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Home My WebLink About2016-00843 - addn/remodel/repair � _� � CITY OF ORONO * 2 0 1 6 - PJ 0 8 4 3 * 2750 KELLEY PARKWAY DATE ISSUED: 08/OU2016 R ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 333 HOLLANDER RD PIN : 25-118-23-43-0005 LEGAL DESC : REG. LAND SURVEY NO. 1281 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTNITY : 434-RESIDENTIAL VALUATION : $ 125,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) REMODEL KITCHEN,DINING,FAMILY ROOM AND BATHROOM APPLICANT PERMIT FEE SCHEDULE 1,267.42 PLAN REVIEW 823.82 TANNER,JOHN&DONNETTE STATE SURCHARGE(VALUATION) 62.50 333 HOLLANDER RD WAYZATA,MN 55391- TOTAL 2,153.74 Payment(s) CHECK 1144 2,153.74 OWNER TANNER,JOHN&DONNETTE 333 HOLLANDER RD WAYZATA,MN 55391- AGREEMEIYT AND SWORN STATEMENT The work for which this permit is issued shail 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 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 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 or due cause. �y� ��1---- g ��j� �2G �� / � l b App' er►nitee Signature Date Issued y ature Date e � � � City of Orono ` Building Permit Application for New Structures or Additions Mailing Address: /�,�� g PO Box 66 Permit number: ` �O� C stal Ba MN 55323-0066• Q rY Y, Date received: Street Address:' ��;�(�� Received by: y ,� 2750 Kelley Parkway rv 1�� Plan review fee: �' � Orono, MN 55356 6 � n `�kESH�� Main: 952-249-4600 Total Fee: „( 15�, ?� Fax: 952-249-4616 ti^Jvv�Jv_a oror�o_�nr� 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: nI Job Site Address: 333 a��Gv�c� K-�. Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes o lf yes,a special event permit is required with Police Deparfinent and Gity Council approval 60 days prior to fhe event Shuttle bus service will be required unless applicant demonstrates s�cient on-site parking is available. Mon-permitted events will not be allowed. CONTRACTOR/APPLIC�41�T INFORAAA�ON:�O�,w� Name: ., �� State License# � Expiration Date: Phone: (cell) (office) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Clrcle One) Email and/or Fax: PROPERTY OWNER INFO�MATIQN: �_ Name: � � �1 0,�� aw�-c.� Phone(day): ' 2 08 Y Address: � Ci : l� r� ZIP: �,3�/ Email and/or Fax --�.�� '33 c'n�e�..� - Cu� ARCHITECT/ENGINEER NFORMATION: ►vame: �,�f.c S Le►��-- Phone (day): 6(2 �Z� 5333 Address: 230� ha;�,�,�,� A,r City: /}�f+HC�.,�ol�i ZIP: S S�`/`'`� Email and/or Fax: — C,�1c �C�e�„�,� ,c c�-� PROJECT INFORMATION: Descri tion of ro'ect: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8� Water Supply ❑New Construction �ingle Family with ❑Accessory Bldg./Garage [►3�Addition attached garage ❑Deck ❑Public Sewer ❑Accessory Building ❑ Single Family with ❑ ffice/Commercial ❑Relocation � �� 1 � detached garage [�Residence (�Private Sewer [�Other: (specify) N^� K' `� ❑Multipte Family/Condo ❑Retaining Wall(s) �� (�,� ❑ Public 4-feet or greater ❑ Public Water *"Any earth movement ma�i requir� ❑Commercial ❑Storage MCWD review 8 permits. ❑ Industria� ❑Warehouse [�Private Well Minnehaha Creek Watershed District(MCWD) ❑Othef: (speCify) ❑Other(speCify) 15320 Minnetonka Blvd Minnetonka,MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehanacreek.or Estimated Construction Valuation (excluding land) $ �,C S;UD U Packet Last Updated: Augusf 2015 Page 21 STRUCT,URE INFORMATION: 1�,Struct:;re Dimensions 1.Structure Dimensions(continued) 2.Type of Construction � `�� •� /��, a. Length(ft.)= �� Number of bedrooms=�_ �� [� d Frame Q�G✓�aKCy ��"\C~� b.Width(ft.)= Number of garage stalls: ❑M so � Areas in sauare feet Attached= � �Me ��/f✓ l �J�C c. Basement= 25�D ❑Pol Bldg. Detached= � ❑ ICF d. 1 u Story = �-1 S� ❑O -s�e Prefab e.2"d Story= ,7�� ❑O -sit Prefab f. YZ Story = ❑ ther( ase specify): g.Total Area= 5��Sv REQUIRED SUBMITTALS: All of the information must be submitted in order for your a plication to be rocessed: Not Enclosed A licabte ❑ Buildin Permit Escrow A reement and Fees ❑ Plan Review Fee ❑ Com leted A lication Form ❑ C,�' 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 R uirements ❑ �' Surve —2 full size,to scale meetin ALL suroe re uirements ❑ Hardcover Calculations O Se tic S stem Certification ❑ Minnehaha Creek Watershed District(MCWD) Permit or Documentation from MCWD statin no ermit is r uired ❑ Landsca e Walls and/or Retainin Wall Plans ❑ Stormwater Pollution Prevention Plan SWPPP ❑ Access Permit O 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 enginee�ng consultant review costs in excess of$500; • Certifies that the information supplied is true and cor�ect 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 pubfic 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 annualfy 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 oi a $10,000 escrow to ensure completion of the as-built survey and all site improvements. � / �/Applicant's Signature: � Date: �/� � Owner's Signature: � �"� Date: ��2`��G �� 7�� 6 Packet Last Updated: August 20f5 Page 22 � w PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS �s�� Address: �7,/�7 U2��1(l� �G" ��C�-�� Permit No.: ��((— 0�� Description of work: Date Rec'd: Septic review by: Date Approved:_ Z/ l.�/ 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: � Ye�s 0 No Date of Survey: Revised date ? : Landscape plan submitted? � Yes ❑ No Landscaper: Proposed Setbacks: � � , Front(Lake) Rear(Street)� ( N S E W ) ( N � E W ) Other Buildings Wetland Side / Side Defined Height: Peak Height: FFE� FFE minus 6 feet= (Existing Contour; � Perimeter(linear feet) _ � 50%= L.F. below grade / Basement? � Yes � No, Sto�ies � � / FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE:\ FOR A BUILDING ON A SLAB FOUNDATION: The distance between the I we �proposed Slab at or above grade— START WITH floor(of the basement or awl s @ce)and measure from hiqhest existinq the highest point of the r of. \ START WITH rade to the highest point of the � roof even if fill was brought in to If you have a... elevate home. SUBTRACTION • GABLE OR IPPED ROOF(no Slab below grade—measure (BASED ON windows): ubtract half the distance from highest existing grade to the ROOF TYPE) between t e highest point of the roof hi hest oint of the roof. to the lo point of the corresponding If you have a... gable o hipped roof SUBTRACTION ' GABLE OR HIPPED ROOF GAB OR HIPPED ROOF(with (BASED ON (no windows): Subtract half • win ws): Subtract half the distance ROOF TYPE) the distance between the be een the top of the highest highest point of the roof to the low point of the w' dow and the highest point of the corresponding gable or r of hipped roof • ALL OTHER ROOF TYPES(flat, • GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION S btract the distance between the half the distance between (BASED ON asemenUcrawl 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: May 2016 z:\forms\plan review checklist 5-2016.docx . . � Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? Permit Number: � Yes 0 No � N/A 0 Yes � � Yes � No 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 0 No � Yes � No 1 2 3 4 � 5 Type(s): Type(s): Fees to be Char ed YES NO Permit i/' Plan Review � State Surcharge �- Investigation Fee � SAC— Number of SAC Units �/ Other(specify) �_ Square Foota e $ er Square Foota e Basement X = $ 1 S� Floor X = $ 2nd FIoOP X = $ Garage X = $ ,t� G� Estimated Construction Value: $ � � � 0�V .. y Orono Inspections Required Work Requiring Separate Permits � Footing O Site Plumbing 0 Grading/Filling 0 Poured Wall 0 Silt Fence/Erosion Control �Mechanical � Fire � Foundation Survey � Hardcover Removal ❑ Fireplace 0 Water Connection 0 Framing ❑ Other(specify) ❑ Masonry ❑ Sewer Connection � Waterproofing/Drain tile 0 Mfg. � Lawn Irrigation ❑ Foundation Waterproofing ❑ Other(specify) ❑ Landscaping � Framing Insulation 0 As-Built Survey Final � Lathe Required State Permits 0 Other(specify) � Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: 0 See Builder Acknowledgement Form � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: May 2016 z:\forms\plan review checklist 5-2016.docx l'Vt�r�C. o,?o��- o��sT /��a�r� ��rs d�s�'/� DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED "a�� PERMR NO.a�� 8�COMPLETED ADDRESS r� �NN� ELEPHONE NO.�P�� r�T7�� CONTRACTOR `' DESCRIPTION 2 � • ryJ ra � ❑ FOOTING ❑ DEMO-FINAL ❑ SEP IC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/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 Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J SITE TIC INSTALL �RACTOR TO MEET Y�OU• _NO � COMMENTS: Q or � (.� -��e �� o � 3 � r� s.�r f] . � .�• !'.�� .1,�'r^-.` 0 � ' l� b r'� /'� • ir '„` +�� ('�`� o� � , � - 3 l��. �. - � �. �� W � � � �WORK SATiSFACTORY:PROCEED ❑PROJECT COMPLETE W ❑CORRECT VIfORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEtiAPORARY V BEFORECdVERIN(i PERMANENT C]CORRECT UNSAFE CONDITION WITHIN H��- ❑p►{OTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS. CaM 1or the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor site: ,�� ,en�� White CopYllnspector's Fil� Gnary Copyf8lN Notice L/ \�� `/ I pq� TIME CITY OF ORONO CALLED IN �� INSPECTION NOTICE SCHEDULED / <7-�-/.(� �;.�C� PERMIT NO. -��"�� co ereo ADDRESS 33� ' ' " � OWNER � TELEPHONE NO. � - �0�`� CONTRACT R � DESCRIPTION � �� W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING F�NAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION D WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNOATION/REMOVAL _ � ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICOPfTRACTOR TO MEET Y�OU:_YES_NO � COMMENTS: � �Yl��s�. �D r SD�c� �n� 0'� �L�wtGt�-�_G " o � I�tJ�6�5 � G�Osc� C� /l 5.D✓tcy �a�.« - �, � � � �Q�� G� G� lQ G1�-erll Q (Ijr'ia�'rc��.r., � �� C/�r�� o- ��s�j.�s -�ror.� N�re�fr � Ve i � �45- F •�°, � e rw�.�c � aoib-a�vy— /ZT �v r � a�� OwY - pvG 5��< yo +�e t� ��-� �n Pvc � !. �fU - p� '�5 GUv@ ✓ � ❑WORK SATISFACTO . n vs�rtiFCT r-nua�FfE W�RRECT WORK�PROCEED ❑ISSUE CEFiTIFICATE OF OCCUWINCY 0 O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE Cd1/ERINO PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN �NSPECTOR WILI RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPEC710N REW IRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in adva�e. (952) 249-4600 OwnerlContractor on site: Inspector: � � v"� "�""- Whits CopyAnspectw's Fils C�nary CopylSMs Notics �� l �� ATE TIME �/ CITY OF ORONO CALLED IN ��, INSPECTION OTI E SCHEDULED -i��-i-�c`7��" PERM�T NO. �I��L�JJ�-� COMPLEfED ADDRESS �-� � -��—f L�% �'� f� �P G� �� OWNER �- _��`f�J 6'1 �C��?/�fiE�EPHONE NO. �` �a� � ��,7f>�l� CONTRACTOR �'��` � DESCRIPTION �-�-�� S l.� �C� T I C�-Y� ��' �''?�C�� ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL 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 W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ TIC INSTALL 2 O'WNERICONTRACTOR TO MEET YOU:�YES_NO v�i COMMENTS: � W � o -� r�� ,, J� �' — � � S� �i ✓'G � 0 W � � Q � 2 W � w � j �V�KSATISFACTOR�F.PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 3 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED �STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on e• Inspector. � � �� White CopyllnspecMr's FNe Canary CopylSfte Notke