HomeMy WebLinkAbout2017-01359 MEZEUMMUM
CITY OF ORONO * 2 ® 1 7 - 0 1 3 5 9
2750 KELLEY PARKWAY DATE ISSUED: 10/19/2017
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS 1669 NORTH FARM RD
PIN 27-118-23-44-0008
LEGAL DESC THE FARM AT LONG LAKE
LOT 007 BLOCK 001
PERMIT TYPE ADVANCED PLAN REVIEW
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ADVANCED PLAN REVIEW
VALUATION $ 15,000.00
APPLICANT ADVANCED PLAN REVIEW 181.20
TOTAL 181.20
KEENAN& SVEIVEN,INC. Payment(s)
15119 MINNETONKA BLVD. CREDIT CARD 0048 181.20
MINNETONKA,MN 55345-
(952)475-1229
Minnesota State License#: BUIL-7252
OWNER
BEENDERS&PETER MONTGOMERIE,ANTOINETTE
1669 NORTH FARM 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 ford ause.
I/-
Ao�ertriitee Signature Date Issued By Signature Date
I PLAN REVIEW CHECKLIST
� FOR NEW STRUCTURES // ADDITIONS
Address: 1(1(Pq U 1� 11� t~V�-� Permit No.: 2Lo —oowo
Description of work: ) Date Rec'd: �'L`1•�7
Septic review by: Date Approved:
Zoning review by: Date Approved: 10- 2_+11`1
Building review by: 1 o / VV Date Approved: to-Z4-
Grading review by: Vy Date Approved:
Zoning District: Zoning File M
Resolution? Yes Reso M Reso Date: Signed: Yes No Resolution / NA
Zoning: Lot Area: SF/AC Width: Structural Coverage: SF %
0uli itted: ❑ Yes ❑ No Date of Survey: Revised dateM:
Landscape plan submitted? ❑ Yes Landscaper: ❑ No/ None proposed
Proposed Setbacks:
7Ffi't(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Buildina Hei ht Analysis:
Distance Between First Floor and defined Top of Roof*(See "building height" (a)
definition):
First Floor Elevation from building plans): (b)
Highest Existing ground level (per survey) or 10' above lowest ground level, (c)
whichever is lower:
Difference between b and (c)*: (d)
DEFINED HEIGHT
*If highest existing adjacent grade is above FFE-Height is(a)-(d): (e)
"If highest-6xisting adjacent grade is below FFE-Height is a + d
Shoreland District MCWD Permit Average Lakeshore Setback Bluff
Met?
s ❑ No Permit Number: es ❑ No ❑ N/A ❑ Yes ❑ o
❑ N/A—see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf % and sf
Cl Yes No ❑ Yes No
1 2 3 4 5 >n` ._— Type(s): Type(s):
Updated: June 2017
z:\forms\plan review checklist 06-2017.docx
Fees to be Charged YES NO
Permit
Plan Review
State Surcharge
Investigation Fee
SAC–Number of SAC Units
Other(specify)
Square Footage $ per Square Footage
Basement X = $
1 s' Floor X = $
2nd Floor X = $
Garage X = $
r—
Estimated Construction Value: $ D V
Orono Inspections Required Work Requiring Separate Permits
,Footing ❑ Site ❑ Plumbing ❑ Grading/Filling
❑ Poured Wall ❑ Silt Fence/Erosion Control ❑ Mechanical ❑ Fire
❑ Foundation Survey ❑ Hardcover Removal ❑ Fireplace ❑ Water Connection
❑ Framing ❑ Other(specify) ❑ Masonry ❑ Sewer Connection
❑ Waterproofing/Drain tile ❑ Mfg. ❑ Lawn Irrigation
❑ Foundation Waterproofing ❑ Dther(specify) ❑ Landscaping
IT..Framing ❑ Septic
�❑ Insulation
❑ As-Built Survey
Final
❑ Lathe Required State Permits
❑ Other(specify)
❑ Nell Electrical
REMARKS (in-house):
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
❑ See Builder Acknowledgement Form
:P"rior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved.
Updated: June 2017
z:\forms\plan review checklist 06-2017.docx