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Home My WebLink About2016-00977 - addn/remodel/repair CITY OF ORONO * 2 PJ 1 6 - 0 0 9 7 7 * 2750 KELLEY PARKWAY DATE ISSUED: 08/16/2016 , ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4760 BAYSIDE RD PIN : 31-118-23-33-0012 LEGAL DESC : BAYSIDE HILLS : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTNITY : 434-RESIDENTIAL VALUATION : $ 10,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,EI,ECTRICAL(STATE) INTERIOR REMODEL[NG DUE TO WATER DAMAGE. APPLICANT PERMIT FEE SCHEDULE 201.32 PLAN REVIEW 130.86 NEXTERA CONSTRUCTION STATE SURCHARGE(VALUATION) 5.00 1211 WINDRUSH RD BUFFALO, MN 55313- TOTAL 337.18 (763)286-1380 Payment(s) Minnesota State License#: BUIL-BC 668680 CHECK 6810 337.18 OWNER BAUMGARTNER, DAVID&JESSICA 4760 BAYSIDE RD MAPLE PLAIN, MN 55359- 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. AI�provisions of laws and ordinances governing this rype 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 afrer work has commenced. The applicant is responsible assuring all equired inspections are requested in conformance rt the Stat ding Code.This permit may be revoked at any time for d �use. / t � / _ �S � 7� �' � � ,c�� 5ti � l �� l � Appl nt Permitee Signature te , Issued By Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O ` _ MailingAddress: Permit number: p�O� � �97 l��O PO Box 66 I Crystal Bay, MN 55323-006� � Date received: �—� "l� Street Address: L� Received by: y�, � 2750 Kelley Parkway � Plan review fee: L Orono, MN 55356 tqkESH�4� 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: � f�rC% :�.�.� ��c��-� x,�� C�i E�<'�Ci' t-ti% Will this be a Parade of Homes, Remodelers S owcase 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 servic will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APP CAI�T INFORMATION: Name: ��- State License# �' �Q Expiration Date: y' Lead Certification Number: Expiration Date: (for work on homes that were consfructed prior to 1978 Phone: (cell) ��j �- z�'�p- ��'� (office) Mailing Address: 2� ' �i,. r� �� City: � ZIP: 7 j 3 /�j' Contact Person: /G c� �'..- Applicant is: ortt c or Homeowner (CircleOne) Email and/or Fax: ��? ,e;,.o� K ,�, PROPERTY OWNER INFORMATION: , Name: j�Gt cJe .a- .,J�CS�c� U�,�-��f't�✓ Phone (day): Address: �'�� S��l.� � City: �z�-� ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits: ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration �Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.ora Estimated Construction Valuation of Project (excluding land) $ ��`�� APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • 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; • 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 �nformation is to annually pdate our records and records of other governmental agencies required by law. If ou refuse to su I the inform t' ,the a tion ma not be issued. Applicant's Signature: t-� Date: �� i/ � Owner's Signature: Date: Last Updated:January 2016 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS � � (Y � --� -c� � �^ � � J ; c ._.• Address: �J��,r`��,��X�"� / '� �L Permit No.: � �(,'i t-"� f L ( Description of work: Date Rec'd: ,� / o �,; Septic review by: /I! � Date Approved: �9 / Zoning review by: Date Approved: ', ;� , Building review by: Date Approved: ��'�� ,' � (J Grading review by: Date Approved: Zoning District: Z ning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % 1 Survey Submitted: 0 Yes � N� Date of Survey: Revised date(?): Landscape plan submitted? 0 Yes 1`'� 0 No Landscaper: � Proposed Setbacks: ,�� Front (Lake) Rear(Street) ( N S E W ) ( N ; S E W ) Other Buildings Wetland Side ' Side Defined Height: Peak Height: '1 FFF��. FFE minus 6 feet= (Existing Contour) ,, Perimeter(linear feet) _ �0% _�;� L.F. below grade Basement? ❑ Yes 0 No, Storie's �' 1 FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the low�e$t proposed Slab at or above grade— floor(of the basement or cra��I s ace)and measure from hiqhest existinq START W ITH the highest point of the roof/ � ra ade to the highest point of the � START WITH roof even if fill was brought in to % � elevate home. If you have a... SUBTRACTION • GABLE OR HIPP D ROOF(n Slab below grade—measure (BASED ON windows): Subtr ct half the dist nce from highest existing grade to the ROOF TYPE) between the hi est point of the of hi hest oint of the roof. to the low poi of the correspondi g If you have a... gable or hipp d roof , SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE OR IPPED ROOF(with � (BASED ON (no windows): Subtract half windows): ubtract half the distance ROOF TYPE) the distance between the between t e top of the highest highest point of the roof to window a d the highest point of the the low point of the roof corresponding gable or hipped roof . ALL O ER ROOF TYPES(flat, . GABLE OR HIPPED ROOF mans d,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract th distance between the �� half the distance between (BASED ON basemenU rawl space floor and the ��.� the top of the highest EXISTING highest e sting grade adjacent to the �.� window and the highest GRADES) foundatio OR 10 feet(whichever is less). point of the roof �� • ALL OTHER ROOF TYPES � (flat,mansard,etc):No EQUALS Defined building height subtraction. Defined building height EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback g�uff M et? � Yes � � � Yes ❑ No Permit Number: 0 Yes 0 No � N/A Na 0 N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf 0 Yes ❑ No 0 Yes � No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Permit (�' Plan Review State Surcharge (�' Investigation Fee � � SAC— Number of SAC Units Other(specify) (/-, Square Footage $ per Square Footage Basement X = $ 15t Floor X = $ 2�d FI00� X = $ Garage X = $ Estimated Construction Value: $ f f/, �� Orono Inspections Required Work Requiring Separate Permits ❑ Footing � Site �lumbing ❑ Grading/ Filling 0 Poured Wall � Silt Fence/Erosion Control � Mechanical 0 Fire ❑ Foundation Survey � Hardcover Removal ❑ Septic � Water Connection � Foundation Waterproofing � Other(specify) ❑ Fireplace � Sewer Connection Framing 0 Masonry O Lawn Irrigation �Insulation ❑ Mfg. � Landscaping � As-Built Survey ❑ Other(specify) Final 0 Lathe Required State Permits � Other(specify) ❑ Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: � See Builder Acknowledgement Form � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. 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Ca11 forthe next inspection 24 hours in advance. (952� 249-4600 OwnerlC tractor on ' �� Inspector. � �`" �� White Copyllnspector's File Canary CopylSite Notice