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Home My WebLink About2016-0141 - windows � � CITY OF ORONO 2750 KELLEY PARKWAY * � 0 1 6 - 0 1 4 1 5 * DATE ISSUED: 1U14/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2650 MAPLERIDGE LA PIN : 21-117-23-24-0050 LEGAL DESC : SHORE HILLS : LOT 000 QLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 17,184.00 NOTE: 4 WINDOWS-2 I'A"I'10 UOORS SAME SIZE i WINDOVd W[T�[HEADGR CHANGES APPLICAI�IT PERMIT FEE SCHEDULE 325.24 PELLA NORTHLAND STATE SURCHARGE(VALUATION) 8.59 15300 25TH AVE N. -SUITE# 100 TOTAL 333.83 PLYMOUTH,MN 55447- Payment(s) (952)345-6047 CHECK 76502 333.83 Minnesota State License#: BUIL-BC645090 OWNER DALY,JOHN& KELLI 2650 MAPLERIDGE LA EXCELSIOR, MN 55331- AGREEMEIVT AND SWORN STATEMENT The work for which this permit is issued shall be perfonned according to the approved plans and specifications,applicable City approvals,and the State[3uilding 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 compicd with whether or not spccitied hercin.This permit will expire and become null and void if construction authorized is not commenced within l80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time afrer work has commenced. Thc applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.Tl�is permit may be revoked at any time fbr due caus /W �iL l l / �/ Applicant Permitee Si re Date Issued B gnature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O�O Mailing Address: Permit number: � ��L • a�Y�S PO Box 66 R�C��D Crystal Bay, MN 55323-0066 Date received: l — — � � StreefAddress: N�� ZO�6 Received by: �r ` 2750 Kelley Parkway Plan review fee: Ft L Orono, MN 55356 I� qk�Esr�o4� CITY OF ORONO � � �_.� 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: r� ` 5. O � Q /� r r � G / 4 n � Job Site Address: �S P 9" (� Will this be a Parade of Homes, Remodelers Showcase Home or other isplay Home? ❑ Yes ❑ No If yes,a special 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. COPVTRACTOR!APPLICANT INFORMATION: / _/ Name: 9S � / 3 y'S • �. 0 �l'j' JC Qi State License# Pella Northland Expiration Date: Lead Certification Numbe 15300 25th Ave N. Ste 100 Expiration Date: (for work on homes tha PI}�mOut}l, MN 55447 Phone: (cell) Lic # BC645090 Ph. 763/745-1400 Ffice) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: / Name: � Cl R M 1�/' G M •O [ �L r Phone (day): `j (, 3 � y ? • 3 S G / Address: a � � V � Q p �� y � C/) City:�X� �ls/o� ziP: SS 3 3 1 Email and/or Fax: 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�Project(excluding land) $ / 7} 1 y APPLICANT ACKNOWLEDGEMENT: y W � qlor.r � Q /o o �( $ a .L s'/ ,�.•/�,rJA �o GJ • Agrees to provide all information required or requested by the Building epartment; �„��.�� h �Q�� C L Qn �� s 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 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 ap lication ma not be issued. ApplicanYs Signature: ��—'—" Date: � � ( l [ l �+ Owner's Signature: Date: Last Updated:January 2016 ' PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: �� (l'�(Q�6� c(Z��Qlrl t� Permit No.: �(�/cP"(�f�-�� Description of work: (Nrv(,(�(@(�(�� N/� /�a(1•"r�B� m1�Q�l�S Date Rec'd: Septic review by: /� /i� Date Approved: .C� Zoning review by: Date Approved: Building review by: Date Approved: �l 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? D 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? 0 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— START W ITH floor(of the basement or crawl space)and measure from hiqhest existinq the highest point of the roof. START WITH rade to the highest point of the 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 g�uff Met? � Yes � No Permit Number: � Yes � 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 0 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 St Floor X = $ 2nd FIOOr X = $ Garage X = $ Estimated Construction Value: $ Orono Inspections Required Work Requiring Separate Permits ❑ Footing � Site � Plumbing � Grading/Filling � Poured Wall � Silt Fence/Erosion Control 0 Mechanical � Fire 0 Foundation Survey 0 Hardcover Removal � Septic 0 Water Connection 0 Foundation Waterproofing 0 Other(specify) � Fireplace � Sewer Connection � Framing 0 Masonry � Lawn Irrigation ❑ Insulation 0 Mfg. � Landscaping � As-Built Survey � Other(specify) ❑ Final 0 Lathe Required State Permits � Other(specify) � Well ❑ Electrical REMARKS (in-house): 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. 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