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Home My WebLink About2016-00677 - addn/remodel/repair CITY OF ORONO * 2 0 1 6 — 0 0 6 7 7 * 2750 KELLEY PARKWAY DATE ISSUED: 06/16/2016 r . � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 115 SMITH AVE PIN : 02-117-23-21-0016 LEGAL DESC : ORONO ORCHARDS ' : LOT 063 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTNITY : 434-RESIDENT[AL VALUATION : $ 4,000.00 NOTE: SEPARATE PERMITS REQUIRED: YLUMBING,MECI�IANICAL,ELECTRICAL(STATE) BATH REMODEL APPLICANT PERMIT FEE SCHEDULE 108.38 STATE SURCHARGE(VALUATION) 2.00 RAM HOMES INC TOTAL 110.38 5524 DICKSON RD MINNETONKA,MN 55391- Payment(s) (612)239-5652 CREDIT CARD 3180 110.38 Minnesota State License#: BUIL-590103 OWNER MILLER,THOMAS 115 SMITH AVE 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,appiicable 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 t any time after work has commenced. The applicant is responsible for uring all required inspections are requested in conformance with e State Building Code.This permit may be revoked at any time for due use. 1�` 1 �l 1 r ( �? �� J�" l 1 �� l ( Ic.: �G Applicant Permitee Signature Date Issued B Signatu Date � CITY OF ORONO 'r, �/0. 3 � - BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �O� Mailing Address: Permit number. �._��-'/�-� �>�� O PO Box 66 Crystal Bay, MN 55323-006��+�` Date received: ��' ! `�—� So �; ,� �, Street Address:' � ;I � �' - y�, G� 2750 Kelley Parkway 1r�-� � I n review fee: �O — U � `qkESH�� Orono, MN 55356 ,� Main: 952-249-4600 Total Fee: !�� %' [�� Fax: 952-249-4616 �vev��.ci.orono.mn.us '' � � This application form must be completed in full and all required information must be submitted. Incomplete applications witl be returned. (Please print) GENERAL INFORMATION: Job Site Address: /is Sv�Z� I,�� o fz-c.�✓� 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. Shutt/e bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICAryT INFORMATION: Name: ��Nuw�c:S '�C State License# �. 5`��3 Expiration Date: 3 Zo r� Phone: (cell) (�iz-23g•,�,Sz (office) — Mailing Address: S�`� �� 2n Cit : ZIP: s53�t5 Contact Person: ►ML��c,� Applicant is: ontra / Homeowner (Circle One) Email and/or Fax: R��"�5�-►4 �I� C��^"I��.co� PROPERTY OWNER INFORMATIq,N: Name: �t.��ltL- ��C��►-� Phone (day): C,tZ- ti i`i -5�Z7 Address: /f5 S�ti(N �� City: ��''A ZIP: �533'i 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& 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 ❑ Other: (specify) `KF.f'�3C:L(�f�'(f� ❑ Multiple Family/Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater �Public Water "*Any earth movement may also require ❑ Commercial ❑ Storage MCWD review&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.minnehahacreek.or � Estimated Construction Valuation (excluding land) $ �� " Last Updated: January 2015 STRUCTURE INFORMATION: � 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction � � � a. Length(ft.)= Number of bedrooms= ,.,/ ❑ ood/F e ��C .� l �eG� „)� b.Width(ft.)= Number of garage stalls: ❑ son � Areas in s4uare feet° Attached = ❑ M tal �(�(� �� ❑ Pol Bldg. c. Basement= Detached = ❑ IC d. 15i Story = ❑ n-si Prefab e.2"d Story= ❑ ff-site refab f. YZ Story = Other(please specify): 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 Calculations 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 ❑ ❑ 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 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 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-built survey and all site improvements. ApplicanYs Signature: Date: �' «' ��' Owner's Signature: ,4w'G Date: �'��`��0 Last Updated: Janu 15 � l `{ �� i�"i% Revi d fior C�de � • 'Compiian CitY of Orono,; ,•_8. — r - . � --- �� i � :' I I N Date " I � �� Reviawer �� -- i I �` �`�� b r� �� ' �I ,� � j �� k�� , 3, o. /� �� 5.��r� �� , . 4�_�. � � �R��p�.� Shor�r O��o�s � �� z � �VG- BQsE � � � ,� ,,,;� �--7'r�� r�q��f 2�-�°� � � 2�►6 , � � �VG $asP _� _ ��g • � 9�� oN � �� l�vP�'� Yae \r,, � ��„o� �.,� � 3°. l ,� �a�P� ��e � f � �� ,�a � o � �� ° '�'O�/,�� 4'-3 1!2" ��alls ! \ � hatChed � Remove door, _ fili in wall I UP I i I��-° id�9 yf'�' `,�tD �r'�l°��/� ��' , �� °�` r��=��i Pr I �(,L=y.�� l h� ��, First Floor �____ _ , ��"4f/P!°� �J 1/4"=1'-0" Advanced Drafting and Bath R@f110d@I �Plan � Residential Design Inc 1146 Edgewater Ave Project number FAE-Powdert' Arden Hills,MN 55N2 �Date 3/9Y1015 B') � 651-341-79'17 '� adrd@comcastnat i !.Drawn by ____ sp j � j Checked by Checker;Scale 1/4'=T-0" ---� 3/9/2015 7:17:37 AM - --- —..._____-- _. __ ... -- . J � U/I�LL. �i/�f�iF�-1-k'�' �L� �1��' 1ri T--� ► v �- 1-`�Urv �' I Z � ( I�f � ��I Z�7 '� � i� S �� -t � � v ,� �� . ��v �Z� �e� M ath B I N G ►vame ,` r ._ Use integers be��re�r� -12 and 12. No free space. ' _. ,. �� . � �''� /,� � ,� �/ i ;' PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS / � � Addrpss: �r � �ZC � � Permit No.: Description of work: Date Rec'd: , Septic review by: � Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: l l� Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot C erage: SF % Survey Submitted: � Yes 0 N Date of Survey: Revised date ? : Landscape plan submitted? �Yes 0 No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N E W ) ( N S E W ) Other Buildings Wetland ide Side Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet)= 50°/ - L.F. below grade Basement? 0 Yes 0 No, Storie FOR A BUILDING WITH A BASEMENT OR CRAWL SPA : FOR A BUILDING ON A SLAB FOUNDATION: The distance between he lowest p posed Siab at or above grade— START WITH floor(of the basemen or crawl spac )and measure from hiahest existinq the highest point of t e roof. START WITH ��de to the highest point of the roof even if fill was brought in to elevate home. If you have a... SUBTRACTION • GABLE OR IPPED ROOF(no Slab below grade—measure (BASED ON windows): ubtract half the dis nce from highest exisUng grade to the ROOF TYPE) between t e highest point of the oof hi hest oint of the roof. to the low point of the correspond ng If you have a... gable or ipped roof SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE R HIPPED ROOF(with (BASED ON (no windows): Subtract half window ): Subtract half the distanpe ROOF TYPE) the distance between the betwee the top of the highest highest point of the roof to windo and the hi hest point of th� the low point of the 9 �i corresponding gable or roof hipped roof • ALL HER ROOF TYPES(flat, '� • GABLE OR HIPPED ROOF mans rd,etc):No subtraction. �� (with windows): Subtract SUBTRACTION Subtract th distance between the half the distance between (BASED ON basemenU rawl space floor and the the top of the highest EXISTING highest ex' ting grade adjacent to the window and the highest GRADES) foundation OR 10 feet(whichever is less). , point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined b ilding height subtraction. Deflned building height EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? 0 Yes 0 No Permit Number: 0 Yes O No 0 N/A � Ye No � 0 N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one %and s % and sf � Yes � No 0 Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Perm it Plan Review � State Surcharge � Investigation Fee �(/' SAC—Number of SAC Units � Other(specify) jj S uare Footage $ er S uare Foota e Basement X = $ 1� Floor X = $ 2nd FIOo� X = $ Garage X = $ �- Estimated Construction Value: $ �f',"�� Orono Inspections Required Work Requiring Separate Permits 0 Footing � Site �Plumbing 0 Grading/Filling 0 Poured Wall � Silt Fence/Erosion Control Mechanical 0 Fire � Foundation Survey � Hardcover Removal � Septic � Water Connection � Foundation Waterproofing � Other(specify) � Fireplace � Sewer Connection �Framing � Masonry 0 Lawn Irrigation 0 Insulation � Mfg. 0 Landscaping 0 As-Built Survey 0 Other(specify) Final � Lathe Required State Permits 0 Other(specify) � Well Electrical REMARKS (in-house): OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: � See Builder Acknowledgement Form 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 �•\fnrmclnlan ravic�iv ehocklic}1(1_9f11F�inev � c-=��- �b f � �. DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI E /` SCHEDULED __�/ " � ' _ � � �ERMIT NO. ` � V � COM�LETED ADDRESS l j c'• , �l OWNER TELEPHONE NO. � �� ✓e�j• CONTRACTOR ��l �� DESCRIPTION �r�"�` C '' ��nld t� ❑ FOOTING ❑ DEMO-FINAL SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q�AMING ❑ 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 _ J ❑ DEMO-SITE ❑ PTIC INSTALL � OWNERICONTRACTOR TO MEET YOU:�YES_NO / ✓` c�., COMMENTS: �f��' . R.� � � '/�7" lG � W a o �'✓�- -�o✓ �h rck.ts�c l� � � � �C✓ �0 lCi � � O � W � Q � 2 W � W � � d W�/�1Af9RFtSATiSFACTORY:PROCEED ❑ PROJECT COMPLEfE w��0 CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED_CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OwnerfContractor on site: � Inspector. te Copyllnspector's File Canary CopylSite Notice 1 - � S�- , DATE TIME� CITY OF ORONO CALLED IN 7 7,�� INSPECTIONNOTIC SCHEDULED � � �'-�� % PERMIT NO. �0��'��P77 COMP�.ETED ADDRESS ��S �!�- �,�_- OWNER TEr-�PHONE NO. �''��3 9�5�.$"-z- CONTRACTOR �"�Y1 �7; d� � DESCRIPTION T L�'t-� ��'� I�k�YL4� W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ 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 _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERfCONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: '� � � � o� a / � J 0 �. � O � - W � Q � � 2 w � W � J d W� ❑WORKSATISFACTORY:PROCEED OJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISS E CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED_CALL TO ARRANGE ACCESS. Call for the next inspection 24 hou in advance. 5 =4600 OwneNContractor on site: Inspector. White Copyflnspector's File Canary CopylSite Notice