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Home My WebLink About2017-00938 - addn/remodel/repair , , CITY OF ORONO * Z 0 1 7 - 0 0 9 3 8 * 2750 KELLEY PARKWAY DATE ISSUED: 08/16/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2450 SIXTH AVE N PIN : 28-118-23-41-0003 LEGAL DESC : WILLOW RUN : LOT 002 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 22,000.00 NOTE: SEPARATE PERMITS REQUIRED: FIREPLACE,ELECTRICAL(STATE) ALTERATION APPLICANT PERMIT FEE SCHEDULE 387.20 TAYLOR,JEFFREY PLAN REVIEW 251.68 2450 SIXTH AVE N STATE SURCHARGE(VALUATION) 11.00 LONG LAKE,MN 55356- TOTAL 649.88 Payment(s) CHECK 4030 649.88 OWNER TAYLOR,JEFFREY 2450 SIXTH AVE N LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which[his 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 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 conformance with the State Building Code.This permit may be revoked at any time for due cause. ` i � ,/ ` �G �� 1�� Applicant P itee Sign ture Date Issue y Signature Date , . C�ty o� �3�°dnQ Buiidin� �errnE� i4��catior� � , �� for �e�nr S�r�ct�res ar �4dditio�s �`��. Mailing Address: Q,�T PO Box 66 �ECEIVED Permit number: p�Q1 7�1Dci3g � �vQ �� Crystal Bay, MN 55323-0066 Date received: 8-g l 7 D StreetAddress:' AUG 0 9 2�17 Received by: „Sy� y , ,� 2750 Kelley Parkwa �v�L��.� `� L1 Orono, MN 5535��OF ORONO Plan review fee: l�kESHo��' Main: 952-249-4600 ---'��--=— - Total Fee: Q Fax: 952-249-461fi vw��.ci.orono.mn.us i This application form must be completed in fuli and ali required information must be submitted. Incomplete applications wiil be returned. (P/ease print) GENERAL INFORMATION: Job Site Address: �ys�- ��,;�-�,� � .��` ��,�� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If yes,a specia/event permit is required wkh Police Department and City Council approval 60 days prior to the evenf. Shuttle bus service wil/be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted evenfs will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �C:�' i„� I E r-. State License# , Expiration Date: . Phone: cell �1c3 �5� 3t (office) Mailing Address: �� X-rh ,�� ,,,� �` Cit : ;�,^G ZIP:�5�s Contact Person: <� � �- „ �-2 Z�j Applicant is: Contractor / meowner (Circle One) Email and/or Fax: S �7/ PROPERTY OWNER INFORMATION: Name: ;fi��{� 1��r 1 a� Phane(daY)� 7�� 3S 5 y��f Address: �.�{S� � r,ct� --��cn�a.� �o� -r � City �;r ,,�� ZIP s 5�,�� Email and/or Fax . ARCHITECT/ENGINEER INFORMATION: Name: Phone(day): Address: C��,. Z�P. Email and/or Fax: ARCHITECT/ ENGINEER INFORMATION: Name: Phone(day): Address: City: Z�p• Email and/or Fax: PROJECT INFORMATION: Descri tion of pro'ect: 1.Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal 8 ❑ New Construction [�Single Family with ❑ Accessory Bldg./Garage Water Supply ❑Addition attached garage ❑ Deck ❑Accessory Building ❑ Single Family with ❑ Office/Commercial � Public Sewer � Relocation detached garage ❑ Residence [�"5eptic ❑Other.(specify) ��`�T��.�.� ❑ Multiple Family 1 Condo ❑ Re#aining 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: (specify) ❑ Other(speCify) 15320 Minnetonka Blvd;Minnetonka,MN 55345 Cl IT�'�Tc-'-� [�rivate Well Phone: 952-471-0590 / Fax: 952-471-0682 ' www.minnehahacxeekofo Estimated Construction Valuation {excluding land) $ ��,�, Packet Last Updated: January 2016 PanP 91 STRUCTURE INFORIV�ATION: 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 sauare feet Attached= c. Basement= Detached = 4. Type of Construcion: d. 1b'Story = e. 2nd Story= 5. Code Edition: f. '/�Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed licable ❑ O 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%s x 11 set p ❑ Minnesota State Ene Code Calculations and Mechanical Code Re uirements ❑ ❑ Surve —2 full size,to scale meetin ALL suive 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 ❑ ❑ Landsca Wal1s and/or Retainin Wall Plans ❑ O Landsca e Plan ❑ ❑ Stormwater Pollution Prevention Plan SWPPP ❑ ❑ Access Permit p ❑ Data Privac Adviso Form APPLICANTIOWNER 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 5500; . Certifies that tne 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 altemative 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 ttme the Certif�cate of Occupancy Is requested, a temporary Certificate of Occupancy may be issued upon receipt of a 510,000 escrow to ensure completion of the as-bullt survey and all site improvements. Applicant's Signature. � Date:�_"� C� � �� Owner's Signature: Date: Packet Last Updated: January 2016 Page 22 , , PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: z�5 lJ S, X'�� , ,%� Permit No.: ��"��.� CL-� Description of work: Date Rec'd: Septic review by: Date Approved: Zoning review by: ,N Date Approved: Building review by: Date Approved: � `� � Grading review by: Date Approved: Zoning District: Zoning File#: Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution /NA Zoning: Lot Area: SF/AC Width: Structural Coverage: SF % Survey Submitted: 0 Yes � No Date of Survey: Revised date(?): Landscape plan submitted? 0 Yes Landscaper: 0 No/ None proposed Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Buildinq Heiqht Analvsis: Distance Between First Floor and defined Top of �a� � Roo�` See "buildin hei hY' definition : First Floor Elevation from buildin lans : (b) Highest Existing ground level (per survey) or 10' �� above lowest round level, whichever is lower: Difference between b and c : (d) DEFINED HEIGHT If highest existing grade is: �e) above FFE-Height is(a)-(d) below FFE-Height is(a)+(d) Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? Permit Number: � Yes � No � N/A 0 Yes 0 � Yes � No No � N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and s %and s 0 Yes 0 No � Yes � No 1 2 3 4 5 Type(s): Type(s): Updated: October 2016 v:\forms�plan review checklist 10-2016.docx Fees to be Char ed YES NO Permit Plan Review State Surcharge Investigation Fee SAC—Number of SAC Units Other(specify) S uare Foota e $ er S uare Foota e Basement X = $ 1 S' Floor X = $ 2nd FlOOr X = $ Garage X = $ -� �n d Estimated Construction Value: $ �G,� V'�� Orono Inspections Required Work Requiring Separate Permits 0 Footing � Site 0 Plumbing � Grading/Filling 0 Poured Wall � Silt Fence/Erosion Control � Mechanical � Fire 0 Foundation Survey � Hardcover Removal Fireplace � Water Connection 0 Framing � Other(specify) � Masonry 0 Sewer Connection � Waterproofing/Drain tile �Mfg. � Lawn Irrigation � Foundation Waterproofing 0 Other(specify) � Landscaping Framing Insulation 0 As-Built Survey Final 0 Lathe Required State Permits � Other(specify) � Well Electrical REMARKS (in-house): OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: 0 See Builder Acknowledgement Form � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2016 v:\forms�plan review checklist 10-2016.docx Reviewed far G��90 � '' Compiiance Ciiy of OrottO ; ; � ��61�0 C�� ` � Date � l �' � Reviewer �' � � �oJ?�. __._._. ___..._.._.�.._...�._..�.._.__._. �___ � __ � . .�.�.� �__.._� � 4 ` � * � S '`O�Q�O 5 � -__ � I ' + ` . t �(��Q � � I � { ��'!��'� i � � � o�Q� " _ f - /A �oQ.��i. ` �..� _ -�-�- ` ��, c� o ' ��(�� __. , � , � �� O J��,�P� �`� � ` � � � 0�'� \�C� .v..: ._._..�_.1.�. � . � ��`�� .� - � ` � _r , �-�� ( - _ _ ,-. , � i ___ - - - - ` � t . ' � , _�._...�_-- - — � � � l ; t�g ��;� � ; � � . , � �, � �-�� '�c� (er t -;,- •: �-.� �.. �'� ' _ � 1 � , y ��s� �� .�� . � RECEIVE AUG 9 2U1 CITY OF ORONO � . 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(952) 249-4600 owner�contrector on site: ��7ti' - � ��-- �E CfTY OF ORONO �� Cq��Ep�N � %' E/� INSPECTION C ��HEDULED ��-(� - / —L�S.L PERMff NO. ' co ETED• -, ADDRESS � OWNER nTELEPHONE NO. � � �I`J� CONTRACTOR � '' DESCRIPTION -✓ � j��'�� `��'n�� 4�j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING �O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q�RAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ? O'WNERICONTMCTOR TO MEET Y�OU:_YES_NO � COMMENTS: �12G- 2Z " GI' � �� 'rOrw•a� �a✓ � 1.��ti/,t9ac.� ` OB� .o�n ' o ' L-L• /�'�µ- �✓ F •P• y yte�..� w �,.irb�s ' � � nGr ,��n - 0 W � Q 61� -td ��,K us — � z � W � j W�K SATISFACTORY:PROCEED ❑PROJECT COMPLEfE � ❑CORRECT WORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORE Cd1/ERING PERMANENT O CORRECTUNSAFECONDITIONWITHIN HOURS. O PMOTOTAKEN INSPECTOR WILL REfURN � ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Call ror the next inspection 2a hours in advance. (952) 249-4600 OvmerlContractor on site: Inspector: w WhiM CopyAnspeetor's Flle C�nary CopylSfte Notks //�� / \\ SFfD // \ / � ---14=8•-- �6 (1033.8) � � \ (1033.1) � _,, (1034.2y/ � I---.-- I / ( � / (1033.1) \\ I I w � � SEPTIC � � � c,o3�.e� \\ � SITE i i p 1 c,o�.s, I—_-- I o c,o3z�) ' —— N � � (��05� I, �.J� PAVFFRS I + � � � � (1033.1) ELEC.��E 3.0) (�o�a) (io�) (�o�.$) rosT ' �------_, --� � � ��o.�.s ��-� J�/ 1936.5 103�4,$j'-�.� � f 30.3 � GARAGE � °' FLOORa i.4) m � (1036.4) ,Nrn (10345) I -i (10332) (10383) 24 + o (10348) GRAVEL ` � �� DRIVEWAY o N ��ooR� • �o�.$) (�03+.�) /. I = N �,o3s.s� EXI.STING ,s.s /. I � u (103Z8)�� 320 9•� ................5oa. �2450 •-- -----.........----------._...•---------••-----•---�---------.._..-----....---------•----._......._._...---•- �(1036.6) m � �� 139.5 � �� 77.3 �, o b 132 5.4 134•t ....-----•-----•- � •---------------•----•----._....---..._..-•-/•------•-._..._.._..._._..__.....---•---•-----• (1036.5) (1038.1) �5.7_.�1034.4) / (,�-5-) � � � (1033.1) / (1034.3) � �g� �iTr_��CcF,� (10322)/ �1� , �E;t.c��c�,'� / I (1033.4) / i / (3�31.4)! (1033.3) % (1033.7) /' /' � �' ELEC. ��' �BOX (1032.4� BOX � / o � � '/ � ,� (10329)� ' / EDGE OF ' , o LOW GROUND� N � �Y v w � � � o � N � � � ' � � � (1032.3)' C \� � � � � I a � � : �J ,,� � RECEIVED AUG 0 9 2U17 CITY OF ORONO ,..,,..,.