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Home My WebLink About2017-01282 - addn/remodel/repair � r CITY OF ORONO * 2 0 1 7 - 0 1 z e z * 2750 KELLEY PARKWAY DATE ISSUED: l U22/2017 ORONO,MN 55356- (952)249-4600 FAX: 952) 249-4616 ADDRESS ' : 3340 SHORELINE DR PIN : 17-117-23-44-0085 LEGAL DESC : REG.LAND SURVEY NO. 1433 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 5,000.00 NOTE: ENTRY REMODEL APPLICANT PERMIT FEE SCHEDULE 123.87 STATE SURCHARGE(VALUATION) 2.50 DANBERRY BLDG CORP. TOTAL 126.37 5413 MANITOU RD TONKA BAY,MN 55331- Pay�ent(s) (952)4745990 CHECK 8453 126.37 Minnesota State License#:BUIL-BC6389415 OWI�TER Holiday Companies GLEASON,NICK PO 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 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 governing this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if wnstruction suthorized 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due caus ' l zz � � S� �� a�� Appli t itee S ature D e Issue y ' ature Date CITY OF ORONO BUILDING PERMIT APPLICATION � � ,�j � �� FOR NEW STRUCTURES OR ADDITIONS �O�O Mailing Address: Permit number. . -� / —�� PO Box 66 Crystal Bay, MN 55323-0066 Date received: �—�—/� —( StreetAddress:' \�N Received by: � `y � ti�, � � �� 2750 Kelley Parkway � �\�'� Plan review fee: �, � �' � Orono, MN 55356 / � 7—D/�� qKfSH� �� Main: 952-249-4600 � � �� Total Fee: 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: , - -=1----�_ ��J`Zv �� _... Job Site Address: � � v � �� -��`-� �� ^ 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 approva160 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/APP ICANT I FORMATIOI�:� /�� Name: � ti'��.n �`�u�` �� uC State License# � Expiration Date: �7/� Phone: cell 'Z ?r /�d office � Mailing Address: :' ;.,� Ci � �� ZIP: �'`` Contact Person: ,� t=1= Applicant is• ontractor) / Homeowner (Circle One) Email and/or Fax: ,,�t=� ��,+. mrk� -----��""� PROPERTY OWNER INF RMATION: � � Name: �'�� /�V J �GCc'� Phone (day): (n Address: City: ZIP: Email and/or Fax ARCHITECT/ENGINEER IN ORMATION: Name: �2� SC�� Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Description of pro�ect: c � 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Dispos & Water Supply ❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Office/Commercial ❑ Relocation ^ detached garage ❑ Residence ❑ Private Sewer �ther: (specify) ❑ 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.m innehahacreek.or / ; / Estimated Construction Valuation (excluding land) $ J� d�� Last Updated: January 2016 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: Areas in square feet Attached= c. Basement= Detached = 4. Type of Construction: d. 1S�Story = e. 2"d Story= 5. Code Edition: f. '/2 Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ ❑ Buildin Permit Escrow A reement and Fees ❑ ❑ Plan Review Fee ❑ ❑ Com leted A lication Form ❑ ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/�x 11 set ❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements ❑ ❑ Surve —2 full size, to scale meetin ALL surve requirements � ❑ Hardcover Calculations ❑ ❑ Se tic 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 compiete; • 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: f� c� Owner's Signature: Date: Last Updated: January 2016 v D TE TIME CITY OF ORONO cnLLED IN �� INSPECTION NOTICE n SCHEDULED T � PERMIT NO. ZBI T~D�L-�� COMPLETED ADDRESS � �' ` �� /` OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ THE ❑ MECHANICAL RI ❑ SITE INSPECTION Q FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS Z ❑ I SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT e ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTRACTOR TO MEET Y�01l:_YES_NO � COMMENTS: � o� � � � �,�, , c;1 lGt�� % c,- ;�� O ' a� p �� „ � �)` .,�, � '� e �L C� � W � Q � W W � � J . W� �.�ORK SATISFACTOHIh Pf�CEED ❑PRW ECT COMPLETE � ❑WRRECT VIfORK 8 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY 0 O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERINf3 PERMANENT O CORRECT UNSAFE CONDITiON WRHIN HOURS. p p f{pT0 TAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALI INSPECTOR O GTATION ISSUED ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. can ror a�e next inspectron 2a nours in adaar�ce. (952) 249-4600 Owr�IContra site: Inspector: w��e copynnapeciors F��e Cenary CopylSib NoNce DATE TIME � CITY OF ORONO CALLED IN �� . INSPECTION N TICE SCHEDULED PERMIT NO. �� COM LETED ADDRESS �� OWNER L PHONE .��" ` ` `d� CONTRACTOR �� DESCRIPTION �� - k� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ tNSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO v�i COMMENTS: � W Cf�'j r✓'�P c;�'1�l G��-� � -� a �— � � 0 � _ � �� 0 � W � Q � Z W � W � j W WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLE7E � ❑CO CT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN �NSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlCon on site: Inspector White Copyllnspector's File Canary Copy/Site Notice DATE TIME y CITY OF ORONO CALLED IN '�T�� INSPECTION�OTICEd�� n SCHEDULED �^/ / �� PERMIT NO. 7' �'� COM LETED ADDRESS � �� , OWNER TELEPHONE NO. CONTRACTOR � DESCRIPTION 4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT e ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c� COMMENTS: a� W � aC � � �2� `�� h I// 0 � � � ° < >�1� -� W � z � � � � � W � j d W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY EFORE COA/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR YVILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED �INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OvmerlContra r on site: Inspector: WhiM Copyllnspector's File Canary CopylSke Notfee