HomeMy WebLinkAbout2015-00865 - addn/remodel/repair CITY OF ORONO *® 5 - 0 0 8 6 5
2750 KELLEY PARKWAY DATE ISSUED: 07/14/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 3745 TOGO RD
PIN : 17-117-23-31-0046
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 009 BLOCK 010
PERMIT TYPE ADDITION/REMODEL/REPAIR
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ADDN/REMODEL/REPAIR
ACTIVITY 434-RESIDENTIAL
VALUATION $ 3,316.80
NOTE: VAPOR BARRIER FOR CAWL SPACE
NOTE: FOAM INSULATION SHALL BE PROTECTED BY IGNITION BARRIER OR TESTED TO UL1040,UL1715 INITIAL:
e
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APPLICANT PERMIT FEE SCHEDULE 108.42
PLAN REVIEW 70.47
COMPLETE BASEMENT SYSTEMS STATE SURCHARGE(VALUATION) 1.66
54004 LOREN DRIVE
MAIL-IN FEE 2.00
MANKATO,MN 56001-
(507)387-0500 TOTAL 182.55
Minnesota State License#: BUIL-143377 Payment(s)
CREDIT CARD 5821 182.55
OWNER
WERNER,CHRISTOPHER&KRISTINA
3745 TOGO RD
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 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.
Applicant Permitee Signature Date Issued By Signature Date
To: Permit Desk Page 2 of 6 2015-07-13 20:21:56(GMT) 15072999410 From: AMANDA BINSTOCK
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEIN STRUCTURES OR ADDITIONS r^/
MailinngO Bdod>es6s. Permit number: / 'O�a 5
Crystal Bay, MN 55323-0066 Date received: /J
Street Address:' Received by:
2760 Kelley Parkway Plan review fee: _
Orono. MN 55356
Total Fee:
i
-~Main: 952-249-4600 Fax: 952 245-4616 ,w�rr.ci.orona.mn.us a
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: 6-7 q co Tu
Will this be a Parade of Homes, Remode rs Showcase Home or other Display Home? El 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 wilt be
required unless applicant demonstrates sufficient on-site parking is available. Nan-permitted events will not be allowed.
CONTRACTOR!APPLICAN,T INFORMATION:
Name: C ow.0,61 t St wuw4
State License# I H -) _ Expiration Date: i
Phone: cell (office) 7-3�7 G S
Mailing Address: �} Yd iA UK _ Cif h -b ZIP_ (na
Contact Person: Applicant is: ontr / Homeowner (Circle one)
Email and/or Fax: Nv� _t.(5yh l 9111�t M C C
PROPERTY OWNER INFORMATION:
Name N Yt
Phone (daY):
Address:
Email and/or Fax
ARCHITECT! ENGINEER INFORMATION:
Name:
Phone (day): City:
ZIP:
Address: -
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 ❑Residence
❑Addition attached garage [:]Garage/Accessory Bldg. E] Public Sewer
❑Accessory Building ❑ Single Family with ❑Deck
❑ Relocation detached garage ❑Office;Commercial ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family;Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
"Any earth movement may also require ❑ Commercial ❑Other(specify)
MCWD review&permits. ❑ Industrial Private Well
Minnehaha Creek watershed District(MCWD) ❑Other: (specify)
1 B202 Minnetonka Blvd
Deephaven,MN 55391
Phone 952-471.0580
Fax 952-471-0582
wrww.Winnehahacreek.o.r9 _. 7
Estimated Construction Valuation(excluding land) $ 3 I L ' ?"
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: �7`1�7 Permit No.:
Description of work: V ,Ir[)PI^ �"�'I e!i' TCTi/' C�/rd WDat 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 Coverage: SF %
Survey Submitted: 0 Yes 0 No Date of Survey: Revised date(?):
Proposed Setbacks:
Front(Lake) Rear(Street) ( N E W ) ( N S E W ) Other Buildings Wetland
�ide Side
Defined Height: Peak Height. FFE: /BUILDINGMCN
inus 6 feet= (Existing Contour)
Perimeter(linear feet) = 50%= L.F. below grade #of Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A SLAB FOUNDATION:
The distance between the lowestpro osed The distance between the top of
START WITH floor(of the basement or crawl space and START WITH slab and the highest point of the
the highest point of the roof. roof.
If you have a... If you have a...
• GABLE OR HIPPED ROOF
• GABLE OR HIPPED ROOF(no (no windows): Subtract half
windows): Subtract half the dista a the distance between the
between the highest point of the r highest point of the roof to
to the low point of the correspondi the low point of the
SUBTRACTION gable or hipped roof corresponding gable or
(BASED ON • GABLE OR HIPPED ROOF( SUBTRACTION hipped roof
ROOF TYPE) windows): Subtract half the ' tan (BASED ON GABLE OR HIPPED ROOF
between the top of the high t ROOF TYPE) (with windows): Subtract
window and the highest p i t of the half the distance between
roof the top of the highest
• ALL OTHER ROOF TY ES(flat, window and the highest
point of the roof
mansard,etc):No su raction. ALL OTHER ROOF TYPES
SUBTRACTION Subtract the distance be een the (flat,mansard,etc):No
(BASED ON basement/crawl space fl or and the subtraction.
EXISTING highest existing grade jacent to the ADDITION Add the distance between the top
GRADES) foundation OR 10 feet whichever is less). (BASED ON of slab and the highest existing
EQUALS Defined building he ht EXISTING grade adjacent to the foundation.
GRADES
EQUALS Defined building height
Shoreland DistrictWD Permit Ave ge Lakeshore Setback Bluff
Met?
0 Yes 0 No Permit Nu ber: 0 Yes 0 No 0 N/A 0 Yes 0 No
0 N/A'- a attached Setback:
Stormwater Quality Existing Hardcver Proposed
Overlay District Hardcover VarianceRegblred CUP Required
Tier circle one (o�o and si) %and s
0 Yes 0 No 0 Yes 0 No
1 2 3 4 5 Type(s): Type(s):
Updated: January 2015
c:\users\rpeitso\documents\plan review checklist 2015.docx
REMARKS (in-house):
Fees to be Charged YES NO
Penn
Plan Review
State,Surcharge
Investigation Fee
SACS Number of SAC Units
Other(specify)
Square Footage $per Square Footage
Basement X = $
1 s`Floor X = $
2nd Floor X = $
Garage X = $
dO
Estimated Construction Value: $
Orono Inspections Required Work Requiring Separate Permits Required State Permits
0 Site 0 Plumbing 0 Grading/Filling 0 Well
0 Silt Fence/ Erosion Control 0 Mechanical 0 Fire 0 Electrical
0 Hardcover Removal 0 Septic 0 Water Connection
0 Footing 0 Fireplace 0 Sewer Connection
0 Poured Wall 0 Masonry 0 Lawn Irrigation
0 Foundation Survey 0 Mfg. 0 Landscaping
0 Foundation Waterproofing 0 Other(specify)
0 Radon Rock Bed
0 Framing
0 Insulation
0 As-Built Survey
Final
0 Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: 0 YES 0 NO New: 0 YES 0 NO / 1 /
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED mac 111 ✓`ala / 4
-�e C-�e, h5e, ( n ( � ' n a r1 ap e ��s f"�2 d 7-o
r�1. >o 4'-0 to v 1, /71s-
Updated: January 2015
c:\users\rpeitso\documents\plan review checklist 2015.docx
To: Permit Desk Page 3 of 6 2015-07-13 20:21:56(GMT) 15072999410 From: AMANDA BINSTOCK
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 souare feet Attached= ❑ Metal
❑ Pole Bldg.
c,Basement= Detached= ❑ ICF
d. 1s'Story =
❑ On-site Prefab
e.2nd Story= ❑ Off-site Prefab
f. '/z Story =
i ' El Other(please specify):
g,Total Area= I
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed Applicable
❑ ❑ Permit Application
❑ ❑ Proposed Building Plans
❑ ❑ MN State Energy Code Calculations and Mechanical Code Requirements Form
❑ ❑ Survey(meeting all requirements)
❑ ❑ Stormwater Pollution Prevention Plan
❑ ❑ Hardcover Calculation(s)
0 ❑ Septic System Site Evaluation Re ort
❑ ❑ Access Permit
❑ ❑ Wetland Buffer Improvement Plan
❑ ❑ Engineered Plans for Retaining Walls 4 feet or above
❑ ❑ Minnehaha Creek Watershed District Permit s
❑ ❑ Plan Review Fee
❑ Application Escrow&Agreement
❑ ❑ Other: _
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$500;
• Certifies that the information supplied is true and correct to the best of hisiher 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 riot 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 recelpt of a$10,000
escrow to ensure completion of the as-built survey and all site improvements.
fit A dill A1.4
Applicant's Signature:*SA /Vi Date:
Owners Signature: Date:
To: Permit Desk Page 4 of 6 2015-07-13 20:21:56(GMT) 15072999410 From: AMANDA BINSTOCK
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To: Permit Desk Page 5 of 6 2015-07-13 20:21:56(GMT) 15072999410 From: AMANDA BINSTOCK
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PAGE2 C 6
1715
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED T—
PERMIT NO. COMPLETED
ADDRESS
OWNER TELEPHONE _ 7/ e
CONTRACTOR
DESCRIPTION
W ❑ FOOTING ❑ DEMO FINAL ❑ SEPTIC FINA /19Q —
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
h ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI T INSPECTION
Q ❑ FRAMING ❑ 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 ❑ E TIC INSTALL
Z OWNERICONTRACTOR TO MEET YOU: YES_NO
y COMMENTS:
a;
j
O
W
O:
Q
2
W
j
O
W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
ccW
❑CORRECT WORK&PROCEED ❑ UE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou7 advance.
OwnedContractor on site:
Inspector.
White Copyllnspector's File Canary Copy/We Notice