HomeMy WebLinkAbout2017-00188 - addn/remodel/repair � CITY OF ORONO * z 0 1 7 - 0 0 1 e e *
' 2750 KELLEY PARKWAY DATE ISSUED: 03/28/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1565 FA[RVIEW COTTAGE LA
PIN : 07-117-23-43-0033
LEGAL DESC : ORCHARD BEACH
: I.OT MB BLOCK MB
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTI VITY : 434-RESIDENTIAL
VALUATION : $ 2,500.00
NOTE: SEPARATE PERMITS REQUIRED: PLUMBING
LOWER LEVEI_BATH FINISH
APPLICANT PERMIT FEE SCHEDULE 92.89
CARVER CONSTRUCTION INC PLAN REVIEW 60.38
9586 GANDER LANE STATE SURCHARGE(VALUATION) 1.25
MINNETRISTA, MN 55375- TOTAL 154.52
(763)458-0954 Payment(s)
Minnesota State License#: BUIL-20377469 CHECK 11026 154.52
OWNER
MARY SNYKER BECKER,TIMOTHY BECKER&
1565 FAIRVIEW COTTAGE LANE
MOUND, MN 55364-
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. 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 180 days at any time afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in apnforma with the State Building Code.This permit may be
revoked,at� ' time f �ue cause. ,
/ /
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, _. ,�! � � � ai� �
Applic nt Permitee Signature Date Issued Signature Date
, City of Orono
Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
;i � • �:��a-�� .��;r�. sE: : , ��-����. �tc. _ !��1 5����l��'U�r` :•�i
�O • O MailingAddress: Q/7—OD��S
��% PO Box 66 Permit number:
Crystal Bay, MN 55323-OOf ,/� Qate received: �- ���
I 1 /
Street Address: r (J,,V / Received by:
y� � 2750 Kelley Parkway ���� /� Plan review fee:
L Orono, MN 55356 � —
C�'�ESH�R� ��/ / r v
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: 1��5� � f2Vf1�-� (s9'r7�(-�c-
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes No
lf yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus servrce wiN be
required unless applicant demonstrates sufficient on-site parking is available. Non-permiKed events will not be allowed.
CONTRACTOR/APPLICANT INFOR ATION:
Name: � �,��� ,� ti
State License# 31"j�6� Expiration Date: x���) I"7
Lead Certification Number: ,v f,4.. Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) "'j 6� �"g �Q �' (office)
Mailing Address: g(p � � City: ' T7�-ZIP: 5� 3"Z�
Contact Person: '�� Applicant is: rac n / Homeowner �c���ie o��
Email and/or Fax:
PROPERTY OWNER INFORMATION: ����
Name: /'�2�J�[ 1F �y�t
Phone{day): �f Z - �c.��- j Z'��
Address: ��s" �7/L✓'��,w ��Cy�.� � L-�+"`t, City:��Q _ ZIP: s��,�/
Email and/or Fax:
PROJECT INFORMATION: Overall project description: ��'4� �L'� ���'}�
Type of Project: Any earth movement may also require
❑ Door(s) �temodel ❑ 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
❑WIIIC�OW�S� :i^v';'i�J.f";l(iln�'hahr�CiEEk;.crq
Estimated Construction Valuation of Project(excluding land) $_Z�f?-c7
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 altemative but to
reject it untii 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 ca�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 annuaUy update our records and records of other governmental agencies required by law. If
ou refuse to su I the i orm 'on,the a lication ma not be issued.
Applicant's Signature: __,._ Date: Z�Z � ��
Owner's Signature: Date:
Last Updated:January 2016
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: l ��� � �����' ✓� �----J Cn��►�,.� � .� Permit No.: ��I� - C�c�(�P�
Description of work: �3�.� �� �M �, �.�, � Date Rec'd: �-� �� � �
Septic review by: Date Approved:
Zoning review by: Date Approved:
Building review by: t� � J L - Date Approved: �- �r �v� �
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? � Yes 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: FFE: FFE minus 6 feet= (Existing Contour)
Perimeter(linear feet) = 50% = L.F. below grade
Basement? � Yes � No, Stories
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION:
The distance between the lowest proposed Slab at or above grade—
floor(of the basement or crawl space)and measure from hiqhest existina
START W ITH the highest point of the roof. rade 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 HIPPED ROOF(no Slab below grade—measure
(BASED ON windows): Subtract half the distance from highest existing grade to the
ROOF TYPE) between the highest point of the roof hi hest oint of the roof.
to the low point of the corresponding 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 distance 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 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 Bluff •
Met?
� Yes � No Permit Number: O Yes � No � N/A � Ye No �
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 � 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 Foota e $ per Square Footage
Basement X = $
1 S� Floor X = $
2nd FIoOP X = $
Garage X = $
Estimated Construction Value: $ �, �v �
Orono Inspections Required Work Requiring Separate Permits
0 Footing � Site �Plumbing � Grading/Filling
� Poured Wall � Silt Fence/Erosion Control � Mechanical � Fire
� Foundation Survey � Hardcover Removal � Septic 0 Water Connection
� Foundation Waterproofing 0 Other(specify) 0 Fireplace 0 Sewer Connection
�Framing � Masonry ❑ Lawn Irrigation
� Insulation 0 Mfg. � Landscaping
0 As-Built Survey ❑ Other(specify)
Final
� Lathe Required State Permits
� Other(specify)
� Well 0 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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CITY OF ORONO CALLED IN _�
INSPECTION NOTICE SCHEDULED �-Z�'i- /7 __��•�_��
PERMIT NO. - COMPLETF,D
ADDRESS L.�'�� �t/`✓l l�O �� C7'��c-vt-l�l
OWNER ELEPHONE NO. -�� �-�
CONTRACTOR � �
� DESCRIPTION �r ���'��
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC 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
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
? 01NNERICONTRACTOR TO MEET YOU:_YES_NO
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W ❑WORKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE
��'�f0�@ECT WORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN
INSPECTOR WFLL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContractor on si�e:
Inspector: � /�"� �`
White CopyAnapector's File Canary CopylSite Notke