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Home My WebLink About2009 - 00466 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2009-00466 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 08/19/2009 (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 200 WOODHILL RD PIN : 02-117-23-12-0001 LEGAL DESC : UNPLATTED 02 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 437-NONRESIDENTIAL&NONHOUSEKEEPIN VALUATION : $ 121,000.00 NOTE: PADDLE COURT REPLACEMENT APPLICANT PERMIT FEE SCHEDULE 1,182.75 CLUB, WOODHILL COUNTRY PLAN REVIEW 768.79 200 WOODHILL RD WAYZATA,MN 55391 STATE SURCHARGE(VALUATION) 60.50 TOTAL 2,012.04 OWNER CLUB,WOODHILL COUNTRY 200 WOODHILL RD 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 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 re .kes . y time ford u Applicant Pe itee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. Co-fiLa • City of Orono S'-(1-L)) Building Permit Application for New Structures or Additions O Mailing Address: Permit number: �DD� 00 Tlo� Cr Box 66 � WD? Q Q Crystal Bay, MN 55323-0066 Date received: A. Street Address:' Received by: � �, ih . G�ti 2750 Kelley Parkway Plan review fee: `�xEsxo4`� Orono, MN 55356 Total Fee: a'O/ a _ 04-) 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: ( L Job Site Address: 2 00 UJ 6©c� � II Qom_A Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No 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 INFORMATION: i ,I f Name: L ()CALA4 CO � .�"kt2 C.0 u_bI ` Pick (fie .e..2tcU�Se�, State License# g Expiration Date: Phone: 9 6-2..-- -03- (/ (office) 6 fa - a 9 0 — S N/o (cell) Mailing Address: b p o o ; II an vk City: W).2��a ZIP: s"'S-.3 I Contact Person: ( is tr T24240p..4kLS a Applicant is: Contractor / Homeowner (circle one) Email and/or Fax: qsa - o3 - 01/ 3 Q...- 2�d4:a.z;<k3 ® M S/0 . Co., PROPERTY OWNER INFORMATION: l Name: LL )0 o&\....; 1( Co �...-i� C u.b Phone (day): '3 - -.S : 7 Address: a©O (.J tno r 2 00,k_ City: (,t.,J ca.. -z_ ZIP: S.r'�'' / Email and/or Fax 4 S ;A60 cJ-e ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal& ElNew Construction Water Supply ❑ Single Family with ❑ Residence ❑Addition attached garage ❑ Garage/Accessory Ell Accessory Building El Single Family with El Deck Bldg. ❑ Public Sewer ❑ Relocation detached garage ❑ Office/Commercial El Other: (specify) El Multiple Family/Condo El Warehouse CI Private Sewer ❑ Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial N.Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) 18202 Minnetonka Blvd (( CG,..,..4_-\5 Deephaven, MN 55391 (�CtC` .. Phone: 952-471-0590 Fax: 952-471-0682 e I ,( www.minnehahacreek.orq Estimated Construction Valuation (excluding land) $ / I/ 000 -20- STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions (continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame ❑ Masonry b.Width (ft.)= Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet Detached= ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1st Story = ❑ Other(please specify): e. 2nd Story= V.wn't N v - f. '/Story = g.Total Area= cb--ae, Co v 2 s REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ 0 Permit Application O 0 Proposed Building Plans O 0 MN State Energy Code Calculations and Mechanical Code Requirements Form ❑ 0 Survey(meeting all requirements) ❑ 0 Stormwater Pollution Prevention Plan O 0 Hardcover Calculation(s) ❑ 0 Septic System Site Evaluation Report O 0 Access Permit O 0 Wetland Buffer Improvement Plan O ❑ Engineered Plans for Retaining Walls 4 feet or above O 0 Plan Review Fee • O ❑ Other APPLICANT 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; • 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. Applicant's Signature: Date: A b " C q -21 - Plan Review Checklist for New Structures / Additions Address/ PID/ Legal: 2.00 w 0 0 0%4 t Lt. IZ-.OA 0 Description of work: (' A 00i—e: Co..u(2.i 41 L4CQ iy`Q,,t'f— Septic review by: NM Date Approved: Zoning review by: 01///4 Date Approved: Building review by: cr), 0 r .1,i../..., Date Approved: Ab- 11- o et Grading review by: Date Approved: Zoning File#: Resolution #: Resolution Date: Zoning District Fire Department Post Office School District Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: ❑ Yes ❑ No Date of Survey: Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Building Defined Height: Building Peak Height: FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START the distance between the basement floor/ START the distance between the slab and the WITH crawl space floor and the highest roof peak, WITH highest roof peak, the top of the cornice the top of the cornice of a flat roof, the deck of a flat roof, the deck line of a mansard line of a mansard roof, or the uppermost roof, or the uppermost point on a round or point on a round or other arch-type roof other arch-type roof SUBTRACT half the distance between the highest SUBTRACT half the distance between the highest window and highest roof peak of a pitched window and highest roof peak of a roof pitched roof SUBTRACT the distance between the basement floor/ ADD the distance between the slab and the crawl space floor and the highest existing highest existing grade within the grade within the foundation or 10 feet, foundation whichever is less. EQUALS Defined building height EQUALS Defined building height Lot Coverage: SF Shoreland District MCWD Permit Received Average Lakeshore Setback Bluff 0 Yes 0 No 0 Yes 0 No 0 N/A 0 Yes 0 No 0 N/A 0 Yes 0 No _ Permit Number: Setback: Hardcover Zones Existing Proposed Variance Required CUP Required 0-75' 0 Yes 0 No 0 Yes 0 No _ 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): /N 14in,0 11,e i c-on_erv'T— Updated: 07/01/2009 z:\forms\plan review checklist.docx Fees to be Charged YES NO Permit t/ Plan Review • State Surcharge Investigation Fee SAC—Number of SAC Units Sewer Connection Water Connection Park Fee Site Inspection Other(specify) Miscellaneous Fees Calculated By: UBC: -3 Construction Type: 'Y Square Footage $ per Square Footage Basement X = $ 1st Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ J 2I, 000 °= Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site ❑ Plumbing ❑ Grading / Filling ❑ Well ❑ Hardcover Removal 0 Mechanical 0 Fire 0 Electrical RJ Footing 0 Septic 0 Water Connection O Foundation Survey 0 Fireplace 0 Sewer Connection O Framing 0 Masonry 0 Lawn Irrigation ❑ Insulation 0 Mfg. O Wall Board 0 Other(specify) ❑ As-Built Survey ,I2' Final ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: 0 YES 0 NO New: 0 YES 0 NO REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 07/01/2009 z:\forms\plan review checklist.docx (J- D TIME CITY OF ORONO CALLED IN ` D /D� INSPECTION NOTICE SCHEDULED IS "!NI l/ .( PERMIT NO. '-c u InI COMPLETED /�ci ADDRESS f x % W CKd/1 ( / l I OWNER -R/ /�l�t 4 K7C KCO�VTR. TELEPHONE NO. (j7!c -c390—5g/0 DESCRIPTION -/[J('X / nitAL4 GL u, ❑ FOOTING 0 MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q ❑ FRAMING ❑ MECHANICAL FINAL 0 LAKESHORENVETLANDS y ❑ INSULATION 0 WOOD BURNER/FIREPLACE ❑ TREE REMOVAL • ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS 0 DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT 0 DEMO-FINAL ❑ SEPTIC INSTALL. 0 FOLLOW-UP ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL v ❑ PLUMBING FINAL ❑ FOUNDATION/REMOVAL • OWNERICONTRACTOR TO MEET YOU: YES NO o COMMENTS: cc W 0- CC CC O CC O U- W CC W W CC d WCC ❑WORK SATISFACTORY:PROCEED .n PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ` ❑ ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C1 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 inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: 22 Inspector. LJJ f t3 y5 White Copy/Inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN g-19- INSPECTION KOTICLSCHEDULED $- d"� wtaa/ PERMIT NO.J –��-CJ`t(A0 COMPLETED 1' ADDRESS Q00 00 \CnI i ( ' ?-4, OWNER CONTR. _S't. 4 TELEPHONE NO. Lf)I ? -0-90 - w D SCRIPTION F.00-2-7 fV �-fi PA 40ez_ a� FOOTING ❑ MECHANICAL RI ❑ EXCAV/GRADING/FILLING Q0 FRAMING ❑ MECHANICAL FINAL ❑ LAKESHORE/WETLANDS " INSULATION ❑ WOOD BURNER/FIREPLACE ❑ TREE REMOVAL • ❑ WALL BD. ❑ WATER HOOK-UP ❑ SITE INSPECTION Q ❑ FINAL ❑ SEWER HOOK-UP ❑ PROGRESS ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ COMPLAINT E DEMO-FINAL ❑ SEPTIC INSTALL. ❑ FOLLOW-UP 2 ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ HARD COVER REMOVAL ❑ PLUMBING FINAL 0 FOUNDATION/REMOVAL OWNER/CONTRACTOR TO MEET YOU: YES_NO o COMMENTS: cc W C cc 0 cc 0 W W W cc O ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE 11.1 (CC 0❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑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 OwnerlContrac�o si Inspector. White Copy/Inspector's File Canary Copy/Site Notice