HomeMy WebLinkAbout2016-01246 - addn/remodel/repair � CITY OF ORONO * 2 0 1 6 - 0 1 Z 4 6 *
2750 KELLEY PARKWAY DATE ISSUED: 10/03/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3061 CASCO POINT RD
P[N : 20-117-23-34-0017
LEGAL DESC : SPRING PARK
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCT[ON TYPE : ADDN/REMODEL/REPA[R
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 1,000.00 � �,, �
NOTE: PROVIDE PICTURES OF DRAINTILE. INITIAL: _�►,\,��
APPLICANT PERMIT FEE SCHEDULE 43.30
PLAN REVIEW 28.15
MOL[TOR-WATERS, DORIS STATE SURCHARGE(VALUATION) 0.50
3061 CASCO PT RD
WAYZATA, MN 55391- TOTAL 71.95
Payment(s)
CHECK 5203 71.95
OWNER
MOLITOR-WATERS, DORIS
3061 CASCO PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which Ihis 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
shail be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within I80 days of the date of issuance,or if construction is
suspended for a period of l80 days at any time afrer 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.
\ ` 0 � ��` � l L_ �"� Li� /� l —
i 1�
Applicant Permit nature Date Issued By� ' nalure Date
, � City of Orono
Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
�i.�. wir����r�, dc�ar�, �ic����, ������s��, ���. -- �� ��'����"1���� ���������)
/�O ;\ Mailing Address: Permit number: �l U �
1�1� PO Box 66 � � `�
� � � Crystal Bay, MN 55323-0066 Date received:
� � Received by:
Street Address:
� � �` ��� ` 2750 Kelle Parkwa
�� '`� � Y Y Plan review fee:
�`� �'� � Orono, MN 55356
�k�st���t !
� Total Fee: � � 9 J
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us l
This application form must be completed in full and all required information must b submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: �jC1o� � +���, ���v� 1� � �,�.�-Z�--,r� , VV�,�% �s� `
Will this be a Parade of Homes, Remodelers Showcase Home or other Dis Home? ' ❑ Yes No
If 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 unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/AP LICANT INFOR ATION:
Name: _ vw�v� °��-e��J�2�
State License# Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were consfructed prior to 1978
Phone: (cell) 3� _ :�R3_�`l3� (office)
Mailing Address: a5ta3 �,� 3� City:�� lp ZIP: s
Contact Person: v�,,�� w;�.e��k�_Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax: �, �,�,� � � p� � , (;pyy�
PROPERTY OWNER INFORMATION:
Name: _�;,,�_ `� �,`� `' `� \v���,,-�zx-����2�-�
� � �-��-� �. +�=��� 5
Phone (day): (Q�a._ l�« - '7`�-7C.�
Address: ��` �,y��Q �..� �_ City:��Z�� ZIP: �53� �
Email and/or Fax: ��`��.ko`�����.��,�.�� �` a �
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review& 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.orq
Estimated Construction Valuation of Project (excluding land) $ �. �� . C'»
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 information is to annually update our records and records of other governmental agencies required by law. If
ou refuse to su I the information, the a lication ma not be issued.
ApplicanYs Signature: �\ � ���r.(�-U��e�..� Date: 9l G[' �(Co
Owner's Signature: ���D ����c:,�� -��a�.� Date: `�l� ��
�st Updated:January 2016
PLAN REVIEW CHECKLIST FO NEW STRUCTURES / ADDITIONS
. .�� , •�
i
Address: �' � � c' Permit No.:
� �.,J `
Description of work: �i/'�/l/� '��U��<Cl�it'1 � ���i/��C�ate Rec'd:
Septic review by: Date Approved:
Zoning review by: Date Approved:
:%�_ �'��
Building review by: � � Date Approved:
Grading review by: Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: SF/AC Width: Lot Coverage: SF %
Survey Submitted: 0 Yes � No Date of Survey: Revised date ? :
Landscape plan submitted? � Yes . � No Landscaper:
Proposed Setbacks:
Front (Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland
• Side ide
,
i
Defined Height: Peak Height: FFE:%_ FFE minus 6 feet = (Existing Contour)
Perimeter(linear feet) = 50�'fo = � L.F. below grade
'l
Basement? 0 Yes � No, Stories`', r''�
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: ,"� FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the low�st oposed Slab at or above grade—
START WITH floor(of the basement or crawl spa�e)and measure from hiqhest existinp
the highest point of the roof.' `, START WITH ro ade to the highest point of the
roof even if fill was brought in to
elevate home.
If you have a... 'y
SUBTRACTION • GABLE OR HIPPED ROOF(no�, Slab below grade—measure
(BASED ON windows): Subtract half the distarce from highest existing grade to the
ROOF TYPE) between the highest point of the r�of hi hest oint of the roof.
to the low point of the correspondi,g If you have a...
gable or hipped roof , SUBTRACTION ' GABLE OR HIPPED ROOF
• GABLE OR HIPPED ROOF(with '� (BASED ON (no windows): Subtract half
windows): Subtract half the distanc� ROOF TYPE) the distance between the
between the top of the highest � highest point of the roof to
window and the highest point of the ,l the low point of the
roof corresponding gable or
hipped roof
• ALL OTHER ROOF TYPES(flat, . 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 g�uff
Met?
0 Yes � No Permit Number: � Yes 0 No � 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 ❑ No
1 2 3 4 5 Type(s): Type(s):
Fees to be Charged YES NO
Permit
Plan Review
State Surcharge �
Investigation Fee
SAC— Number of SAC Units (/''
Other(specify)
Square Footage $ per Square Foota e
Basement X = $
1 St Floor X = $
2"d Floo� X = $
Garage X = $
/ ,� �
Estimated Construction Value: $ / �l/
Orono Inspections Required Work Requiring Separate Permits
❑ Footing ❑ Site ❑ Plumbing ❑ Grading/ Filling
0 Poured Wall ❑ Silt Fence/Erosion Control ❑ Mechanical ❑ Fire
0 Foundation Survey � Hardcover Removal � Septic � Water Connection
❑ Foundation Waterproofing 0 Other(specify) 0 Fireplace 0 Sewer Connection
� Framing 0 Masonry ❑ Lawn Irrigation
❑ Insulation ❑ Mfg. � Landscaping
� As-Built Survey 0 Other(specify)
Final
❑ Lathe Required State Permits
❑ Other(specify)
❑ Well 0 Electrical
REMARKS (in-house):
� /
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: ��<<,�'� ��C�U��S t�I � (�/�'���`f'� IP
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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EXISTING SE�TICIN "A"
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INSTALL 2" REBAR AND CORE
FI�L AT 2'—�" TYPICAL SPACING
REINSTALL BLACK
LANDSCAPE SOIL
INSTALL NEW NON—PERMEABLE
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INSTALL NEW NON—PERMEABLE
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REINSTALL EXISTING DRAINAGE
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The wall has shearec� just at�ove the garage floor anc� has deflected ulward
a�proxiniatel�� 2.5-ulches.
��
DATE T1�AE
CITY OF ORONO CALLED IN �"����
INSPECTION N TICE SCHEDULED /-/� /7 �• �
PERMIT NO. ���D/� COMPLETED
ADDRESS �/�� �� � ���
OWNER'1�� � � TELEPHONE NO. ��� ���� �7�
CONTRACTOR
� DESCRIPTION
� �� \
4i ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC AL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
�Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
Q�D'WN NTMCTOR TO MEET Y'OU:�'YES_NO
� COMMENTS:
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� ❑WORK SATISFACTOR�F.PROCEED ��� TSSOJECT COMPLETE
W �CORRECT NfORK�PROCEED ❑ UE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN
❑C�TATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cal1 for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on s' �
Inspector:
White CopYAnsPector's Flle C�nary CopylSite Notice