HomeMy WebLinkAbout2015 - 01144 (voided) City of Orono
'Building Permit Application for Maintenance / Replacement / Remodel
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
T Mailing Address: .�
�O�V PO Box 66 Permit number: p��/j� ��
O Crystal Bay, MN 55323-0066 Date received: ' "9--
Street Address: Received by: �/
ti• L 2750 Kelley Parkway Plan review fee: cQ/ ' —0/4.3
Orono, MN 55356 Q
�kESHO�� l/i'
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 b- .• bmitted. 4
Incomplete applications will be returned. (Please print) 4, #
GENERAL INFORMATION:
Job Site Address: t.V;SO vwev 4, rA
Will this be a Parade of Homes, Remodelers Showcase Home or other Displa ! • 4Y i i o
If yes,a special event permit is required with Police Department and City Council approval 60 da •.r,• t. h ice will be
required unless applicant demonstrates sufficient on-site parking is available. ,� 0 : nt 'll no 1 "1:.
CONTRACTOR/APPLICANT INFORMATION: / _ 'ie % D
Name: `(c Wy k!b. o` Si2.. t •
State License# (C• 2' Ck4 3 .2°‘ "a--
Lead Certification Number: l3 pt-'ç - c= t 1 eN W -a. - 1 . • op a a • k 1 .1,0 i 'ci
(for work on homes that were constructed prior to 1978 t
Phone: (cell) iZ 9 1$ 295 2, % •ffice)
Mailing Address: 2i7 c SLd-eS blvd City: v"```"'^14--bi.IcZIP:
ss 30t
Contact Person: V.a.s. 1 �o 'r S titv.G 1,\ ,pplicant is: ontracto / Homeowner (Circle One)
Email and/or Fax: .4-15v.kak.csc..S2 rke..1X . Ca v,..
PROPERTY OWNER INFORMATION:
Name: A 1, W ‘ \ c-ck
Phone (day): 1 t 1 . 13 3 • $y
Address: yS-d 1,.)o I vee#0 4 City: 0 v v a ZIP:
Email and/or Fax:
PROJECT INFORMATION: Overall pr, -ct description:
Type of Project: Any earth movement may also require
❑ Door(s) 0 Remode 0 Fire Damage MCWD review&permits:
❑ Re-roof, asphalt 0 Repa' 0 Storm Damage Minnehaha Creek Watershed District(MCWD)
15320 Minnetonka Blvd
❑ Re-roof,cedar
0 Re- 'ration 0 Water Damage Minnetonka, MN 55345
0 Re-roof, other(specify) 1 0 ' •ing 0 Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
Oe�N.- Qe-'DU I ti V Vindow(s) www.minnehahacreek.orq
Estimated Construction aluation of Project(excluding land) $ 15 1 066
APPLICANT ACKN• LEDGEMENT:
• Agrees to provid" .II information required or requested by the Building Department;
• Certifies that " 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 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 inf ion,the application may not be issued.
Applicant's Signature: Date: CI , C1 l 1-
Owner's Signature: Date:
Last Updated:January 2015
• PLAN REVIEW
) CHECKLIST;FOR NEW STRUCTURES / ADDITIONS
Address: 4550 �,�j O N er-k0 n RC Permit No.: �aIS- 1 `L:/-'
Description of work: Pe C,tC- Date Rec'd: `l Q I �7
C Septic review by: Date Approved:
Zoning review by: Date Approved:
Building review by: Date Approved:
Grading review by: Date Approved:
Zoning District: 112- I( Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: SF/AC Width: Lot Coverage: SF
Survey Submitted: ❑ Yes ❑ No Date of Survey: Revised date(?):
Proposed Setbacks:
Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
Side Side
Defined Height: Peak Height: FFE: FFE minus 6 feet = (Existing Contour)
Perimeter(linear feet) = 50% = L.F. below grade # of Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the lowest proposed The distance between the top of
START WITH floor(of the basement or crawl space)and START WITH slab and the highest point of the
the highest point of the roof. roof.
If you have a... If you have a...
• GABLE OR HIPPED ROOF(no •
GABLE OR HIPPED ROOF
(no windows): Subtract half
windows): Subtract half the distance the distance between the
between the highest point of the roof highest point of the roof to
to the low point of the corresponding the low point of the
SUBTRACTION gable or hipped roof corresponding gable or
(BASED ON • GABLE OR HIPPED ROOF(with SUBTRACTION hipped roof
ROOF TYPE) windows): Subtract half the distance (BASED ON • GABLE OR HIPPED ROOF
between the top of the highest ROOF TYPE) (with windows): Subtract
window and the highest point of the half the distance between
roof the top of the highest
• ALL OTHER ROOF TYPES(flat, window and the highest
point of the roof
mansard,etc):No subtraction. • ALL OTHER ROOF TYPES
SUBTRACTION Subtract the distance between the (flat,mansard,etc):No
(BASED ON basement/crawl space floor and the subtraction.
EXISTING highest existing grade adjacent to the ADDITION Add the distance between the top
GRADES) foundation OR 10 feet(whichever is less). (BASED ON of slab and the highest existing
EQUALS Defined building height EXISTING grade adjacent to the foundation.
GRADES)
EQUALS Defined building height
Shoreland District MCWD Permit Average Lakeshore Setback Bluff
Met?
❑ Yes ❑ No Permit Number: 0 Yes 0 No 0 N/A 0 Yes 0 No
0 N/A—see attached Setback:
Stormwater Quality Existing Hardcover Proposed
Overlay District (% and sf) Hardcover Variance Required CUP Required
Tier(circle one) (%and sf)
❑ Yes ❑ No ❑ Yes ❑ No
1 2 3 4 5 Type(s): Type(s):
Updated: January 2015
z:\forms\plan review checklist 2015.docx
REMARKS (in-house):
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 = $
1st Floor X = $
2nd Floor X = $
Garage X = $
Estimated Construction Value: $
Orono Inspections Required Work Requiring Separate Permits Required State Permits
❑ Site 0 Plumbing 0 Grading/ Filling 0 Well
❑ Silt Fence/ Erosion Control 0 Mechanical 0 Fire 0 Electrical
❑ Hardcover Removal 0 Septic 0 Water Connection
❑ Footing 0 Fireplace 0 Sewer Connection
❑ Poured Wall 0 Masonry 0 Lawn Irrigation
❑ Foundation Survey 0 Mfg. 0 Landscaping
❑ Foundation Waterproofing 0 Other(specify)
❑ Radon Rock Bed
❑ Framing
❑ Insulation
❑ As-Built Survey
❑ Final
❑ 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 2015
z:\forms\plan review checklist 2015.docx
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Christine Mattson
From: Christine Mattson
Sent: Tuesday, October 06, 2015 11:49 AM
To: 'nancy.abramson@lakesmn.com'
Subject: 4550 Wolverton Place
Attachments: Variance Application -August 2015.pdf
Nancy,
Per our telephone conversation yesterday, according to zoning code definitions 78-1,the Lot Line, Front is defined as a
lot that abuts an existing or dedicated public or private street.
According to City Code Sections 78-1435 and 78-1404 no accessory structure (pool) may be located closer to the street
than the principal structure.
Attached is the variance application packet. Please don't hesitate to contact us if you have any questions.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway ; Orono MN j 55356 (physical address)
PO Box 66 Crystal Bay I MN 55323-0066 (mailing address)
'S952.249.4620 E 952.249.4616
cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE WILL BE CLOSED: Wednesday, November 11, 2015
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