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Home My WebLink About2016-00669 - addn/remodel/repair CITY OF ORONO * 2 0 1 6 - 0 0 6 6 9 2750 KELLEY PARKWAY DATE ISSUED: 07/18/2016 ORONO,MN 55356- (952)249-4600 FAX: (952)2494616 ADDRESS 155 TRUFFULA TR PIN 33-118-23-44-0040 LEGAL DESC MEADOW WOOD POND LOT 006 BLOCK 001 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 30,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) BASEMENT/KITCHEN REMODEL APPLICANT PERMIT FEE SCHEDULE 490.12 PLAN REVIEW 318.58 FINISHED BASEMENT CO. STATE SURCHARGE(VALUATION) 15.00 5600 EXCELSIOR BLVD MINNEAPOLIS,MN 55416- TOTAL 823.70 (651)224-7000 Payment(s) Minnesota State License#:BUIL-20460771 CHECK 4967 823.70 OWNER STAGGS,JEFF 155 TRUFFULA TR LONG LAKE,MN 55356- 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 uilding Code.This permit may be revoked at any time for due cause. —� J Af plicant Permitee Signa ate I Issued By Signature Date ` CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �O A, Mailing Address: Permit number: l VO PO Box 66 Crystal Bay, MN 55323-0016Y4� 5323-00 4� Date received: Street Address:' �� Received by: ti� Gti 2750 Kelley Parkway Plan review fe `gkESHO�� Orono, MN 55356 Main: 952-249-4600 Total Fee: 8 3,7v Fax: 952-249-4616 www.ci.orono.mn.us 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: Will this be a Parade of Homes, Remodelers Showcase Home or other Displ y 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 serAig will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFOR ATION: Name: MIn-. -( - o State License# lf'�C 4{o o')7 1 Expiration Date: 7_.j I- Phone: cell) q-yiI (office 5l- 2-2,4 - ?oo p Mailing Address: 1:54a r 6(,vt Cit : -E t Pik ZIP: $q/-G Contact Person: 7,',,., Frd' Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: -A �o r S A ra �/� al��f �•3 r�-�. �,.� 1 PROPERTY OWNER INFORMATION: Name: aG� s JI- (^�rA— C"r IS,\ Phone (day): Address: i5S Trw fF�la 6�. 1 City: 01',5 ^6 ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: -/ PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3. Structhre Type 4. Sewage Disposal& El Construction Single Family with [:1 Accessory Bldg./Garage Water Supply ❑Addition attached garage ❑ Deck [:]Accessory Building El Public Sewer El Family with El ❑ Relocation �I detached garage Residence EJ Private Sewer Other: (specify) /ce-*, Multiple Family/Condo Retaining Wall(s) ❑ Public 4-feet or greater ❑ Public Water "Any earth movement may all o require ❑ Commercial ❑ Storage MCWD review&permits. ❑ Industrial ❑Warehouse Private Well Minnehaha Creek Watershed District(MCWD) ElOther: (specify) ❑ 15320 Minnetonka Blvd ( p ) ❑ Other(specify) Minnetonka,MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) Q&d Last Updated: January 2015 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 _fes El Pole Bldg. c. Basement= 6'35 .SGS / `, Detached= ❑ ICF d. 15`Story = ❑ On-site Prefab e.2nd Story= ❑ Off-site Prefab f. '/2 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 Applicable ❑ ❑ Building Permit Escrow Agreement and Fees ❑ ❑ Plan Review Fee ❑ ❑ Completed Application Form ❑ ❑ Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/2 x 11 set ❑ ❑ Minnesota State Energy Code Calculations and Mechanical Code Requirements ❑ ❑ Survey—2 full size,to scale(meeting ALL survey requirements) ❑ ❑ Hardcover Calculations ❑ ❑ Septic System Certification ❑ ❑ Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD stating no permit is required ❑ ❑ Landscape Walls and/or Retaining 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 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. Applicant's Signature: �— - Date: 6,1111 21/--6 Owner's Signature: Date: Last Updated: January 2015 Shoreland District MCWD Permit Average Lakeshore Setback Blcrf Met? ❑ Yes ❑ No Permit Number: 13Yes ❑ No 13N/A E3 Yes No ❑ ❑ N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf ❑ Yes ❑ No ❑ Yes ❑ No 1 2 3 4 5 Type(s): Type(s): Fees to be Charged YES NO Permit Plan Review q/ State Surcharge Investigation Fee SAC—Number of SAC Units Other(specify) Square Footage $ per Square Footage Basement X = $ 1 sc Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ Orono Inspections Required Work Requiring Separate Permits ❑ Footing ❑ Site XPlumbing ❑ Grading/Filling ❑ Poured Wall ❑ Silt Fence/Erosion Control Mechanical ❑ Fire ❑ Foundation Survey ❑ Hardcover Removal ❑ Septic ❑ Water Connection ❑ Foundation Waterproofing ❑ Other(specify) 1KFireplace ❑ Sewer Connection Framing ❑ Masonry ❑ Lawn Irrigation Insulation ❑ Mfg. ❑ Landscaping ❑ As-Built Survey ❑ Other(specify) Final ❑ Lathe Required State Permits ❑ Other(specify) ❑ 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. Updated: October 2015 7-Unr c\nInn ravialni rharlrlict 1 n-gn15 rinry PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: �� - r(>� �t� Permit No.: Description of work: Date Rec'd: Septic review by: �� i Date Approved: l� Zoning review by: Date Approved: Building review by: Date Approved: &11(ell& 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 dateM: : Landscape plan submitted? Yes 0 No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak He! ht: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = —50%= L.F. below grade Basement? 0 Yes 0 No, S ries FOR A BUILDING WITH ABASEMENT OR RAWL SPAC FOR A BUILDING ON A SLAB FOUNDATION: Th distance between the owest proposed Slab at or above grade— STARTWITH fl r(of the basement or cr W space)and measure from highest existing e highest point of the roof. START WITHrg ade to the highest point of the roof even if fill was brought in to elevate home. If you have a... SUBTRACTION GABLE OR HIPPED ROOF Slab below grade—measure (BASED ON windows): Subtract half the dis ce from highest existing grade to the ROOF TYPE) between the highest point of the ro highest point of the roof. to the low point of the corresponding If you have a... gable or hipped roof SUBTRACTION GABLE OR HIPPED ROOF • GABLE OR HIPPED ROOF(with (BASED ON (no windows): Subtract half windows): Subtract half the distance ROOF TYPE) the distance between the between the top of the highest highest point of the roof to window and the highest point of the the low point of the roof corresponding gable or hipped roof • ALL OTHER ROOF TYPES(flat, GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract the distance between the half the distance between (BASED ON basement/crawl space floor and the the top of the highest EXISTING highest existing 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 building height subtraction. Defined building height EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx oP",-bd DATE TIME CITY OF ORONO CLED IN INSPECTION NOTICE 60�SCHEDULED PERMIT NO. COMPLETED ADDRESS OWNER TELEPHO NO. /a C', `7 CONTRACTOR12 DESCRIPTION W El FOOTING ❑ DEMO-FINAL ❑ SEPTIC L Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING 0 ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS INSULATION WOOD BURNER/FIREPLACE ❑ COMPLAINT v FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ TIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO COMMENTS:QZ �� a cc Z�w W Q _lam �C4 �C� .1D�4•�. i►tE'Gs� e lCGfi1caG j !pcc elf rc .a.rS a core ¢ W ❑WORK SATISFACTORY:PROCEED El PROJECT COMPLETE a ❑CORRECT WORK&PROCEED 44/kr ET ISSUE CERTIFICATE OF OCCUPANCY O O El CORRECT WORK,CALL FOR REINSPECTION qVCed� TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED El OP ORDER POSTED.CALL INSPECTOR INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnedContractor on site: Inspector. :� i 61 White Copy/Inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. /� "� '� COMPLETED ADDRESS S —Fk-'i j rf c t I CIL T2 OWNER TELEPHONE N � CONTRACTOR DESCRIPTION i Arl -� ""a W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI -7—� /, ❑ EXCAV/GRADING/FILLING Q [I FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z N SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q AMING ❑ MECHANICAL FINAL ❑ RATED WALLS INSULATION El WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SE TIC INSTALL Z OWNEWONTRACTOR TO MEET YOU:7YES_No COMMENTS: ^C W a O �O W cc Q 2 W Z W c d W WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE cc [03RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY ❑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 inspectionA4 hour Wa-ffia 9 ) 249-4600 Owner/Contractor on site: Inspector. White Copy/Inspector's File Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION MPTICE 'SCHEDULED //. _2 PERMIT NO. CJ -CO(0 O PLETED ADDRESS OWNEREPHONE NOS/'335- ASS f CONTRACTOR � f �� DESCRIPTIONS-� 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 v 'FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL ..t ❑ DEMO-SITE ❑ SEPTIC INSTALL Z OWNEWCONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: E1eG- � nn L. A6, MS . o , I Q G6✓r� c.�l� ra..s z�o�G�lo•-c W OC j W ❑WORK SATISFACTORY:PROCEED O PROJECT COMPLETE a: ❑CORRECT WORK&PROCEED O ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY CI BEFORE COVERING PERMANENT Cl CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN INSPECTOR WILL RETURN O CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR l INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Can for me next Inspection 24 lours in advance. (952) 249-4600 OwnerlContractor on site: ! Inspector. White Copyllnspector's Fila Canary CopylSlta Notice ��? DATE TIME V1 CITY OF ORONO CALLED IN INSPECTION TICE SCHEDULED PERMIT NO. . COMPLETED ADDRESS OWNER TELEPHO N S 5Fg' CONTRACTO / DESCRIPTIO ��- W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING C ❑ 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 .t ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OIMNENICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: f�1�LT �'ISGc lid S/Cl C/ DYE I Q 6�� a� 7-a�-�6 by t�• s. 2 62 WU ❑WORK SATISFACTORY.PROCEED PROJECT COMPLETE W ❑CORRECT WORK 3 PROCEED ❑ E CERTIFICATE OF OCCUPANCY QO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR C3 CITATION ISSUED O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 7A hours In advance. (952) 249-4600 Ownw#Contmctor on site: Inspec �-' t VWMte CopyAnspectoes File Canary CopyBib Nothm