HomeMy WebLinkAbout2015-00819 (Re-model) CITY OF ORONO * 2 0 1 5 — 0 fd 8 1 9 *
' 2750 KELLEY PARKWAY DATE ISSUED: 06/30/2015
ORONO,NIN 55356- � �
952 249-4600 FAX: 952 249-4616 �
ADDRESS : 1271 ARBOR ST �'
PIN : 10-117-23-31-0033
LEGAL DESC : CRYSTAL BAY MINNETONKA
: LOT 000 BLOCK 002
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 5,098.00
NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE)
(INTERIOR DRAIN TII,E,MOISTURE BARRIER,&SUMP PUMP&INSTALL) �
NOTE: CALL FOR TRENCH INSPECTION BEFORE COVERING.INITIAL: ����'� �
APPLICANT PERMIT FEE SCHEDULE 139.40
PLAN REVIEW 90.61
COMPLETE BASEMENT SYSTEMS STATE SURCHARGE(VALUATION) 2.55
54004 LOREN DRIVE
MANKATO,MN 56001- MAIL-IN FEE 2.00
(50�387-0500 TOTAL 234.56
Minnesota State License#:BUIL-143377 Payment(s)
CREDIT CARD 5821 234.56
OWNER
RICHARDSON,STEVEN&SARAH
1271 ARBOR ST
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. 1'his permit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.l'his 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.
1'he 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 due cause. �l.,j
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Applicant Permitee Signature � � Date Issued By Signatur Date
To: permit desk Page 2 of 7 2015-06-23 18:48:19(GM'T) 15072999410 From:AMANDA BINSTOCK
� , CiTY OF ORC�NO
� �UILDINC PERNIIT APPLICATI(�N �
FOR fVEW ST�UCTURES OR ADDITi�NS a
M2fllrlgA9d�s5: � . Permit numher: �`_ — v8�
��T� PO Box fi6
, Crystal Bay,MN 55323-U06 I�y Date recefved: �/Z
Street.address: �I�'� Receivea by:
� �4� 2750 Kelley Parkway Plan revi�wl�e;
� Orana, MN 55356 /_
f�kESH�4� 70ta)�8@; Q�,�Orj�(o
Main: 952-249-4600 Fax: 952-249-4616 �_ci.orono.mn.us
This appllcadon form must be compieted in fult and a�l requlred irtformation m�t b�s Itted.��
Incornplet�app�(cations will be returned. Please prrnt
GENERAL INFORMQTION: a - __a
Job Site Address. �'�,�'] � j�-y�'}p�' ''�*��-
Will this be a Parade of Homes, Remadelers Showcase Home or other Display Home? ❑ Yes �Na
X yes,a specief everrt pemtit Is�equ�red w�tt Poike L1ap�rL�rrorH artd G'tty Coltnct!approva!60 days prior to the ever�. Shcdtde hus servJCe wiH be
,�equirsci unJess appHcant dema�strates sufJ7�nt arr-s#�parking is�vallable. Adon-pet»ihtCd BVB»t3 vdlN nOt be BdOt�d.
CONTR�ICTOR 1 APPUCANT INFQRMAT{dN:
� �.
Name: /1 - � � � -
�-..._.__... _.__ _ .
State License# �(';f ` '72__ Expiratian Date: �� j��
Phone; oel offiae - $7' b �3�
Mailing Address_ +-}GC s� Ci _ ZIP. 1�+0�:�
Contact Person: � Applicant Is: �entra�to Homeowner ic+re�a��
Email and/or Fax: �,�pti�5����.,{�i,i
_'
PRBPERTY t3Ww INFORMA O :
Name: f� C, Y �
Phone(c3ay): •2��
Address: Ci ;y�, - ZIP: �r��
Emaii and/or Fax
ARCHlTECT J ENGINEER INFQRMATION:
hlame;
Phone(day): �
Address: City; ZIP:
Email andfor Fax:
PROJECT INFORMATION: Descri tion of ro'ect: ��ti`Id Y ��,�a1 � C� 1(YIGi� s�''
, 1.Type oE Praject 2,Prnpossd Uss 3.Struckune Ty 4.Sewage Dispa�� 8�
� Water Supply i ��
I
❑New Gonstruction []Singl�Family with ❑Res�dence
❑Addition attached garage ❑Garage/Accessory Bidg. ❑ Fub�ic Sewer
❑Accessay Buflding ❑ Single Farruly wfth ❑aeek
❑ ReloC�tion d�teched g�rage ❑QfficetCommercial ❑ Privaie Sewer
❑Other. (speclty} ❑ Multipie Family/Condo ❑Warehouse
❑ Public ❑Storage ❑ Public V�Jater
•*Any earth movement rnaq aiso require ❑Commerciai ❑t]ther(specifyj
MCWD review 8 permits. ❑ Industrial ❑Private Wel!
MinneYraha C�eek V'Jat�rshed DisVict(MC1MD) ❑�her. (specliy)
18202 f�nnetonka Bivd
Deephaven,MN 55391
i Phona: 952-471-0680
Fax: 952-377-0682
www.min h h r k.
Esifmated Construction Valuation(excluding I�nd) $ ��`1�
To: permit desk Page 3 of 7 2015-06-23 18:48:19(GM� 15072999410 From:,4MANDA BINSTOCK
�
, STRUCTURE INF4RMATION: �'
9.Structure Dime�ivn� 1.Strucivre Dimenstons(continued) 2.Type of Cun�trucUon �
a
a.Length(ft.)= Number af bed�ooms= ���p�f FrBme
b.Wldth(ft.)= Number af garage sialls: ❑Masonry
fAreas in sauare feet pnaCp,ed= ❑Metal i
❑Pole Bldg. ;
� c.Bas�rr�nt= D�lached=
�ICF
d. 1815toty �
❑�n-site Prefab
e.2`�Story=
❑Oif-site Prefab
f. Y:Story =
❑Other(piease specify};
g.Tatal�4rea� �
�
REQUIRED SU�MPTTI�LS:
All of the informatian must be submitted in order for our a lication to be rocessed:
Not
_Enclosad licab�e
D ❑ � Rermit lieation
O � Proposed Building Plans _ _
0 0 MN State Ener Cad�Calculatinns and Mechanica!Code Re uirernents Form
❑ Sunre meeti alf re uirements � �
' n ❑ Stormwat�Polfutian Preventio�Plan !� �
❑ -� ❑ Hardcover Calcu►atia s •
O ❑ Se tic S stem Site Eualue�tlan R� ort �
❑ O Access Rermit ^ �
4 ❑ O WeUarid BufFer Irn rovem��rt Plan �
k _ ❑ ❑ En ineered Plans for Retaini� Walls 4 fee!or abo�e _
O O Minnehaha Creek UVatershed District Permit s
� O O Plan Review Fee
; 0 ❑ AppHcation Escraw&Agreement
r---� ----- -.-
[] ❑ Othe�;
APPLICANT/�WNER ACKtVUWLEDGEMENT:
• Agrees#�pravide all infwmation required or requested by the Building Department;
• Agreas to pay the City of Orono for angin�rNng consuttartt review costs in excess of�00;
• C�r�ifies that the information supplied is true and correct to the best of hislher knowte�ige. The appiicant recagnizes that they
are solely responsible for submitting a complete appllcatian t�ing�w�re that upon failure to da so,the staff has no alternative
but to reJect it uniil it is complete;
• Ackn4wledges the EscrowAgreement is completed and signed; �
• Understartd�some or all of the information th�t you are asked to pravide on this application is c►assified by State law a�eithar i
privete ar confideniial. Private data is information which generally cannot be given ta the pubUc but�an k�given to the subject '
of the data. Ca�'idential d2ta is infarmabon which generally cannot be given to either the publiC or the SubjeCi of the dat8. Our
purpose and intended use oF this iniormation is to annually update our records and records of other governmerrtai agenaes
required by law. If you refusa to supply the informa�on,the application may not be issued.
I
» Agreres U�at in the ever�t that weather or ather canditiams prevsrit ths complattan o'F an as-�Ik surrrey at tha time t�e
t;ertrficate of Occupancy is requestacl, a ternporery Certificats of Occupancy may be�i�sued vpon receipt of�$10,Ii00 �
esc�ow to ensure compietIon of tha�-buitt sunrey and ai!slte lmprovements.
A�Plicant's Signature: �'�L�l.��" Date: ���3���j
Qwner's Signatu�e: Date:
, PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: � � � � ���� ����C�� Permit No.: �J[����%
y� �. ��
Description of work: �dl�('�' (�v' ✓�,�j/] �f /� .�� Date Rec'd:
�
Septic review by: Date Approved:
Zoning review by: Date Approved:
Building review by: Date Approved: l
Grading review by: Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: SF/AC Width: Lot verage: SF %
Survey Submitted: � Yes Date of Survey: Revised date ? :
Proposed Setbacks:
Front(Lake) Rear(Street) ( N S ` E W ) ( N E W ) Other Buildings Wetland
Side Side
Defined Height: Peak He ht: FFE• FFE minus 6 feet= (Existing Contour)
Perimeter(linear feet)= 5 /o= L.F. below grade #of Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL PACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance betw the lowest pro sed The distance between the top of
START W ITH floor(of the baseme or crawl spac and START W ITH slab and the highest point of the
the highest point of th roof. roof.
If you have a...
If you have a... . GABLE OR HIPPED ROOF
• GABLE OR HIP D ROO (no (no windows): Subtract half
wfndows): SubVa t half distance the distance between the
between the high t poi of the roof highest point of the roof to
to the low point of e rresponding the low point of the
SUBTRACTION gable or hipped ro corresponding gable or
(BASED ON . GABLE OR HIPPE OOF(with SUBTRACTION hipped roof
ROOF TYPE) windows): Subtract If the distance (BASED ON . GABLE OR HIPPED ROOF
between the top of highest ROOF TYPE) (with windows): Subtract
window and the hi e t point of the half the distance between
roof the top of the highest
• ALL OTHER RO F ES(flat, window and the highest
pofnt of the roof
mansard,etc): subtr Uon. . ALL OTHER ROOF 7'YPES
SUBTRACTION Subtract the distan between e (flat,mansard,etc):No
(BASED ON basemenUcrawl spa floor and he subtraction.
EXISTING highest existing gra e adjacent t the ADDITION Add the distance between the top
GRADES) foundation OR 10 f et(whicheve is less). (BASED ON of slab and the highest exisUng
EQUALS Deflned building etght EXISTING grade adJacent to the foundatlon.
GRADES
EQUALS Defined building helght
Shoreland District M WD Permlt Average Lakeshore Setback Bluff
Met?
� Yes � No Permit Nu er: � Yes 0 No 0 N/A � Yes 0 No
� N/A—s e attached Setback:
Stormwater Quality Existing Hardcov r Proposed
Overlay District (%and sfl Hardcover Variance Required CUP Required
Tier circle one %and s
0 Yes � No � Yes O No
1 2 3 4 5 T e(s): Type(s):
Updated: January 2015
c:\users�rpeitso\documents\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 Foota e $ er S uare Foota e
Basement X = $
1gt Floor X = $
2nd Floo� X = $
Garage X = $
Estimated Construction Value: $
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site 0 Plumbing 0 Grading/Filling 0 Well
0 Silt Fence/Erosion Control 0 Mechanical � Fire � Electrical
0 Hardcover Removal � Septic 0 Water Connection
� Footing 0 Fireplace � Sewer Connection
� Poured Wall 0 Masonry � Lawn Irrigation
� Foundation Survey � Mfg. � Landscaping
� Foundation Waterproofing � Other(specify)
0 Radon Rock Bed
� Framing
� Insulation
0 As-Built Survey
Final
Other(specify)� e,yl��
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: 0 YES � NO New: � YES � NO
OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED ��l�( �G� ��e✓�C
� �
Updated: January 2015
c:\users�rpeitso\documents\plan review checklist 2015.docx
To: permit desk Page 1 of 7 2015-06-23 18:59:36(GM� 15072999410 From:AMANDA BINSTOCK
,
. , , � �
D�G
FAX COVER SHEET �
TO permit desk
COAAPANY City of C3rono
FAXNUMBER 19522494696
FROM AMANDABINSTOCK �
DATE 2Q15-�-23 18:45:10 GMT
RE Permit Application
COVER MESSAGE
Please see attached permit application. Cantact Amanda with any questions and for
payment. 507-387-0500 or abinstodc@mycompletebasement.com
�������"�� ��r C��1�' ���'��L� ���
PLAN CH�CKED BY TE Ce
�2'� '�
WV�IW.METROFAX.COPA
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To:permit desk Page 5 of 7 2015-06-23 18:48:19(GM'i) 15072999410 From:AMANDA BINSTOCK
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To: permit desk Page 6 of 7 , 2015-06-23 18:59:36(GM� 15072999410 From:AMANDA BINSTOCK
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� DESCRIPTION ��-���� ��� -�—� IL -
� ❑ FOOTING ❑ DEMO-FINAL W10�`�I���"' SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI � �, EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL �P�TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINA��`°"n' � PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLA�I�COMPLAINT
v INAL ❑ WATER HOOK-UP �� ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE PTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERtCONTRACTOR TO MEET� YES_NO
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� ❑CARRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
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❑CORRECTUNSAFECONWTIONWITHIN HOURS. ❑pHOTOTAKEN
INSPECTOR WFLL RETIJRN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hPurs in advance. (g52) 249-46��
OwnertContractor on site: �l ln r
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Whke CoPYAnspector's Flle Canary CopylSite Notice