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Home My WebLink About2012-01004 (add./remod./repair) CITY OF ORONO * Z 0 1 2 - PJ 1 0 0 4 * • " 2750 KELLEY PARKWAY DATE ISSUED: 10/16/2012 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3165 CASCO CIR Pllv : 20-117-23-43-0026 LEGAL DESC : SPRING PARK : LOT 036 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTIOI�TYPE : ADDN/REMODEL/REPAIR VALUATION : $ 8,000.00 NOTE: SHED/BOATHOUSE REPAIR,REROOF, SIDE&LEVEL EXISTING STRUCTURE APPLICANT PERMIT FEE SCHEDULE 162.25 ARMSTRONG, WARD& KATHLEEN STATE SURCHARGE(VALUATION) 4.00 6898 EDGEBROOK PLACE EDEN PRAIRIE, MN 55346- TOTAL 166.25 OWNER ARMSTRONG, WARD& KATHLEEN 6898 EDGEBROOK PLACE EDEN PRA[R[E, MN 55346- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specitications,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 wiil expire and become null and void if construction authorized is not conunenced 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 th the S[ate Building Code.This permit may be revoke at any time f u c � / (� / I Z- / i Ap t er i ee Signatu Date Issued By Si ture Date EPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED A OVE. �( � . " �," City of Orono � � � Building Permit Application for New Structures or Additions o��_��o v Mailing Address: Permit number: � O�O,�.O PO Box 66 Crystal Bay, MN 55323-0066 Date received: �0 '�—�Z a -a'A�, �, StreetAddress:' Received by: �'.�c, " G��' 2750 Kelley Parkway Plan review fee: ��5• � f� r�ESH04'� Orono, MN 55356 ��a_�� 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 print) GENERAL INFORMATION: _ ('��jGO �� Job Site Address: �j�f �,�-��— ��, ,�_ 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/API'LICANT INFORMATION: Name: - State License# Expiration Date: Phone: (office) (cell) Mailing Address: _ City: ZIP: Contact Person: _ Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: (e�A�� /��l�� S%�v� c. Phone (day): �_ . , � � - Address: �� F��y� r�� i�`jf�C City: fc��,s/ �j-�4,c'CZIP: 5��/�_ Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: �r'��' i � C��s c� r�T � p!� Name: �/n �1 � 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 ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer ❑ Other. (specify) �oi¢r uS� ❑ 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 T ! Deephaven, MN 55391 �Q� / ` ��S� Phone: 952-471-0590 ��.'� �j�c�� Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ � Uvv � � Packet Last Updated: 03-06-2012 -21 - STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions (continued) 2.Type of Construction a. Length (ft.)= � , Number of bedrooms= � �ood/Frame b.Width (ft.)= � Number of garage stalls: ❑ Masonry Areas in spuare feet Attached= ❑ Metal ❑ Pole Bldg. c. Basement= Detached = -� ❑ ICF � r�' d. 15t Story = `..�' %5 _ ❑ On-site Prefab e. 2"d Story= ❑ Off-site Prefab f. '/z Story = ❑ Other lease s eci � % /�ccsr (p p �Y)� �c..� g.Total Area= �,K L�:- � REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ ❑ Permit A lication ❑ ❑ Pro osed Buildin Plans ❑ � MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ ❑ Surve meetin all re uirements uJ T / � o e S 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: /' o F F � r/ ' c'� j s r �� Sr,��t� Tu�-� - APPLICANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consuttant 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 $10,000 escrow to ensure completion of the as-built survey and all site improvements. �n �� 7 ApplicanYs Signature: V;�%�/��y `��° Date: Owner's Signature: �f�/��, Date: �� - .� - i,� Packet Last Updated: 03-06-2012 -22 - �m.�.....=m+..w�...m .�_.... ..��..«,1s� ..�.«..Y_' .»:�.:..._ NT.�y-.-� . .__r_. - ' ' . . _ _ �'y.".. � _ . .. . . . . .. . Pian Revievv Checkfis� for (Vew Structures / i4ddifions �4 Address/ PID / LegaL �� 1 � �� C � �� s Descriptionofwork: 3 y�--�- �•—�� ,``��$�,� Septic review by: i��+ Date Approved:_ /� � � �-- ; Zoning review by: Date Approved: Buildin review b � " �=. ,: �__ 9 Y� �. �� .� Date Approved: i� --i;� -- 6� Grading review by: Date Approvecl: Zoning File#: Resolution#: Resolution Date: �, Zonin District Fire De artment Post Office School District ;; Zoning: Lot Area: SF/AC Width: Depth: Survey Submitf�:d: 0 Yes 0 No Date of Survey: Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E VI► ) ( N S E W ) Other Buildings Wetland Side Side ; Building Defined Height Building Peak Height: #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL$PACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement flooN crawl START the distance between the slab and the highest space floor and the highest root 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 round uppermost point on a round or other arch-type - or other arch-t e roof roof SUBTRACT half the distance between the highest window 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 basement Floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet, whichever is less. EQUALS Deflned buildin hei ht EQUALS Defined buildin hei ht �' ;' Lot Coverage: SF % Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff � Yes � No 0 N/A 0 Yes � No � Yes � No ❑ Yes 0 No � N/A Permit Number. Setback: Hardcover Zones Existin Proposeci Variance Requirec� CUP Re �ired � 0-75' � Yes 0 No ❑ Yes ❑ No 75-250' Type(s): Type(s): 250-500' 500-1000' REMARKS (in-house): d �� -/`�� Updated: 09/11/2009 z:\forms�plan review checklist.docx ., _ ., . . ..., m .. .. �� ;�,�'��. ..�',g. . :��.�..,-��'��%_-� _ �� .� . . _ Fees to be Char ed YES NO Permit �`` '� Plan Review � ?.-=�``� State Surcharge o�'J� investigation Fee SAC-Number of SAC Units �, Sewer Connection s. Vlfater Connection Park Fee Site inspection Other(specify) ' �; Miscellaneous fees Calculated By: ' S uare Foota e $ er S uare Foota e Basement X = � ;, 1 S` Floor X = $ 2nd FIOo� X - � Garage X - � �� Estimated Construction Value: $ ��=�� Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing 0 Grading / Filling 0 Well � Hardcover Removal 0 Mechanical � Fire 0 Electrical � Footing 0 Septic 0 Water Connection 0 Poured Wall 0 Fireplace ❑ Sewer Connection �� ❑ Foundation Survey � Masonry � Lawn Irrigation 0 Radon Rock Bed � Mfg. 0 Framing 0 Other(specify) 0 Insulation 0 As-Built Survey ;Final ❑ Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access:Existing: � YES 0 NO New: � YES ❑ NO REMARKS (TO BE NOTED Ofd PERMIT AND INITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\forms\plan review checklist.docx