑ On-site Prefab `s c. Basement= ❑ Off-site Prefab d. 1 St Story = ❑ Other(please specify): e. 2"d Story= f. '/z Story = g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: N ot Enclosed Applicable � ❑ Permit A plication � ❑ Pro osed Buildin Plans � ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form � ❑ Surve meetin all re uirements � ❑ Stormwater Pollution Prevention Plan � ❑ Hardcover Calculation s � ❑ Se tic S stem Site Evaluation Re ort � ❑ Access Permit � ❑ Wetland Buffer Im rovement Plan � ❑ En ineered Plans for Retainin Walls 4 feet or above � ❑ Plan Review Fee ❑ ❑ Other APPLICANT 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; • 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. ApplicanYs Signature: Date: —( � Last Updated: 9/29/2009 - 18 - , Plan Review Checklist for New Structures / Additions Address/ PID/ Legai: ZOS.(a 5�t�t2-��.�NG Description of work: �Z.�:,wwd�,�. Septic review by: /J%/� Date Approved:_ Zoning review by: N!� Date Approved: Building review by: �— Date Approved: ��' ZZ- t0 Grading review by: Date Approved: Zoning File#: Resolution#: Resolution Date: Zonin District Fire Department Post Office School District Zoning: \ Lot Area: SF/AC Width: Depth: \ Survey Submitted: �� , ❑ Yes � No Date of Survey: Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Building Defined Height: Buildin eak Height: # of Stories Ok?: 0 YES �, FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: �. FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl SZART the distance belween the slab and the highest space floor and the highest roof peak,the top of WI'FF{� roof peak,the top of the cornice of a flat roof, the cornice of a flat roof, the deck line of a � � the deck line af a mansard roof, or the mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type or other arch-t e roof �'� r f SUBTRACT half the distance between the highest window and SUBTRACT Ftal e distance between the highest window hi hest roof eak of a itched roof and'h' esf roof eak of a itched roof SUBTRACT the distance between the basement floor/crawl ADD the disf�rice betwee�the slab and the highest space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet, whichever is less. EQUALS Defined building height EQUALS Defined buildin hei ht . Lot Coverage: SF % Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff 0 Yes ❑ No ❑ N/A ❑ Yes ❑ No ❑ Yes ❑ ❑ Yes ❑ No ❑ N/A Permit Number: Setback: Hardcover Zones Existin Proposed Variance Required CUP Required 0-75' ❑ Yes ❑ No ❑ Yes ❑ No 75-250' Type(s): Type(s): j 250-500' 500-1000' RE ARKS (in-house): nr�} ,;_l-�.,aN,:,� Updated: 09/11/20D9 z:\forms�plan review checkfist.docx Fees to be Charged YES NO 'Peemit .� ' Plan Review � 'State:Surcharge Investigation Fee SAC-'Number of`SAC.Units. Sewer Connection `Water Connection :- _. _ .:, Park Fee Site Inspection _ Other (specify) Miscellaneows Fees _ . Calculated By: Square Foota e � $ per Square Foota e Basement X - $ 1 St Floor X = $ 2nd FlOor X - � Garage X = � , Estimated Construction Value: � Z��d� °o Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site f�Plumbing ❑ Grading/ Filling 0 Well ❑ Hardcover Removal ,0'Mechanical ❑ Fire J�Electrical ❑ Footing ❑ Septic ❑ Water Connection ❑ Poured Wall � Fireplace ❑ Sewer Connection ❑ Foundation Survey 0 Masonry 0 Lawn Irrigation ❑ Radon Rock Bed ❑ Mfg. �'Framing 0 Other(specify) �nsulation ❑ As-Built Survey �Final ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES ❑ NO New: � YES ❑ NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.docx '� I / / `1--f �� AT / r TIME �� CITY OF ORONO CALLED IN � � ' INSPECTION NOTICE /-. SCHEDULED � PERMIT NO.�;=�I�� l_ C^'��'COMPLETED ADDRESS ��Z�� .'� �,�)C,l�<�' J i l'�l l' ,��= OWNER TELEPHONE NC7:�l'��, �� -�� CONTRACTOR �j�"�'f I/( L�- ��/�f""i�/C�,YI' � � DESCRIPTION 1 t ,C, T1/��(-��.�,�- � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEP C FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU: YES_NO � COMMENTS: � W a 0 ' 1 LJ�s� � 'l L .1 � �,^ C�Q (�6A+< � X� � � O � W � Q � 2 W � W � � � �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W O�ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONW�TNIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cali for the next inspection 24 hours in advance. �952� 249-46�� OwnerlContractor on site: Inspector. � White Copyllnspector's File Canary CopylSite Notice DATE TIME ✓ CITY OF ORONO CALLED IN � INSPECTION NO�l�_04��-SsCHEDULED � a �� PERMIT NO. � COMPLETED ADDRESS a(�� OWNER TELEPHONE NOK-'�-� � CONTRACTOR �iC'�JY/C� - C D >; DESCRIPTION _��/�(,d� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q �URED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y RAMING ❑ 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 ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � � O � � O � W � Q � Z W � W � � GW /C]WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE � ,�CORRECT WORK 8 PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOA �CITATION ISSUED ❑ INSPECTION REDUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnedContracto n 't • Inspector. White Copyllnspector's File Canary CopylSite Notice