HomeMy WebLinkAbout2010-0139 - bridge CITY OF ORONO PERMIT NO.: 2010-01039
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 10/25/2010
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 200 WAYZATA BLVD W
PIN : 36-118-23-43-0001
LEGAL DESC : UNPLATTED 36 118 23
LOT 000 BLOCK 000
PERMIT TYPE : ZONING PERMIT
PROPERTY TYPE : COMMERCIAL-BUSINESS •
CONSTRUCTION TYPE : BRIDGE
APPLICANT STRUCTURE PERMIT 50.00
Wayzata Country Club TOTAL 50.00
200 WAYZATA BLVD W
WAYZATA,MN 55391-
OWNER
Wayzata Country Club
200 WAYZATA BLVD W
WAYZATA, MN 55391-
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
sh I be compied with whether or not specified herein.This permit will
e i and become null and void if construction authorized is not
m enced within 180 da s of the date of issuance,or if construction is
usp nded for a period o 81 •ays at any time after work has commenced.
he pplicant is respons ble fo Suring all required inspections are
-sted n conforman.-with th Stat�uildir�Code.This permit may be
revs ed a . y time for d.a cause.
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Ape ic.• i ee :ign. . • - Date Issu-I By Signature Date
• ' •TE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
,
City of Orono
Zoning Permit Application
Mailing Address: Permit number: o20/0-0/039
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66
Cstal Bay, MN 55323-0066 Date received: /020//0
l\\41" Street Address:"11, Escrow amount:
�ti 2750 Kelley Parkway Permit Fee: 41 770-011
.t9x 4Orono, MN 55356
ESHO
100,Z4`-- wReceived by:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us (A, j Lip ()
This application form must be completed in full and all required information must be submitted. (Pleas print.)
GENERAL INFORMATION:
Job Site Address: L.(w \,4J( - t,eCLGi2A-- _ blvd . w4/Zu1?7,L4-7, bill
CONTRACTOR I APPLICANT INFORMATION:
Name: -4147k C4414 e/tbc-b
Phone: (AL-s0 I-5SC 3 Fax: CI 92_-40q-,953a-
Address: go b + t e3(✓� City: Ln/'jZ-74z., i S
ZIP: mit/
Contact Person: ✓-p i�C1V�- �3 -f Contact's phone number (p/Z_-S-0/-5S03
Email Applicant is: Contractor Homeowner (Circle One)
PROPERTY OWNERICOR TION:
Name: CyGLIA e.--11.4/0
Phone (day): 6102- -1 3 n �p
Mailing Address: p,(;1; L4)-- + V a -cdi Fj I v . Bila r-r 7d--/A MAI ZIP: c,2-6oi/
Email and/or Fax G(rat N 1�- GIL ro,,r-1 .ci j-69 W ? c- .C
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Overall Project Description:
Check TYPE OF PERMIT COST
Box
Residential Dock- Permanent dock on any lake or initial seasonal dock not on $30 + engineering review
Lake Minnetonka(permanent dock requires CUP) costs
Commercial Dock $50+ engineering review
costs
Escrow for erosion control and engineering review costs $2,000
Minor Land Alteration (grading, filling or excavating)-500 or less cubic yards $50+ engineering review
outside of lakeshore setback or less than 10 yards in lakeshore setback costs
Escrow for erosion control and engineering review costs $2,000
Major Land Alteration (grading, filling, or excavating) more 500 cubic yards or $30
more than 10 cubic yards in lakeshore setback (also requires CUP)
Escrow for erosion control and engineering review costs As determined by CUP
Stairway to Lake $50+ engineering review
costs
Escrow for erosion control and engineering review costs $2,000
Retaining Wall not requiring a building permit(A building permit is required for any $50+ engineering review
retaining wall that measures more than four feet from bottom of footings to top of costs
wall. Tiered retaining walls are considered one wall unless the walls are separated
by twice the height of the lower wall.)
Escrow for erosion control and engineering review costs $2,500
Tree Removal or intensive vegetation removal in 0 to 75 foot zone No charge.
Structure Permit for other structures not requiring a building permit but regulated $50+ engineering review
by the zoning code (including, but not limited to accessory building of less than 120 costs
square feet, detached deck or platform and sport court)
Escrow for erosion control and engineering review costs -.dd#5sEte-- /0/4- /4(---j
(over)
APPLICANT/OWNER ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Planning Department;
• Owner agrees to pay the City of Orono for engineering consultant review costs where applicable;
• 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 attached Escrow Agreement is completed and signed by Owner;
• 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. P 'vate data is information which generally cannot be given to the public but can be given to
the subject of the data. nfidential data is information which generally cannot be given to either the public or the
subject of the data. Ou pprpose and int ed use of this information is to annually update our records and records
of other governmental gOncies required law. If you refuse to supply the information, the application may not be
issued.
The undersigned certify that th. (nfo ati., suppled tr an correct to the best of their knowledge.
Applicant's Signature: A 11 •... ,0^ /1l7 Date: / '7"/,�
Property Owner's Signature: Date:
TYPE OF PERMIT: SUBMISSION REQUIREMENTS:
Except for tree removal permits, all permits require a completed application
form, escrow agreement(signed by the property owner) and escrow check
from owner, two copies of all plans, and three copies of all grading plans or
surveys/site plans
Residential Dock Seasonal Dock—survey showing proposed dock
Permanent Dock- plans as approved by CUP and copy of LMCD permit
Commercial Dock 1. Structural plans for the dock
2. Survey showing the proposed location of the dock
3. Copy of LMCD permit
Minor Land Alteration 1. Grading plan including existing and proposed contours
(Less than 10 cu.yds. within 75' of lake 2. Amount of fill to be imported and/or exported and haul route
or less than 501 cu.yds elsewhere.) 3. Amount of earth to be moved around on site
4. Erosion control plan or copy of MCWD Erosion Control Permit
Major Land Alteration 1. Plans as approved by Conditional Use Permit
2. Erosion control plan or copy of MCWD Erosion Control Permit
Stairway to Lake 1. Construction plans for stairway
2. Topographical survey of property with proposed stairs drawn in.
3. Erosion control plan or copy of MCWD Erosion Control Permit
Retaining Wall 1. Plans for wall(s)
2. Unless repair or exact replacement of existing wall, grading plan including
existing and proposed contours
3. Hardcover calculation worksheets if in shoreland district
4. Erosion control plan or copy of MCWD Erosion Control Permit
Tree Removal Call 952-249-4600 to schedule inspection.
Structure Permit 1. Plans for structure.
2. Survey of property with proposed structure drawn in and with setbacks to
property lines, other structures on property and the septic system indicated
.The general location of any sewer and water services should be shown if
applicable.
3. Grading plan if grading is required
4. Hardcover calculation worksheets if in shoreland district
5. Erosion control plan or copy of MCWD Erosion Control Permit
Last Updated: July,2010
ANDERSON ■ URLACHER P.A.
STRUCTURAL ENGINEERING
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KEEP THIS PLAN SCT ON SITE AT ALL T MES
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901 NORTH THIRD STREET.SUITE 220•MINNEAPOLIS,MN 55401
612-692-9958• CELL 612-839-2897•FAX 612-692-9960
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STRUCTURAL ENGINEERING
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED Z Q
PERMIT NO. Zb'o-61°39 COMPLETED 2- is-- l r
ADDRESS 2-0 o wA\rz6,--fla
OWNER (AlA+Y744, C4. C i!.V e TELEPHONE NO. `is z_ 2t l� _ 6 053
CONTRACTOR
DESCRIPTION - O4(9 A!.5
Lit,11 FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
ct ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
ti ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
• ❑ 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
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
• OWNER/CONTRACTOR TO MEET YOU: YES_NO
o COMMENTS:
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LU ElCORRECT WORK&PROCEED I: ISSUE CERTIFICATE OF OCCUPANCY
OO El CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
✓ BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑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
OwnerlContror on it
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
DT TIME
CITY OF ORONO CALLED IN '/
INSPECTION o OOH I ���3q SCHEDULED a7-/ 7"—// q:
PERMIT NO. / COMPLETED
ADDRESS '?''OZa t ' �V
OWNER a CG TE PHONE NO. $57-- 210 6653
CONTRACTOR �'�
>: DESCRIPTION
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h ❑ FRAMING ❑ MECHANICAL FINAL
❑ TREE REMOVAL
0 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
❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
o COMMENTS:
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❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
U BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
0 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. 4-,/7 (.3
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White Copylinspector's File Canary Copy/Site Notice
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