HomeMy WebLinkAbout2012-00561 - attached deck CITY OF ORONO * 2 QJ 1 2 - 0 0 5 6 1 *
2750 KELLEY PARKWAY DATE ISSUED: 07/02/2012
ORONO, MN 55356-
� (952) 249-4600 FAX: (952) 249-4616
r
ADDRESS : 1629 BOHNS POINT RD
PIN : 17-117-23-11-0005
LEGAL DESC : REG. LAND SURVEY NO. 0565
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPA[R
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DECK ATTACHED
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 7,500.00
NOTE: REPLACE EXISTING DECK
ADV PLAN REVIEW PD 6/19/12 2012-00560
APPLICANT PERMIT FEE SCHEDULE 162.25
MAAS EXTERIORS STATE SURCHARGE(VALUATION) 3.75
8600 GRACE LN TOTAL 166.00
LORETTO, MN 55357-
(612)990-3087
Minnesota State License#: BC639537
OWNER
GREEN, RANDALL
1629 BOHNS PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
[he 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 �����
requeste ' conformance with t State Building Code.This permit may be ����
revok t any time for du ��
f7� � ,� /�
` !d?/.Z � l +� l f ]� �-L-� C-:�'�il ;7i�/'� �1/t �O'
Applicant Permitee Signature Date Issued B Signaturc Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� �� ��/�.�
City of Orono
.
� Building Permit Application ��� ��
for New Structures or Additions
Mailing Address: Permit number: 020/07� �l�S��
g,0,�. PO Box 66
Crystal Bay, MN 55323-0066 Date received: (9-1�l- ��-
0�..:��..:, � S
I _ � Received by:
�,a, "�'�� �, , Street Address:
'�'�c, �� �w 2750 Kelley Parkway Plan reviewfee: q�0�a� -(Jp s�v�
\l.�E•� `fi ¢� Orono, MN 55356
�:_sHo. IO S.�,fj �J�
_=-' 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 be submitted.
Incomplete applications will be returned. (Please prinf)
GENERAL INFORMATION: �, , � .� ,
Job Site Address: �u= � l �-�t'�in ' � ,;-�-t �'�l
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 I APPLICANT INFORMATtON: �
Name: 11'l N �t S L- � �1 :., � , �i
State License# �:j;' j�� 9 .$'3 '� Expiration Date: �- 3��� �Qf�
Phone: O 4�/ - < < t-- e> " ` office cell
Mailing Address: �,��>�,�. :::r�,�r L�-,.. r City: �v r� -, ZIP: f'; i� 7
Contact Person: � ,.►'1 r-�r� S Apphcant is: �ontraCtor -/ Homeowner (Circle One)
Emailand/orFax: ��'1/i %tS, 1Y'�z-,c '� _ ��-�,�;./ C , ,:•
---.
PROPERTY OWNER�NFORMATION:
�.
Name: �-.�;� ��5 // ,,�r���l,�,�
Phone (day):
Address: i s.� :,:,�,, '�.;- /%'� Cit : c=.- �. , c ZIP:
Email and/or Fax � r>,., �; // ,� , ,..��� ,;.� / , �� :.�
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 &
Water Supply
❑ New Construction �Single Family with ❑ Residence
❑ Addition . • attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer
❑ Accessory Building �5+�c�5 ❑ Single Family with � Deck =-
❑ Relocation p � � detached garage ❑ Office/Commercial ❑ Private Sewer
❑ Other: (specify) �' �"�-)��'� � {�/` ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
*"Any earth movement may require ❑ Commercial ❑ Other(specify)
MCWD review& 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) $ � S' `� `� � /
I �
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. 15'Story = ❑ On-site Prefab
e.2"d Story=
❑ Off-site Prefab
f. Yz Story =
❑ Other(please specify):
g.Total Area= �
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
N ot
Enclosed A licable
� ❑ Permit A lication
;p ❑ Pro osed Buildin Plans
❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
❑ ❑ Surve meetin all re uirements
C� ❑ Stormwater Pollution Prevention Plan
❑ ❑ Hardcover Calculation s
❑ ❑ Se tic S stem Site Evaluation Re ort
:
❑ ❑ Access Permit
❑ ❑ Wetland Buffer Im rovement Plan
❑ ❑ En ineered Plans for Retainin Walls 4 feet or above
❑ ❑ Plan Review Fee
❑ ❑ 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 $10,000
escrow to ensure completion of the as-built survey and all site improvements.
`�� --- --�/ .' `% �� 1 �� � �- � �..
ApplicanYs Signature: ;� , - � Date: �
Owner's Signature: Date:
:...,.. �. .,vwym.........$,.w....a..;.c..u.+s�.v...r....w.•�w i a.iw'�'Ysy°r' ,.r.n...��.nn ....-.H....-.,. �..w..-,:� p..w,: .. c,q r....�.a...,. .. ,.. . _ '..��s
..u. ... �, a,rip....w�+*e.�....,..q'a*....: .C.'Rq'Fi w.....wa4 W'.�....w..�.c..�..
Plan Review Checklis� for Nev� Structur°es / Additions
r� . , - ..-�
Address/ PiD/ Legal: l�'�s � � ��t� �- �--� �L�S< �
Description of v✓ork:
Septic review by: ( T� Date Approved:�� -- � �� �
Zoning review by: /t� "e'� Date Approved:
Building review by: �J ;, Date Approved: � � �� -�t;c;�
Grading review by: r'`�.: ,` /`E Date Approved:
Zoning File#: Resolution#: -• Resolution Date:
Zonin District Fire De artment Post Office S ool District
Zoning: Lot Area: SF/AC Width: Depth:
Survey Submitted: 0 Yes ❑ No Date of Survey: �
�
Pro osed Setbacks ,�`
Front(Lake) Rear(Street) ( N S E W ) ( N S E W Other Buildings Wetland
Side Side
Building Defined Height: Building Peak Height: ,� #of Stories Ok?: � YES
<
FOR A BUILDING WITH A BASEMENT OR CRAVI/L SPACE: �OR A BUILDING ON A SLAB FOUNDATION:
i
START WITH the distance between the basement floor/crawl ` START the distance betv✓een the slab and the highest
space floor and the highest roof peak,the top of ' WITH roof peak,the top of the cornice of a flat roof,
the cornice of a flat roof,the deck line of a � the deck line of a mansard roof, or the
mansard roof,or the uppermost point on a ro[�d uppermost point on a round or other arch-type
or other arch-t e roof �' `' roof
' SUBTRACT half the distance between the highest wirulow and SUBTRACT half the distance between the highest window
� � hi hest roof eak of a itched roof ' and hi hest roof eak of a itched roof
SUBTRACT the distance between the basementfiToor/crawl ADD the distance between the slab and the highest
space floor and the highest existi�g grade within existin rade within the foundation
the foundation or 10 feet,whicta�ver is less. EQUALS Defined buildin hei ht
EQUALS Defined buildin hei ht
Lot Coverage: SF %
`.�
Shoreland District ,.IVICUIlD Permit Received Avera e Lakes`�ore Setback Bluff
x ,�'D Yes � No ❑ N/A �'`�� � Yes � No
� Yes � No � Yes ❑ No '�� 0 N/A
Permit Number: `�� Setback:
E�
g
Hardcover Zones Existin Peo oseci Variance Required CUP Required
0-75' , '' � Yes � No � Yes 0 No
75-250' TYPe�S): Ty�e(�s):
2 50-500' ''�.
� 5d0-1000' ,y
�
` REMARKS (in-house): :�A.� '�. �r�:'.� «.�,;'�`�:.��_<�;�e �� - `'_
; %�
, �
{
Updated: 09/11/2009
z:lforms\plan review checklist.docx
_ , _. . :_. _
�-�-� �� -�_�,�_ ,� � .,�.:..,. , ,.�_ w. �. ,.: . � _ ....� _ : _ � .
Fees to be Char ed YES NO
Permit �;�`"`
Plan Review �,/
State Surcharge
Investigation Fee f`'
SAC—Number of SAC Units
Sewer Connection
Water Connection
Park Fee
;�.: Site Inspection
Other(specify)
Miscellaneous Fees
Calcufated By:
;
S uare Foota e $ per Square Foota e
Basement X = $
1 St Floor X = $
2"d FIOOr X = $
Garage X = $
Estimated Construction Value: $
� "�' �� "''`°
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site 0 Plumbing � Grading / Filling ❑ Well
� Hardcover Removal � Mechanical ❑ Fire � Electrical
� Footing � Septic � Water Connection
0 Poured Wall � Fireplace � Sewer Connection
� Foundation Survey � Masonry 0 Lawn Irrigation
� Radon Rock Bed � Mfg.
�Framing � Other(specify)
0 Insulation
� As-Built Survey
�inal
� Other(specify)
REMARKS (in-house):
z
Other Review: Reviewed by: Date Approved:
Access:Existing: 0 YES 0 NO New: 0 YES ❑ NO
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
Updated: 09/11/2009
z:\forms\plan review checklist.docx
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Certificate of Survey
�
for William M. I<rutzig
of Tract A, Registered Land Survey No_ 5b5 ' �
Hennepin County, Minnesota p�� •
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LAKE '�
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E/ev. = 929.77 aI of � � f'r Pa.ree/ . . , . ;�i� ._, i� � �`�\..
5-25-8? � �� � ' �
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ERI�APnf �(�.� _-, S78 �� ��+1 � lS��,-�l �
ry� ' •.._S8�°S2 3a i„�935./ : S7° m ; _
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I hereby certify that this is a true and correct representation of a survey of the boundaries of
Tract A, Registered Land Survey No. 565, Hennepin County, Minnesota, and of the location of a
proposed building_ It does not purport to show other improvements or encroachments.
Date : 5-?_7-83, house sho4�n 10-12-84 � ��Z/'B I Esr+fr. Shown GORDON �jOFFIN C0. , INC.
//-30-89 .P�u:red�Youre r Er.y t/o ce t o�r ��:C�v"`"' y '�
Scale: 1" = 50' ,o e ,�`�".� -��i
/z-/o-89 TPo t E/ed.r,
oNsz�-83 93�,5 :� Spot elevation Mark S. Gronberg Regl� No. 12755
o„'�Z-�°-By `�7 : Iron marker Gordon R. Coffin Reg. No_ 606�I
Engineers & Surveyors
Long Lake, Minnesota
--�
� � ��
/ DA E TIME
CITY OF ORONO CALLED IN �(� ��'
INSPECTION NOTICE SCHEDULED �� � �
PERMIT NO.�'���'����� COMPLETED
ADDRESS I � � � ������ � �� �
OWNER TELEPHONE NO. ��� -���`���
CONTRACTOR � •
� DESCRIPTION ��� ` ���-`- � �� "��/�
11� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING �
� ❑ POURED WALL O MECHANICAL RI ❑ LAKESHORE/WETLANDS
ti
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINA�� ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES NO
� COMMENTS:
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GW ❑WORK SATISFACTORY:PROCEED �ROJECT COMPLETE
� ❑CORRECT WORK&PROCEED ❑ I SUE CERTIFICATE OF OCCUPANCY
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� ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR r GTATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-460�
OwnerlContractor on site: -
Inspector. �,t � `� -S �
White Copyllnspector's File Canary Copy/Site Notice