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HomeMy WebLinkAbout2012-00971 - shed CITY OF ORONO * 2012 - 00971 * ' 2750 KELLEY PARKWAY DATE ISSUED: 10/08/2012 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS 2995 WATERTOWN RD PIN 04-117-23-21-0010 LEGAL DESC OLD CRYSTAL BAY ROAD 2ND ADDN LOT 003 BLOCK 003 PERMIT TYPE ACCESSORY STRUCTURE PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE SHED> 120 SQ FT ACTIVITY 328-OTHER NONRESIDENTIAL BUILDINGS VALUATION $ 14,000.00 NOTE: 12 X 16 GARDEN SHED APPLICANT PERMIT FEE SCHEDULE 250.75 SAM MESSICK STATE SURCHARGE(VALUATION) 7.00 1930 FOUNTAIN LANE N TOTAL 257.75 PLYMOUTH,MN 55447- (612)310-5494 PAID WITH CC# 1668 Minnesota State License#:BC639427 OWNER SMITH,CHRISTOPER&ELANOR 2995 WATERTOWN RD- 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 Building Code.This permit may be revoked at any time for due cause. Alfplicant Petmitee Signature Date Issued Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono Building Permit Application i for New Structures or Additions _ Mailing Address: Permit number: Q/ —(gyp 7/ ej, PO Box 66 %O O Crystal Bay, MN 55323-0066 Date received: 9-Z� i �. Street Address: Received by 2750 Kelley Parkway �r Plan review fee: \t9 �sFio4// Orono, MN 55356 Tota Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us (L-0 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: �(M UTAr '`fQI• p f Co 0 ro no Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ANo 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 required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: eS5/64, State License # OC(P391a7 Expiration Date: 3 ''31—/ Phone: &1X_1_; /0-5N9 C__1/ (office) (cell) Mailing Address: 0V'7:; `A 11 . City.. 'ice' ZIP: Contact Person: �A-W'; rA&$S/6V,, Applicant is: ntractor / Homeowner (circle One) Email and/or Fax: C*kf PROPERTY OWNER INFORMATION: Name: cigrk. S syvtl`l(x Phone (day): I52-913-7,,rYV Address: w¢ ot,1A RO. city: f ZIP: S53S�O Email and/or Fax COM ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3. Structure Type i 4. Sewage Disposal & Water Supply ❑ New Construction ❑ Single Family with ❑ Residence ❑ Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial El Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial Other(s ecify) MCWD review& permits. ❑ Industrial Private Well Minnehaha Creek Watershed District(MCWD) [ Otn9r: (specify) 18202 Minnetonka Blvd (7OM Slaeo Deephaven, MN 55391 Phone: 952-471-0590 l2 x 16 Fax: 952-471-0682 www.minnehahacreek.org NN Estimated Construction Valuation (excluding land) $ ©y t/ . 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 = El 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 19 ❑ Permit Application n ❑ Proposed Building Plans ❑ i3 MN State Energy Code Calculations and Mechanical Code Requirements Form 21 ❑ Survey (meeting all requirements) ❑ ts Stormwater Pollution Prevention Plan ❑ ® Hardcover Calculation(s) ❑ 9 Septic System Site Evaluation Report ❑ ® Access Permit ❑ lel Wetland Buffer Improvement Plan ❑ Engineered Plans for Retaining Walls 4 feet or above ❑ EI Plan Review Fee ❑ ❑ 1 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. Applicant's Signature: Date: Owner's Signature: Date: Plan Review Checklist for New Structures / Additions Address/PID/Legal: Z`1°l S l,Ulq`►t:'C�'�OvJ�1 fLp" Description of work: SN V3 Septic review by: N/A Date Approved: Zoning review.by: C-/Ll. Date Approved: Building review by: oeo. Date Approved: i U i Z -ZAr 2 Grading review by: /'L-1 K11 Date Approved; Zoning File* Resolution#: Resolution Date:` Zoning District Fire'Depart ment Post Office SchoolDistrict Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: 0'Yes 0 No Date of Survey: Proposed Setbacks: Front(Lake) Rear ) l 'N j E AIS E W ) -Other Buildings Wetland Side Side 25? f 'fy 25 z2o 12 ` a o' Building Defined Height: O Building-Peak Height: #of Stories 00: YES FOR A'BUILDING WITH ABASEMENT OR CRAWL SPACE: FOR-A BUILDING ON A SLAB FOUNDATION START WITH the distance between the basement floor/crawl START the distance between'the slab andthe highest space floor and the highest roof peak,the top of WITH roof peak,:the top of the comice:of a flat roof, the cornice of:a flat roof,:the.deck line of a the deck line ofa=mansard roof,or:the mansard:roof,or the uppermost.point on a round uppermost point on a round or other arch-type or other arch4ype roof roof SUBTRACT half the distance between.the highest window and SUBTRACT half the distance between the highest window highest roofpeak of a pitched roof and highest hest roof: eak of a pitched roof SUBTRACT the distance between the basement floor/crawl ADD the distance between.the.slab and the highest space-floor and the highest existing,grade within existing rade within the foundation the foundation or 10 feet,whichever is less. EQUALS Defined building height EQUALS Defined buildingheight Lot Coverage: SF -0/o Shoreland'District M,CWD PerrnitReceived Avera a Lakeshore Setback `Bluff D, Yes .0 No �N/A 0 Yes ,No 0 Yes ,R�No 0 Yes 3 No )a'N/A Permit Number: Setback: Hardcover':Zones Existing Proposed Variance Required CUP:Required 0-75' 0 Yes No 0 Yes No 75-250` Type(s): Type(s): 250.500' 500-1000, REMARKS (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Charged 'YES X10, Plan Review Investigation Fee Sewer Connection Park Fee Fo- Other(specify) Calculated By; S uare Footage $ er Square Footage Basement X 1"'t Floor X = 2nd Floor X Garage X - Estimated Construction'Value: $ I"I, 600 Orono inspections Required Work Requiring Separate Permits Required State Permits O-.Site 0 Plumbing 0 Grading/Filling 13 Well 'D Hardcover Removal D Mechanical 0 Fire Electrical Footing 0 Septic ,0 Water Connection 0 Poured Wall 0 Fireplace M Sewer.Connection 0 'Foundation Survey 0 Masonry 17 Lawn Irrigation 0 'Radon Rock Bed 0 Mfg. 13 :Framing 0 Other(specify) .0 Insulation .0 -Built Survey Final '0 Other,(specify) REMARKS (in-house); Other Review: Reyiewed`by: Date Approved: Access:Existing: '0 'YES 17 NO New: -0 YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z VormMplan review checklist.dom DAT TIME CITY OF ORONO CALLED IN l-0 INSPECTION NOTICE �J7/ SCHEDULED /'q AW la' PERMIT NO. -20102, -,00971 D U7 COMPLETED ADDRESS a295 Ad r/ OWNER a�. W /�leSS�C �ELEPHONE NO. Fcla 310 Sg9V CONTRACTOR DESCRIPTION ����� �1 ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWN ERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: CC W Q_ cc Z) O Cr O LL W QC Q Z W Z W CC Uj*^Z}dSRK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR 1:1 CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. White Copyllnspebtor's File Canary Copy/Site Notice D E TIME ")RONO CALLED IN ..ON NOTICESCHEDULED ..AIT NO.a o 12—009-7 1 COMPLETED ADDRESS a?�s / OWNER f s5 TELEPHONE NO. W Z 3 l0 CONTRACTOR 3Z DESCRIPTION ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W a J O cc O 2 W Q cc 2 . W W LU ❑WORK SATISFACTORY:PROCEED %<PROJECT COMPLETE QZ W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING 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 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. White CopylInspector's File Canary Copy/Site Notice