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Home My WebLink About2018 - 00281 - addn/remodel/repair 111141 311 111111111111111111111 CITY OF ORONO * 20 1 8 - 0028 1 2750 KELLEY PARKWAY DATE ISSUED: 03/19/2018 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1849 WEST FARM RD PIN : 27-118-23-43-0026 LEGAL DESC : N/A : LOT 14 BLOCK 1 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 165,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) BASEMENT FINISH APPLICANT PERMIT FEE SCHEDULE 1,519.42 STATE SURCHARGE(VALUATION) 82.50 NEXT ERA CONSTRUCTION TOTAL 1,601.92 1211 WINDRUSH RD Payment(s) BUFFALO,MN 55313- (763)286-1380 CHECK 7147 1,601.92 Minnesota State License#:BUIL-BC 668680 OWNER SHULER, SUSAN&DAVID 1849 WEST 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 80 days at any time after work has commenced. The applican s re pon .I,for assuring all required inspections are requested in onf. •'ce ith the State Building Code.This permit may be revoked at. y ti fe due cause. 1 /(e) --Ped-co ,)9 Applicant IV ite- ignature Date Issued By ature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) G V.„..046,..‘ O� Mailing Address: Permit number: /p— O?)$I O PO Box 66 Crystal Bay, MN 55323-0066 Date received: 3-1 .3-1 g Street Address: :: ee: -2750 Kelley Parkway 7• tP d �l,9KFSH0�� Orono, MN 55356 ~ l4 \ i910` 00 R� Total Fee: 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 bebmitted. Incomplete applications will be returned. (Please print) ' / 40). / q,a2) GENERAL INFORMATION: + ,• ,, � Job Site Address: w ,c� R8 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes . 3JNo 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/APP CANT INFORMATION: Name: �-e' - - LrtA Conck., i%do State License# Q C(0 6 c6‘ e o Expiration Date: Lead Certification Number: Ai o0— I I y /i y - a Expiration Date: (for work on homes that were constructedprior to 1978 Phone: (cell) _763 -at b , 1 3 30 (office) Mailing Address: , f t, / A r City , , 4.,(o ZIP: CS-3 I Contact Person: k iii; Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: �\ ` rt ,.erc,. roti,S-t- (\) . iaN QUI , ( O PROPERTY OWNER INFORMATION: Name: _Gc yh 1 ,�c.\//r� k �e.i- 1 Phone (day): Address: S 0._ r, d(N.‘tpc 5 City: ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project description: 3.0e 14,,C..1A A- -'-t r‘Clr1 Type of Project: Any earth movement may also require ❑ Door(s) Remodel Fire Damage MCWD review&permits: o Re-roof,asphalt 0 Repair 0 Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar 0 Restoration 0 Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) 0 Siding 0 Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 0 Window(s) YcNiekt..els I1. www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ 16S , 000. 00 APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • 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; • 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 enerally cannot be given to either the public or the subject of the data. Our purpose and intended use of this informati n is annually update our records and records of other governmental agencies required by law. If you refuse to supply the inf a' n,th application may not be issued. riltietitoee Applicant's Signature: Date: 3/13/1?) Owner's Signature: Date: MAR m18 Last Updated:January 2016 CITY OF ORONO .R PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: ig'T ( Ki. Kff,,t4 Act / Permit No.:Zvr 8'O&L 1 Description of work: Date Rec'd: 5/i 5//s Septic review by: Date Approved: Zoning review by: Date Approved: 1� Building review by: /(1 .2:e.-) � Date Approved: 3//41/4 /l Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: 0 Yes 0 No Date of Survey: Revised date(?): Landscape plan submitted? 0 -s 0 No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) N S E W ) ( N S E W ) Other Buildings Wetland Side ide Defined Height: Peak Heigh: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% = L.F. below grade Basement? 0 Yes 0 No, Stori t. FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the I est•roposed Slab at or above grade— START WITH floor(of the basement or c wl sp- e)and measure from highest existing the highest point of the r f. START W ITH Grade to the highest point of the roof even if fill was brought in to If you have a... elevate home. SUBTRACTION • GABLE OR PPED ROOF(no Slab below grade—measure (BASED ON windows): ubtract half the dista cefrom highest existing grade to the ROOF TYPE) between t e highest point of the roof highest point of the roof. to the to point of the correspondin If you have a... gable o hipped roof SUBTRACTION • GABLE OR HIPPED ROOF • GAB OR HIPPED ROOF(with (BASED ON (no windows): Subtract half win ows): Subtract half the distance ROOF TYPE) the distance between the een the top of the highest highest point of the roof to ndow and the highest point of the the low point of the oof corresponding gable or hipped roof • ALL OTHER ROOF TYPES(flat, • GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION ubtract 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? Permit Number: 0 Yes 0 No El N/A 0 Yes 0 0 Yes 0 No 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) D Yes O No D Yes O No 1 2 3 4 5 Type(s): Type(s): Fees to be Charged YES NO Permit: _ Plan Review t/" State Surcharge _ t1 Investigation Fee LA SAC Number of SAC Units _ `- ti� Other(specify) L---- Square /Square Footage $ per Square Footage Basement X = $ 1st Floor X = $ 2nd Floor X = $ Garage X = $ / � Estimated Construction Value: $ G/IP 5- Orono Inspections Required Work Requiring Separate Permits O Footing 0 Site Plumbing 0 Grading/Filling O Poured Wall 0 Silt Fence/Erosion Control Mechanical 0 Fire O Foundation Survey 0 Hardcover Removal 0 Septic 0 Water Connection O Foundation Waterproofing 0 Other(specify) tI Fireplace 0 Sewer Connection 1Araming 0 Masonry 0 Lawn Irrigation -"FInsulation 0 Mfg. 0 Landscaping 0 As-Built Survey 0 Other(specify) Final O Lathe Required State Permits O Other(specify) 0 Well X.Flectrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: O See Builder Acknowledgement Form O Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 7\fnnnc\plan raviow rhorklict 1(1-9(11 c rinry