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Home My WebLink About2017-01169 - addn/remodel/repair � . CITY OF ORONO * 2 0 1 7 - 0 1 1 6 9 * 2750 KELLEY PARKWAY DATE ISSUED: 10/06/2017 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1980 SPATES AVE PIN : 10-117-23-42-0021 LEGAL DESC : TOURGANEAU ADDN : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVTTY : 434-RESIDENTIAL VALUATION : $ 6,979.50 NOTE: SEPARATE PERMITS REQUIRED:MECHANIGAL, ELECTRICAL(STATE) FINISH ATTIGGARAGE APPLICANT PERMIT FEE SCHEDULE 154.85 PLAN REVIEW 100.65 CREAR,MR.&MRS. STATE SURCHARGE(VALUATION) 3.49 1980 SPATES AVE WAYZATA,MN 55391- TOTAL 258.99 Payment(s) CHECK 5567 258.99 OWNER CREAR,MR.&MRS. 1980 SPATES 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,applicable City 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 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 applican 's responsible for ng all required inspections are requested' nformance wi e at uilding Code.This permit may be revoke at y ' e fo ue use. � /U� � �/� pplic ee Signature D e Issu By Signature Date . ` Ci�y of �ro�� uiidin� P�rr��t i4p��cation for �evv �tre�c�ur�s or �da�t��s Mailing Address: �o�j PO Box 66 Permit number: v�D/�7-U/l(p� Q Crystal Bay, MN 55323-0066 Date received: �-,�(�i�`--f�� StreetAddress:' Received by: j�� y� ��C' 2750 Kelley Parlcway � Plan review fee: �,�kEs�o�`�,L Orono, MN 55356 /1� �� Main: 952-249-4600 v"- Cj(�,� Totai Fee: �� 9 Fax: 952-249-4616 wwu,�.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. Incomplete applications wiil be returned. (P/ease print) GENERAL INFORMATION: _ __ �` � ' '' � . � � �-, � I.: _ � Job Site Address: � � . � ,- . -, , ` , �r , ,: � �-��_�_ � ,�J `�(,�1�.� �j 7/ Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes - No /f yes,a specia/event pe�mit is required wkh Police Department and City Counci/approval 60 days prior to the event. Shutt/e bus service will be required unless applicant demonstrates sufficient on-s/te parking is evailab/e. Non�ermitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: State License # Expiration Date: _ Phone: cell (office) Mailing Address: Cit : Z�p: Contact Person: Applicant is: Contractor / Homeowner Email and/or Fax: fc�►�ie o�e� PROPERTY OWNER INFORMATION: � /��J Name: -/'✓��L�%��Z ��-��`1�-- Phone(day): � '7� Address: l ` _'L� �i -' � Ci :�G'%"� � ZIP: � ��/ Email and/or Fax -`� y ; ,.— ��s�._e� r- `7 < :C�,, ARCHITECT/ENGINEER INFORMATION: Name: Phone(day): Address: Cit : ZIP: Email and/or Fax: ARCHITECT/ENGINEER INFORMATION: Name: Phone{day): Address: Cit : Z�p. Email and/or Fax: PROJECT INFORMATION: Descri tion of ro'ect: 1.Type of ProJect 2. Proposed Use 3. Structure T e Yp 4.Sewage Disposal& ❑ New Construction Water Supply ❑ Single Family with ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck ❑Accessory Building ❑ Sin le Famil with ❑ Public Sewer � Relocation g Y ❑ Office/Commercial detached garage ❑ Residence Q Septic ��Other.(specify) �li�'I Sh� /�"j)�_. � 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 8 permits. ❑ Industrial ❑Warehouse Minnehaha Creek Watershed District(MCWD) ❑ PubliC Water 15320 Minnetonka Blvd;Minnetonka,MN 55345 ��(�, er. (SpeCi ) � ; O�he�(speCify Phone: 952-471-0590 / Fax: 952-471-0682 f""' —/ C� '" '— -- �"��"� ❑ Private Well www.minnehahacreelc.ora Estimated Construction Valuation (excluding land) $ -,� ; �:Z �, � Packet Last Updated: January 2016 Pa.qe 21 STRUCTURE IPlFORA��TIOH: 1. Structure Dimensfons 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. 1s'Story = 5. Code Edition: e.2nd Story= f. '/�Story = g.Totai Area= REQUIRED SUBMITTALS: A11 of the information must be submitted in order for our application to be processed: Not Enclosed A 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'/�x 11 set ❑ ❑ Minnesota State Ener Code Catculations and Mechanical Code Re uirements p p 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 ❑ ❑ Landsca e Plan ❑ ❑ Stormwater Pollution Prevention Plan SWPPP ❑ ❑ Access Permit ❑ ❑ Data Privac Adviso Form APPLICANT/OMINER ACKNOWLEDGEMENT: . Agrees to provide all information required or requested by the Building Department; . Agrees to pay the City of Orono for engineering consultant revfew 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 comptetion of an as-built survey at the tfine the Certificate of Occupancy is requested, a temporary Certiflcate of Occupancy may be Issued upon recefpt of a 510,000 escraw to ensure completion of the as-bu(It survey and all site improvements. �� ApplicanYs Signature: Date: ,.- ' , �';,.-� C.. ,�z� -J '` Date: �wner's Signature: �� , -�-. Packet Last Updated: January 2016 Page 22 . • � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: ( l l3s� , �,0(iL��5 �`i'1/`� Permit No.: Description of work: Date Rec'd: , Septic review by: Gf/ e� Date Approved: Zoning review by: Date Approved: Building review by: Date Approved:_ Z Grading review by: Date Approved: Zoning District: Zoning File#: Resolution? Yes Reso#: Reso Date: Signed: es No Resolution/NA Zoning: Lot Area: SF/ C Width: Stru ral Coverage: SF % Survey Submitted: � Yes No Date of Survey: Revised date ? : Landscape plan submitted? � Yes andscaper: � No/None proposed Pro osed Setbacks: Front(Lake) Rear(Street) ( S E W ) ( S E W ) Other Buildings Wetland Side Side Buildin Hei ht Anal sis: Distance Between First Floor and defined p of Ro f*(See"building heighY' �a� � definition : First Floor Elevation from buildin lans : (b) Highest Existing ground level (per survey) or 1 ' above lowest ground level, �� whichever is lower: Difference between b and c *: (d) DEFINED HEIGHT *!f highest existing adjacent grade is above FE-Height i (a)-(d): (e) *If hi hest existin ad'acent rade is below FE-Hei ht is a + d Shoreland District MCW Permit Average Lakeshore Setback gluff Met? 0 Yes � No Permit Number� 0 Yes � No 0 N/A � Yes � No � N/A—see ttached Setback: Stormwater Quality xisting Propose Overlay District Tier ardcover Hardcove Variance Required CUP Required circle one % and s % and s , 0 Yes � No � Yes 0 No 1 2 3 4 5 � Type(s): Type(s): Updated: June 2017 z:\forms\plan review checklist 06-2017.docx . Fees to be Char ed YES NO Permit ✓' Plan Review [/` State Surcharge (/� Investigation Fee SAC—(dumber o#SAC Units � Other(specify) t� S uare Foota e $ er S uare Foota e Basement X = $ 1�' Floor X = $ 2nd FI00� �.j X � i J�' _ $ Garage X = $ Estimated Construction Value: $ �� 7 7� �J� Orono Inspections Required Work Requiring Separate Permits � Footing � Site � Plumbing � Grading/Filling 0 Poured Wall � Silt Fence/Erosion Controi Mechanicai � Fire 0 Foundation Survey � Hardcover Removal 0 Fireplace 0 Water Connection 0 Framing � Other(specify) � Masonry � Sewer Connection 0 Waterproofing/Drain tile � Mfg. � Lawn Irrigation 0 Foundation Waterproofing 0 Other(specify) � Landscaping �Framing � Septic � Insulation 0 As-Built Survey Final 0 Lathe Required State Permits � Other(specify) 0 Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: � See Builder Acknowledgement Form � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. 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Cpen guardrails must have in'.ermediate rai�s or an cmamentai pa;tern so that a sphere 4" in di�meter cannot pass through. - � / � � � �/ � blT� � TIME V CITY OF ORONO CALLED IN � INSPECTION N�O,�,IC SCHEDULED D 3:a� PERMIT NO.� -dll � COMPLETED ADDRESS l �� i1 �.U-�- � - �I-7 OWNER � TELEPHONE NO. � CONTRACTOR � DESCRIPTION (�LL,S(��- ly ❑ 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 � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP �4 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNER/CONTFiACTOR TO MEET YOU:_YES_NO v�, COMMENTS: a� a %".�-l��V� ,r��vb/-� Ua T�r ��r�",�� r_ o "� c-G r� -� � G P ��o�e'e /-_ � G u c-+G�"-�4c� �'o v � c�t � Pi� 'tU/�fl. c}�� -+�i��'�.` Q �� J�v L �vti � ��/''OG�/��t G-�`�G 1��v��"/��%U' h � W � j d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE ��O CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑�GORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECOND�TIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED O INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-460� OwnedContractor on ' e: Inspector. o� �fc�f' � White Copylinspector's Ffle Canary Copy/Site Notice �� o�re nME ✓ CITY OF ORONO cnLLED IN INSPECTION OTICE BCHEDULED ��-.- _ZZ• �� PERMIT NO. � COMPLETED ADDRESS pMINER TELEPHONE NO.�I o1�J�I'�G� CONTRACTOR / � � DESCRIPTION � ly ❑ FOOTING ❑ DEMO-FINA ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAVK3RADIN(3/FIWN(i O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI � SITE INSPECTION Q � FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNERIFIREPLACE ❑COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 41 ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL _ v ❑ DEA�-SITE ❑ SEPTIC INSTALL ? O�WNEItlCONTRACTOR TO MEET 1f�U:_Y88._NO ' � COMME� �/ec. ��1Q��c> rb� �c�'3�X'�G � n r - o ► Alte� Q ►•.��,� 7� �:� '' �r ,c� .P�vr � a,Lt Gf �- ° �a /� �a�' r G►vl��c�i o,�, W � � 2 ��/�s l�� !��5 � 1`l�✓'�►- `��e� ` � O� �a fr1�aL� -� Gb .�o� �o��i � rI e(,v �i�`4N'LGKI ` � W ❑WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE � ❑OORRECT WOFiK a PROCEED O ISSUE CERTIFK'.ATE OF OOCl1P11NCY o �OOqqECT WORK,CALL FOR REINSPECTION TEMPORARY �j� �EFORECOVERIN� PEqMANBVT ❑pORRECTUN3AFECONO1T10N WITHIN �1�• O PHOTOTAKEN INSPECTOR WILL RETURN ❑8TOP ORDER P08TED.CAI.L INSPECTOR ❑CITATION ISSUED ❑INSPECTION REDUIRED.CALL TO ARFiANOE ACCESS. csN br u�e next r��apect�o�2�nours M edve�o.. (952) 249-4600 on sitg: Inspector•G�-/�- � Whib CaPYn��+FlN Camry Co�NMk�