HomeMy WebLinkAbout2013-00555 - shed CITY OF ORONO 11111111HHI 11011111111 II
3 - 00555 *
2750 KELLEY PARKWAY DATE ISSUED: 07/03/2013
• ORONO, MN 55356-
1 (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4490 WATERTOWN RD
PIN : 31-118-23-21-0005
LEGAL DESC : N/A
: LOT 001 BLOCK 001
PERMIT TYPE : ACCESSORY STRUCTURE
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SHED> 120 SQ FT
ACTIVITY : y49-A-L-fOT1IER - . D '••. : ---- U I •ES `Z_& , C-4 iz_z_d • 161 '6`'
VALUATION : $ 7,000.00
NOTE: STORAGE SHED
APPLICANT PERMIT FEE SCHEDULE 147.50
CHELBERG,GLEN&MICHAELA PLAN REVIEW 95.88
4490 WATERTOWN RD STATE SURCHARGE(VALUATION) 3.50
MAPLE PLAIN,MN 55359
TOTAL 246.88
PAID WITH CC# 4417
OWNER
CHELBERG,GLEN&MICHAELA
4490 WATERTOWN RD
MAPLE PLAIN, MN 55359
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
revokedat any time,sr due cau
' !' a / !3 / %
A phcant Permitee Signature C Date Issued By S. nature r Dat
tAt SEPARATE PERMITS REQUIRED FOR WORK OTHE HAN DESCRIBED ABO .
((24"f/3
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
�o V Mailing Address: Permit number: p2()/3-0,5:5,-
PO Box 66
Crystal Bay, MN 55323-0066 Date received: ,6-7?V 4
Street Address: Received by:
*114'
L2750 Kelley Parkway Plan review fee:
Orono, MN 55356
kESHOS" Total Fee: 4'
0 /`
t�g
Main: 952-249-4600 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: �J
Job Site Address: VY?Q �ciPt/0 c./.4/ c�v Nc./.4 Mit7,5 J 1'S `7-
Will this be a Parade of Homes, Remodelers Showcase Hoene or other Duplay Home? 111 Yes lel No
If yes, a special event permit is required with Police Department and City Council approval 60 days p r 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: .,Sc_.4-)
State License# Expiration Date:
Phone: (cell) (office)
Mailing Address: City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION: 6-?4/ C�e/�e
Name:
Phone (day): 9,532-2)- / -9„77
Address: ycf90 4./a f r-{��-.� ,� /� City /A, ZIP: ,53Y,5-9
Email and/or Fax �/ �!p /Y 7`5 ��^.Gc�fson Com
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 El Single Family with ❑ Residence
El Addition attached garage ❑ Garage/ « -ssory Bldg. ❑ Public Sewer
❑Accessory Building El Single Family with ❑ Deck
El Relocation l f detached garage El Office/Co mercial ❑ Private Sewer
❑ Other: (specify) �t�eC I Z 46 ❑ Multiple Family/Condo El Warehous
[' Public l Storage ❑ Public Water
**Any earth movement may also require El Commercial ❑ Other(spe« )
MCWD review&permits. El Industrial ❑ Private Well
Minnehaha Creek Watershed District(MCWD) El Other: (specify)
18202 Minnetonka Blvd
Deephaven, MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.orq
Estimated Construction Valuation (excluding land) $
STRUCTURE INFORMATION:
1.Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction .
a. Length (ft.)= 76 Number of bedrooms= t
ig Wood/Frame
b.Width (ft.)= /2 Number of garage stalls: ❑ Masonry
Areas in square feet Attached = ❑ Metal
❑ Pole Bldg.
c. Basement= Detached = ❑ ICF
d. 1st Story = ❑ On-site Prefab
e. 2nd Story=
❑ Off-site Prefab
f. 'h 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
❑ ❑ Permit Application
❑ 0 Proposed Building Plans
❑ 0 MN State Energy Code Calculations and Mechanical Code Requirements Form
❑ 0 Survey(meeting all requirements)
❑ ❑ Stormwater Pollution Prevention Plan
O ❑ Hardcover Calculation(s)
❑ 0 Septic System Site Evaluation Report
O ❑ Access Permit
❑ 0 Wetland Buffer Improvement Plan
❑ 0 Engineered Plans for Retaining Walls 4 feet or above
❑ ❑ Plan Review Fee
❑ 0 Application Escrow&Agreement
El 0 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: ERZ, �C
p� Date: /iv,
Owner's Signature: 4,1. _ Date:
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Addrees/Permit Number: 99 cs 0 W tib R 7towN R-0444
description of work: 1 2 Ro 5)--1 010 w IT-14 1,1 (o w oACI-(
Septic review by: 0.1(-- Date Approved:
Zoning review by: 1...`/U 0AA/97") Date Approved: G •2 3 - Zb 13
Building review by: 4 (PAA------ Date Approved: 6 •Z3 — 2013
Grading review by: i`r/A Date Approved:
Zoning District: tZ R 't A Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: ZZ•Z(0 $F/AC Width: i MArGy(AA Lot Coverage: N/A SF _%
Survey Submitted: )2I'S'es D No Date of Survey: 3' z.9 - ?6 Revised date(?): —
oP1 it"ILL
Proposed Setbacks:
Front(L-ake) Rear(Street) ( N S E) W ) ( N S E Other Buildings Wetland
Side Side
30oI o00' (puo ' z2() ' —7Sr' 4- 11bS'
Defined Height: o {< Peak Height: FFE: — FFE minus 6 feet= - (Existing Contour)
Perimeter(linear feet) = ____ 50%= #of Stories Ok? D YES
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE:
The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION:
START WITH proposed floor(of the basement or crawl
space)and the highest point of the roof. START WITH The distance between the top of slab and
If you have a... the highest point of the roof.
If you have a...
• GABLE OR HIPPED ROOF(no • GABLE OR HIPPED ROOF(no
windows): Subtract half the windows): Subtract half the distance
distance between the highest point between the highest point of the roof
of the roof to the low point of the to the low point of the corresponding
SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof
(BASED ON ROOF • GABLE OR HIPPED ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with
TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance
distance between the top of the between the top of the highest
highest window and the highest window and the highest point of the
point of the roof roof
• ALL OTHER ROOF TYPES(flat,
• ALL OTHER ROOF TYPES(flat, mansard,etc):No subtraction.
mansard,etc):No subtraction. ADDITION Add the distance between the top of slab
SUBTRACTION Subtract the distance between the (BASED ON and the highest existing grade adjacent to
(BASED ON EXISTING basement/crawl space floor and the EXISTING the foundation.
GRADES) highest existing grade adjacent to the GRADES)
foundation OR 10 feet(whichever is less). EQUALS Defined building height
EQUALS Defined building height
Shoreland District MCWD Permit Received Average Lakeshore Setback Met? Bluff
D Yes D No „.13-N/A D Yes o
D Yes o D Yes D No /A
Permit Number: Setback:
Stormwater Quality Existing Proposed Variance Required CUP Required
Overlay District Tier Hardcover Hardcover
D Yes D No D Yes D No
Type(s): Type(s):
Updated: January 2013
v:\forms\plan review checklist 2013.docx
REMARKS (in-house):
Fees to be Char.ed AYES 3 NO
Plan Review
Investigation Fee
Other(specify) 11111_
Square Footage $ per Square Footage
Basement X = $
1st Floor X = $
2nd Floor X = $ •
Garage X = $
Estimated Construction Value: $ 0042
`2
Orono Inspections Required Work Requiring Separate Permits Required State Permits
❑ Site ❑ Plumbing ❑ Grading/ Filling 0 Well
O Hardcover Removal 0 Mechanical ❑ Fire 0 Electrical
O Footing 0 Septic ❑ Water Connection
O Poured Wall 0 Fireplace ❑ Sewer Connection
❑ Foundation Survey 0 Masonry ❑ Lawn Irrigation
O Radon Rock Bed 0 Mfg.
O Framing 0 Other(specify)
O Insulation
O As-Built Survey
Final
O Wetland Buffer
❑ Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: 0 YES 0 NO New: 0 YES 0 NO
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED
Updated: January 2013
v:\forms\plan review checklist 2013.docx
DATE TIME
CITY OF ORONO CALLED IN I l— /Jn
INSPECTION NOTICE SCHEDULED 0 Pt'nl
PERMIT NO. ZJ 13- COMPLETED
ADDRESS '-1`/` 0 W747afZ 77)w&) (21)/11
OWNER TELEPHONE NO. 6i99t`.3-tyZ4
CONTRACTOR Mi��-
>; DESCRIPTION
LI.. O FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLgNDS
y ❑ FRAMING ❑ MECHANICAL FINAL
LI 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
• OWNERICONTRACTOR TO MEET YOU:_YES NO
o COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED 0,-FiRerACT COMPLETE
CC ❑CORRECT WORK&PROCEED Pi ISSUE CERTIFICATE OF OCCUPANCY
O LICORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. CI PHOTO TAKEN
INSPECTOR WILL RETURN
El CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site: y�
Inspector. a� gS
White Copy/Inspector's File Canary Copy/Site Notice
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