HomeMy WebLinkAbout2014-01269 - addn/remodel/repair CITY OF ORONO * Z 0 1 4 - 0 1 Z 6 9 *
2750 KELLEY PARKWAY DATE ISSUED: 10/3U2014
ORONO, MN 55356-
(952) 249-4600 FAX: 952) 249-4616
ADDRESS : 3160 SUSSEX RD
PIN : 04-117-23-32-0008
LEGAL DESC : FOX BEND
: LOT 002 BLOCK 001
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTTON TYP : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 9,000.00
NOTE: EXTEND EXIST G DECK
A PLICANT PERMIT FEE SCHEDULE 177.00
JLF HOMES,LLC PLAN REVIEW 115.05
1452 INDUSTRIAL BLV .- SUITE STATE SURCHARGE(VALUATION) 4.50
MAPLE PLAIN,MN 553 9 TOTAL 296.55
(763)479-0795 Payment(s)
Minnesota State License : BUIL-20521437 CHECK 8522 296.55
WNER
CHENITZ,RICHARD& ATRICIA
3160 SUSSEX RD
LONG LAKE,MN 5535
AGREEMENT A D SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specific tions,applicable City approvals,and the
State Building Code. This pe it is for only the work described and does
not grant permission for additi al or related work which requires sepazate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether r not specified herein.This permit will
expire and become null and voi if construction authorized is not
commenced within 180 days of he date of issuance,or if construction is
suspended for a period of 180 ys at any time after work has commenced.
The applicant is responsible for assuring all re �red inspections are
requested in conformance with he State Buil Code.This permit may be
revoked at any time for due ca e.
� /� ,t31 �/
Applicaitt�Pe 'ee ignat e Date Issue y Signature Date
City of Orono a��'���°��
Building Permit Application oc� 2 9 2��4
for New Structures or Additions c�n c�= �t �:. �._
Mailing Address:
O�r PO Box 66 Permit number: O�� —�/02. 9
`w0 Crystal Bay, MN 55323-0066 Date received: O
StreetAddress:' Received by:
y ,� 2750 Kelley Parkway Plan review fee:
�' c,` Orono, MN 55356
�'� ESHO�� Main: 952-259-4600 Total Fee: �9(j>� �
Fax: 952-249-4616 vrs;��v �i or�r� m�� �_is Y"
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (P/ease print)
GE ERAL INFORMATION:
Job Site Address: .s��� ��S-��X I��
Will his 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. Shuttle bus service will be
requi d unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CO TRACTOR/APPLICANT INFORMATION:
Nam : �"l.t= lfo�-..�r c, �C
Stat License# (��- - ��5 a� y3 7 Expiration Date: 3 - �� ����.��-
Pho e: cell /�Z - go .- �vr� office
Maili g Address: � siy.s- 1'1 �s��,�� �l i .. City:Muy/-z �a.� ZIP: �s3 ��
Cont ct Person: �c�� I= l�e Applicant is: eAtra� / Homeowner (Circle One)
Ema I and/or Fax: '• v� � ; L� o��f,�c„-.
��
PRO ERTY OWNE INF RMATION:
Nam : l�; � �c ti�y c �r �.,�Z
Pho e (day):
Addr ss: 3l�O S';,1Jz�c f City: O!'6.�cr Nt�vZIP:
Ema I and/or Fax
ARC ITECT/ENGINEE INFORMATION:
Nam :
Pho e (day):
Addr ss: — � City: ZIP: _ _
Ema I and/or Fax:
PR JECT INFORMATION: Description of project:
1.Ty e of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal &
Water Supply
❑ N w Construction ❑ Single Family with ❑ Residence
❑A dition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer
❑A cessory Building ��;s���y ❑ Single Family with � Deck
❑ R location � detached garage ❑ Office/Commercial ❑ Private Sewer
�Ot er: (specify) �XS�'�� (���a'�� ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
''*An earth movement may require ❑ Commercial ❑ Other(specify)
MC review&permits. ❑ Industrial ❑ Private Well
Minne aha Creek Watershed District(MCWD) ❑ Other: (Specify)
18202 Minnetonka Blvd
Deep aven, MN 55391
Phon : 952-471-0590
Fax: 52-471-0682
www. innehahacreek.or
Esti ated Construction Valuation (excluding land) $
Packet Last Updated. 04/19/2013
Page 22 of 23
^
STRUCTURE INFORMATION:
1. Structure Dimensions 1. Structure Dimensions (continued) 2.Type of Construction
a. Length (ft.)= Number of bedrooms=
❑Wood/Frame
b.Width (ft.)= Number of garage stalls: ❑ Masonry
Areas in square feet Attached = ❑ Metal
❑ Pole Bldg.
c. Basement= Detached= ❑ ICF
d. 15`Story = ❑ On-site Prefab
e. 2"d Story= ❑ Off-site Prefab
f. '/2 Story = a ❑ Other(please specify):
g.Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
N ot
Enclosed A licable
❑ ❑ Permit A lication
❑ ❑ Pro osed Buildin Plans
❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
❑ ❑ Surve meetin all re uirements
❑ ❑ Stormwater Pollution Prevention Plan
❑ ❑ Hardcover Calculation s
❑ ❑ Se tic S stem Site Evaluation Re ort
❑ ❑ Access Permit
❑ ❑ Wetland Buffer Im rovement Plan
❑ ❑ En ineered Plans for Retainin Walls 4 feet or above
O ❑ Minnehaha Creek Watershed District Permit s
❑ ❑ Plan Review Fee
❑ ❑ Other:
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 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 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: Date:
Packet Last Updated: 04/19/2013
Page 23 of 23
I
PLAN REVIEW CHECFCLIST FOR NEW STRUCTURES / ADDITIONS
Ad ress/Permit Number: 316C'� .�.�SS� �C
D cription of work: �tr3�'�Ir�- 1�-�1!��/�- '}' Z � 1.''�'1�-.'�� o^�
Septic review by: -� Date Approved: �� ' � � ` /y
Zoning review by: . (' • Date Approved: i v •3 �-- I �1
Building review by: Date Approved: 1 c�-3 d -1!�_
Grading review by: �N //� Date Approved:
Zo ing District: r/`.C. Zoning File#: Reso#: Reso Date:
Zo ing: Lot Area: r''.Cr . SF/AC Width: Lot Coverage: SF _%
Su ey Submitted: �1 Yes 0 No Date of Survey: Z•Z?- �2 Revised date(?): Y-1 t- �2-
Pr osed Setbacks:
ront(Lake) Rear(Street) ( N S � W ) ( N S E W� Other Buildings Wetland
Si Side
�3S r Zbo ' �' 93 �lo ,4�-r�a��� i �o �+
De ined Height: N �(4 Peak Height: � FFE: -" FFE minus 6 feet= � (Existing ntour)
Pe imeter(linear feet)_ — 50%_ #of Stories Ok? 0 YES
FO A BUILDING WITH A BASEMENT OR CRAWL SPACE:
The distance between the lowest FOR A BUILDING ON A S OUNDATION:
S WITH proposed floor(of the basement or crawl
space)and the highest point of the roof. STA �H The distance between the top of slab and
If you have a... the highest point of the roof.
If you have a...
GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no
'ndows): Subtract half the windows): Subtract half the distance
di ce between the highest point between the highest point of the rooi
of the to the low point of the to the low point of the corresponding
SUBTRACTION correspondi able or hipped roof SUBTRACTION gable or hipped roof
(BASED ON ROOF . GABLE OR HIPP OOF( ' (BASED ON . GABLE OR HIPPED ROOF(with
TMPE) windows): Subtract hal ROOF TYPE) windows): Subtract half the d(stance
distance between th of th between the top of the highest
highest window the highest window and the highest point of the
point of th f roof
• ALL ER ROOF TYPES(flat,
. ALL OTHER ROOF TYPES(flat,
nsard,etc):No subtraction. mansard,etc:No subtraction.
ADDITION Add the distance between the top of slab
SUBTRACTION ,SUbtract the distance between the BASED ON and the highest existing grade adjacent to
(BASED ON EXIST)NG basemenUcrawl space floor and the E ING the foundation.
GRADES) ,' highest existing grade adjacent to the GRAD
foundation OR 10 feet(whichever is less). EQUALS Defined building height
EQU Defned building height
Shoreland District MCWD Permit Received Avera e Lakeshore Setback Met? Blu
0 Yes � No �' N/A G Yes �No
� Yes � No � Yes � No �N/A
Permit Number: Setback:
Stormwater Quality Existing Proposed Variance Required CUP Required
Overla District Tier Hardcover Hardcover
� Yes No 0 Yes No
1�'�/�- � Type(s): Type(s):
Up ated: January 2013
v:\f rms\plan review checkiist 2013.docx
REMARKS (in-house):
Fees to be Cha ed YE NO
���[F .�»�$ j � { 4,... � �k .� ''L+�' ' `"4ta :a..�.M' x�,. ��'ra� a (%t����� f �.
,.},i
Plan Revlew
•7Li�jiO����� � kr; a � i y� �:A���a'�b �. � r �� riy'. T ��, i��Q,� �r '�3� yw') ��(J�,.�.:
k N"..b.M, )@L.� �it� �'��L<fi^� � .�f � ..'S .1��'cr.4 ���'aTSA-L`�s�t ��33e�'M��'�# ,f•n,�Z`k�i�����Ai,.�
investigation Fee
�^� :`�^ � �C ,*�,.'{�' ^xt�r'4�'�*h#� Yk :�s�i�' .
;.',:k��bzkk..>+:::v,ro�����1it���y, �'a*�'.:� ,5.��.'.3s�r��", g ;ti�a,v'"^���� '�'j�j�.� r�"•;r.��,^!.�,�''���''..,:
Other(specify)
S uare Foota e a er S uare Foota e
Basement X = $
1 St Floor X = $
Znd Floo� X = $
Garage X = $
Estimated Construction Value: $ 9�D�� �`s'
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site 0 Plumbing 0 Grading/Filling � Well
0 Hardcover Removal 0 Mechanical 0 Fire 0 Electrical
0 Footing 0 Septic � Water Connection
O Poured Wall � Fireplace 0 Sewer Connection
� Foundation Survey � Masonry 0 Lawn Irrigation
�adon Rock Bed 0 Mfg.
Framing � Other(specify)
0 Insulation
0 �ys-Built Survey
T�inal
� Wetland Buffer
� Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: � YES 0 NO New: � YES � NO
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED
Updated: January 2013
v:\forms�plan review checklist 2013.docx
DATE TIME ,/
CITY OF ORONO CALLED IN �
INSPECTION NOTICE SCHEDULED
PERMIT N0.�1�1�� COMPLEfED _ ��/
ADDRESS ��� ����'`
OWNER TELEPHONE NO.
CONTRACTOR `�L � ��
� DESCRIPTION ��''� �,'�a�� �'e a '
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 (�GERAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
��'FINAL ❑ WATER HOOK-UP /�,FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
� ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 pyyNEpICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:�`•���•� �r•/e,9 7� G'c<< ��� _
� �-`KeG /� c��a:�. '
o�
o �Q P�u�,r�� �C'•r�,r�rs �'6� s,s�•�ioEstr - �m ♦ "D:c
� (� Pror�d� �►�r�� a i M•.:, 3 � .r�.lr � �� .i'�r�'r�__�
°° �� P«rie� ��t' r�s��s ow. .�s.:-.s w'Q� 7�s.' r�
W /���`"�- / �o/e r•��r �. a I� �a
� W/��1 /v /b �l A�/1 �7����/ ' �!�'��s �1 T y"�r a�L�C-
Q �
2 (�� �a�it,,��r,s3 � ,�o r ,3�„t,�,f �.G�.weR•s-'�. '
W�,j"> /"/?S!i/�e /A*0 6 d !�b . .� t/l
� �i r�� �t e�/t ,!'a� 1y� .,..sa � .
j
� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
❑CORRECT YYORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O�RRECT WORK�LL FOR REINSPECTION TEMPORARY
V �O fC PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p p f{pT0 TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952) 249-4600
pwner�Contractor on site:
Inspect �
White CopYfl�sPe�tor'a File C�nary CoPYlSke Notiee
DATE TI E
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.�G`l��/-biad� COMPLEfED % `
ADDRESS 3/6 U slC�S S ek ��.
OWNER TELEPHONE NO.
CONTRACTOR �L-� ��e 5�
� DESCRIPTION � p p ` r� �
t~y ❑ FOOTING � ������DEM - IIQAE� ,fi ❑ 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 ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q �AL ❑ WATER HOOK-UP OLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTAACTOR TO MEET YOU:_YES_NO
y COMMENTS:
� �di�'l" �io` s .p/"Ol'//!OQ/l �'
j
� O/�/C'� i�'yl ��
�
0
�
W
� ,
Q
z ✓.�1��- �'•7.C�c�
W
�
W
aC
�
W ❑WORK SATISFACTORY:PROCEED OJECT COMPLE?E
� ❑CORRECT VYORK 8 PROCEED ❑ISSUE ERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
�CORRECT UNSAFE CONDITION WRHIN HOURS. p pHOTO TAKEN
INSPECTOR WFLL RETURN
❑STOPORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
Ca�1 for the next inspection 24 hours in advance. (952) 249-4600
OMrneHContractor on site:
Inspector. ^�"'
White CopyAnspector'a Flle Canary CopylSite Noties
Established in 1962 62115
VEYS COMPANY II� C . 'N�°'�[ N°. _
L 0 T S U R F.B.NO_ �17-49
,
LAND SUI�VEYORS SCALE: 1 �� _ __e0,
R GISTERED t1NDER THE LAW5 OF STATE OF MINNESOTA o Denotes Iron Monument
7601 73rd Avenue North (763)56d-3093 ❑ Denotes Wood Hub Set
Fax No. 560-3522 or excovation only
Minneapolis, Minnesot - x0o0.0' De otes Existing Elevation
3 u r u P � II r � C�P r t i f i r tt��� �� ��,�� 000.o De tes Proposed Elevatian
� a�,�� ���N � ��A����� tes Surface Drainage
,���Y �I IN ��Y ��,+j';� � ��������� 2� �� �.NOTE: Pro osed grades are subject
. /_ i e to results of soi l tes ts.
.\ '�'`. 9B6.3 . i�� ��I�M ����I�IQNi7
�� Pro osed building information
hti`'� � -� �; �' ���t`Y'����� ' mu be checked with approved
Property locatecl in Sectiot� 986 "' 2�'��� � ii ng plan ond development or
•-r
" 4, Tcywnshi.p 1.1��. e 23, ...._o'ti 2y�� 7,0'o o �;��' �� � � - z"��� construcbonore excavation
Herinepin Co. , � `��4 �\ _ . e'• y -
Minnesota a•�15.p. ' � m � , Proposed Top of Block
9�73 �' 8d o 4� > '��r%�� Pro osed Gara e Floor
os e - �: , P 9
9B .2 '� g8'4" Pr Resid;�C�1�L ��,�i4�8"� g87.0 �� Proposed Lowest Floor(spo�r� ro� �;
.�"\,___--� - w 3�'� �� � s87.o '. Type of Buiiding +
� 8,4��_ _ ti � 987.0 � -�VLL ��;��`'��h.s ��
r>�o�o`��� �� m 9B7.6 �T=`���" . 15�..-0 ��, �
, � � .'!-�� - Top Spk �i�"�1'r
\.1 C= / o `���''I_'- 9B6.44
� � f� 987.2 2yp�. � _ _ - ��Q. . (5n5L-ME:rf7 `",�/�l �::.p�.'i ';!�VAT"Iol•�
15•��-•- 987.0 �Ff�'���S�Y��
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Top k
� 9B7.5 � F�_ ..---• �
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� 975.3
976.4 ( 3 Z.�� � ._.� 991.5
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aVV 972.44 �V 97 .78 � Eo,sement -- I � ,
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The onl easements show are from plats of record or information � Risers ,'� 9 78 Qi �� - • - .
y 984.5 � � ���;;.,. .
provided by client. �j
��9B3.57 �
We hereby certify thot t is is a true and correct representation of . � O�`CT 2 9 2(l14
a survey of the boundari s of the above described lond and the
location of all buildings a d visible encroachrnents, if any, from or on (;
said land. �N'��
Surveyed by us this 27t doy of February 20 02 Lo 2, I310 .k l, Fox Bend �
Rev Drawn BY 9. ..11�.n,ee�r� � ,k
Signed_ �k. z �. F-_. .�, !� _
.�,� , � -t .
� �_n�,.. �, �� Fiie Namp Ch�rles F. A de�'son, Minn, R�g. No.21753 ar .
. . `�=_" Fb2-1fb91749inv62115.S90 Greqcr y . ProsCh, Minn fiec� .Nq.. 24�392' ,
-{ .it, 07 �� �►
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