The URL can be used to link to this page

Home My WebLink About2015-01467 - addn/remodel/repair CITY OF ORONO 2750 KELLEY PARKWAY * 2 0 1 5 - 0 1 4 6 7 DATE ISSUED: 11/23/2015 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 3245 WATERTOWN RD PIN : 05-117-23-11-0001 LEGAL DESC : AUDITOR'S SUBD.NO.203 : LOT 002 BLOCK 000 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDN/REMODEL/REPAIR ACTIVITY 434-RESIDENTIAL VALUATION $ 4,400.00 NOTE: DECK REBUILD IN-KIND NOTE:PRIOR TO RELEASE OF ESCROW MONEY,AN IN-KIND FINAL INSPECTION MUST BE COMPLETED. INITIAL: APPLICANT PERMIT FEE SCHEDULE 123.87 PLAN REVIEW 80.52 BLAINE CONSTRUCTION INC STATE SURCHARGE(VALUATION) 2.20 8243 OAKWOOD AVE NEQ OTSEGO,MN 55330- TOTAL 206.59 (612)237-8930 Payment(s) Minnesota State License#: BUIL-20103113 CHECK 8496 ?06.59 OWNER RHAME,CARL&ANDREA 3245 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. J Applicant Perm'*e SIgnature Date ssued By St ature Date City of Orono Building Permit Application for New Structures or Additions Mailing Address: PO Box 66 Permit number: ?0/ ,5—01 Vto Crystal Bay, MN 55323-0066 Date received: / /S Street Address:' Received by: y 2750 Kelley Parkway 2° �'2 Plan review fee: (L i�lcd�b �O Orono, MN 55356 Fe ,,/ '1ktsrloc� Main: 952-249-4600 Total Fee: Ey" �Y/ Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and all required information must be submi d. ✓ Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 3aJ.3` tjc✓l oW �Xc'41I Will this 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 wil e required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APP AN INFORM TION Name: yl n ,y/)0— State License# Expiration Date: ,3 Phone: cell office Mailing Address: 3 Oa 1 . rn+pCitx: ZIP: 33 Contact Person: , Applicant is: on rac / Homeowner (Circle One) Email and/or Fax: �r�>!�Ytn�, CQ/LS �>^ ��,cD�✓� PROPERTY OWNER INFORMATION: Name: /` "� /) r , A Aa Phone(day): �' - A - J Address: 3 4V" e vL,1' City: an 0 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. Structure Type 4. Sewage Disposal & Water Supply ❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage ❑Addition attached garage 9&Deck Public Sewer ❑Accessory Building Single Family with ❑ Office/Commercial ❑ Relocation detached garage ❑ Residence ❑ Private Sewer ❑ Other: (specify) 40 e-0% Re.bbi I ❑ Multiple Family/Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater ❑ Public Water "Any earth movement may require ❑ Commercial ❑ Storage MCWD review&permits. ❑ Industrial ❑Warehouse Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ Other(specify) 15320 Minnetonka Blvd ft � Minnetonka, MN 55345 (C� Phone: 952-471-0590 cr w Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ o Packet Last Updated: August 2015 Page 21 STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) .3,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. 151 Story = & ❑ On-site Prefab e.211 Story= Z, h - E] Off-site Prefab f. '/2 Story = 7 ❑ 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'h 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: 1� Date:IF Owner's Signature: Date: Packet Last Updated: August 2015 Page 22 , PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: 32.45 Vyaka' Y' Permit No.: 2015 0143P 1 Description of work: —M M 1 Date Recd: ' ((0 ' Septic review by: (1 �� Date Approved: Zoning review by: V nIJ Date Approved: I b' �S Building review by: i� � t,�� Date Approved: Lo Grading review by: —'" Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: PKYes 0 No Date of Survey: Revised date(?): parbal COPYLandscape plan submitted? 0 Yes �� No LLaandfi per _ !EV Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50%= L.F. below grade Basement? 0 Yes 0 No, Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lowest proposed Slab at or above grade— START WITH floor(of the basement or crawl space)and measure from highest existing the highest point of the roof. START WITH grade 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(no Slab below grade—measure (BASED ON windows): Subtract half the distance from highest existing grade to the ROOF TYPE) between the highest point of the roof 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 the low point of the window and the highest 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 Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? es 0 No Permit Number: 0 Yes 0 No �A 0 Ye No 0 N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf J� 0 Yes o 0 Yes No Type(s): Type(s): Fees to be Charged YES NO Permit Plan Review (/ State Surcharge Investigation Fee SAC—Number of SAC Units (/t Other(specify) Square Footage $ per Square Footage Basement X = $ X = $ 2nd Floor X = $ Garage X = Is Estimated Construction Value: $ Orono Inspections Required Work Requiring Separate Permits noting 0 Site 0 Plumbing 0 Grading/Filling 0 Poured Wall 0 Silt Fence/Erosion Control 0 Mechanical 0 Fire 0 Foundation Survey 17 Hardcover Removal 0 Septic O Water Connection 0 Foundation Waterproofing 17 Other(specify) 0 Fireplace 0 Sewer Connection raming 0 Masonry 0 Lawn Irrigation 0 Insulation 0 Mfg. 0 Landscaping 0 As-Built Surve 0 Other(specify) Final 0 Lathe Required State Permits Other(specify)rit !< �.�ro /—rv1Ct 0 Well 0 Electrical REMARKS (in-house): OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED: er Ack emen Q � MAk& /;L rior to release of escrow money .��e kd Updated: October 2015 74nr clnlnn raviaw chanklict 9(-9(115 riner DATA PRIVACY ADVISORY In accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd. 2, "Tennessen warning", we would like to inform you that your request for a permit or license from the City of Orono or any of its departments may require you to furnish certain private or confidential information. You are notified that: 1. The information you furnish will be used to determine your qualification for the permit or license requested. 2. You may refuse to supply data, but refusal may require that the City deny the permit or license. 3. The information may be shared with other local, state or federal agencies to the extent necessary to process the permit or license. 4. If your requested permit or license requires Council action to approve, some information may become public. 5. You have certain rights under Minnesota State Statute 13.04(see following page)to review private data on yourself. 6. Your full name is required to process this application or permit. Moir n First Middle Last #ay3 � - Address 0 k e4 el M41 �"��a ��3�-f7,?0 City 1i State Zip Phone I understand my rights as stated above. Signature Packet Last Updated., August 2015 Page 7 Permit Application: Self-Checklist for Completeness Please note, the applicant must initial in the boxes below to acknowledge the minimum required information is included with the submittal. If not, the application will NOT be accepted. Call 952.249.4620 to schedule a meeting with staff if you have questions on application submittal requirements. ElCompleted Application ElPlan Review Fee Paid EaSigned Escrow Agreement & Escrow Payment EaBuilding Plans (to scale) x2 Certificate of Survey (to scale) showing the proposed project & meeting all requirements x2 Hardcover Calculations (if applicable) I am aware that Orono will not issue a building permit without a copy of MCWD permits (or documentation from the MCWD stating the proposed project does not trigger their permitting requirements). I will contact the MCWD at 952-471-0590 re rding this pr Signed by: Address: o? w Permit #: � of Y(P:� Packet Last Updated: August 2015 Page 2 City of Orono ;�RONo, Hardcover Calculation Worksheet r 1 CARL f .4�t/,PR CA ANAME Property Address: 32 ys uo"14 TER 7-011r/.11 IP 4d 0 Prepared by: CZD4JBCAC f AJUP C 1 TFS, /A/C. Date: 7-ZZ-/3 Stormwater Quality Overlay District Tier: (Circle one) Tler 1 Tier 2 Tier 3 Tier 4 Tier 5 Step 1: EXISTING HARDCOVER In the following table identify all items of existing hardcover on the property, keyed by letter to Certificate of Survey(survey must accompany this form). Use as many lines as necessary to accurately depict existing hardcover status of the property. For Tier 1 properties,identify any features by letter which are split at the 75' setback line and calculate hardcover square footage separately for each-portion. Key to Hardcover Item (Describe) Length x Width Total SurveySquare Feet Exam le Gara,e 24'x30' 7200 j A 11,pWX F 15'.*2 S.F. B 0.6 rk 216 S.F. C cytor, /4vo a Tr/0 5-3 S.F. D a2et2CA q 7.6 36 S.F. E .211/,5 'f 3 7/ ely a-75, F OT 7 S.F. F Sr E T i.�G t 3/ S.F. G 40ty&p ,BaROER s 3 9 S.F. H ni S.F. IG.4 A A G Of S.F. S.F. K S.F. L S.F. M S.F. N S.F. O S.F. P S.F. Q S.F. R S.F. S S.F. T S.F. U S.F. V S.F. W S.F. X S.F. Y S.F. Z S.F. 1 Total Existing Hardcover S'285 S.F. Excludable Hardcover(See'City Code Sec.78=1684 __. Zn!A/ 44 / S.F. S.F. S.F. S.F. S.F. 2 Total Excludable Hardcover 3/ S.F. 3 Net Existing Hardcover Subtract line 2 from line 1 SLS S/ ST - ,14) Total Lot Area 26' ,Syg S.F. RE Existing Hardcover Percentage [(3)+(4) / ��go % AUG 19 2013 (Proposed Hardcover next page) 02,J5 WabliiK 0---- CITY OF1eKDtjd013 ZO — (30P --- 1 - - i 07 Joc flL I - _ ja Q led �b � b � M � o _ J cgyy, N C O o � rl ---- ----- ----- ---- ------- „th JII i a � ��;'�'j° ill°"=✓r,r+r ` i � b � M O - J M 4-1Z211 a r 4, o - - ----- - S lo U Q e�o C � h rx T-1 CITY DATE CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. 2615-6l 40 COMPLETED ADDRESS -3 Z S o f F:k OWNER TELEPHON NO. (P ( 2- CONTRACTOR CONTRACTOR 3: DESCRIPTION D 6TC W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL c3 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 Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE S PTIC INSTALL 2 OWNERICONTRACTOR TO MEQ: YES—NO vdi COMMENTS: W J O QC O W W cc Q 2 W W j - d WWORK SATISFACTORY:PROCEED El PROJECT COMPLETE Qz RRECT WORK&PROCEED El CERTIFICATE OF OCCUPANCY W OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR Ll CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS_ Call for the next inspection 24 hours in adva . (952) 249-4600 Owner/Contractor on site: Inspector. White Copyllnspectoes File Canary JopylSite Notice DAT TIME CITY OF ORONO CALLED IN 11 - -tom INSPECTION _aOHEDULED —L PERMIT NO. 5 COMP E ADDRESS p OWNER TELEPHONE NO- CONTRACTOR CONTRACTOR ii j Q 3Z DESCRIPTION ' `Y-" "'�'y W ❑ FOOTING ❑ DEMO-FINAL ❑ S TIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI CAV/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 Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: W a cc J O cc O W W cc Q 2 W Z W J O W ❑WORK SATISFACTORY:PROCEED XPOJECTCOMPLETE QC ❑CORRECT WORK&PROCEED UE CERTIFICATE OF OCCUPANCY W ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY 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 hours in a e. (952) 249-4600 Owner/Contractor on site: Inspector_ White CopylInspector's File Canary CopylSite Notice ao s.s rnI) rn f U ................... S --------•--._. ._ 4.0 10.1 Ld co coo 0 oa: LL Z 20.0 pN AV / D�— /I J 7.5 cc N O }- m 36.6 Q 00 F v wa I a,S,; / o w 0 p2l C, OD -------------- 0 LU d�ti 'W /l �� /,. / I I MM ,. / nCb 0 co z ::)LLJ / AD vo roes cn \ / / v) o� m ,`O o,� pCb S Do a. o ✓ N m W W � aOOw as CL CL CL CL LU PROJECT GRONBERG & ASSOCIATES, INC. DATE 7-22-13 CIVIL ENGINNERS, LAND SURVEYORS, LAND PLANNERS = 445 NORTH WILLOW DRIVE LONG LAKE, MN 55356 1It,=220' " w 952-473-4141 13-302 - m--. Planning • Zoning Department Memo To: Finance Department From: Christine Mattson, Planning Assistant CC: Street File Date: December 10, 2015 G/L: 101-22205 Re: Escrow Refund Building Permit#2015-01467 pertaining to 3245 Watertown Road is complete. Please refund $700 to the property owner,Andrea Rhame. The following is attached: • Original signed escrow agreement • Copy of cash register receipt showing escrow amount received Mail to: Andrea Rhame 3245 Watertown Road Long Lake, MN 55356 wAstreet files\watertown rd\3245\escrow refund 2015-01467.doc x BUILDING PERMIT ESCROW AGREEMENT Orono Building Permit# 2p(S 70,q(D 1 AGREEMENT made this day of NOyt, W 2015, by and between the CITY OF ORONO, a Minnesota municipal corporation ("City") and t\ t Ardrtl!i- rP wjt ("Owners"). Recitals 1. A building permit application has been filed for I a-I44 AQ(,-rVJ UPLW-f located at 3 9A5 141Qkf iiMYL 9=6=t the ("Subject Property"), legally described as 2. Owners request the City to review this application which requires City approval and may require consultant legal and/or engineering review. 3. The City will commence its review of the application and incur costs associated with said review only if the Owner establishes an escrow to ensure reimbursement to the City of its costs. NOW THEREFORE,THE PARTIES AGREE AS FOLLOWS: 4-700 1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow Agreement, the Owners shall deposit$3,506 with the City. All accrued interest, if any, shall be paid to the City to reimburse the City for its cost in administering the escrow account. 2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City for all out-of-pocket costs the City has incurred(including planning, engineering, in excess of$500, or legal consultant review) or will incur in reviewing the plan. Eligible expenses shall be consistent with expenses the Owners would be responsible for under a building permit application. The escrow will also guarantee reimbursement to the City for all out-of-pocket costs the City has incurred to assure that the work is completed in accordance with the Stormwater Pollution Prevention Plan and the provisions of Orono City Code Chapter 79. The financial security may also be used by the City to eliminate any hazardous conditions associated with the work and to repair any damage to public property or infrastructure that is caused by the work (including planning, engineering, or legal consultant review) associated with building permit # 9-0 64(01 if compliance with the approved building permit is not accomplished. 3. MONTHLY BILLING. As the City receives consultant bills for incurred costs,the City will in turn send a bill to the Owners. Owners shall be responsible for payment to the City within 30 days of the Owners' receipt of bill. 4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment to the City within the timeframe outlined in #3 above, shall issue a Stop Work Order until the Owners pay all expenses invoiced pursuant to#3. The City may draw from the escrow account without further approval of the.Owners to reimburse the City for eligible expenses the City has incurred. 5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be returned to the Owners when all requirements related to the project are complete. City Staff shall review the terms of this escrow agreement two times per year to determine whether the requirements of the project have been successfully completed and whether it is appropriate to return the funds. Owner may also request the release of the funds, and such funds shall-be released upon City Staff receiving the appropriate verification that all requirements of the project have been successfully completed. M 6. CERTIFY UNPAID CHARGES. If the project is abandoned by Owners, or if the eligible expenses incurred by the City exceed the amount in escrow,the City shall have the right to certify the unpaid balance to the subject property pursuant to Minn. Stat. §§415.01 and 366.012. CITY: CITY OF ORONO OWNER: By: Its: LanftKA PZ & Internal Use Only: 0 Original to Finance Department G Copy to Street Fite Packet Last Updated. August 2015 Page 23