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HomeMy WebLinkAbout2016-00227 - building permit app CITY OF ORONO • n BUILDING PERMIT APPLICATION �1 FOR NEW STRUCTURES OR ADDITIONS 10 4•KO OAT Mailing Address: Permit number: 0 A y�'O PO Box 66 �`- Crystal Bay, MN 55323-0066 Date received: ,r Street Address:' Received by: 2750 �� � 2750 Kelley Parkway Plan review fee: (3 7/,3 2--Jt�kESH���G Orono, MN 55356 Main: 952-249-4600 Total Fee: � ��� ac)-1C:> Fax: 952-249-4616 www.ci.orono.mn.us ExroW Rn IALANWA4+,,, rri6lux6 Ye.3- This application form must be completed in full and all required information mustbb submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 7.17 00 k_z ?Z;,-..) - _.`‘ C 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 servicei�411 Se required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION:i Name: C__.--,1C-\c,,J_� C._c. ,'r2<c-,a\-1c,.J State License# •L,-k7 cY-.,S Expiration Date: :,13i t, ,(� Phone: (cell) (eS\ _ - 9,..e,_- 9l3_ 3c..z.:--e_ (office) i..5\_3 - - .....L.,7__ Mailing Address: -7 L. { _e_,-„�,h.l, .k.b , Cit :-�..C(���,.yl.-t ZIP: �31, ' Contact Person: ..y^-) <'"1-y�� `N-- Applicant is: (ontractoi. / Homeowner (Circle One) Email and/or Fax: f-5c : � ioc.e,; o,-,sw� N:,:,,,. , ,::-., PROPERTY OWNER INFORMATION: Name: kJ * A,->:14..-LA, \-\c, -.......--) Phone (day): riST_- 72z-c.) t-i-`-c okk Address: t`toi'S`'i /"u. ,..4‘.. Q,.,.i City: &IEA, ?r ZIP:` 5341 Email and/or Fax c,irw.e..\vat, 0 Y..s,,,V. C.:-c;e^-•••-- ARCHITECT/ENGINEER INFORMATION: Name: M-stL-i--_ Et1.,,,- (. ('_l-v- 6 _) Phone (day): (1.:=.p.._- 7te - 7 1`'-Z-_ Address: City: r;r,,--i ZIP: Email and/or Fax: ,,;IC.�l. 0 h f i✓\v- ,,,„C1;„.,,.,,,r,c@-P,:_,-y. c4,,,, PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal& New Construction Water Supply (� Single Family with ❑Accessory Bldg./Garage Addition attached garage ❑ Deck Building ❑ Public Sewer ❑ Accessory ❑ Single Family with 0Office/Commercial ❑ Relocation detached garage 0 Residence (Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo 0 Retaining Wali(s) ❑ Public 4-feet or greater 0 Public Water *"Any earth movement may also require 0 Commercial 0 Storage MCWD review&permits. ❑ Industrial 0 Warehouse [g Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other:(specify) 0 Other(specify) 15320 Minnetonka Blvd Minnetonka,MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.orq Estimated Construction Valuation (excluding land) BASO , 000 Last Updated: January 2015 STRUCTUI • ' AIION: 1.Structure 1i •' re l r r f 1.Structure Dimensions (continued) 2. Type of Construction a. Length(ft:)\ � ;; '' ` Number of bedrooms= • EXWood/Frame b.Width(ft.)= tic' Number of garage stalls: Lic 0 Masonry Areas in square feet Attached = 0 Metal 0 Pole Bldg. c.Basement= J ( & Detached = ❑ ICF d. 1st Story = 0 On-site Prefab e.2nd Story= Zi Z7 ❑ Off-site Prefab f. 1/2 Story = 0 Other(please specify): g.Total Area= 401 7_(P REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclpad Applicable ❑ Building Permit Escrow Agreement and Fees ❑ 0 Plan Review Fee 0 Completed Application Form p� Elr 0 Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8''A x 11 set O Minnesota State Energy Code Calculations and Mechanical Code Requirements lam 0 Survey—2 full size,to scale(meeting ALL survey requirements) [►3' Hardcover Calculations Septic System Certification I21* 0 Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD stating no permit is required ❑ / Landscape Walls and/or Retaining Wall Plans 1:1e—/ Stormwater Pollution Prevention Plan(SWPPP) ❑ l3 Access Permit 0 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: k 1 t s Owner's Signature: nYt.;/ 61/. Date: Last Updated: January 2015 �" 3r e ,, ., 3,-:,,,-4!:N PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ' o D , . Com•, -�,,., '•e ,,,, d '..:.-2.1u...,,,--44,-, S��S4 Address: 2�(XJ cU 1(( Permit No.: .i.® G-- 4 �,. a Description of work: N Q Si9ctirn1 Y u Date Rec'd: -A" ,-, 45(L:,-.' ri �� , x / ,� f Ev t s�' �i^Pi�/'sta'tct�X , ' ''s� Septic review by: _ -9 / Date Approved: m/� ; E ;' '-1(.7`"�J 3' s 4,, Y4i t 14 Zoning review by: rIgIli ..1!� i Date Approved: /- E -0 4 ;,, ,z,- Building review by: / (Ir/,r__ Date Approved: _ .' a 4¢c, � '� , Grading review by: _- Date Approved: ) ,) . a> 1 1 Zoning District: I- 18 Zoning File#: Reso#: $ 'j ' " Zoning: Lot Area: b /32�/(AAS :' -Width: Lot Coverage: ; ;4 to y 2 ��q •(Lc Revised d �S �' SurveySubmitted: Yes � No Date of Survey: Landscape plan submitted? D Yes D No Landscaper: ` ' Proposed Setbacks: Siete/Mired' 'A ,,r A 1,MrMIMWV}-:::;,,,,.::§11'''i l�[1��.q 1 l Front(L e)`-0 Rear(Str t ( N S Ep W ) ( N S E ©' Other Buil,!, 6 4:kt.0) •e , Side Side _ ' X03 �� ' 30 l ?c� x,� :` it,f' ,: .P�, Defined Height: 2--'1 J —...1 Peak Height: `�3 r!, ) FFE: lOUTC,1�FFE minus 6 feet= -,,t;,..- . li(sl E • t, , Perimeter(linear feet)= 50% = L F ,a1ar':i [ i ' k r a Basement? D Yes 0 No, Stories IL',._ ) *- ' : V FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDA,fit;., �'t" "in iW y'y4 The distance between the lowest proposed S' :tLl'ztit71W r= floor(of the basement or crawl space)and 4 il <ibi f" Ira`I U Eic : ,: .. l , 1, START WITH the highest point of the roof. '.114;[, le[ ',1',1,r-r, Tru i.0,.. START WITHa' ;,'4.il eaT� If you have a... SUBTRACTION • GABLE OR HIPPED ROOF(no I t:`l J' f•IR t r I"' Lt' .� ,$ l (BASED ON windows): Subtract half the distance I hill!�e117=r 1=t�-`a I"i E�f-ti t.!ils ROOF TYPE) between the highest point of the roof liP' . e 1' i to the low point of the corresponding ..'41,41-1.--'''..iti �„ v gable or hipped roof SUBTRACTION } , t�f1 �f� tatj�t4�rs ; :rjj'''.; • GABLE OR HIPPED ROOF(with (BASED ON .7 '. It",l n•ows tt`1'l..r.i!{.I`� Y windows): Subtract half the distance ROOF TYPE) i $" distance b , t between)the top of the highest s,4,c'j lrj' , ' a=nC` �r;' window and the highest point of the SOI jCe al"lrt`a`"+L ' roof 1r TYr tiItit fr t.� • ALL OTHER ROOF TYPES(flat, • t ' ' o �,, ':rte`i„i�.�,t,� Tl 1 �•® ;r mansard,etc):No subtraction, s.` y(C," .' a< .tet ; SUBTRACTION Subtract the distance between the {Al�fi t1eCCC >_LrX. R (BASED ON basement/crawl space floor and the '',5, 'I"L I .i; ' .' , IC/v �y �4It)v X01} 1i {i✓ +t OL, r"/t` EXISTING highest existing grade adjacent to the A G ,! '. GRADES) foundation OR 10 feet(whichever is less). , JIB"4.441.0t"' P.'%.4.,,f,1,471 :DC ), @' tlt�t ,ll..P f,L i"'°" EQUALS Defined building height V 1 Vi-1.-to . Yap • . °- EQUALS :9611„r!>! u ld '- i.�tt i ?' . :{ r ,_ `.�, .;w a,,, - • . ,; ,, •.,:a *tea�'y '"° r Updated: October 2015 , � r' 3 z:Aforms\plan review checklist 10-2015.docx , � t�ati VItI Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? Permit Number: ((4 - C'y�" ❑ Yes ❑ No �N/A 0 Yes )1( 0 Yes XNo n✓ 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) ❑ Yes No ❑ Yes X No 1 2 3 4 0 Type(s): Type(s): Fees to be Charged YES NO Permit c./ Plan Review State Surcharge 1----- Investigation Investigation Fee (/' SAC—Number of SAC Units Other(specify) ,t` Square Footage $ per Square Footage _ Basement 3.3 z z, X /Uo, 1- Y = $ 353, 03 - 7Z-, 1s' Floor / O G} X /O , �4 _ $ 2ndFloor (��J l = , 370 , 7 5 � -( -/ X /neo, $ l0,-L Garage � c� X --6 - = $ q7 5-z,' . oa Estimated Construction Value: $ e 0 // C &�`- Orono Inspections Required Work Requiring Separate Permits OFooting 0 Site Plumbing 0 Grading/Filling Poured Wall Silt Fence/Erosion Control Mechanical 0 Fire Foundation Survey 0 Hardcover Removal Septic 0 Water Connection 731 Foundation Waterproofing 0 Other(specify) Fireplace 0 Sewer Connection Framing 0 Masonry 0 Lawn Irrigation Insulation -Mfg. 0 Landscaping As-Built Survey 0 Other(specify) Final Lathe Required State Permits 0 Other(specify) /Well /Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: ❑ See Builder Acknowledgement Form ❑ Prior to releas of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 R A BUILDING WITH A BASEMENT OR CRAWL"" I A6Et" t The distance between the lowestpYopQsed P START WITH floor(of the basement or crawl spade)a �fir.; li:31te_w 4t, 50 the highestpolntofti� Coof,` ,�,� '.- oviwt r)/11 . If you have a �4"� tc�` ; SUBTRACTION GAEL E 'IPP ROOF(nQ xrr:,,,,f, projeeI— 1 2 ROOF • TYPE) twee e. igant ,, to the I pot e_eor , ondi g` 4,t', gable of� ro6f� x • GABLE OR#FtgED QOF(with windows):. ubbrac:fe disa oe ., A / between thetop.ofthehigh t ,, # P�, `„ window and the Highest poli, of. roof r �� ,t • ALLOT!p e.,0:41 1E„' f r ii,- ” *� wj a C 77`le 3 (,� SUBTRACTION Subtract'the dl§ , •r, "` ,".. , 1 00 (BASED ON basement/crawl spa oo a# f r EXISTING highest existing gradeadj csnttoithe¢' �. { .. " k 4' �0 c tco GRADES) foundation OR 10 feet`�iiitoc lever i jes8 Defined building height EQUALS i f 3t00 ' , -:. ',,-„,,,:i .'.,,,Itic-14-,: 3 FOR A BUILD!-G WIT i4-BASEMENT OR CRAWL SPACE: The distance between the lowest proposed `j3 START WITH floor(ohigthehest point ofth or crawl space)and the highest point the roof. rk , If you have a... SUBTRACTION • GABLE OR HIPPED ROOF(no f,.: (BASED ON windows): Subtract half the distance r j ROOF TYPE) between the highest point of the roof to the low point of the corresponding gable or hipped roof ; GABLE OR HIPPED ROOF(with W(f)12•6 windows): Subtract half the distance between the top of the highest window and the highest point of the roof • ALL OTHER ROOF TYPES(flat, mansard,etc):No subtraction. SUBTRACTION Subtract the distance between the (BASED ON basement/crawl space floor and the ,( 4.3r + j;' EXISTING highest existing grade adjacent to the �b'ro GRADES) foundation OR 10 feet(whichever is less). VD r EQUALS Defined building height lc 2 ,g# '�, +4 L F 1. The Gregory Group, Inc. INVOICE NO. 84586 Proposed Site Plan Survey For: d.b.a. I. F.B.NO. 1085-56 LOT SURVEYS COMPANY SCALE: 1" = 30' CYCLONE CONSTRUCTION Established in 1962 LAND SURVEYORS • Denotes Found Iron Monument REGISTERED UNDER THE LAWS OF STATE OF MINNESOTA 7601 73rd Avenue North (763) a60-3093 O Denotes Iron Monument Property located in Section " Minneapolis, Minnesota 55428. Fax No.i 560-3x522 p Denotes Wood Hub Set for 4, Township 117, Range sor• Ur-u-Vl J'r-'s &$rtifIl atr excavation only - - - - � Hennepin County, Minnesota 886.3 � r - � ` � Denotes Existing Contours x 989.4 i `i Denotes Proposed Contours Basis for bearings is x000.0 Denotes Existing Elevation P! assurned 1 I 000.0 Denotes Proposed Elevation Denotes Surface Drainage \ _ RECEIVED 989.4 `��� ��� ��� `\ II � ,\ � \ \\ i `�^y '0 2016 992.5 I I I \ \ I ` S 89°01'05 E 494.15 / I I O ---- ---- - / `992,7x 9 \ \ / / I - - - \ \ � \ \ \ " 994.7 - - - p--o-o-o o -o -opo-o-o-o-o-o- o -o -o -o- to -o- \ \ \\ - i � 977.5 - - - - - -�ol CITY - CRONO r--- t---- ------- - 1---- 1 °/ 2.7 I / - - - -----�----------------------------------- ���------ _ I I I 996.9 _- / x i / \ o `� - on' /t---=�-\----_�-- \� � \ / ----------\\`----- -- -'-� --- --- \ ------ I 998.9 ��-- \ \ ago / - -- �� L ``� � / , 992.0 y ` o \ m ( I 11 �5B6 Draurage Proposed Tanks Utlllt`y\EaSPyrflentl I I \ Primary Septic �5/te 1 --1 I I o/ \. / _ _ / \ \ Al 1 I I 99rne'er \ 5dt-fence \ i 1 1 WOOdS 1 \ 996.5 I I r \----------------------\ o \ / 997.9 \ \ ------�-^'�---------- I I I \ \ \ Top Spike 9972 \ 998 Top Spike 1 I \ 58 3 1 \ \ 998.98 x 1' C58 7 \ j „` 997.70 \ / O I I I 1 \ \ \ .� - `-S `` \� - Sy 996.9 _ I I I I \ Top Spike Q..... i .` / Top p„`e-----------`\` 997.41 3515.00w........ ���` 998.2 150 99&35- \ I I 99/.9 \ 99.73 - 7Ci9B� \ \ \ \ \ \ I 999.4 I I I x 5B 9 t / io 1`x0•'. \ \ ,,p'� �> \ �� \ \ \ \ \ \ I ! I \\ I ' / c / N 1 00/� ♦ .y.a� `iii o I I \ v \ I I \ o j t 'mss' // x7.7 � i / / 0 23'4y" a� u'- S io i ✓� ; O S 1001.2 iii"9°$' 2'0" O` iii �i �� \i999.7 \ \ \ 1004.0 T/1v / & 996.0i'�° 1002.0 �� ' 6 13.3" 998.5 9W - (0 N II \ 1999.4 \\ \\ ! 1 215.00 14'0" n / m a ?' 0 000 2z.o" taro^ ry r. %6' �� 00.0o x/oo/.o o y 9 /002 r1W � I 1 \ I \ �° Top Spike �� ..?........ s s` 0y $o \ \ \\\ •••�•••-• •: / \ NOTE: Proposed grades are subject to results of soil tests. N I I ` I °� 999_.05 k 1002.9 A'•., o., ?,....s�, yf•Aoo: 99.. \ \ \ p 9 J ' I o ?.• (YJ /°� \ Proposed building information must be checked with H I \\ I \\ 1 I o ' Top Spike approved building plan and development or grading OpTarrve ore eX� aVdtto-n ani tarrBtPu'ction-' Z II WOodS Proposed grades shown on this survey are interpolations of proposed contours from the drainage, grading and/or development plans. \ \ Top of Block - Reference /� �s0 j �' NOTE: The relationship between proposed floor 1002 ( Top Spike _�' Top Spike elevations to be verified by builder. d f001.Q8 �/ / 1001.4 1001.29 - Proposed _ 1005.0 Proposed First Floor o � I Proposed i p i / W �1 / ®weld 1003.27 Proposed Top of Block 1002.97 Proposed Garage Floor p I \\ `•E �000 h i 7 0 s 994.27 Proposed Basement Floor ��1 P � 993.69 Proposed Sunken Family Room 50.0 \ d \ `\ I 1O� 6 %/ 992.27 Proposed Sport Court Floor \ I \\ \ \ �` �� /a Proposed hardcover 17 \\ i /�V p ,' cA no Lot area = 88,329 sq ftwu Bulldmg = 5,035 5q ft g & Zoning Pla eview Type of Building Driveway 5, l 45 Sq ft h--7 Full Basement Walkout i' r 51dewalk = 163 5q ft Sit@ Plan View @: "� i w...�.. Woods X Deck = 166 5q ft 999.9 ��� // ,�� Rear Porch = 191 5q ft PROVE I \ Front Porch = 216 5q ft ' 0 APPRO WIT VISIONS (S" not") I I \ �` `• \ \ / Total = l 0, 92 l sq ft }� QENI Percentage = 12.36%fl 1AA h \ \ \ m I CO \� Property Address: 2780 Deer Run Trail East ----------=----_ _ �` \ \ Orono, MN 992.9 991.5 \-o \ \ \ 7 _ o \ \ E 6T 29.29_ -- \ b�\ R= 0.00` 99a 127 g8 p��, S \\ Lot 1, Block 1, CRYSTAL BAY PRESERVE Deer R u /n 16,42 RSe� W Hennepin County, Minnesota l \ 1 c7 7 996.1 \ 997.6 \\ Note: Topography by Others \\ Rock Construction Entrance / 996.6 \ \ \ \ \ 8 The only easements shown are from plats of record or information \`\\ �/ 9971 �\OR ORONG.001 I \ \ \ \ Of provided 11 client. I SITE � G ING PLAN I certify that this plan, specification, or report was prepared by me or under my direct supervision and that I am a duly Licensed land Surveyor under the laws of the State of Minnesota. Surveyed this 19th day of February 2016. Rev 3-29-1 6 house location Drawn By J.dtaq'16'� 4-8-1 6 5e tic tanks 5-1 1-1 6 Raised house 2' File Name 5-23-1 6 contours cbp-1-1 inv84586 Siteplan.dwg 5-24-16 lowered prop grades 0.5' 5-25-16 lowered prop flr5t floor and shown 999 contour EVAPPROVED APPROVED WITH ❑ DISAPPROVED BY DATE % 15� 4 , k \13 Signed Grego . P sch, Minn. Reg. No. 24992 s ( /1 2111 tx ri TYcitil, E 2-01 7,77 + a