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Home My WebLink About2013-00519 - addn/remodel/repair , . , CITY OF ORONO * z 0 1 3 — 0 0 5� 2750 KELLEY PARKWAY DATE ISSUED: 06/26/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADllRESS : 1300 SIXTH AVE N PIN : 26-118-23-31-0004 LEGAL DESC : UNPLATTED 26 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 47,000.00 NOTE: SUNROOM REPLACEMENT(GREENHOUSE) NOTE: PROVIDE EROSION CONTROL (INITIAL) APPLICANT pERMIT FEE SCHEDULE 649.50 MN RUSCO, INC. PLAN REVIEW 422.18 5558 SNETANA DR. MINNETONKA, MN 55343- STATE SURCHARGE(VALUATION) 23.50 (952)935-9669 TOTAL 1,095.18 Minnesota State License#: 2173 OWNER COFFINDAFFER, CLARENCE 1300 S1XTH AVE N LONG LAKE, MN 55356- 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 no[specified herein.This permit will expire and become null and void if construction au[horized is not commenced within l80 days of the date of issuance,or if construction is suspended for a period of I days at any time afrer work has commenced. The applicant is respons� e or assuring all required inspections are re d in conform c ith the State Building Code.This permit may be voked a ny i e due cause. -O � ,�� ,�, / Applican Permitee Signature Date Is By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. r , . � . � �-� � � 9_ 3 City of Orono ,, � � / ' /�/ Buildin Permit A lication � � `� J pp for New Structures or Additions Mailing Address: p'� ��j —� � 9 O PO Box 66 Permit number: � �� Crystal Bay, MN 55323-0066 Date received: �P `� g��3 Street Address:� Received by: y ,� 2750 Kelley Parkway Plan review fe : F c,` Orono, MN 55356 � / 04�/� `qkESHO�� Main: 952-259-4600 Total Fee: J / � Fax: 952-249-4616 �vv�N�,v ci or�no mo us This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: i , � Job Site Address: I ��'�� C�t.-cr�T ��.� Will this be a Parade of Homes, Remode�ers Showcase Home r 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 ill e required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: j1'1 l� � 1.��GCU �Ci�= ��$ State License# O c�0 � i 7� Expiration Date: 3 -.�/ - �f1/ Phone: cell CQ I:2 -� O- "7 office Z — — 4� Mailing Address: � � ,4 � Cit : ' �� ZIP: �- - Contact Person: �� G�5 Applicant is: C rac / Homeowner (CirdeOne) Email and/or Fax: �i4x �5 Z��5�� 5�'/ lo��n'lin�'��'SatQ r'�-!S� -� �Y�'l PROPERTY OWNER INFORMATION: ' �� 1 �� Name: � �,�nL� c,�� Phone (day): �'�1,�. -.23�-' Cot� �7� Address: ( OO p� Cit : �Ca'�t� ZIP: -��.5rc Email and/or Fax '�'jn - o l . t.c�•-r� ARCHITECT I ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8 Water Supply ❑ New Construction ingle Family with ❑ Residence ❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building �Single Family with ❑ Deck �elocation � detached garage ❑ Office/Commercial ❑ Private Sewer ther. (specify) ��I�LR'� �2�i1��' �] Multiple Family/Condo ❑Warehouse �� ❑ Public �Storage ❑ Public Water "*Any earth movement may require ❑ Commercial Ot er(spe ify) MCWD review& permits. ❑ Industrial �{'�-n�DuS� ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other' (specify) 18202 Minnetonka Blvd Deephaven,MN 55391 P hone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) � 1'�' � � ��o Packet Last Updated: 04/19/2013 Page 22 of 23 . , ,, � STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction � „ a. Length (ft.)= C� � Number of bedrooms= ❑Wood/Frame b.Width (ft.)= ( �!J i Number of garage stalls: ❑ Masonry �,n�eu S� �etal ��.1�'►'i�r��rvL Areas in square feet Attached = ❑ Pole Bldg. S�^'n �''�� c. Basement= Detached = ❑ ICF d. 1 S�Story = ❑ On-site Prefab e. 2"d Story= � ❑ Off-site Prefab • f. '/z Story = ❑ Other(please specify): �� ' �50ri g.Total Area= �jt�— s��dac-"�' REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Ap licable ❑ ❑ Permit A lication ❑ ❑ 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 ❑ ❑ Minnehaha Creek Watershed District Permit s ❑ ❑ Plan Review Fee ❑ ❑ Other: 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 complete; • 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. Applicant's Signature: '� /�1�i ��(sG!' Date: Owner's Signature: Date: Packet Last Updated: 04/19/2013 Page 23 of 23 , . PLAN REVIEW CHECKLIST f�R NEW STRUCTURES I ADDITIONS Address/Permit Number: I 3 0� C.�v l�Ttil t'ZO►4✓-� � Description ofwork: �unl2bOn� ��G�i'V1l.�N� �TN K i.�v►✓�1 Septic review by: /V//� Date Approved: Zoning raview by: �� Date Approved: Building review by: Date Approved: b "1°! " ��-3 Grading review by: 1� Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zon g: Lot Area: SF/AC Width: Lot Coverage: _% Survey ubmitted: � Yes � No Date of Survey: Revised e ? : Pro osed tbacks: Front{Lake Rear(Street) ( N S f W ) ( N S E W ) Oth uildings Wetland Sitle Side Defined Height: Peak Height: FFE: FF inus 6 feet= (Existing�Contour) Perimeter(linear feet)= 50%_ #o tories Ok? �YES FOR A BUILDING WITH A BASEMENT CRAWL'SPACE: The dista between the lowest FOR A BUILDING ON A SLAB fOUNDATION: START WffH proposed fl r(of the basement or crawl space)and th highest point of the roof. START WITH The distance between the top of slab and If you have a... the highest poirrt of the roof. If you have a... • GABLE OR PED ROOF(no . GABLE.OR HIPPED ROOF(no windows): Su ct half the windows): Subtract half the distance distance between e highes oirrt between the highest-poirrt of ihe roof of the roof to the I oint the to the low point of the corresponding SUBTRACTION con'esponding gable ' ped roof SUBTRACTION gable or hipped roof (BASED ON ROOP . GqBLE OR HIPPEO O F(with (BASED ON . GABLE OR HIPPED ROOF(with T�'E) windows): SubVa alf th ROOF TYPE) windows): Subtracf haif the distance distance betwee the top of between the top of the highest highest wind and the highes window and the highest point of the point of the t°0f . ALL OTHER ROOF 7YPES(flat, • ALL OT R ROOF T1fPES(flat, mansard,etc:-No subtractton: mans ,etc):No subtractlon. ADDITION Add the distance beiween the top of slab SUBTRACTION Subtract e distance between the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING base Ucrawl space floor and the EXISTING the foundation. GRADES) high existing grade adjacent to the GRADES fo dation OR 10 feet(whichever is less). EQUALS Defined building height EGUALS ned bufldfng heigM Shoreland Dis ct MCWD Permit Received Avera e Lak hore Setback Met� Bluff � Yes G No � N/A C Yes � No � Yes G No G Yes G � N/A Permit Number: Setback: Storm terQuality Existing Proposed Variance Required CUPRequired Overl District Tier Hardcover Hardco�er G Yes � No � Yes C No Type(s): Type(s): Updated: January 2013 v:\forms�pian review checklist 2013.docx REMARKS (in-house): - Fees to be Cha ed �`�°°�" �'`� �``;��`_ .��u`�`,�: ��g� Plan Review Investigation fee !/' Other(sP��Y) S uare Foota e $ r S uare Foota e Basement X = $ 18t Floor X = $ 2"d Floor X = $ Garage X = $ Estimated Construction Value: S y?,nbD°� Orono inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing 0 Grading/Filiing G Well G Hardcover Removal � Mechanical 0 Fire G Electrical �oting � Septic � Water Connection ured Wall G Fireplace � Sewer Connection G foundation Survey � Masonry 0 Lawn Irrigation G Radon Rock Bed � Mfg. G Framing G Other(specify) G Jnsulation G As-Built Survey ,Rt Final D Wetland Buffer � Other(specify) REMARKS (in-house): bther Review: Reviewed by: Date Approved: Access: Existing: O YES � NO New: � YES G NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED p/tAV 1�� l'ws'�or-� Gor�T/1.�L Updated: January 2013 v:\fortns�plan review chedclist 2013.docx DATA PRIVACY ADVISORY In accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd. 2, "Tennessen warning", 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 ce�tain private or confidential 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 extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under Minnesota State Statute 13.04 (see following page) to review private data on yourself. 6. Your full name is required to process this application or permit. �� First Midd e Last i �� va�-� �� I Address ��.�e � �s�.�7p �l� �- D'7 � City State Zip Phone erstand y r' hts as stated above. Signat re � A I R�� /�l � s558 �� °� �� e -f�� 4� l� SS.�l.� Packet Last Updated: 04/19/2013 Page 20 of 23 � � ' � �.�e . �.. �Y � Ai� / ; y" I �' � : x� . . :y :.. � � �»yp w . � ., ��'� 7�W ��' � ��j� fiWr{ V �'r f.i / — ` 1 �'�N. '� .. � , i '� ! 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"M' �, _�,�� ,.ti �r � � .� � � ��.�� s,�,. �� `� `� �,r'�,. ��. � ►�) ,Y � g' �-�' .C� 7 DATE TIME ✓ CITY OF ORONO ��ALLED IN /—�-"-�-� --,��- INSPECTIO OTICE/� SCHEDULED _�_.LL- /� ��v PERMIT N w COMP�ETED ADDRESS I 3 � �C�1 ��{�_ OWNER TELEPHONE NO�`="�._a-�b�4$ CONTRACTOR' r � � \ � S � � DESCRIPTION � v � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI � LAKESHORFJWETLANDS y ❑ FRAMING ❑ 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 O SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO c�.� COMMENTS: � W C o C c�1�- '{� rs� v n1 o ,�b � � ' � � `" o I� �v � Q � z W � W � j d W� RK ATISFACTORY:PROCEED ❑PROJECT COMPLEfE � ❑CORFECT WORK 8 PROCEED ❑ ISSUE CERT�FICATE OF OCCUPANCY O �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WIIL REfURN ❑CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED_CAIL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-460� OwnerlContractor on s'te: Inspector. White Copyflnspector's File Canary CopyfSite Notice ��' � , / -�'� �;� � G ,GATE J TIME ` CIN O�ORONO CALLED IN �� "( ��j INSPECTION NOTICE SCHEDULED ` � ` � � PERMIT NO. '<-'-�!-��-�l��i �� COMPL�TED � ADDRESS � �C�C�, :� /X�� 'II(.`C~ �+ OWNER TELEPHONE NO�% �� `�� ' 7�r�� CONTRACTOR ��'7�� LL ��C'r �: DESCRIPTION �� /l� �� I �"/1 .�� 1 l_/ �i��C/�21 � � ❑ FOOTWG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION 0 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 ❑ SEP � INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEP IC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRAC YES_NO � COMMENTS: � W a � J O a � O � W � Q � Z W � W � j GW ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOF REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITNIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: Inspector. � f�"1%�� White Copyllnspector's File Canary CopylSite Notice � l � � ;�-'I� � � 0 �� N 87°42' 00" E 300.19 � � ..... � CITY �F 4RON� � � 511'E PLAN �... �f��.�'�;±J{� pLAN � ' ,(��'A�P��'IV��Q GAMC�C: /}�OD� �oo� I ❑ ��OV�� `i ��`tr�J��S � C� DiSAPPRO '�� Y _ G�--- � t�l1T� s-z 5-o� � I :........... .......................... .......................... 300 -................•--......... I (968. .8) I 16.4 (962.0) I (972.5) I (977.4) o N I � � c� iI ...........r�............ v N i'/_ � J EASEMENT FOR INGRESS 16 z (960.1) AND EGRESS SEE DOC. (ss . .a) � N0. 620993 I (sss •8) Z (ss� ss.$) I Z (973.2) 8.7 (959.8) O i O (971.1) � o rn2rn � o �7�� o� ,P 63.3) ( � 1 (966. (964. rw I N �9se.a� FENCED ; � AREA �'� o �- � I : (s�o.�)�6� .a) I � (s�z.�) �2.e i"e �°�� N 966.5) 965.1) (959.4) 00 DQ �� 02o I: � � � � ti a� ��(� c,,� L, ��n � O �-- '.''i� --r_�__.� Y . (966.2) �964.6) I N I (969 1) (959.9) I .124•Q.. ....1.......•••••••-••........ .(96581 �96�.3) � .................... . � �s6�.2> � EXIS i iNG! ,� I GA€tAGE� �'�� sso.a> 1 (968 ) °' 22.3 � i (967.3) 965.9) 964.3) (96 `,�P� (967.3 � 5.0� I (96 . vE�'�R\v�V, �966.5) 2.5 10.89N5�9.5 �960.7) I G��9ss.2) � � I > � � I ..._{96 .... . ......••---107.1...............�967.1 •5 N'J v � � � ' �� EXISTING 16.2 � ��Y'� �1 � c , C�`Y OF OR�N4 162 HOUSE � ��.�� .�. S1TE PLAN GRADIN6 PI.Ad�fi. � N � �� APPROVED � � !7 APP�#4Y�D W1tITH ��1SIONS (966.7 Z „ ,6., / I ❑ D18APP `;,� c96 .3 965.7) � Q ��-�-- ��_._ ' (963.9) •••••-- - HENNEPI CdI1N � I R.O.W. M Nl�l� (�-1�l ��.0 I 3 �: I �� N� N 88°48' 30" W 164.97 � R=1465. w w � W ':, � COUNTY ROAD 6 (F.K.A. NORTH WATERTOWN ROAD� N 88°48' 30" W 164.04 R=1432 �� DESIGNED REVISION DATE OESCRIPTION \ DRAWN CHECKED 06- 1 19