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Home My WebLink About2016-00320 - addn/remodel/repair CITY OF ORONO * Z 0 1 6 - 0 PJ 3 2 0 * "� 2750 KELLEY PARKWAY DATE ISSUED: 04/06/2016 ' ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2112 SUGARWOOD DR Pliv : 34-118-23-21-0026 LEGAL DESC : SUGAR WOODS : LOT 007 BLOCK 004 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATIOI�i : $ 6,500.00 NOTE: DECK REPAIR APPLICANT PERMIT FEE SCHEDULE 154.85 PLAN REVIEW 100.65 JOHN HOLM CONSTRUCTION STATE SURCHARGE(VALUATION) 3.25 P.O.BOX 2182 MAPLE GROVE,MN 55311 TOTAL 258.75 (612)799-3390 Payment(s) Minnesota State License#: BUIL-9283 CHECK 6639 258.75 OWNER BERG, K&K 2112 SUGARWOOD DR LONG LAKE,MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according[o the approved plans and speci5cations,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. `�� j�-- � ' �p - I � � �1 � S L � �� lic t Permitee Signature Date Issued By Sign ure Date City of Orono �uilding Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) O Mailing Address: Permit number: ��o-DG�j J C�' � �O PO Box 66 ,/ \�,j Crystal Bay, MN 55323-0066 Date received: 7— �`�� a'� Street Address: Received by: � � 2750 Kelle Parkwa ti�. G� Y Y Plan review fee: t �, Orono, MN 55356 'kESHO� ' � Total Fee: � � � � - Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �'' _i �, This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: ^ /� Job Site Address: � � �� Q !� � L � � �/I/ Will this be a Parade of Homes, Remodelers howcase Home or other Display Home? Yes No If yes,a special event permit is required with Police Department and City Council approva160 days prior to the event. Shutt/e bus se ice will be required un/ess applicant demonstrates s�cient on-site parking is availab/e. Non-permitted events will not 6e allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ��,�-^� � �'j�Y��j�!�G, �� State License# ��po�Z�� Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) � 3 3 � (office) S�"r''l� Mailing Address: p � � � City: IP: '— Contact Person: Applicant is: Contrac or / omeowner (Circle One) Email and/or Fax: �`.�� -�.y�� -�,�� PROPERTY OWNER INFORMATION: Name: L �j Phone (day): ' .- Address: f�n/� � R-�c City: �� ZIP: Email and/or Fax: -� PROJECT INFORMATION: Overall pro�ect description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof,asphalt $(J Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ � APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • 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; • 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 ou refuse to su information, e a lication ma not be issued. ApplicanYs Signature� Date: ` '- �� Owner's Signature: Date: � � Last Updated:January 2015 �� / /— l C PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS � Address: � `� �U�r.lv� �/"�'a'd �/�!Vt('i Permit No.: Description of work: -.P P� ,�P�2[� Date Rec'd: Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: � Date Approved: "! 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: O Yes 0 No Date of Survey: Revised date ? : Landscape plan submitted? Yes � No Landscaper: Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( S E W ) Other Buildings Wetland Side Side Defined Height: Peak Hei ht: FF : FFE minus 6 feet= (Existing Contour) Perimeter(linear feet)= 50%= L.F. below grade Basement? 0 Yes � No, S ries FOR A BUILDING WITH A BASEMENT OR CRAWL SPAC : FOR A BUILDING ON A SLAB FOUNDATION: The distance between th lo est proposed Slab ffi or above grade— START WITH floor(of the basement or space)and measure from hi9hest existi�a the highest point of the ro . START W ITH rst ade to the highest pofnt of the. roof even if fill was brought in to If you have a... elevate home. SUBTRACTION • GABLE OR HIP ED R OF(no Slab below grade—measure (BASED ON windows): Su act half e distance from highest existing grade to the ROOF TYPE) between the ghest pofn of the roof hi hest oint of the roof. to the low p t of the co sponding If you have a... gable or hi ed roof SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE O HIPPED ROO with (BASED ON (no windows): Subtract half windows. Subtract half the istance ROOF TYPE) the distance between the betwee the top of the highes highest point of the roof to windo and the highest point the the low point of the roof corresponding gable or hipped roof . ALL THER ROOF TYPES(flat, • GABLE OR HIPPED ROOF m sard,etc):No subtraction. (with windows): Subtract SUBTRACTION SubVa the distance between the haK the distance between (BASED ON basem nUcrawl space floor and the the top of the highest EXISTING highe existing grade adjacent to the window and the highest GRADES) foun Uon OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS De ned bullding height subtraction. Deflned building height E�UALS Updated: October 2015 z:\forms\plan review checklist 10-2015. ocx Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? 0 Yes � No Permit Number: 0 Yes � No � N/A � Ye No � 0 N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circie one % and sf %and s 0 Yes � No � Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit tr Plan Review �/ State Surcharge (/ Investigation Fee t/' SAC—Number of SAC Units t/' Other(specify) V S uare Foota e $ er S uare Foota e Basement X = $ 1�Floor X = $ 2nd Floo� X = $ Garage X = $ / � �Estimated Construction Value: $ G�, �J � Orono Inspections Required Work Requiring Separate Permits � Footing � Site 0 Plumbing O Grading/Filling � Poured Wall � Silt Fence/Erosion Control 0 Mechanical 0 Fire � Foundation Survey 0 Hardcover Removal � Septic 0 Water Connection 0 Foundation Waterproofing 0 Other(specify) � Fireplace 0 Sewer Connection � Framing O Masonry O Lawn Irrigation 0 Insulation O Mfg. � Landscaping � As-Built Survey 0 Other(specify) Final 0 Lathe Required State Permits 0 Other(specify) 0 Well � Electrical 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 calculations must be submitted and approved. 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