HomeMy WebLinkAbout2015-01175 - Interior remodel & small addition .-� CITY OF ORONO
. * 2 0 1 5 - 0 1 1 7 5 *
2750 KELLEY PARKWAY DATE ISSUED: 10/27/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1825 CONCORDIA ST
PIN : 17-117-23-22-0015
LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK
: LOT 008 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 142,000.00
NOTE: SEPARATE PERM[TS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE)
[NTER[OR REMODEL AND SMALL ADDITION
NOTE: PRIOR TO RELEASE OF�FSC OW MONEY,AN AS-BUILT SURVEY AND HARDCOVER CALCULATIONS MUST BE SUBMITTED
AND APPROVED. WITIAL: �I �
APPLICANT PERM[T FEE SCHEDULE 1,374.19
STATE SURCHARGE(VALUATION) 71.00
LECY BROS HOMES TOTAL 1,445.19
15012 HWY 7
MINNETONKA, MN 55345- Payment(s)
(952)944-9499 CHECK 43291 1,445.19
Minnesota State License#: BUIL-20325555
OWNER
WING,JOHN
1825 CONCORDIA 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. This permit is for only[he work described and does
not grant permission for additional or related work which requires sepazate
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
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ �' I �; ��� / �
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Applicant Permitee Signature Date Issue Signature Date
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City of Orono � � �L;�S.
Building Permit Application �
for New Structures or Additions
_�� Mailing Address: -, ��-�
PO Box 66 �C��-�' �
��0��, Permit number. - /1 � 1 �
�� � Crystal Bay, MN 55323-0066 Date received: �� - �5--(
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� � 1'� � , � StreetAddress:' _ ._ _ Received b : � �
�, � ,�t� 2750 Kelle Parkwa
��y,� �' y y (r ` �� r - Plan review fee: �. � �
��`�kE,`s H�`�/ MainO 952 24�600 6 �� � > _-�-�-�-�--------_ __ __ _ ___—.._ 1�'1�
i Total Fee:
Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must e submitted.
Incomplete applications will be returned. (P/ease print)
GENERAL INFORMATION:
Job Site Address: � �.::� , '. ;:�✓: :. ,��,, .:�. �,.�... �..�..�.�;.�.,,�'�.
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. Shuttle bus service will be
required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: �< <;,,. -$ �.,,•w.� ,
State License# 2, c, 'S t r?s� Expiration Date: ? � �a � 2�+ C.
Phone: (cell) L ��-- 70 3 - �2 5 3 (o�ce) 9 5 2� '?�F� - �4 pj��
Mailing Address: i s'� i 7` t..L: t.� c... Cit : w��� ZIP: r'�'� � �
Contact Person: �-���....t Applicant is: ontracto / Homeowner �c�.��o�e�
Email and/or Fax: �`... �-� .� �t,..H..�. ...� .� � �. �-.. .�,..-P-�6�� .;�.«.�.�.
PROPERTY OWNER INFORMATION:
Name: ...�v�v� V..f - �� c,
Phone (day): ��v JJr��s.
Address: ' Z� -��+ - �'• �-- �"�" HOMES & REMODELING
Email and/or Fax
Paul Weld
- ARCHITECT/ENGINEER INFO�MATION: Cett:6�z.3oo.�2,0
� Name: L �.c u , .�.w pauhueld@(ecyGros.com �
- Phone (day): r S x.. M ��? �-. ,.� �, ,� ,,� .,e
• Address: ���, � u` �} � �5�1z Hiyhivay 7 �Minnetonka,MN g5345
4 � `''�'f 95r•944•9499 � lecybros.com
Email and/or Fax:
�,i«mse urtc,•i2,ssss
PROJECT INFORMATION: Descri tion of ro�ect: .-1 j� ��� ', /'� . , � t—� / �", l 1<�"l./
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage
[�ddition attached garage ❑ Deck ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑Office/Commercial
❑ Relocation detached garage ❑ Residence ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
*"Any earth movement may require ❑ Commercial ❑ Storage
MCWD review 8 permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ��ther: (speCify) ❑Other(speCify)
15320 Minnetonka Blvd
Minnetonka,MN 55345 r
Phone: 952�71-0590 't`'°~� .�-���'�
Fax: 952�71-0682 \y o,��,w, .�,,,,,.�.�,� " ;
� /.a o�f .
www.minnehahacreek.or � '' �` �,�
Estimated Construction Valuation (excluding land) $ t `f.L, u��
Packet Last Updated: August 2015
Page 21
STRUCTURE INFORMATION:
1.Structure pimensions 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 sauare feet Attached= ❑Metal
c.Basement= Detached= ❑ Pole Bidg.
d. 1''Story = � lQ S ❑ ICF
S•S '� 'Ss' � ❑On-site Prefab
e.2"d Story= S � 3a' 3 - �i'1
❑Off-site Prefab
f. '/,Story = ��� t � �� ' i Y'� ❑p�er(please specify):
g.Total Area= C�t �7 T.L � 3 ��
r�.. t � .f -
REQUIRED SUBMITTALS:
All of the information must be submitted in order for our ap lication to be rocessed:
'i', Hflt.
Enclos�d �li�able �� , . � �
0 � Buildin Permit Escrow A reement and Fees
� ❑ Plan Review Fee
� Gom leted lication Form
0" ❑ Pro osed Buildin Ptans-2 fuil size sets,to scale and 1 reduced 11 x 1T or 8"/,x 11 set
� ❑ Minnesota State Ener Code Calculations and Mechanicai Code Re uirements
� ❑ Surve -2 full size,to sca{e meetin ALL surve re uirements
� ❑ Hardcover Calculations
� � Se tic S stem Certification
� ❑ Minnehaha Creok Watershed District(MCWD)Perrnit or ,�.��7„ ��4 ;„��,�
Documentatian from MCWD statin no ermit is re uired
C1 �' Landsca e Wails and/ar Retainin Wall Plans
� o- Stormwater PolluBon Prevention Ptan SWPPP
❑ G� Access Permit
❑ Oata Privac Adviso Form
APPLICANT/OWNER ACKNOWLEDGEMENT:
• Agrees to provide alt information required or reQuested by the Building Department;
• Agrees to pay the Clty of Orono for engineering consultant review costs in excess of;500;
• Ce�tifies that the information supplied is true and correct to the best af hislher knowledge_ The applicant recognizes that they are
solely rospansible for submitting a complete application being aware that upon failure to do so,the staff has no altemative but to
reject it until it is comp4ete;
• Acknowledges the Escrow Agreement is completed and signed;
+ Understands some or all of the infoRnation that you are asked to provide on this application is classified by State law as either
private or confidentiaL Private data is informetion which generally cannot be given to the public but can be given to U�e subject of
the data. Confidential data is informaGon 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 rewrds of other govemmental agencies
required by law. If you refuse to supply the information,the application may nat be issued.
� • eA�s'ees;4f�f ir►tta� a�►.3rt�t�k��+sr a'r ott�r ct��fiicrttr`Pr�vn�sY tfte cc�ar� ���ir�ft acirv�y t�E�e;iiu���
� �estffrr.�a of Us,^rw�ancy is�reqtrr�sted,n iGem ' �°�.
' �rar�Cett�t3c3Ye trf�fl�a�c�,r rrya��. .. �pon.r6cd�pt a€&5�44,'�� �
e�crar�r�o�tss�ar�,eo�xzpKeflo�;uf tYEs as�>u'��s�rrrr��r�ii all s2��fripruyarzscerrl�,
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..v; . . �,
ApplicanYs Signature: Date: '�"�`�"�'� . ����„�;,���
Owner'sSignature: Date: 9 'a�- /-5' � �" �
Packet Last Updated: August 2015
Page 22
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: e'Masonry
Areas in sQuare feet Attached= ❑ Metal
❑ Pole Bldg.
c. Basement= Detached= ❑ ICF
d. 1 Si Story = � ,, ,c 5 3, �. = 3.�i�
❑ On-site Prefab
e.2"d StOry= � x 3:,'� "5 _ !�.�
❑ Off-site Prefab
f. '/z Story = !�, 2 ri� �`� ' i�7 ❑ Other(please specify):
g.Total Area= �� � �` �'�• "� � �,;��
r�, t .. �" -
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
❑ 0' Buildin Permit Escrow A reement and Fees
❑ ❑ Plan Review Fee
0'' ❑ Com leted A lication Form
�' ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/z x 11 set
❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
�` ❑ Surve —2 full size,to scale meetin ALL surve requirements
0" ❑ Hardcover Calculations
❑ �' Se tic S stem Certification
❑ ❑ Minnehaha Creek Watershed Distnct(MCWD)Permit or .4,.�,� � �,.e� r �,_ ,,.�;,F,: I
Documentation from MCWD statin no ermit is re uired
❑ 0' Landsca e Walls and/or Retainin Wall Plans
❑ f� Stormwater Pollution Prevention Plan SWPPP
❑ C�' Access Permit
❑ Data Privac Adviso Form
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 E500;
• 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�iuilt survey and all site improvements.
ApplicanYs Signature: ��� ��'���� Date: ``` "'r��,-� :�'~
�
Owner's Signature: Date:
Packet Last Updated.• August 2015
Page 22
Y .
Christine Mattson
From: Christine Mattson
Sent: Wednesday, September 23, 2015 8:06 AM
To: 'andyjohnsrud@lecybros.com'
Cc: 'David Crook'; Roger Peitso
Subject: 1825 Concordia Street/#2015-01175
Attachments: letter.pdf; application.pdf; Escrow Agreement- Building Permit w Erosion Control
2015-01175.pdf; Survey Requirements-August 2015.pdf
Andy,
Attached is a copy of the letter and enclosures being mailed today. Please don't hesitate to contact me if you have any
questions.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway � Orono � MN � 55356(physical addressJ
PO Box 66 � Crystal Bay � MN � 55323-0066 (mailing addressJ
`�' 952.249.4620 � '� 952.249.4616
� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE W/LL BE CLOSED: Wednesday, November 11, 2015
i
, .
�O1 V�
C ITY OF ORONO
.� ,�, Street Address: Mailing Address: Telephone(952)249-4600
`y�, G� 2750 Keliey Parkway P.O.Box bb Fax (952)249-4616
�.q t�, Orono, MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us
kFSHO�
September 23, 2015
Andy lohnsrud
Lecy Brothers
15012 Highway 7
Minnetonka, MN 55345
Re: Building Permit Application#2015-01175
1825 Concordia Street
On September 15, 2015 the City received a building permit application for porch and patio additions. Staff conducted
a preliminary review based on the information provided and requests the following items be submitted or revised in
order for your application to be considered complete and for the plan review to continue:
1. Certificate of Survey.
a. Please note our engineer has not reviewed the survey so additional comments may be forth coming.
b. According to Hennepin County there is a 15 foot wide fire lane/right-of-way adjacent to the north
property line. Please have the survey updated to reflect the adjacent fire lane/right-of-way.
c. No erosion control measures are shown. Please have the survey updated to show the location of
erosion control measures.
d. Enclosed is a copy of the City's updated survey requirements. Please have the survey updated to meet
all of the City's survey standards and submit two copies for our review.
2. Landscape Plan. Will there be any changes to the landscaping with the proposed covered entries,patios and/or
sidewalk? If so,the City requires a landscape plan be submitted showing all the proposed exterior/landscaping
improvements, i.e. patios, grading, sidewalks, retaining walls, etc. The plan should include the name of the
individual performing the work.
3. Owner Discrepancy. According to the Hennepin County website the property owner is different than the one
listed on the permit application. Please provide us a copy of the deed or proof of ownership.
4. Owner Signature on Application. Please have the owner sign the second page of the building permit
application. Copy enclosed.
5. Escrow&Escrow Agreement. Permits involving grading and/or review by the City's engineer require submittal
of an escrow and an escrow agreement. The purpose ofthe escrow is to guarantee reimbursement to the City
for out-of-pocket costs incurred during the review of your plans. Additionally this escrow will guarantee
conformance with City Code Chapter 79 relating to erosion control and stormwater. The required escrow
amount for this project is$2,500. The escrow agreement is enclosed. The property owner must sign the escrow
agreement and submit a check for$2,500.
September 23,2015
1825 Concordia Street
Page 2 of 2
6. Minnehaha Creek Watershed District (MCWD). Your project may trigger the Minnehaha Creek Watershed
District's (MCWDs) permitting requirements; please contact the MCWD directly at 952-471-0590 regarding
your project. Please note,the City of Orono will not issue a building permit without a copy of the MCWD permit
or documentation stating the proposed project does not trigger any of their permitting requirements.
The above information is required in order for the plan review to continue. Please feel free to contact me at
952.249.4620 or by email at cmattson@ci.orono.mn.us if you have any questions on the above requirements.
Sincerely,
CITY OF ORONO
�w � I�..��./i 1
Christine attson
Planning Assistant
c Andy Johnsrud via email
John Wings; 1825 Concordia Street;Wayzata, MN 55391
David Crook via email
Roger Peitso, Building Official
enclosures
, �
�O`V
� C ITY OF ORONO
� �, Street Address: Mailing Address: Telephone(952)249-4600
yF �� 2750 Kelley Parkway P.O. Box 66 Fax (952)249-4616
�qk�SH���c Orono, MN 55356 Crystal Bay,MN 55323 www.ci.orono.mn.us
October 9, 2015
Andy Johnsrud
Lecy Brothers
15012 Highway 7
Minnetonka, MN 55345
Re: Building Permit Application#2015-01175
1825 Concordia Street
On September 30, 2015 we received additional information in response to our September 23�d letter. Staff conducted a
preliminary review based on the information provided and requests the following items be submitted or revised in order for
your application to be considered complete and for the plan review to continue:
1. ertificate of Survey.
a. According to Hennepin County there is a 15 foot wide fire lane/right-of-way adjacent to the north property
line. Please have the survey updated to reflect the adjacent fire lane/right-of-way.
b. Show proposed grading and proposed elevations of the patios.
c. No erosion control measures are shown. Please have the survey updated to show the location of erosion
control measures.
d. Enclosed is a copy of the City's updated survey requirements. Please have the survey updated to meet all
of the City's survey standards and submit two copies for our review.
P ease note our engineer has not reviewed the survey so additional comments may be forthcoming.
2. Owner Discrepancy. According to the Hennepin County website the property owner is different than the one listed
on the permit application. Please provide us a copy of the deed or proof of ownership.
3. Hardcover Caiculations. We are having a hard time rectifying the hardcover calculations. We have found sometimes
the math is not correct based on the numbers shown,sometimes the numbers shown on the hardcover calculation
worksheet don't match the breakdown submitted. While we believe the property is conforming in hardcover,please
submit updated information. I have enclosed examples to illustrate the issue.
4. crow& Escrow Agreement. Permits involving grading and/or review by the City's engineer require submittal of
`V _escrow and an escrow agreement. The purpose of the escrow is to guarantee reimbursement to the City for out-
of pocket costs incurred during the review of your plans. Additionally this escrow will guarantee conformance with
City Code Chapter 79 relating to erosion control and stormwater. The required escrow amount for this project is
$2,500. The escrow agreement is enclosed. The property owner must sign the escrow agreement and submit a
check for$2,500.
The above information is required in order for the plan review to continue. Please feel free to contact me at 952.249.4620
or by email at cmattson@ci.orono.mn.us if you have any questions on the above requirements.
Sincerely,
CITY OF ORONO
���V� Yr�11111�1.� �
Christine Mattson
Planning Assistant
c Andy lohnsrud via email
John Wings; 1825 Concordia Street;Wayzata, MN 55391
David Crook via email
Roger Peitso, Building Official
enclosures
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CITY OF ORONO
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SEP 3 0 2015
CITY OF ORONO
, �
Christine Mattson
From: Christine Mattson
Sent: Friday, October 09, 2015 1:35 PM
To: 'andyjohnsrud@lecybros.com'
Cc: 'David Crook'; Melanie Curtis; Roger Peitso
Subject: 1825 Concordia Street/#2015-01175
Attachments: letter.pdf; hardcover calculations.pdf; Escrow Agreement- Building Permit w Erosion Control
2015-01175.pdf
Andy,
Attached is a copy of the letter and enclosures being mailed today. If you have any questions, please don't hesitate to
contact me.
Christine Mattson
Planning Assistant
City of Orono
2750 Kelley Parkway � Orono � MN � 55356 (physical addressJ
PO Box 66 � Crystal Bay � MN � 55323-0066 (mailing addressJ
`/� 952.249.4620 � ==� 952.249.4616
� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
OUR OFFICE W/LL BE CLOSED: Wednesday, November 11, 2015
1
� PI,�N 6�EViE11V GFfECF(LlST FOR �VEIM STRtJCTURES / 14DD[TIONS
Address: ��� �d�� �"C�'� Permit No.: ��.� ' �(�7�',�'
Description of work: e �� �-- (��o�����(�� Date Rec'd: �''��'��
Septic review by: _� �-� Date Approved: '�'�
Zoning review by: , ; Date Approved: I b' �� '�
Building review by: Date Approved: �,�•�� '��
.;�'-'' /
Grading review by: �6'� 9� Date Approved: /`��'/�—�%jS
Zoning District: ��`o� ��"�- Zoning File#: Reso#: Reso Date:
�,
Zoning: Lot Area: SF/AC Width: Lot Coverage: ,' '' ��..;•" SF �%.� ?.�� %
Survey Submitted: �'es � No Date of Survey: Q'�� • 6� Revised date(?): f(�'tZ'��
;. Proposed Setbacks:
, 0 ,��`� �
F nt (Lake�S ar(Street�� �i ��- S E W � ( N ' S ; E W � Other Buildings Wetland
''��� Side �-�ride
\Y.�.I��F L�t'�.1/ �..��1-c I�
Defined Height: Peak Fleight: FFE: FFE minus 6 feet= (Existing Contour;
� Perimeter(linear feet) = 5Q% = L.F. below grade #of Stories
.p.
FOR A BUILDING WITH A BASENiEtdT OR CRA`�!L SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the lowest proposed The distance between the top of
START WITH floor(of the basement or crawl space)and START WITH slab and the highest point of the
the highest point of the roof. roof.
` If you have a._ -" If you have a...
• GABLE OR HIPPED ROOF
• GABLE OR H!aPED ROOF(no (no windows): Subtract half
windows): Subtract half the distance the distance between the
betw,e�n the highest point of the roof highest point of the roof to
to2tie low point of the corresponding the low point of the
SUBTRACTION gable or hipped roof corresponding gable or
�. (BASED ON . GABLE OR HIPPED ROOF(with SUBTRACTION hipped roof
ROOF TYPE) windows): Subtract half the distance (BASED ON . GABLE OR HIPPED ROOF
between the top of the highest ROOF TYPE) (with windows): Subtract
window and the highest point of the half the distance between
roof the top of the highest
• ALL OTHER ROOF TYPES(flat, window and the highest
point of the roof
mansard,etc):No subtraction. . ALL OTHER ROOF TYPES
' SUBTRACTION Subhact the distance between the (flat,mansard,etc):No
(BASED ON basemenUcrawl space floor and the subtraction.
� EXISTING highest existing grade adjacent to the ADDITION Add the distance between the top
�" GRADES) foundation OR 10 feet(whichever is less). (BASED ON of slab and the highest existing
EQUALS Defined building height EXISTING grade adjacent to the foundation.
GRADES
EQUALS Defined building height
Shoreland District f�iCWD Permit Average Lakeshore Setback B�u�
Met?
�f Yes � No Permit Number: Yes ❑ No O N/A � Yes No
/ N/A—see attached Setback:
Stormwater Quality Existing Hardcover Prop�sed
Overlay Distric4 (%and sf� �ardcover Variance Required CUP Required
Tier circle one %and s
�� � Yes No Q Yes No
1 2 3 4 5 •� Type(s): Type(s):
Updated: January 2015 ,. � �,
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�.��.� ��' � � �`� l�'��`�
. � '," �.`c".5,��.u'. �,�_ 'k-JK'L�t.Gi"f�n"».�..4t'�'d�xSL wr,.U,°:�.`"�°�'S§`!R!',�w?�k=.'Yk"•�"-�'x�ShkA$Y`,A-�,...�...`�'r` ;,. , , ��'-�`�
REMARKS (in-house):
Fees to be Char ed YES NO
Permit
Plan Review (/�
State Surcharge f/�
Investigation Fee
= SAC—Number of SAC Units
Other(specify)
S uare Foota e $ er S uare Foota e
Basement X = $
1S�Floor X = $
2"d Floo� X = $
Garage X = $
Estimated Construction Value: $ / `� �e ���
Orono Inspections Required Work Requiring Separate Permits Required State Permits
;.
� ❑ Site �'Plumbing 0 Grading/ Filling ❑ Well
0 Silt Fence/ Erosion Control Mechanical � Fire �( Electrical
Q Hardcover Removal 0 Septic � Water Connection
Footing ❑ Fireplace � Sewer Connection
� Poured Wall � Masonry ❑ Lawn Irrigation
�' 0 Foundation Survey � Mfg. 0 Landscaping
� � Foundation Waterproofing � Other(specify)
� Radon Rock Bed
� Framing
Insulation
� As-Built Survey
Final
❑ Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: ❑ YES ❑ NO New: 0 YES � NO
OFFtCIAL REMARKS -TO BE NOTE ON PERMIT AND INITfALLED
���� � �� � � l�
� � �, � ,��- ` ..
Updated: January 2015
z:\forms\plan review checklist 2015.docx
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� . REC�'IVED
- - RONO COPY ��i� � � �015
, � o
��` ��"'. City of Orono CITY OF ORONO
; � � Hardcover Calculation Worksheet
�
�� Property Address: 1�,� ' C' ,
�'�'�, ti�- f��s,,� �4���/'"c�i� �� f".
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�
Step 1: EXiSTING HARDCt?VER
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Certi�ca#e of Survey(survey musf accompany this farm). Use as many lines as necessary to
accurateiy depict existing hardcouer status of the property.
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�>��/ I�l,�'Q� �� "" 11
DATA PRIVACY ADVISORY
In accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd. 2, "Tennessen warning", we
wouid like to inform you that your request for a permit or license from the City of Orono or any of its departments
may require you to furnish certain private or confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary
to process the permit or license.
4. If your requested permit or license requires Council action to approve, some information may
become public.
5. You have certain rights under Minnesota State Statute 13.04 (see following page)to review private
data on yourself.
6. Your full name is required to process this application or permit.
��..a�.. l.r-r),t. 1.o... �, C,,;,,!,t�,1 :�
First Middle Last �
� �-
;a J t .G• ,, r •a �.c„�rJ't,,,�
Address
;,�t,.,s-�3�•�-' w�<,�' ��%� � ° ''� � !1- �� ,t 1..f�o
City State Zip Phone
I understand my rights as stated above.
s��, ��.A..:;•ar�s�,;,,�.-
Signature
Packet Last Updated: August 2015
Page 7
Permit Application: Self-Checklist for Completeness
Please note, the applicant must initial in the boxes below to acknowledge the minimum
required information is included with the submittal. If not, the application will NOT be
accepted. Call 952.249.4620 to schedule a meeting with stafF if you have questions on
application submittal requirements.
����-� Completed Application C, �`�
,
i . . C C� QI � tc�� l�
PI n R vi w F P � ��y �'`��
L a e e ee aid �
� ��
�L�"
L�
, \.���, l c� �'�c �C,-
- ,.> Signed Escrow Agreement & Escrow Payment � � ti�
� k
,
�
���- Building Plans (to scale) x2 �j
l�'�` �� ��,��
,.p , Certificate of Survey (to scale) showing the proposed project & �,�
� meeting all requirements x2 ;�;��: c�t�r ��.�-fi� ��►r� �
5f��i� c i�C" i�fLs ii ks} .. i���.'� •1<.: �c_�-t�
1:.,4 C (, .. •`sE �_�4�d Lu1k. � IJ�.:t_ 1�}' 1`� °
�� , , ��/
�s��' Hardcover Calculations (if applicable) �;' ���
���V`
I am aware that Orono will not issue a building permit without a ��:�\
copy of MCWD permits (or documentation from the MCWD '
�'�-' the proposed project does not trigger their permitting ���r�����f�
requirements). I will contact the MCWD at 952-471-059 _
r�gyr in �,��is project. `� �
Signed by: ;>��� 6��'.��J�-
Address: � � 2 `-> �. ���C �►cl � ;� ; ��—
Permit #: ��`-; � � -- r`; I I "� G,
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Packet Last Updated: August 2015
Page 2
Christine Mattson
From: Lauren Sampedro <Isampedro@minnehahacreek.org>
Sent: Friday, September 11, 2015 1:55 PM
To: Melanie Curtis; Christine Mattson
Subject: 1825 Concordia St, Orono
Hi Melanie and Christine,
Lecy Bros. Homes stopped in today to show MCWD the addition plans for 1825 Concordia St. The footings for the patio
are outside of the floodplain and do not trigger our erosion control rules. No permit is needed from MCWD for this
project.
Please let me know if you have any questions.
Have a great weekend,
Lauren Sampedro
District Representative
Minnehaha Creek Watershed District
15320 Minnetonka Blvd
Minnetonka, MN 55345
952-641-4580
�::,�
MINNEHAHA CREEK
WATERSHED OiSTR1CF
1
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17-117-23-22-0015 A-T-B: Torrens �
��' Print Date: 9/21/2015
Owner Larry F Gehl Market $1,575,000
Name: Total:
Parcel 1825 Concordia St Tax $19,953.24
Address: Orono, MN 55391 Total: (Payable:2015)
Property Residential Lake Shore Sale �529,000
Typ@: P�ICe: This map is a compilation of data from various
sources and is furnished"AS IS"with no
Home- Homestead Sale 08/1994 representation or warranty expressed or
stead: Date: impiied,including fitness of any particular
purpose,merchantability,or the accuracy and
completeness of the information shown.
Parcel 0.83 8Cf2S Sale Warranty Deed COPYRIGHT�O HENNEPIN COUNTY 2015
Area: 36,270 sq ft Code:
,�, Think Greere!
https://gis.hennepin.us/Property/print/default.aspx?C=45 0773.1024204734,4977129.42174... 9/21/2015
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❑ STOP ORDER POSTED. CALL INSPECTOR
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White C Ilnspector's Ffle Canary CopylSite Notice
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DATE TIME
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White Copyllnspector's File Canary CopylSite Notice