HomeMy WebLinkAbout2016-01072 - deck repair , CITY OF ORONO * z 0 1 6 - 0 1 0 7 2 *
2750 KELLEY PARKWAY DATE ISSUED: 09/09/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1849 FAGERNESS PO[NT RD
PIN : 17-117-23-23-0021
LEGAL DESC : MAPLEGATE INLET
: LOT 004 BLOCK 001
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCT[ON TYPE : DECK REPAIR(REPLACE BOARDS)
VALUATION : $ 12,000.00
NOTE: REBUILD DECK
APPLICANT PERMIT FEE SCHEDULE 232.30
STATE SURCHARGE(VALUATION) 6.00
VANTAGE CONSTRUCTION SERVICES, LLC TOTAL 238.30
14355 24TH ST Payment(s)
WATERTOWN, MN 55388- CHECK 6217 238.30
(612)272-2828
Minnesota State License#: BUIL-BC647228
OWNER
SHUMAN,THOMAS& STACY
1849 FAGERNESS PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved pians and specifications,applicable City approvals,and the
State E3uilding 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 l80 days of the date of issuance,or if construction is
suspended for a period of l80 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. `
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Applicant Permitee Signature Da Issued By ature Date
�ity o� �rono
��i�c�i�� �erm�t Applicatfo� ,�
f��- �'�rr� ����ct�res or i4d 't�o�s �� ��
Mailing Address:
�Q� PO Box 66 ; Permit number: ( � � ��; �,
� Crystal Bay, MN 55323-0066 �' ,�' Date received: �j �j�
�
StreetAddress:' - _�,� -� �' Received by: �' �
y� ,� 2750 Kelley Pa ay �., i � �` z�� Plan review fee: � �'�
�, Orono, MN 5535 . � ���C� - C;(�� � �J�_`--------
_._..__.
'�kfSH��� Main: 952-249-4600 -fiotal Fee:
Fax: 952-249-4616 www.ci.orono.mn.us
Tk�i�application form must be completed in fuli and af( required information must be submitted.
Incomplete appifcations will be returnec�. (Please print)
GENERAL INFORMATION:
Job Site Address: �r�� ' � ��, �;, 2�1��
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home. ❑ Yes ❑ No
lf yes,a specia/event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required un/ess applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLIC NT INFO IVIATION:
Name: Vc.,�,� , ' -��• .��, ��r�.� H� L.9.-_ '
State License # a3C ����� a2�. Expiration Date: %; � , Zp ic�;
Phone: cell (�g�- , -�, _ office
Mailing Address: 'y' ��'- 'Zy'1`� - Cit : ZIP: `j53g��,
Contact Person: ;��iL -i H�. � Applicant is: o tracto / �Homeowner
Email and/or Fax: �� �^ (Circle One)
CS `c�i n r�n �y C�Y��C'1�1� ��rr�
PROPERTY OWNER INFORMATION:
Name: �:�--,:-Y,�•; r�� S�ra.� v ��r�� •v►�,�r
Phone (day): � _ - _ �r-y
Address: 1�`���� f=�-.,T:r�-� k� . �2.1 City: �:�<-• y� ZIP� �j�j3�i i
Email and/or Fax
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: Z�p•
Email and/or Fax:
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone(day):
Address: City: Z�p•
Email and/or Fax:
, ;` . ; �.
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PROJECT INFORMATION: Description of project: ��� �-��` � ��� ` �����=> �- � ��:� , (�' �<-
1.Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal 8�
❑ New Construction Sin le Famil with �Nater Supply
❑Addition � 9 y ❑ Accessory Bldg./Garage
attached garage � Deck ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑ Office/Commercial '
�Relocation detached garage ❑ Residence ❑ Septic
Other.(specify) p.E=�¢�� �=� � ❑ Multiple Family/Condo ❑ Retaining Wall(s) (Compliance certificate
❑ Public 4-feet or greater may be required)
"'Any earth movement may require ❑ Commercial ❑ Storage
MCWD review�permits. ❑ Industrial ❑Warehouse
❑ Public Water
Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) ❑ Other(SpeCify)
15320 Minnetonka Blvd; Minnetonka,MN 55345 ❑ Private Well
Phone: 952-471-0590 / Fax: 952-471-0682
wv✓w.m i n n e h a h a creek ara
Estimated Construction Valuation (excluding land) $ /2 �
Packef Last Updafed: January 2016
Page 21
STRUCTURE IHFORMATION:
1. Structure Dimensfons 1.Structure Dimensions(continued)
a. Length(ft.)= Number of bedrooms= 2. Occupancy:
b.Width(ft.)= Number of garage stalls:
3. Occupant Load:
Areas in sauare feet Attached=
c. Basement= Detached= 4. Type of Construcion:
d. 15i Story =
e.2"d Story= 5. Code Edition:
f. Yz Story =
g.Total Area=
REQUIRED SUBMITTALS:
Afl of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
❑ ❑ Buildin Permit Escrow A reement and Fees
❑ � Plan Review Fee
❑ ❑ Com leted A lication Form
❑ ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8 Y�x 11 set
❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
❑ ❑ Surve —2 full size,to scale meetin ALL surve re uirements
❑ ❑ Hardcover Calculations
❑ ❑ Se tic S stem Certification
p ❑ Minnehaha Creek Watershed District(MCWD)Permit or
Documentation from MCWD statin no ermit is re uired
❑ ❑ Landsca e Walls and/or Retainin Wall Plans
❑ � Landsca e Plan
❑ ❑ Stormwater Pollution Prevention Plan SWPPP
❑ ❑ Access Permit
❑ ❑ Data Privac Adviso Form
APPLICANT/OWNER ACKNOWLEDGEMEIVT:
. 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 govemmental agencies
required by law. If you refuse to supply the information,the application may not be issued.
. �grees lhat in the event tha4 weather or other conditions prevent the completion of an as-built surv�y �t the time the
Certificate of Occupancy is reque�ted, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000
escrow to ensure completion of the as-bullt�urvey and all site improvements.
ApplicanYs Signature: Date:
Owner'� Signature: Date:
Packet Last Updated: January 2016
Page 22
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: � ��� CC�E'��'-'7��i�. , ���i?� � ��1C� PermitNo.: �����/�����
Description of work: �j C�UI�L_ (�-�C.�' Date Rec'd:
Septic review by: Date Approved:
Zoning review by: Date Approved:
� ,-
Building review by: �� � � Date Approved: c� � �
Grading review by: Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
�
Zoning: Lot Area: SF/AC ! Width: Lot Coverage: SF %
Survey Submitted: � Yes ❑ No Date of Survey: Revised date ? :
Landscape plan submitted? 0 Yes � No Landscaper:
Proposed Setbacks:
Front(Lake) Rear(Street) ( N S E W ) N S E W ) Other Buildings Wetland
Side Side
Defined Height: Peak Heig'ht: FFE: FFE minus 6 feet= (Existing Contour)
Perimeter(linear feet) = 50°/ = L.F. below grade
Basement? 0 Yes � No, S or' s
FOR A BUILDING WITH A BASEMENT OR CRAWL S AC : FOR A BUILDING ON A SLAB FOUNDATION:
The distance bet een th lowest proposed Slab at or above grade—
floor(of the bas�ment or awl space)and measure from hiqhest existinq
START WITH the highest po�nt of the roo. START WITH rq ade to the highest poinl of the
roof even if fill was brought in to
elevate home.
If you have,ia...
i
SUBTRACTION • GA�LE OR HIPPED R OF(no Slab below grade—measure
(BASED ON wi�idows): Subtract half e distance from highest existing grade to the
ROOF TYPE) b�etween the highest poin of the roof hi hest point of the roof.
Z6 the low point of the corr sponding If you have a...
�gable or hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF
• ' GABLE OR HIPPED ROOF with (BASED ON (no windows): Subtract half
the distance between the
windows): Subtract half the q istance ROOF TYPE) highest point of the roof to
between the top of the highes�
window and the highest point Qf the the low point of the
roof ` corresponding gable or
hipped roof
• ALL OTHER ROOF TYPES(fla . GABLE OR HIPPED ROOF
mansard,etc):No subtraction. (with windows): Subtract
SUBTRACTION Subtract the distance between the half the distance between
(BASED ON basemenUcrawl space floor and the the top of the highest
EXISTING highest existing grade adjacent to the window and the highest
GRADES) foundation 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 Bluf# '
M et?
❑ Yes ❑ No Permit Number: 0 Yes � No 0 N/A � Ye No �
� N/A—see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf % and sf
� Yes � No � Yes 0 No
1 2 3 4 5 Type(s): Type(s):
Fees to be Char ed YES NO
Permit �/
Plan Review �/
State Surcharge
Investigation Fee j�"
SAC—Number of SAC Units �
Other(specify)
Square Footage $ per Square Footage
Basement X = $
15� Floor X = $
2"d FIoO� X = $
Garage X = $
Estimated Construction Value: $ /�, ( `��_�
Orono Inspections Required Work Requiring Separate Permits
� Footing 0 Site 0 Plumbing ❑ Grading/Filling
� Poured Wall 0 Silt Fence/Erosion Control ❑ Mechanical 0 Fire
0 Foundation Survey � Hardcover Removal 0 Septic 0 Water Connection
0 Foundation Waterproofing ❑ Other(specify) � Fireplace � Sewer Connection
Framing ❑ Masonry � Lawn Irrigation
� Insulation 0 Mfg. � Landscaping
❑ As-Built Survey ❑ Other(specify)
Final
� Lathe Required State Permits
❑ Other(specify)
❑ Well � Electrical
REMARKS (in-house):
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
0 See Builder Acknowledgement Form
0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved.
Updated: October 2015
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INSPECTION NOTICE SCHEDULED �(fp
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ADDRESS f � `� � � �f- �
OWNER TELEPHONE NO. �/�������
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Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ��FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� LJ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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❑ DEMO-SITE �TIC INSTALL
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V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WFLLRETURN
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❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
C r the nex spection 24 hours in advan�e. (g52) 249-460�
r on site: `�' � ` "�
Inspector: �
ts Copyllnspector's Ffle Canary CopylSfts Notke
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INSPECTION NQT��{�� �/�y SCHEDULED D � �
PERMIT NO. Ot�� / OMPLETED
ADDRESS f
OWNER EPHON NO. l�—�7�—����
CONTRACTOR � L _
� DESCRIPTION
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADINC�/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
J�FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICOMRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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INSPECTOR WFLL REfURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACGESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on site:
Inspector.�_X��'7�
�
White Copyllnspector's File Cenary CopylSite Notke
� � � � �
DATE TIME
CITY OF ORONO CALLED IN �
INSPECTIOM OTICE SCHEDULED -� �
PERMIT NO. "e 1 , COMPLETED
ADDRESS ' � � �-I `� T C?� �-���'� �
OWNER TELEPHONE N0.1-� � Z -�a�������5 I�
CONTRACTOR `���C� Cb�
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O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z �] RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q �FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
��❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
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2 OWNERICONTRACTOR TO MEEf YOU: YES_NO
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OwnedContractor on site:
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