HomeMy WebLinkAbout2016-00520 CITY OF ORONO
2750 KELLEY PARKWAY * 21 6 — 0 0 5
DAT0 E ISSUED: 05/27/22 011
6
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS 2725 WAYZATA BLVD W
PIN 33-118-23-13-0019
LEGAL DESC CRYSTAL BAY BUSINESS CENTER
LOT 3 BLOCK 2
PERMIT TYPE ADDITION/REMODEL/REPAIR
PROPERTY TYPE COMMERCIAL-BUSINESS
CONSTRUCTION TYPE ADDN/REMODEL/REPAIR
ACTIVITY 437-NONRESIDENTIAL&NONHOUSEKEEPIN
VALUATION $ 50,000.00
NOTE: INTERIOR BLOCK WORK(STRUCTURAL)&BUILD STORAGE LOCKERS
OTHER INSPECTION REQUIRED: ROLL DOOR TESTS
APPLICANT PERMIT FEE SCHEDULE 715.92
MONTGOMERY BRINKMAN LLC STATE SURCHARGE(VALUATION) 25.00
1901 OAKCREST AVE TOTAL 740.92
#6 Payment(s)
ROSEVILLE,MN 55113- CREDIT CARD 4781 740.92
(612)221-6626
OWNER
Metro Mini Storage
BARNES,CHRIS
13528 W.BOULTON BLVD.
FOREST LAKE,IL 60045-
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 use.
Applic itee Signa a Date Issued By gifnature Date
. " CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
A TO MailiPO Boxr
�O ess:66 CV-�(Q� Yate
number: I - 7 S 2
l V Crystal Bay, MN 55323-0066 CJ 1 'Date received: 2 1
Street Address:'y� G Received by-
an _0
2750 Kelley Park ay Plan review fee:
kESHOR� Orono, MN 55356
Main: 952-2494600 Total Fee:
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: ,,v1
Job Site Address: 7 �d 0t-a,,�o l5 535 ic
Will this be a Parade of Homes, Remode s Showcase Home or other Display Home? El Yes o
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/APPLICANT I FORMATION:
Name: maet
State License# Expiration Date:
Phone: cell / office
Mailing Address: _001 p City: .", 11,0 ZIP: I
Contact Person: Applicant is: Contractor J Homeowner (Circle One)
Email and/or Fax: eGot-1
PROPERTY OWNER INF RMATION:
Name: e -Self 6i-o✓
Phone(day): - 13 _[ 1 , - t di 5
Address: 5 L, , o Cit :6� -e4 1AI-e ZIP: L60L15
Email and/or Fax vrie p
ARCHITECT/ENGINEER INFORM TION: Q
Name: g" I-, V L tc
Phone(day): 51- qQ 7-6,0 Sk Y'
Address: 3 5 2 L04t 62"AJ�jCit : +t 4tV 4P: �
Email and/or Fax:
rrlao 0f- 0o✓ rtAtl �,t
PROJECT INFORMATION: Descri tion of pro'ect: �11;lal 1z,
exi
1. Type of Project 2. Proposed Use 3.St cture Type 4. Sewage Disposal&
Water Supply
ElNew Construction ElSingle Family with [IAccessory Bldg./Garage
ErAddition attached garage ❑ Deck Di/public Sewer
❑Accessory Building ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage ❑ Residence ❑ Private Sewer
�f Other:(specify) Va-1 ❑ Multiple Family/Condo ❑ Retaining Walls)
ublic 4-feet or greater Public Water
**Any earth movement may also require Commercial ❑ Storage
MCWD review&permits. ❑ Industrial $Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other:(specify) 'O-Other(specify)
15320 Minnetonka Blvd 2
Minnetonka,MN 55345
Phone: 952471-0590
Fax: 952-471-0682
www.m innehahacreek.or
/� •
Estimated Construction Valuation(excluding land) $ � I Q0p
Last Updated: January 2015
r
STRUCTURE INFORMATION:
1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction
a. Length(ft.)= Number of bedrooms=
❑Wood/Frame
b.Width(ft.)= Number of garage stalls: �9 Masonry
Areas in square feet Attached= L(Metal
❑ Pole Bldg.
c. Basement= Detached= ❑ ICF
d. 151 Story = ❑On-site Prefab
e. 2nd Story= ❑Off-site Prefab
f. %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
❑ A Building Permit Escrow Agreement and Fees
❑ ❑ Plan Review Fee
❑ K Completed Application Form
❑ Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/2 x 11 set
❑ Minnesota State Energy Code Calculations and Mechanical Code Requirements
❑ 39�_ Survey—2 full size,to scale(meeting ALL survey requirements)
❑ Hardcover Calculations
❑ Septic System Certification
❑ Minnehaha Creek Watershed District(MCW D)Permit or
Documentation from MCWD stating no permit is required
❑ Landscape Walls and/or Retaining Wall Plans
❑ Y Stormwater Pollution Prevention Plan SWPPP
❑ ar 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: Date:
Owner's Signature: Date:
Last Updated., January 2015
I aCIAO4
` DATE TIME
CITY OF ORONO CALL DIN
INSPECTION NOTICE SCHEDULED I
PERMIT NO. q L14`ffha0 COMPLETED
ADDRESS a vZ`7 t Z�ICS L7 11c�1 L{�
OWNER TELEPHONE N . z�
CONTRACTOR r
DESCRIPTION
W ❑ FOOTING ► e� DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
❑ 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
y COMM TS:
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❑CORRECT WORK 6 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C 1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTOTAKEN
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
Owner/Contra r on site:
Inspect
White Copyllnspector's File Canary CopylSite Notice
V
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION T CE SCHEDULED
PERMIT NO. — z® COMPLETED
ADDRESS z� 7'2- S at'Zq 4 ly d
OWNER TELEPHONE NO.
CONTRACTOR ,l l
3.
DESCRIPTION S�c�NaS e /mac X, el f
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ AA DON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q AMING ❑ MECHANICAL FINAL El 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
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
R COM ENTS:
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d ❑ RRECT WORK CALL FOR REINSPECTION TEMPORARY
C1 BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL RETURN
❑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/Contract n site:
r.
Inspecto
white Copyllnspectoes File Canary Copy/Site Notice
Y
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICESCHEDULED
PERMIT NO.ip& 00'�'z'0 COMPLETED
ADDRESS
OWNER TELEPHONE NO.
CONTRACTOR �L
DESCRIPTION � 70tt; `
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
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 FINALRATED WALLS
INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
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iW WORK SATISFACTORY:PROCEED O PROJECT COMPLETE
CC ❑CORRECT WORK&PROCEED El ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owneri'Con r on site:
Inspector.
White Copyllnspectoes File Canary Copy/Site Notice
DATE / TIME
CITY OF ORONO CALLED IN
INSPECTION NQJICE giZ SCHEDULED —
PERMIT NO. �� OMPLETED J
ADDRESS 5 a
OWNER A WEPHOI)IE NO Sl' -1405FID
CONTRACTOR
DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
QAMING ❑ 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 ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
COMMENTS:
W
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W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
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❑ RRECT WORK 6 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
FOR COVERING PERMANENT
❑CO RRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
L1 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
OWneric r on site:
Inspector.
White Copynnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED
PERMIT NO.' '--QQ CO PLETED
A"Ess Z 7Z5` Lo2r zr 7S /ff lvd
OWNER TELEPHONE NO.
CONTRACTOR
DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ S INSPECTION
Q [3FRAMING ❑ MECHANICAL FINAL TED WALLS
E3INSULATION E3WOOD BURNER/FIREPLAC ❑ COMPLAINT
❑ FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP
W ❑AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE
❑ SEPTIC INSTALL
2 OWEPJCOKTRACTOR TO MEET You:_YES_No //
c COMMENTS: a r �4' ``
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0 [03 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V 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 bnPw*m 24 hours In advwlm (952) 249-4600
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