HomeMy WebLinkAbout2013-00412 - addn/remodel/repair �
y CITY OF ORONO * 2 0 1 3 - 0 0 4 1 2 *
2750 KELLEY PARKWAY DATE ISSUED: 06/1U2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2215 BAYVIEW PL
PIN : 17-117-23-44-0026
LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 9,500.00
NOTF_: DECK
APPLICANT pERMIT FEE SCHEDULE 191.75
SOLID FOUNDATION CONSTRUCTION STATE SURCHARGE(VALUATION) 4.75
4326 7TH STREET NE
COLUMBIA HEIGHTS, MN 55421- TOTAL 196.50
Minnesota State License#: BC646691
OWNER
DLJNN,TIMOTHY
3010 BROOKS LANE
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. 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 18 ays of the date of issuance,or if construction is
suspended for a perio 0 0 days at any[ime after work has commenced.
The applicant is nsi e or assuring all required inspections are
requested i orm n w th the State Building Code.This permit may be
revo jd`'ai an e fbr ause. l
I / �U , 3 / /
pplicant Per itee ignature Date Issued Sign re e
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
•
� CITY OF ORONO (� -, J�--�
BUILDING PERMIT APPLICATION � ��
FOR NEW STRUCTURES OR ADDITIONS
�'�O Mailing Address: Permit number: �/3" � �
� �O PO Box 66 I�
Crystal Bay, MN 55323-0066 Date received: � —rV
StreetAddress:' Received by:
y� � 2750 Keliey Parkway Plan review fee: � `a� -
� Orono, MN 55356 7� ' /
`9kfSH0�� �`�/��j "Z���7"��
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:
Job Site Address: �2 l S' 1�a-� ���..� ��uc� � �},��,�„�� �U'
WII this be a Parade of Homes, Remodeters Showcase Home or other Display Home? ❑ Yes No
If yes,a specral event permit is required with Police Department and City Council approva/60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be a/lowed.
CONTRACTOR/APPLICAN�INFORMATION:
Name: Sol� ,.,,.,n-�a,-;�,.� C_�� �� �,..c-r'. �
State License# Q c �,��,(� � l Expiration Date: ��/31 /r
Phone: (cell) (,��- ��- 31Q� (office) ��v�ce..
Mailing Address: �-{3av �: 5 , � Cit : (,qi�nnb; I�t-T� ZIP: S�-ta I
Contact Person: d'�h,� p;.,,n,� Applicant is: ontracfor"�/ Homeowner (ClrcleOne)
Email and/or Fax: � o v�v� �d v�n,� � v�e , c�w�
PROPERTY OWNER INFORMATION:
Name: 'r��nn O.;���`�
Phone(daY)� C�l�- �'.f8v -Cc999 �/��� �;a
Address: �J10 r3t�oa�5 (��n City: r� ZIP: 5339�
Email and/or Fax -r:.,,�� ��.j �;, „��,;r , ��,�,,,�
ARCHITECT/ENGINEER INFORMATION:
Name: (3�;uv� 1-}�r�v�
Phone(day): "�i�3- ����l - a�`� �-
Address: �. �r ti3c� 3 �S' City: Q�lu� � ZIP: ��3�
Email and/or Fax. 4��p5 � cx�1 v,,,,��n �;- c;e ��a w� P� : ��w�
PROJECT INFORMATION: Descri tion of ro�ect:
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8�
Water Supply
❑ New Construction ,�Single Family with ❑ Residence
❑Addition attached garage ❑Garage/Accessory Bldg. ,�Public Sewer
❑Accessory Building ❑ Single Family with �,peck
❑ Relocation detached garage ❑Office/Commercial ❑ Private Sewer
�Other: (specify) ��C.✓� ❑ 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) $ � , ��� , ���
��'� � ��� '���
PLAN REVIEW CHEG�(LIST �OR IVEW STRUCTUR�S I ADDITi ION
,
/�ddress/Permit Number: ��` "� �a`��E i �� � �CX�
Descri�tion of work: �e��-�
Septic review by: �y� � � Date Approved: �- Z--� � � �
Zoning review by: �- �� �" �� �- G-- �� Date Approved: � �1� - i�
�uilding review by: Date Approved: � ' �� ` �-�
Grading review by: � �"�1 f/� Date Approved: �"'
Zoni�g District: �2�d � Zoning File#: Reso#: Reso Qate:
Zoning: Lot Area: : 3 f 5��� SF/AC Width: r'�"� Lot Coverage: ���'� SF d�Q/o
Survey Submitted: �J Yes � No Date of Survey: �-/� �/ c Revised date(?):
Pro osed Setbacks:
Front(Lake) Rear(Streetj ( N S � W ) ( N S E �;� ) Other Buildings Wetland
Side Side
�� �� �u /�7�19 c:u-+-t..-� �/"r°�
Defined Height: �" Peak Height: '� FFE: - FFE minus 6 feet= (Existing Contour}
` Perimeter(linear feet)_ _ 50%= r #of Stories Ok? � YES
FOR A BUILDING WITH A BASEMENT OR CRAVIPL SPACE:
The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION:
START WITH proposed floor(of the basement or crawl
space)and the highest point of the roof. START WITH The distance between the top of slab and
If you have a... the highest point of the roof.
. GABLE OR HIPPED ROOF(no :f you have a...
windows): Subtract half the GABLE OR HIPPED ROOF(no
windows): SubtraCt half 4he distance
distance between the highest point between the highest point of the roof
of the roof to the low point of the to the low point of the corresponding
SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof
(BASED ON ROOF . GABLE OR HIPPED ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with
TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance
,. dis4ance between the top of the between the top of the highest
highest window and the highest window and the highest point of the
�• point of the roof roof
• ALL OTHER ROOF TYPES(flat,
• ALL O7HER ROOF TYPES(flat,
mansard,etc):No subtraction. mansard,etc:No subtraction.
ADDITION Add the distance between the top of slab
SUBTRACTION Subtract the distance between the (BASED ON and the highest existing grade adjaCent to
(BASED ON EXISTING basemenUcrawl space floor and the EXISTING the foundation.
GRADES) highest existing grade adjacent to the GRADES
foundation OR 10 feet(whichever is less). EQUALS Defined building height
EQUALS De£ned building height
Shoreland District MCWD Permit Received Avera e Lakeshore Setback Met? Bluff
�'Yes � No � N/A 0 Yes �'No
0 Yes � No 0 Yes � No �N/A
Permit Number: Setback:
Stormwater Quatity Existing Proposed Variance Required CUP Required
Overla District Tier Hardcover Hardcover
� Yes No Q Yes No
3 � 1'� `�. `�`� TYPe�S)� TYPe(S)�
Updated: January 2013
v:\forms�plan review checklist 2013.docx
REMARKS (in-house):
Fees to be Char �d YES 6V0
�' Permit �`'"
Plan Review �
State Surcharge ��n`
Investigation Fee
�AC—Nurr�ber of SAC Units
Other(specify)
Sauare Foota e $ er S uare Foota e
Basement X ' �
15f Floor X = $
�'
2nd FIoOP X = �
Garage X - �
Estimated Construction Value: $ °$����' ��?
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site 0 Plumbing 0 Grading/ Filling 0 Well
� Hardcover Removal � Mechanical � Fire 0 Electrical
Footing � Septic � Water Connection
C] Poured Wall � Fireplace 0 Sewer Connection
0 Foundation Survey � Masonry 0 Lawn Irrigation
� Radon Rock Bed � Mfg.
�Framing 0 Other(specify)
� Insuiation
0 As-�uitt Survey
a�
�Final
0 Wetland Buffer
17 Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date/Approved:
Access: Existing: � YES � NO New: � YES 0 NO
OFFICIAL REMARKS -TO BE NOTED ON PERMiT AND INITIALLED
� Updated: January 2013
v:\forms�plan review checklist 2013.docx
.
STRUCTURE INFORMATION:
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
a�u + � II
a. Length(ft.)= � Number of bedrooms=
❑Wood/Frame
i�
b.Width(ft.)= �3, �3 Number of garage stalls: ❑ Masonry
Areas in sauare feet Attached= ❑ Metal
❑ Pole Bidg.
c. Basement= Detached= ❑ ICF
d. 1 S`Story =
❑ On-site Prefab
e. 2"d Story= ❑Off-site Prefab
f. '/z Story = '
�Other(please specify): C��M po�� T�-
g.Total Area= 'rt`eX
REQUIRED SUBMITTALS:
All of the information must be submitted in order for our 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
❑ ❑ 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
❑ ❑ 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
Certifcate 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.
�
ApplicanYs Signature: ' '� v1 ��` �'� �� Date: �S/ ��l I�
,�
Owner's Signature: Date:
ncryNti-'1IV IrVUN 1 �l, MINNESOTA
ZZ lr ��
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City of Orono `
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Planning 8 Zoning Plan Revi�avv ��
a- b� � `
Site Plan Review Date: 0 ��\
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� 1 ) GARAGE
Legai description of premises: 2) TOP OF FNDTN
Lots 23 and 24, Wallace's Addition to the Village of Minnetonk� Beach 3) BASEMENT
This survey shows the boundaries and topography of the abov� described 4) LOOKOUT
property, the location of an existing house thereon, and the proposed
location of a proposed house and driveway. It does not purport to show any 5) FIRST FLOOR
other improvements or encroachments.
• : Iron marker found
��-: Existing contour line 0 20
�-: Proposed contour line
53.5 : Proposed spot elevation
Bearings shown are based unon an as����„A� �at��r,,,
/ DATE TIME V
CITY OF ORONO CALLED IN �O —.�
INSPECTION NOTICE SCHEDULED �o-�L l� :o O
PERMIT NO.�D13 �U� �I �COMPLETED
ADDRESS d�l� C��-
OWNER TELEPHO E NO.
CONTRACTOR °SQ��� r"������
�; DESCRIPTION ������ �
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
� ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
�
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� ❑CORRECT WORK&PROCEED !l; ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. J PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� ZQ9-46��
Owner/Contractor on site:
Inspector. c �
White Copyllnspector's File Canary Copy/Site Notice
�� �' TE TIME �
CITY OF ORONO CALLED IN '
INSPECTION NOT SCHEDULED � "� ��'��
PERMIT N0. 'DO �COMPLETED
ADDRESS a�al S U ��
OWNER TELEPHONE NO.��Z 3D9 J���S
CONTRACTOR �L�Z� G��tC�—C � �t C�
>; DESCRIPTION ��'�'� r�""``
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ 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
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI L ❑ FOUNDATION/REMOVAL
� OWNER/ NTRACTOR TO MEET YOU: YES NO
� COMMENTS:
�
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� �` BA�iRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REiNSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. C PHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46�0
Owner/Contractor on si
Inspector. �_ �
White Copyllnspector's File Canary CopylSite Notice
� D E TIME "
CITY OF ORONO c�iN J-��
INSPECTION NOTICE '���sCHEDULED �'� �
PERMIT NO.�C�l� , co ETED �
ADDRES '
OWNER �I TELEP NE NO�(.� —3� �
CONTR TOR
�: DESCRIPTION
�
1y� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
� ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
�
O ❑ 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 FINAL ❑ FOUNOATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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GW ❑WORK SATISFACTORY:PROCEED ROJECT COMPLETE
� ❑CORRECT WORK&PROCEED �; ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �� CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cal1 for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on site:
Inspector. r �( -�
White Copyllnspector's File Canary Copy/Site Notice