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Home My WebLink About2015-00454 (add./remod./repair) CITY OF ORONO * 2 0 1 5 — 0 P1 4 5 � 2750 KELLEY PARKWAY DATE ISSUED: 05/07/2015 . ORONO, MN 55356- � 952 249-4600 FAX: 952 249-4616 ADDRESS : 2696 CAROLINE AVE PIN : 20-117-23-24-0034 LEGAL DESC : WESSELS SUBD OF SPRING PARK LO : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 75,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) INTERIOR REMODEL APPLICANT PERMIT FEE SCHEDULE 912.84 STATE SURCHARGE(VALUATION) 37.50 REVISION LLC TOTAL 950.34 153 E LAKE STREET Payment(s) WAYZATA,MN 55391- CHECK 10794 950.34 (952)540-7150 Minnesota State License#: BUIL-BC639027 OWNER MILLER,CHARLES&JILL 2696 CAROLINE AVE WAYZATA, MN 55391- AGREEMENT A1vD 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 goveming 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 a[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 ti or ue cause. �GJ u , , 1��"' ��.�c_-� Gy�,1c�v� � ,�7 , !�" �� Applicant P � e Sign ure Date Issued By Signature Date _____..� / /- CITY OF ORONO i � � BUILDING PERMIT APPLICAT�N Q��/J ; I FOR NEW STRUCTURES OR AD ITIONS �O • O ailing Address: 1�� PO Box 66 Permit number: �d�S� Crystal Bay, MN 55323-0066 Date received: 7'o� � ,5 -i \� Street Address:' 2_ �eceived by: ''�% t':1�Y�� ti�, GZ � \�,n�. 2750 Kelley Parkway d �Li Plan review fee: 9�. � � 1�kfSHO�� `�\v Orono, MN 55356 � �(�7 ��Jc-_ � �,� � Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us 3 This application form must be completed in full and all required information mus be su mitted. Incomplete applications will be returned. (P/ease print) GENERAL INFORMATION: � Job Site Address: �� J� 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 approva/60 days prior to the event. Shutt/e bus service �ll be required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLIC NT INFORMATION: Name: �.�,v� ��n , l.L C State License# �O�- Expiration Date: Phone: cell }1 office Mailing Address: (- F- � Cit : � 2�,1� ZIP: `i53�1 I Contact Person: (�� t o. Applicant is: ontractor,' / Homeowner (Circle One) Email and/or Fax: �� j �dn . 'Gt� �� PROPERTY OWNER INFO.RMATION: ` - � Name: � �1C�f I� CL\} J 1 `, �� 1x� Phone (day): Address: City: ZIP: Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Descri tion of ro�ect: � ��% �� ' 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& � Water Supply ❑ New Construction �Single Family with (�Residence ❑Addition , attached garage ❑Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ,,,r��-Ci�L f ❑ Single Family with ❑ Deck �Relocation (� detached garage ❑Office/Commercial ❑ Private Sewer Other: (specify) IL��--�1'n� ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water *'Any earth movement may also require ❑ Commercial ❑Other(specify) MCWD review 8�permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (speCify) 18202 Minnetonka Blvd Deephaven,MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ � � � ��.� 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: ❑ Masonry Areas in square feet Attached = ❑ Metal ❑ Pole Bldg. c. Basement= Detached= ❑ ICF d. 15f Story = ❑ On-site Prefab e. 2"d 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 Enclos d Ap licable ❑ Permit A lication ❑ Pro osed Buildin Plans ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ Surve meetin all re uirements ❑ 1� Stormwater Pollution Prevention Plan ❑ � Hardcover Calculation s ❑ !a� Se tic S stem Site Evaluation Re ort ❑ Access Permit ❑ Wetland Buffer Im rovement Plan ❑ En ineered Plans for Retainin Walis 4 feet or above ❑ � Minnehaha Creek Watershed District Permit s ❑ ❑ Plan Review Fee ❑ ❑ Application Escrow&Agreement ❑ ❑ Other: 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�he as-built survey and all site improvements. ApplicanYs Signature: � Date: `� ' �C� � �_� Owner's Signature: Date: PL�►N REVIEW CHECKLIST FOR IVE1l1� �TRUCTURES f AD�ITIOIVS Address: ��G) fv C W��-.��J� � `�'� Permit No.:___�a �-t�v�� Des�cription of work: ��- Date Rec'd: � � - �� `�� X�' Septic review by: ��;y f�� Date Approv� Zoning review by: �r •� Date Approved: Buildingreviewby: �; „��(',�v ��;:-,�-_. DateApproved: �1�Z '�- 2.�� 5 Grading review by: —�^ Date Approved: � Zoning District: Zoning File#: Reso#: Reso D oning: Lot Area: SF/AC VIlidth: Lot Coverage: SF % Su ey Submitted: � Yes 0 No Date of Survey: Revis d date � : Propo d Setbacks: Front (La e) Rear(Street) ( N S E W ) ( N S E W ) O er Buildin�s Wetland Side Side �efined Height: Peak Height: FFE: FFE inus 6 feet= (Existing Contour Perimeter(linear feet) = 50% = L.F. below grade #of Sfories FOR A BUILDING WITH A BASEMENT O CRAINL SPACE: FOR A UBLDING ON A SLAB FOUNDATION: The distan between the lowest proposed The distance between the top of START W ITH floor(of the sement or crawl space)and START W ITH slab and the highest point of the the highest poi of the roof. roof. If you have a... If you have a... • CABLE OR HIPPED ROOF • GABLE OR HIP D ROOF(no (no windows): Subtract half windows): Subtrac alf the distanc the distance between the t- between the highest p 'nt of the of highest point of the roof to to the low point of the co spo ding SUBTRACTION gable or hipped roof the low poi�t of the corresponding gable or (BASED ON . GABLE OR HIPPED RO (w SUBTRACTION hipped roof ROOF TYPE) windows): Subtract h the dista e (BASED ON . GABLE OR HIPPED ROOF between the top of t highest ROOF TYPE) (with windows): Subtract window and the h' est point of the half the distance between roof the top of the highest ; window and the highest • ALL OTHE OOF TYPES(flat, point of the roof � mansard, c):No subtraction. ALL OTHER ROOF TYPES SUBTRACTION Subtract the istance between the � (flat,mansard,etc):No (BASED ON basemenU rawl space floor and the subtraction. EXISTING highest isting grade adjacent to the ADDITION Add the distance between the top GRADES) found ion OR 10 feet(whichever is less). (BASED ON of slab and the highest existing EQUALS D ned building height EXISTING grade adjacent to the foundation. RADES E ALS Defined building height Shoreland Distric MCWD Permit �verage Lakeshore Setba g�uff Met? 0 Yes No Permit Number: � Yes ❑ No 0 N/A 0 Yes ❑ No 0 N/A—see attached Setb k: "` Stormwater/�uality Existing Hardcover Proposed Overlay District o Hardcover Variance Required Ct�P Re ired Tier circle one (��and sf� % and s � Yes � fVo � Yes a 1 2 3 4 5 Type(s): Type(s): Updated: January 2015 z:\forms\plan review checklist 2015.docx �v C' �� n , ti. �__ . _..:. _ _ _ _ ___ _. ._._ _ ._ �:_..__. ..__ REMARKS (in-house): Fees to be Char ed YES NO Permit � Plan Review !� State Surcharge Investigation Fee SAC—Number of SAC Units Other(specify) Square Foota e $ per S uare Foota e Basement X = $ 15� Floor X = $ 2nd Floor X = $ Garage X = $ �' Estirnated Construction Value: $ �5� f�� O�ono Inspections Required VHork E2equiring Separate Permits Required State Permits � Site Plumbing � Grading/ Filling � Welf �`' � Silt Fence/ Erosion Control Mechanical a Fire Electrical 0 Fiardcover Removal � Septic � Water Connection � Footing � Fireplace � Sewer Connection ❑ Poured Wall � Masonry � Lawn Irrigation ❑ Foundation Survey � Mfg. 0 Landscaping � Foundation Waterproofing � Other(specify) 0 Radon Rock Bed ,�Framing Insulation 0 As-Built Survey ` Final ❑ Other(specify) REfd1�4.f2KS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES � NO New: � YES Q NO ��FFICIAL 12EMAR!(S-TO BE NOTED ON PERA4IT AND INITIALLED � � Updated: January 2015 z:\forms\plan review checklist 2015.docx F. .. . -...,.. . ..._. .._� . ..< _:., _ - . s... ,.�„ . _... , _ . . . . �, .. _ . . _ ,, . ,--,.. _.;-.. .r ; ,. _.�. _..._ ., _. 4. � � /� � DATE TIME � CITY OF ORONO CALLED IN � INSPECTION N rl� � SCHEDULED �i y S PERMiT NO. � COM LETED ` ADDRESS OWNER TELEPHONE NO.LS�"�U�� CONTRACTOR, Ul SC U'✓L LL.� � . � DESCRIPTION ll� ❑ FOOTING ❑ DEMO-FINAL ❑ S TIC F L Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q �Rft#ING ❑ MECHANICAL FINAL ❑ PROGRESS �❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO _ � COMMENTS: J`' �G.�l lJ'�.�c - �a�X y •� s,��.K� v � �S � ' � J � '�` `S"'�� ,�ai.e /�s...�. ,pDS�s FQ r de4 i ` "'.S � S��`'�s 6 rn co<<��..,:a y�'t 4 S. ��4 a�G�.r�_ Q � /c//rV(��A a'" O'�,�6 ��w3 s�LC�f �� ilal�AGr �' �o`t�,i�t�tt�•µ� !'c nt�4cJ�� 6 — 2 � GG ✓ r��'C -E e� '� G6�/c�/ W � � a W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � �ECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CAIL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-460� OwnerlContractor on site: Inspector. � �'�' � White Copyllnspector's Ffle Canary CopylSite Notiee