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Home My WebLink About2012-00978-voided permit � � City of Orono Building Permit Application / for New Structures or Additions Mailing Address: Permit number: � .¢,0,�. PO Box 66 �j�� Crystal Bay, MN 55323-0066 Date received: "3'i rh3Y'�- �.. . - Received by: a ; ��; >��i', a, Street Address:� '�,E, , ' �� titi 2750 Kelley Parkway Plan review fee: l v�`'�� °y P� C C� l � N� � Orono, MN 55356 ��la' DQ 7 '�kEssos� �---_' Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us "' 1•j„j,. � This application form must be completed in full and all required information mus be submitted. Incomplete applications will be returned. (P/ease print) GENERAL INFORMATION: Job Site Address: 3350 ��x SfrQet �0 �N SJr Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �X No If yes,a special event permit is required with Police DepaRment and Ciry 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/APPLICANT INFORMATION: Name: S`�1�nC'� �� f�OODP.f mC�r� � �-C- State License# i��o 0 3� a � Expiration Date: 3 T3 i / 2 C � -' Phone: GS a -'-��3 — S�-t 3 5 office �v� — i cell Mailing Address: 1 , ?� Iv11 n►12, K� i3�vC Cit : c( ZIP: S 3�� Contact Person: J� �� r Applicant is: ontrac or / Homeowner (CircleOne) Email and/or Fax: C�drnlniSfiu�' � �ne��elm� corr� PROPERTY OWNER INFORMATION: Name: �qy��(� Phone (day): Address: 3�� ( S City: Q►�� ziP: 553S� Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: ��ter ��i� � Pc.,�l� �P��..`�nc�l ��r��; ��e.�-� Phone(day): (o �� — �—`i l�r — 'T�'75 Address: i4{3�5� M�Kv�u:'tov�k� L��•��1. City: 1.lJcl..�2�� ZIP: �� 3� ( Email and/or Fax: ,,e.��r� �o-�_ �,-iw�rc_t[5� a�r cL►.�t�c-} - �v �M PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply �New Construction �,Single Family with ❑ Residence Addition attached garage �,Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial �Private Sewer ❑Multiple Family/Condo ❑Warehouse ❑ Public ❑Storage ❑ Public Water "*Any earth movement may require ❑Commercial -�-9t�ie MCWD review 8�permits. ❑ Industrial � Private Well Minnehaha Creek Watershed District(MCWD) ❑Other: (specify) ��` ///�� 18202 Minnetonka Blvd �h ��` �i v • � Deephaven,MN 55391 �"� '� Phone: 952-471-0590 �v��-��Ci°w Fax: 952-471-0682 www.minnehahacreek.or �L Estimated Construction Valuation (excluding land) $ , � l O� bC'O .�'� Packet Last Updated: 03-06-2012 -21 - i STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction i a.�Len = - '�+ Number of bedrooms= P �� ❑Wood/Frame �� b. dth (ft.)= � �+ Number of garage stalls: �Masonry Areas in square feet Attached = ❑Metal ❑ Pole Bldg. c. Basement= Detached= d. 1s1 Sto �? � � -5' ;� F'vot ❑ ICF rY = nd , •�� ouS�- � On-site Prefab e. 2 Story= �� _ 5 �`� ❑ Off-site Prefab _ f. '/z Story = t-�:,�...��t��v � � Ot er g. Total Area= �� REQUIRED SUBMITTALS: All of the information must be submitted in order for your 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 ❑ Plan Review Fee ❑ ❑ Other: APPLICANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide alt information required or requested by the Bwiding 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 glven 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-built survey and all site improvements. ApplicanYs Signature: Date: ��/� � Owner's Signature: Date: � - � l� -/ � Packet Last Updated: 03-06-2012 -22 - � R Jesse Struve From: Jesse Struve Sent: Monday, October 29, 2012 4:01 PM To: Melanie Curtis Cc: Christine Mattson Subject: 20121029 3350 Fox St-2012-00977 Melanie, I have reviewed the survey dated 9/12/12 and have the following comments: • I was told this permit is for the building of a pool house only. The survey submitted, shows a wide range of proposed improvements. If the application is only for a building then all the other items shown on the survey should be removed. This includes the proposed pool, proposed pool deck, proposed driveway extension, proposed fountain, and proposed retaining walls and stairs. • The proposed grading on the survey should only reflect the installation of the building and not all the other items shown. • The survey should show the gravel path which head to the lake. • The survey needs to show where erosion control measures are going to be installed. Jesse Struve, PE Director of Public Works/City Engineer City of Orono (952) 249-4661 - Direct (952) 249-4616- Fax www.ci.orono.mn.us � �i�n i�eview Checklist for New Structures / Additions Address/ PID / Legal: � Description of work: � � �. , �� Septic review by: �� i� Date Approved: ��'�• ' � Zoning review by: Date Approved: Building review by: Date Approved: Graciinc� reviewr by: Date Approved: Zoning File#: Resolution#: Resolution Date: � Zonin District Fire De artment Post Office School District �`' Zoning: Lot Area: SF/AC Width: Depth: Survey Submitted: � Yes 0 No Date of Survey: Proposed Setbacks: � �t(Lake) r(Streetj ( � S E 194' } ( N S � W ) Other Buildi s Wetlancf Side Si q,�, 3 � �� i � t� � � �;, Building Defined Height: Building Peak Height: #of Stories Ok?: 0 YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: START WITH the distance between the basement floor/crawl START the distance between the slab and the highest space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice of a flat roof, the cornice of a flat roof,the deck line of a the deck line of a mansard roof, or the mansard roof, or the uppermost point on a round uppermost point on a round or other arch-type or other arch-t e roof roof SUBTRACT half the distance betwsen the highest window and SUBTRACT half the distance between the highest window hi hest roof eak of a itched roof and hi hest roof eak of a itched roof SUBTRACT the distance between the basement floor/crawl ADD the distance between the slab and the highest space floor and the highest existing grade within existin rade within the foundation the foundation or 10 feet,whichever is less. EQUALS Defined buildin hei ht � EQUALS Defined buildin hei ht Lot Coverage: SF % Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff � Yes � Nc � N/A ❑ Yes o � Yes 0 No � Yes ❑ No �/A Permit Number: Setback: Hardcover Zones Existin Pro osed Variance Required CUP Rec�uired 0-75' ,1 Q � ��. � � �,� ' � Yes � No 0 Yes � No � 75-250' Type(s): Type(s): 250-500' 500-1000' .��f�� - � , REMARKS (in-house): Updated: 09/11/2009 z:\forms\plan review checklist.docx Fees to be Char ed YES NO � Permit Plan Review � State Surcharge � Investigation Fee SAC—Number of SAC Urtits Sewer Connection 1Riater Connection Park Fee Site Inspc�ction �� Qther(specify) � Miscellaneous Fees � Calculated By: S u�re Foota e $ er S uare Foota e ��"' Basement X = $ 1 St Floor X = $ 2nd Floo� X = $ Garage X = $ p Estimated Construction Value: $ � Work Re uirin Se arate Permits Re uired State Permits Orono Inspect�ons Required q g p q � Site ❑ Plumbing ❑ Grading / Filling 0 Well ❑ Hardcover Removal 0 Mechanical � Fire 0 Electrical � Footing 0 Septic � Water Connection �: � Poured Wall � Fireplace � Sewer Connection ❑ Foundation Survey � Masonry 0 Lawn Irrigation � � Radon Rock Bed � Mfg. ❑ Framing 0 Other(specify) � Insulation � As-Built Survey � Final � Other (specify) �'. � REMARKS (in-house): i Other Review: Reviewed by: Date Approved: f` Access:Existing: � YES � NO New: � YES 0 NO �r REMARKS (TO BE NQTED ON PERMIT/aND INITIALLED BY PERSON PULLING PERMIT) �'± �°; Updated: 09/11/2009 z:\forms�plan review checklist.docx