HomeMy WebLinkAbout2017-00473 - second story addition � CITY OF ORONO * 2 0 1 7 - 0 0 4 7 3 *
2750 KELLEY PARKWAY DATE ISSiJED: OS/22/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS : 825 FOREST ARMS LA
PIIY : 07-117-23-12-0011
LEGAL DESC : FOREST ARMS
: LOT 003 BLOCK 002
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
COI�TSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 120,000.00
NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE)
SECOND STORY ADDITION
APPLICANT PERMIT FEE SCHEDULE 1,235.92
STATE SURCHARGE(VALUATION) 60.00
NIEMELA CONSTRUCTION INC.
5765 QUAM AVE NE TOTAL 1,295.92
OTSEGO,MN 55330- Payment(s)
(612)532-7956 CHECK 1011 1,295.92
Minnesota State License#: BUIL-BC602194
OWNER
BRANDENBURG,NATHAN&BETH
825 FOREST ARMS LA
MOUND,MN 55364-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit 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 goveming 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 after work has commenced.
The applicant is r nsible for assuring all required inspections are
requested in co o ance with the State Building Code.This perrrtit may be
revoked at or due cause.
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plicant Permitee gttatti�e ate Issued By Signature Date
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City of Orono
Building Permit Application
for New Structures or Additions
�, Marting Address: d� �_
� PO Box 66 Permit number: ,. ;�,�
�;�,,C�l�l.,\
j Q '�,, Crystal Bay, MN 55323-0066 Date received: _�� (��-j�I
�� Sfreet Address:� , _____--�. eive�d-b�F� � �-�_
`�`�� , ,�, 2750 Kelley Parkway 7 �� j� - �.�
� P�n review fee: �t�'� `
� �`i Orono, MN 55356 ��c� �K f� -_._ ------ _T.`_
����tsr������,� Main: 952-249-4600 Total Fee: � `- ' �Z
-�'" Fax: 952-249-4616 www ci oror�o.rnn.us
This application form must be completed in full and all required'informatior� must be sub itted. .
Incamplete appiications will be returned. (Please print) �!!�$� S��J(p��%
GENERAL INFORMATION: / • I [� /J
Job Site Address: g a�_��ST�rrn s LA�'I�� C�r'o n0� /I/1 '�/ S7 3� 7
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes �No
(f yes, a special event permit is required with Police Department and City Council approva!60 days prior to the event. Shuttle bus service wrll be
required unless applicant demonstrates sufficient on-site parking is avarlable. Non-permitted events will not be allowed.
CONTRACTOR J APPLICANT INFORMATI�N:
Name: � ifm-e�1 �ons ruc�0l1� �nC• _
State License# �6 0�( R Expiration Date: 3 3/ aar g
Phone: cell _7Cv',. a ►3 . SS 9�i ___ office 7G3, ya-$, yyS��/
Mailing Address: --S �LS_Qvp ►+a .,�_�-e. -------- --- ----------Cit : S _ ;��a�r/ ZIP: s 37
_.
- -- . ..._ --
Contact Person: /3 n N�"�e rN�P/a Applicant is: ontracto / Homeowner �c���ie o�e�
--- — --- ----- -- —
Email and/or Fax: ���n ;�w+r j� co h 5�i-vc 'oh, C o t-n
PROPERTY OWNER'I�V F RMATION•
Name: N �1 �j���,(rQ�
Phone (day):
Address: Cit : ZIP:
Email and/or Fax N e y� � U� ��� n • ��jV�
ARCHITECT/ENGINEER INFORMATION:
Name:
-- -------------- --
Phone (day): — ---- ---- — --- ------
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Description of pro ect:
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
❑ New Construction (� Single Family with ❑Accessory Bldg. /Garage
�Addition attached garage ❑ Derk � Public Sewer
❑Accessory Building ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage � Residence ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family!Condo ❑ Retaining Wall(s)
❑ Fublic 4-feet or greater � Public Water
""Any earth movement may require ❑ Commercial ❑ Storage
MCWD review 8.permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other (specify) ❑ Other(specify)
15320 Minnetonka Blvd
Minnetonka.MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
w�,nrw.mi nnehahacreek.ar
Estimated Construction Valuation (excluding land) $ _���Q� _
Packet Last Updated: August 2015
Page 21
� s
��STRUCTURE INFORMATION:
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
�✓�
a. Length (ft.)= Number of bedrooms= �
b. Width (ft.)= Number of garage stalis: ❑ ( G��,¢�Q�C� ,�/ ���1
!/ �
Areas in square feet Attached = � �
❑ ' ��C� ���=���� �p�'S � ��
c. Basement= Detached = � �
d. 1 S'Story = �
e. 2"d Story= �
f. '/z Story = �
g. Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
❑ ❑ Buildin F'ermit Escraw A reement and Fees
❑ ❑ Plan Review Fee
❑ ❑ Com leted A lication Form
❑ ❑ Pro osed Building Plans—2 full size sets, to scale and 1 reduced 11 x 17 or 8'/z x 11 set
� ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
_ ❑ Surve —2 fuli slze,to scale(meeting ALL surve requirements)
❑ Hardcover Calculations
❑ Septic S stem Certification
9D ❑ Minnehaha Creek Watershed District(MCWD)Permit or
___ Documentation from MCWD stating no permit is re uired _ _
❑ Landsca e Walls and/or Retainin Wall Plans
❑ Stormwater Pollution Prevention Plan SWPPP
❑ � Access Permit
❑ ❑ Data Privacy Advisory Form
APPLICANT/OWNER ACKNOWLEDGEMENT:
. Agrees to provide all information required or requested by the Building Department; j
� • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; i
• 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 I
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 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-buiit survey at the time the I
Certificate of Occupancy is requested, a temporary Gertificate of Occupancy may be issued upon receFpt of a $10,000 i
escrow to ensure completion of the as-b ilt survey and al1 site improvement5. i
ApplicanYs Signature: Date: � [
Owner's Signature: Date:
Packet Last Updated: August 2015
Page 22
PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address: �� �e�� �� ��17V i'C.� Permit No.: �� '~ �d�7J
Description of work: �Z J7v� �( �Q� Date Rec'd: c7 ��V �� `
Septic review by:��NV�C/I � �U`Lt/�� Date Approved: �—'
Zoning review by: Date Approved: �' ��
Building review by: Date Approved: �� �
Grading review by: 1 v� Date Approved: "—'
Zoning District: ' � Zoning File#: �� '�qL�
Resolution? Yes Reso#: 7 � Reso Date: 5•g�11 Signed: Yes No Resolution/NA
Zoning: Lot Area: �i�� �/AC Width: Structural Coverage: Z77�/•GISF � %
Survey Submitted: 0 Yes �No Date of Survey: Revised date(?):
Landscape plan submitted? � Yes Landscaper: � N /None pro 0
Proposed Setbacks:
1 3o ta I o
�� F nt(Lake) R r(Street) ( I� S E W ) ( N S E W ) Other Buildings Wetland
Side �ide
l�0 � �3 3S' 37 '
Buildinq Heiqht Analvsis:
Distance Between First Floor a efined Top of �a�
Roofi` See "buildin hei ht" efinition :
First Floor Elevation f m buildin lans : (b)
Highest Existing g�`ound level (per survey) or 10' ���
above lowest�: round level, whichever is lower:
Differenc�between b and c : (d) r
De ined Buildin Hei ht(a) - (d): �e�
Shoreland District MCWD Permit Average Lakeshore Setback g�uff
Met?
s � No Permit Number: 0 Yes No 0 N/A � Yes
No
/A–see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and s % and s
g •�'j� $,��] Yes � No � Yes No
1 2 3 4 5 C� c �S�
T pe(s : Type(s):
c�
N�c. s����-
Updated: October 2016
v:\forms�plan review checklist 10-2016.docx
� Fees to be Char ed YES NO
Permit i'
Plan Review
State Surcharge
Investigation Fee (%
SAC—Number of SAC Units
Other(specify)
S uare Foota e $ er S uare Foota e
Basement X = $
1 St Floor X = $
2nd Floo� X = $
Garage X � . = $
Estimated Construction Value: $ ,�l�%r '�/l�l/
Orono Inspections Required Work Requiring Separate Permits
�Footing � Site � Plumbing � Grading/Filling
� Poured Wall 0 Silt Fence/Erosion Control �,Mechanicai � Fire
� Foundation Survey 0 Hardcover Removal � Fireplace � Water Connection
0 Framing � Other(specify) � Masonry � Sewer Connection
O Waterproofing/Drain tile �Mfg. � Lawn Irrigation
� Foundation Waterproofing � Other(specify) � Landscaping
�Framing
Insulation
� As-Built Survey
�Final
� Lathe Required State Permits
0 Other(specify)
� Well Electrical
REMARKS (in-house):
�J
1� C�nrv��n
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
� See Builder Acknowledgement Form
Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved.
Updated: October 2016
v:\forms�plan review checklist 10-2016.docx
�
� Permit Application: Self-Checklist for Completeness
Please note, the applicant must initial in the boxes below to acknowledge the minimum
required information is included with the submittal. If not, the application will NOT be
accepted. Call 952.249.4620 to schedule a meeting with staff if you have questions on
application submittal requirements.
��' Completed Application
� ��� l
e��`
� Plan Review Fee Paid �" �`�
�j��� . C�� `�� �y�c��-
�� � ����
�- cN� a�
�%� Signed Escrow Agreement & Escrow Payment
v'� Building Plans (to scale) x2 �� ��c�f`
t
a �`
��' 2,��''�
� v�1
Certificate of Survey (to scale) showing the proposed project &
meeting all requirements x2
������
. . . �i �������� �
Hardcover Calculations (if applicable) �'`" �
���� � ����
I am aware that Orono will not issue a building permit without a
copy of MCWD permits (or documentation from the MCWD stating
' the proposed project does not trigger their permitting
require ts). I will contact the MCWD at 952-471-0590
regar ' i
Signed by:
Address: �zS — T � �
Permit #: ��(; �� — � '�-��j 3
Packet Last Updated: August 2015
Page 2
�
DATA PRIVACY ADVISORY
In accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd. 2, "Tennessen warning", we
would like to inform you that your request for a permit or license from the City of Orono or any of its departments
may require you to furnish certain private or confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary
to process the permit or license.
4. If your requested permit or license requires Council action to approve, some information may
become public.
5. You have certain rights under Minnesota State Statute 13.04(see following page)to review private
data on yourself.
6. Your full name is required to process this application or permit.
\r�1^A.+� 'Iv 1�c,�l�R�- ��o�����n��
First Middle Last
�Zc� ��s� �Vlt,nns 1��
Address
\�\�a 'M� �J'�J��-F �` Z— ��10—c��53
City State Zip Phone
I underst d y rights as stated above.
ignature
Packet Last Updated. August 2015
Page 7
Bob Niemela
From: Nathan Brandenburg <NathanBrandenburg@siegelbrill.com>
Sent: Tuesday, May 9, 2017 9:37 AM r,.;,;,,
�;,.�,� � � 2���
To: bob@niemelaconstruction.com
Cc: jeremy
Subject: FW: MCWD No Permit Needed: 825 Forest Arms Lane, Orono ���`4F ORONO
Bob,
Below is an e-mail from the MCWD stating no MCWD permit is necessary. Melanie has a copy as well.
Nate
Very truly yours,
Nathan M. Brandenburg
Siegel Brill PA
Direct: (612) 337-6114
T(612) 337-6100 F (612) 339-6591
100 Washington Ave S � Suite 1300
Minneapolis, MN 55401
www.siegelbrill.com<http://www.siegelbrill.com/>
[cid:image001.gif@01CDF7F6.39387830j
CONFIDENTIAL:This email may contain privileged or confidential information that is for the intended recipient only. If
you are not the intended recipient, please refrain from reading and delete all copies of this email. IRS NOTICE: Any tax
advice that may be contained in this email and any attachment was not intended or written to be used for the purpose
of avoiding penalties that may be imposed under the tax laws or promoting or recommending any transaction.
From: Chase Vanderbilt [mailto:cvanderbilt@minnehahacreek.org]
Sent: Wednesday, March 08, 2017 3:56 PM
To: Melanie Curtis <MCurtis@ci.orono.mn.us>; Christine Mattson (Orono) <cmattson@ci.orono.mn.us>
Cc: Nathan Brandenburg<NathanBrandenburg@siegelbrill.com>
Subject: MCWD No Permit Needed: 825 Forest Arms Lane, Orono
Good afternoon,
This letter is to inform you that no MCWD permit will be needed for the proposed addition project at 825 Forest Arms
Lane, Orono.
Please let me know if you have any further questions.
Best regards,
1
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Chase Vanderbilt
District Representative
Minnehaha Creek Watershed District
15320 Minnetonka Blvd
952-641-4580
2
�mSZ ��t � �.e�'��'�c�l ( ��Je �
New Construction Energy Code Compliance Certificate
Per N1101.8 Building Certificate A building certificate shall be posted in a pennanently visible location inside Dnte Certficate Posted ��������
the building. The cert�ficate shall bc completed by the builder and shall list infoimation and values of
components listed in Table Nl 101.8. 3�3/�7
Mailing Address of the Dwelling or llwelling Unit City MAY 1 0 Z 017
825 Forest Arms Lane, Orono, MN 55364 Orono
Name ot Residenlial Contractor MN License Number
Niemela Construction, Inc. BC602194 CITY OF ORONO
THERMAL ENVELOPE RADON SYSTEM
Type:Check All That Apply Passive(No Fan)
w
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��� � �", � � �, Active(4f'ith fan and monometer or
� � �
a >. )( other system monitoring device)
cd V = _. � 0.. «�+
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; � O N ri O N � U
Insulation Location � .� z � � � p i w �
� o` ao �n
ro � � � � � � a� -o �o
j_' 1J o o � °A °A
[� = z i,.. i�. r�. w � r.� x Other Please Describe Here
Below Entire Slab
Foundation Wall Type in location interior exterior or integral
Perimeter of Slab on Grade
Rim Joist(Foundation) Type in location interior exterior or iniegral
Rim Joist(i9f Floor�+) R-21 X intenor
Wa11 R-21 X
Ceiling,flat R-49 X X
Ceiling,vaulted R-49 X X
Bay Windows or cantilevered areas R-2�
Bonus room over garage
Describe other insulated areas R-49 Closed Cell Foam and Blown in ceilin over Gara B
Windows&Doors Heating or Cooling Ducts Outside Conditioned Spaces
Average U-Factor(excludes skylights and one door)U: 0.28 Not applicable,all ducts located in conditioned space
Solar Heat Gain Coefficient(SHGC): �.26 X R-value 8
MECHANICAL SYSTEMS Make-up Air Select a Type
Appliances Heating System Domestic Water Heater Cooling System X Not required per mech.code
Fuel Type Nat Gas EIeCt1'IC Passive
Manufacturer Lennox Lennox Powered
Interlocked with exhaust device.
Model ML193UH045XP24B 13ACXN018-230 Describe:
Inpu��� 44,000 Capac�ty�n ourp��in 1.5 Other,describe:
Rating or Size BTUS: Gallons: Tons
Heat Loss: 11 229 Heat 5 485 Location of duct or system:
Structure's Calculated � Gain_ '
nFVE o� 93% sE�a� l3
HSPFi Lower Level
Calculated 5�4g5
Efficienc coolin�load: Cfm's
"round duct OR
Mechanical Ventilation System "meta]duct
Describe any additional or combined hea[ing or cooling systems if installed:(e.g.two fumaces or air Combustion Air Select a Type
source heat pump with gas back-up furnace): X Not required per mech.code
Seleet Type Passive:
Heat Recover Ventilator(HRV) Capacity in cfms: Low: High: Other,describe:
Energy Recover Ventilator(ERV)Capacity in cfms: Low' High: Location of duct or system:
Continuous exhausting fan(s)rated capacity in cfms:
Location of fan(s),describe: Cfm's
Capacity continuous ventilation rate in cfms: "round duct OR
Total ventilation(intermittent+conUnuous)rate in cfins� °metal duCt
rea e y version
SHEET INDEX ��w.:Mr�o.r.+�e�k�c m ____ ____ . 3
STRUCTURAI NOTES ^������1 a�w�
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