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Home My WebLink About2011-00240 - addn/remodel/repair . - ;' CITY OF ORONO PERMIT NO.: 20��-00240 ; 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE IssUED: 05/02/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 10 MYRTLEWOOD RD P[lv : 36-118-23-33-0009 LEGAL DESC : MYRTLEWOOD : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 4,500.00 � NOTE: DECK REPLACEMENT APPLICANT pERMIT FEE SCHEDULE 118.00 : FREELAND,BRYAN PLAN REVIEW 76.70 10 MYRTLEWOOD RD WAYZATA,MN 55391- STATE SURCHARGE(VALUATION) 2.25 TOTAL 196.95 OWNER FREELAND, BRYAN 10 MYRTLEWOOD RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approva(s,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 I 80 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 responsible for assuring all required inspections aze requested in con rmance with the State Building Code.This permit may be revok any t for due cause. / / �/ �/ `� Applicant Permitee Signature Date Iss By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . � �� ;� � �� City of Orono c 1�� Building Permit Application for New Structures or Additions Mailing Address: a�� _p(�a �/�O,j� PO Box 66 Permit number: ,u� � Crystal Bay, MN 55323-0066 Date received: d�`,� / I j �� 1',a �y �t�-�: a.�; Street Address:' Received by: �� , y �� 2750 Kelle Parkwa \,�`';,'��?�;.�t�a. p Y Y Plan review fee: \� t�� '` 4� Orono, MN 55356 �_ Esi�o. ---�� Total Fee: I , r Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us J 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: � � �` , _.� �,,, , Will this be a Parade of Homes, Re odelers Showcase Home or other Display Home? ❑ Yes No k:�. lf yes,a special event permit is required with Po/ice Department and City Council approval 60 days prior to the event. Shuffle bus servrce will be ' required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. �`�' ,,. Gt, �.. CONTRACTOR/APPUCANT INFORMATION: Name: C��.�c3..,� rcee\��.��, State License# Expiration Date: Phone: — �y '"� office) cell Mailing Address: Cit : � • f'''� Contact Person: g Applicant is: Contractor / omeowner (Circle One) Email and/or Fax: ' PROPERTY OWNER INFORMATION: Name: � Q �Q Phone (day): — —�-r,g Address: Cit :�'j� ZIP: S��_ �� Email and/or Fax � L c- ARCHITECT/ ENGI�ER INFORMATION: Name: 1�,r�.-� �.:+��ei Phone (day): �a---��—l��y� Address: �, c�c-,T,��ye'��5�� .� City: ��c,�� ZIP:Sti'��t-I Email and/or Fax: r��Q��,�.,�., �;-�� J PROJECT INFORMATION: 1. Type of Project 2. Pro osed Use 3. Structure Type 4. Sewage Disposal& Water Supply ❑ New Construction Single Family with ❑ Residence ❑Addition attached ara e ara e/Accesso Btd 9 9 0/G 9 ry g. ❑ Public Sewer ❑Accessory Buildi 1`\ \ ❑ Single Family with [� Deck ��elocation �e'c'r�n Y e c-�L�L detached garage ❑ Office/Commercial �nvate Sewer �'Other: (specify)��,,'y�� a�,< ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water �"'Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial �rivate Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ � �(�;�� ,�^ ;;�;� ;:� :':� • :.. � f�. � ti � ' � . ; � � _ � � � � � . � � � ; ; , .- .�„�. _ . . , :. �.—v.,� �.,—,�.,�— . ... � . � : ,a , " — � �`� '<:t: STRUCTURE INFORMATION: '� 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction ^�� a. Length(ft.)= �/�� JrC Number of bedrooms=� �Wood/Frame {'� � ` ❑ Masonry b.Width(ft.)= �� Number of garage stails: ❑ Metal Attached =� ❑ Pole Bldg. Areas in s4uare feet Detached= ❑ ICF ,� ❑ On-site Prefab ��,��4,Q ��E� a� c. Basement= � �i� ❑,�,�ff-site Prefab \ � `� d. 1 St Sto �� L�Uther(please specify):��,��Q,� �C-�K ,;, rY = ':� e.2"d Story= �_ f. '/z Story = g.Total Area= c�� REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ Permit Application ❑ 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 � ' ` ❑ ❑ Septic S stem Site Evaluation Re ort '� M�: 9 � ❑ ❑ Access Permit � ,b ; ,z� r ❑ ❑ Wetland Buffer Im rovement Plan .�� ,: ❑ ❑ En ineered Plans for Retainin Walls 4 feet or above � ❑ ❑ Plan Review Fee �� ❑ ❑ Other �::, � >. �` APPLICANT ACKNOWLEDGEMENT: �� k�; � . Agrees to provide all information required or requested by the Building 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 altemative but to reject it until it is complete; �� • Acknowledges the Escrow Agreement is completed and signed; �`° �ti:':7 • 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 tne data. Our �"'s� 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 informafion,the application may not be issued. c:' ;, �' 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 agreement to ensure completion of the as-built survey and all site improvements. E;, � � �`- — � ApplicanYs Signature: 1 i(, Date: '7 � � � � �..s , � , . --� Pian Review Checklist for New Structures / Addi#ions Address/PID/ Legal: ( (� 1�1�1�`IT L C:(/�00� �?�JAd Description of work: ��GK �C� l,_�,�yv'r Septic review by: /v/�) Date Approved: Zoning review by: /�lr9 Date Approved: Building review by: � Date Approved: Y'2 8'1 � Grading review by: /1!/� Date Approved: Zoning file#: Resolution#: Resolution Date: Zonin District Fire De artment Post Dffice Scho istrict - Zoning: Lot Area: SF/AC Width: epth: Survey Submitte • �Yes � No ` Date of Survey: Pro osed 5etbacks Front(Lake) ar(Street) 1 N S E W ) `( N S E W Other Buildings �letland Side Side Building Defined Height; Building Peak Heigh � #of Stories Ok?: � YES fOR A BUILDING WITH A BASEAAENT OR'CRA SPACE: FOR A-BUILDING OM 14 SLAB FOUNDATION: START WITH the distance between thebase nt floor/crawl START the distance between the slab and the highest space floor and the highest roof p ,the#op WITH roof,peak,the top of#he cornice of�flat roof, the�rnice of a flat roof,the deck lin f a #he tleck line of a mansard roof,or the mansard roof,or the uppermost point o ound uppermost point on a round orother arch-type or other arch= roof roof SUBTRACT half the distance between the high indo nd SUBTRACT half the distance befin+een#h�highest window hi hest roof eak of a itched roo and hi hest roof eak of a itched.roofi SUBTRACT the distance between the base nt floor/-crawl ADD the distance between theslab-and#he highest space floor and the highest e ting grade within existin ratle within�he foundation the foundation or 10 feet, ichever is less. QUALS Defined buiidin hei ht EQUALS Defined buildin fiei ht Lot Coverage: SF % Shoreland District MCWD'Perr�it Received Avera e La hore.Setbac�C BiufF � Yes � No � N/A � Yes � No � Yes � `N D Yes 0 No G N/A Permit Number: Setback: HardcoverZ es Existin Pra osed Variance Re uired CUP Re wired 0-7 ' � Yss � No G Yes n No 7 50' TYP��S)�' e(s): 50-500' 500-1000' REMARKS (in-house): N� G�FANb� Updated: 09/11/2009 z:lformslplan review checklistdoac • . . Fees to be Char ed �ES NO mr � � '�: ��. �t,k.s�a�. ��` v� _ , r .., � :y� . :- ..-� . �..,_ . � �. .. ...�.�. ..� . .� .:�..:. Plan Review �/ . - .� _._,,. ,, ..: . .. - _ ,G ��..,.. .. �....'.�-e.-.��F. . .._, .�. . . ..� _.... .. .. '. _-... �. .V.w,...9 ...:. ... Lr f,. .r..�.�, . . u:..,, n..-. .. ... Investigation Fee _ __..�,_ . ., , .. _,, .:> �. Sewer Connection � . � . _ Park Fee . ._ . . _ Other{specify) , _ . Calculated By: S uare Foota e $ er S uare Foota e Basement X = $ 1�Floor X = � 2nd FIOo� X - $ Garage X = $ Estimated Gonstruction Value: $ `l.SOD�—`' Orono lnspections Required Wark Requiring Separate Permits Required State Permits � Site G Plumbing 0 Grading/Filiing � Well � Hardcover Removal � Mechanical 0 Fire � Electrical �Footing � Septic � Water Connection � Poured Wall 0 Fireplace G Sewer Connection � Foundation Survey O Masonry 0 Lawn lrrigation 0 Radon Rock Bed 0 Mfg. �Framing G Other(specify) 0 Insulation 0 As-Built Survey �Final G Other(specify) REMARKS (in-house): Other Re�iew: Reviewed by: Date Approved: Access:Existing: C YES 0 NO New: � YES 0 NO REMARKS(TO BE NOTED ON PERMIT AND lNITIALLED BY PERSON PULLING PERMIT) Updated: 09/11/2009 z:\formslplan review checklist.doac � � —{ I�� I � � TIME CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED � � _�_ PERMIT NO. N � / ,� COMPLETED ADDRESS � � V �+ � ` '� ` OWNER TELEPHONE NO. � �a '� I Z�' �j CONTRACTOR S'.r:c i-=,v�C�. �_ ) L_ �� _.1.�Ct-� - � DESCRIPTION �i T l�,�--�_ �' ' �_ � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a O �'� � � v 5 � S 1 d� � � � � `' f �l O � W ^ � �t ,' �1 � Q z � �' �X,� 7��^jr' � �4 c��-�v� W � � � d /�r W y�WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CARRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN �STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on si e: Inspector. �2. �� :�1 � _ __ White Copyllnspector's File Canary CopylSite Notice / "' � ��/V_ D TIME " CITY OF ORONO CALLED IN � � � INSPECTION N TICE /7 (� SCHEDULED �'1 ; v PERMITNO. �� —Qv�/'� COMPLETED ADDRESS D D� _-�=-� OWNER T EPHON NO. __ CONTRACTOR 1��"�,liGt �: DESCRIPTION i�� (�-�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPIJ�INT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OW C� ONTRACTOR ET YOU:�YES_NO � COMMENTS: � W � � � � / �c� ��S c2a �'' , � 0 � W � Q � 2 W � W � � � ❑WORKSATISFACTORY:PROCEED %�PROJECTCOMPLEfE W ❑CORRECT WORK&PROCEED L'ZSSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WiTHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTIONREOUIRED.CALITOARRANGEACCESS. Call torthe next inspection 24 hours in advance. (g52) 249-4600 OwnerlContractor on sit : Inspector. c . � � White Copyllnspector's File Canary CopylSite Notice