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Home My WebLink About2016-00934 - addn/remodel/repair � CITY OF ORONO * Z 0 1 6 - 0 0 9 3 4 * , 2750 KELLEY PARKWAY DATE ISSUED: 08/10/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2100 SIXTH AVE N PIN : 27-118-23-31-0024 LEGAL DESC : PHILLIPS WOODLAND TERRACE 2ND : LOT 002 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 3,800.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHAN[CAL, ELECTRICAL(STATE) INTERIOR BATH REMODEL ONLY APPLICANT PERMIT FEE SCHEDULE 108.38 PLAN REVIEW 70.45 METRO CONSTRUCTION STATE SURCHARGE(VALUATION) 1.90 3307 BRUNSWICK AVE N CRYSTAL, MN 55427- TOTAL 180.73 (612)207-4679 Payment(s) Minnesota State License#: BUIL-681358 CREDIT CARD 7494 180.73 OWNER Orono Woodlands 2100 SIXTH AVE N LONG LAKE,MN 55356- AGREEMENT AND SWORIY STATEMEIVT 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 wi[h whether or no[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 ring all required inspections are requested in conformance with State Building Code.This permit may be revoked at any ime fo due c e. _ �� t � �j ' ��-�.� `�� i ; Appli n erm� ign ure ate Issu y Signature Date P�r � C�ty o� ��ono ' �ui�c�in� �erm�t �4p��ecation for IVew S�truc�ures or �4ddit�ans Mailing Address: Permit number: � �Q� PO Box 66 �,, � �- r' � : ' < <'� C� o Crystal Bay, MN 55323-0066 _ yw Date received: C�� \ -�(� 0%' ��P — StreetAddress:' ��-� Received by: ��--� y� ,� 2750 Kelley Parkwa y g P l a n r e v i e w f e e: j�� (� �.��i �( � f• c. Orono, MN 55356 f �'�k E S H o��' Main: 9 5 2-2 4 9-4 6 0 0 Total Fee: l $Q. 7 3 Fax: 952-249-4616 �vv✓�v.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 �p,,L Will this be a Parade of Homes, Remodelers Showca e Home or othe isplay Home? ❑ Yes �No /f yes, a specia/event permit is required with Po/ice Department and City Council approval 60 days prior to the event. Shuttle bus service i�4ll be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be a!lowed. CONTRACTOR/APPLICANT INFORMATION: Name: c� State License # ( Expiration Date: Phone: cell office Mailing Address: O ,,v� Cit : ZIP: Contact Person: Applicant is: � / Homeowner (Circle One) Email and/or Fax: ,�,,;,,,,,, ,,a��,�,�� PROPERTY OWNER INFORMATION: Name: C`� rn n ��/-��lti..�►(�� Phone (day): Address: Cit : �. Z�P: Email and/or Fax ^- ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: Citv: Z�p� Email and/or Fax: ARCHITECT/ ENGINEER INFORMATION: Name: Phone(day): Address: Cit : ZIP: Email and/or Fax: � PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal& ❑ New Construction Water Supply ❑ Single Famity with ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck ❑Accessory Building ❑ Sin le Famil with ❑ Public Sewer g y ❑ Office/Commercial �elocation Q ��/ Q /' detached garage ❑ Residence Other: (specify) IJ�TGt K2t��f ❑ Septic ❑ Multiple Family/Condo ❑ Retaining Wall(s) (Compliance certificate ❑ Public 4-feet or greater may be required) *"Any earth movement may require ❑ Commercial ❑ Storage MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Public Water Minnehaha Creek Watershed District(MCWD) Other: Spe Ify) Other(speCify 15320 Minnetonka Blvd;Minnetonka,MN 55345 �'f�Js,�,�� ❑ Private Well Phone: 952-471-0590 / Fax: 952-471-0682 www.minnehahacreek.orq Estimated Construction Valuation (excluding land) $ Packet Last Updafed: January 2016 Page 21 STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) " a. Length(ft.)= Number of bedrooms= 2. Occupancy: c��v� � b.Width(ft.)= Number of garage stalls: 3. Occupant Load: Areas in square feet Attached= c. Basement= Detached= 4. Type of Construcion: �f'�(.� d. 15i Story = ��l ��L�� e.2"d Story= 5. Code Editiorr. �" f. 'h 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'/z x 11 set ❑ ❑ Minnesota State Ener Code Cafculations and Mechanical Code Re uirements ❑ ❑ Surve —2 full size,to scale meetin ALL surve re uirements ❑ ❑ Hardcover Calculations ❑ ❑ Se tic S stem Certification ❑ ❑ Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD statin no ermit is re uired O ❑ Landsca e Walls and/or Retainin Wall Plans ❑ ❑ Landsca e Plan ❑ ❑ Stormwater Pollution Prevention Plan SWPPP ❑ ❑ Access Permit � ❑ Data Privac Adviso 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 coRect 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 general�y 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 govemmental 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-b It survey and all site improvements. �_ ApplicanYs Signature: Date: ��/(p Owner's Signature: Date: �' � ��-cx��, ��t(� � Packet Last Updated: January 2016 Page 22 ' PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS � �� , � �� Address: _ �(;� � �� Permit No.: G�� `�" Description of work: Date Rec'd: Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: c� - Date Approved: � �� Grading review by: Date Approved: . Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: � Yes 0 No Date of Survey: Revised date(?): Landscape plan submitted? � Yes 0 No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N E W ) ( N � E W ) Other Buildings Wetland Si �Side ; Defined Height: Peak Height: FE�J FFE minus 6 feet= (Existing Contour; Perimeter(linear feet) = 50%= L.F. below grade Basement? 0 Yes � No, Stories FOR A BUtLDING WITH A BASEMENT OR CRAWL SPACE: FO A BUILDING ON A SLAB FOUNDATION: The distance between the lo est proposed Slab at or above grade— START W ITH floor(of the basement or cr I space)and measure from hicahest existino the highest point of the ro . \\ START W ITH ra ade to the highest point of the roof even if fill was brought in to If you have a... '� elevate home. � SUBTRACTION • GABLE OR HI PED ROOF(no Slab below grade—measure (BASED ON windows): S tract half the distance from highest existing grade to the ROOF TYPE) between th highest point of the roof hi hest oint of the roof. to the low oint of the corresponding If you have a... gable or ipped roof SUBTRACTION ' GABLE OR HIPPED ROOF • GABL OR HIPPED ROOF(with (BASED ON (no windows): Subtract half wind s): Subtract half the distance ROOF TYPE) the distance between the be en the top of the highest highest point of the roof to wi ow and the highest point of the the low point of the r f corresponding gable or hipped roof • LL OTHER ROOF TYPES(flat, . GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION S tract the distance between the half the distance between (BASED ON b semenUcrawl space floor and the the top of the highest EXISTING ighest existing grade adjacent to the window and the highest GRADES) oundation OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined building helght subtraction. Defined building height EQUALS Updated: May 2016 z:\forms\plan review checklist 5-2016.docx Average Lakeshore Setback Shoreland District MCWD Permit Met? Bluff � Yes 0 No Permit Number: 0 Yes 0 No 0 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 0 No � Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Perm it Plan Review Z/' State Surcharge Investigation Fee i/� SAC—Number of SAC Units Other(specify) Square Foota e $ per Square Foota e ' Basement X = $ 1 S' Floor X = $ 2nd FIOOr X = $ Garage X = $ Estimated Construction Value: $ �-�� Orono Inspections Required Work Requiring Separate Permits � Footing 0 Site Plumbing 0 Grading/Filling ❑ Poured Wall � Silt Fence/Erosion Control Mechanical � Fire 0 Foundation Survey � Hardcover Removal � ireplace � Water Connection 0 Framing 0 Other(specify) 0 Masonry 0 Sewer Connection O Waterproofing/Drain tile 0 Mfg. � Lawn Irrigation � Foundation Waterproofing � Other(specify) � Landscaping ' Framing ° �Insulation 0 As-Built Survey Final � Lathe Required State Permits � Other(specify) � Well Electrical i ;: REMARKS (in-house): OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: 0 See Builder Acknowledgement Form 0 Prior to release of escrow money an as-built survey and hardcover calculaiions must be submitted and approved. Updated: May 2016 z:\forms\plan review checklist 5-2016.docx ♦ A � � I if � j� P � Re�riewe� far �� '" o►n tia de G��' " P nce Ci of O �(/� � rono � �� , � l R�vtewer __ _ � _ _ _ �� _ �� CI1P , � � �� i ��/ �� ' n �o�� t � � _ !I f��i `� Ne w � 6lv '�--� W'� '�"��°k�v�� <k�,►.•�),�q vF , _ � � r � S�F T�R __ _ ,, F FTY R S � - ,� e,��5�'"��'Ur � � RFQ�c�zi�qeF _ 9 � � V �RED N� LF� I _ ex�,o.,�— _ _ _ _ . . _ _ _.___ __ _... _ _ _ . __ _ .,___. _ __.._ �_ _ . _ _ __ _ _. __ __ _ _ _ i , • �rti��r ��t�� tui��a�tn�t�e�t� �� ` � . �t�. ��ar��e��t�ori� ,� �i�� I�i� i� #�a ��#i� t �# � � ► e , � � , I A 1 �''yE�.�� Metr�� . �� ti � , .. ; � �.« �� : b� on �� x��:��,�.�:�: - �„, b ,�� . 86,�'_ .SN qi.. .. �K "k ';t'. ,. .;�;:� ��^�.�. , �� has fulfilied th F �uiremen �� "� �'" �� Q �� ' ��rol Act(��1)Section 402, and has received certificat� n to condu�;lea�z� "�iat�, repair, ��t�aintingactivities pursuant � 'to40`�FR�a'rt 74��s � _ ..'J� �, 4 ~ . ��t�t��t��Yt �or�: yt All �PA Administered States, Tribes, and Territories This certification is valid from the date of issuance and expires February 11, 2020 NAT-F149975-1 �.�v Certification# Michelle Price, Chief � . January 28, 2015 Lead, Heavy Metals, and Inorganics Branch Issued On ��` � .. DATE TIME y CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. eWb'a"13�I COMPLETED 3' •/ ADDRESS �/�O 5v� �✓� /1F_ OWNER TELEPHONE NO. CONTRACTOR ,�-`+��o �'��- � DESCRIPTION �� /��'� T�� 1� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMINCa ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q �INAL ❑ WATER HOOK-UP �flLLOW-UP 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ ❑ SEPTICINSTALL � v ❑ DEMO-SITE 2 pyYNEpICpHTAACTOR TO MEEf Y�OU:_YES_NO y COMMENTS: � 'T�•s .a�.-.�.•� �%�e%9 0•� 9��-/G 6�. oll�la.-� L. �s.ccla-� .�u,,�•� �`��' -✓�'9Y3"' �. � � 0 W � Q � W � r � F'�n�� O WORK SATISFACTORY:PROCEED �ECT COMPLETE W O CORRECT WORK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOMERIN(i PERMANENT O CORRECT UNSAFE C�IDIl10N WITHIN HOl1RS• ❑pH0T0 TAKEN INSPECTOR WILL RETURN ❑qTAT10N ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANCiE ACCESS. CaN for the next inspection 24 hours M advance. (952) 249-4600 on site: � �nspectoe w�� wMta CoovAnweetor's RI� C�n�►Y CopYlSib Notia -� �- ✓ � TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED � -�� ' PERMIT NO. MPLET�D ADDRESS �� OWNER L HO O. ��—�7��7/ CONTRACTOR � V � DESCRIPTION y 4i ❑ FOOTING ❑ DEMO-FIN L ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING R ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ � ❑ DEMO-SITE ❑ SEPT�C INSTALL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � � ' J 0 � 0 � W � Q � W � w � � J a W� KSATISFACTORY:PROCEED ❑PROJECT COMPLETE W RECT VYORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COMERINCa PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR YVILL RETURN O STOP ORDEH POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. � Call for the next inspection 24 urs in adv �2 249-46�� OwneHContractor on site: Inspector: White Copyllnspector's File Cenary CopylSMe Notkx