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Home My WebLink About2018-00074 - addn/remodel/repair • CITY OF ORONO I I I I II II11 II III II II II II II 2750 KELLEY PARKWAY * Z 1 S — 0 0 0 7 4 DATE ISSUED: 01/31/2018 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 1840 LAKEVIEW TER PIN : 27-118-23-42-0010 LEGAL DESC : LONG LAKE COUNTRY CLUB ADDN : LOT 005 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 5,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) INTERIOR REMODEL APPLICANT PERMIT FEE SCHEDULE 123.87 PLAN REVIEW 80.52 R,KORY STATE SURCHARGE(VALUATION) 2.50 500 NOR 500 NORTH BRANCH ROAD MINNETRISTA,MN 55364- TOTAL 206.89 Payment(s) CREDIT CARD 0829 206.89 OWNER KOEHLER,KORY 500 NORTH BRANCH ROAD MINNETRISTA,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 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 for due cause. 16\311_ /lei) 6('An) ' // /6 Applicant Permitee Signature Date Issued By S. ature Date CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS O 0, g9 iiLiD A Mailing Address: Permit number: c=7:70O�D/ — d�d 7 lVO,. POBox66 Crystal Bay, MN 55323-00 Date received: / ��-1 Street Address:' 1 2750 Kelley Parkway '',/..,/\W � Received by: 4- y� iv— G�� Plan review fee: `�xH ESo4'� Orono, MN 55356 Main: 952-249-4600 Total Fee: , iy ,,/,, 4 *)dr 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 e4o L- v IEt,0 DC2Ac . Will this be a Parade of Homes, Remodelers Showcase Home or other Display 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. CONTRACTOR/APPLICANT INFORMATION: Name: KAOK- t t-{LOC- State License# Expiration Date: Phone: (cell) fa t2, 1501 (c,c (o (office) Mailing Address: 500 kb Expojci4 rO City: 1'Y1 iut,A-m tc n,, ZIP: 5-53s Contact Person: ILc,is...‘ E �lApplicant is: Contractor / omeown (Circle One) Email and/or Fax: ` ko rii r1P\- r- i►�c hotrv-I Pt►L.CsDr✓1 PROPERTY OWNER INFORMATION: Name: ��-E�� Phone (day): lo V-2_ 1 (oD'i Address: 500 oitiirk arZOt�c-Ak IZo City: 0Awkic.- teicil ZIP: 5S3S'� Email and/or Fax k o rLA 0-)e\CI‘er 11->c 2 ino�-rvt r>`k.t_ ,cx,rr ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & Water Supply ❑ New Construction Single Family with Cl Accessory Bldg.I Garage ❑Addition attached garage ❑ Deck El Public Sewer ❑ Accessory Building 0 Single Family with ❑ Office/Commercial 0 Relocation detached garage 12,Residence 0 Private Sewer ❑ Other: (specify) ❑ Multiple Family I Condo 0 Retaining Wall(s) 0 Public 4-feet or greater ❑ Public Water **Any earth movement may also require ❑ Commercial 0 Storage MCWD review&permits. 0 Industrial 0 Warehouse KPrivate Well Minnehaha Creek Watershed District(MCWD) ❑ Other:(specify) 0 Other(specify) 15320 Minnetonka Blvd Minnetonka, MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.orq Estimated Construction Valuation (excluding land) $ +.5 I Dcc 00 Last Updated: January 2015 STRUCTURE INFORMATION: 1. Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= Number of bedrooms= 0 Wood/Frame b.Width(ft.)= Number of garage stalls: 0 Masonry Areas in square feet Attached= 0 Metal 0 Pole Bldg. c. Basement= Detached= ❑ ICF d. 1st Story = 0 On-site Prefab e.2nd Story= 0 Off-site Prefab f. 1/2 Story = 0 Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ 0 Building Permit Escrow Agreement and Fees ❑ 0 Plan Review Fee ❑ 0 Completed Application Form ❑ ❑ Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/2 x 11 set ❑ 0 Minnesota State Energy Code Calculations and Mechanical Code Requirements ❑ 0 Survey—2 full size,to scale(meeting ALL survey requirements) ❑ 0 Hardcover Calculations ❑ 0 Septic System Certification ❑ 0 Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD stating no permit is required ❑ 0 Landscape Walls and/or Retaining Wall Plans ❑ 0 Stormwater Pollution Prevention Plan(SWPPP) ❑ 0 Access Permit ❑ 0 Data Privacy Advisory Form APPLICANT/OWNER ACKNOWLEDGEMENT: • 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 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 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-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 to ensure completion of the as-built survey and all site improvements. •' �' Applicant's Signatu 1 Date: 22- S Owner's Signature: Date: 22. Last Updated: January 2015 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: / �9`�� aaU!eW r PermitNo.: Zf8 ` 69D 711-- Description of work: Date Rec'd: //2.r...//5 Septic review by: Date Approved: Zoning review by: Date Approved: Buildingreview b : �.e%� ff'i' Date Approved: / / J Yy i� PP � .r Grading review by: Date Approved: Zoning District: Zoning File#: Resolution? Yes Reso#: Reso Date: Signed: Yes No Resolution I NA Zoning: Lot Area: SF/AC Width: Structur• Coverage: SF % Survey Submitted: D Yes D No Date of Survey: Revised date(?): Landscape plan submitted? Yes Landscaper: 0 No/ None proposed Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N - E W ) Other Buildings Wetland Side Side Building Height Analysis: Distance Between First Floor and define. Top of Roof (See "building height" (a) definition): First Floor Elevation (from building plans): (b) Highest Existing ground level (per survey) or 1 I above lowest ground level, (c) whichever is lower: Difference between (b) and (c)*: (d) DEFINED HEIGHT *If highest existing adjacent grade is abov• FFE-Height is(a)- d): (e) *If highest existing adjacent grade is be/,w FFE-Height is(a) + .) Shoreland District WD Permit Average Lakeshore Setback Bluff \ Met? Yes D No Permit Nu, ber: D 'es 0 No 0 N/A 0 Yes 0 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) Yes D No D Yes D No 1 2 3 4 5 Ty e(s): Type(s): __-/- Updated: /Updated: June 2017 z:\forms\plan review checklist 06-2017.docx Fees to be Charged " YES NO Permit, Plan Review (/ State Surcharge r Investigation Fee Ww..k.° !.Z Other(specify) Square Footage $ per Square Footage Basement X = $ 1St Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ DO 67 Orono Inspections Required Work Requiring Separate Permits ❑ Footing 0 Site elEC,Plumbing 0 Grading/Filling ❑ Poured Wall 0 Silt Fence/Erosion Control g Mechanical 0 Fire ❑ Foundation Survey 0 Hardcover Removal 0 Fireplace 0 Water Connection O Framing 0 Other(specify) 0 Masonry 0 Sewer Connection O Waterproofing/Drain tile 0 Mfg. 0 Lawn Irrigation ❑ Foundation Waterproofing 0 Other(specify) 0 Landscaping Framing 0 Septic )3( Insulation 0 As-Built Survey Final ❑ 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. Updated: June 2017 z:\forms\plan review checklist 06-2017.docx , 264 - _--o— _ i r t? 1 / d% , ,,, c,) ..5,\,‘ , - E (4 s- . ;:•;,,,-1 ! CD« }' "+� RS t I (12L \r it,, g is — _ l ;)"1`71 . L_ , f 7 B1 , 1 r its j c !— O s i >,...? i ....., ,........_.1 : r �—►_1 •:; �1_( , , 1 , - .....4 . ' 1- tit Z Eo IVILt '! it YA .....,,,,,......,„f okk cfki t5 I • , f/ '' 4"Z Lii c3- 1 - z k - 30 i 11.0 -,......z . put invirz ,. ......11 ('' . i . ,. -I z,,„ 1.. .. .,,,„-•, ,0 ,, , ,... ....... , 3 1 i 1 •_.- 4 2 i t i 0 , -9.- :'..g —9 -- • *N4 4.- Z f 1 '..,P. D I i , f--- .. . _ —i pci-i-z• 1 I J A \1 41111.11.M.A.•••••OWINARIPP,•••••••111.1.••••••••••*•••••••••••••••• • I 11) s'7 C-- \ , I 1 1, I 1 ,,. 1 i , .......1 ,3 . ., ( ... _ ... -1 (- " ) _I 1 ...w. ,. „. o, . 1 • ......, .,,...,... , _.1 . .. , , ...,.... ---) -r• ' 1 i ,.. i 1 (' . rc i - i I , ,.,.. ... , ..... j I ! z...,........ . 7 1 ! 1 4 i k .......- x >.< 1 g / / r ATE TIME CITY OF ORONO CALLED IN I a�/ INSPECTION TICor 7 HEDULED '%�/11il ,-3;36 PERMIT NO. 7CCOMP ED ADDRESS / F D U1 & OWNER ir-i1 dI TELEPHONE NO.0/2 -0/-4056 CONTRA,:TOP DESCRIPTION a_iti/"`" W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING C ❑ FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION i ❑ FRAMING 0 MECHANICAL FINAL 0 RATED WALLS Is.(0.1t1SULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL v ❑ DEMO-SITE 0 SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU: YES_NO 2 S: 4/44014j COMMENTCOr r'eci6A2- - OJCO /i oew iu &Z 4.1- 4/Ookk Ca Zri stl• — 6 .4,5 e 4)ea- c/sef� e �r2�. IX ce, rn istca a.. - 0 W - rftits - elms �A Coe 61/42p 6� -f- d.r CC II c 2 Pr'ouree. 6J6 z - Ap f 5,c7le ar d 6 /•.. lm_ Q •e OW 4 c.r.t�i7/�brse �r.44, Im j 'este-N."0 Cod" e �'/o - d/SIt� !/e.e-e %c c i- 1?e t 't�/�ev.5. p� -/ <Cr/'ec&-Y- a is W 0 WORK SATISFACTORY ED 0 PROJECT COMPLETE GQ✓er' CC CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY LU 0 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING _ PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnedContractor on site: Inspector:_C /i White Copy/Inspector's File Canary Copy/Site Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION NOTI ,/SCHEDULED 73-75— 3:30 PERMIT NO. '(/OF-D6 0 77 COMPLETED ADDRESS / V G /- e ',J OWNER TELEPHONE NO. I2- /'` O 4 CONTRACTOR O r �y DESCRIPTION -/GC_-ltii (Ae-- W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING v2 0 FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL Q ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION FRAMING 0 MECHANICAL FINAL 0 RATED WALLS 1, ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP i ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL v ❑ DEMO-SITE 0 SEPTIC INSTALL Z OWNER/CONTRACTOR TO MEET YOU:_E_NO /J Fii COMMENTS: £/�, �� — �-P1-1 CC LU r ,-fR,Nfr ti! - 161 1j pf -__ o C) /%!S u I4 e, �/btf K' �r a,- yam.e cc W + s c/P '�f4,seay GYt a��@e/ C le /, '�c o4,e. cc G/'t wt @..e.0-r' I Q t `''pct,/ a (�Gr4 7i ,4t04 /•., 4 ' /heed 3 0" v/82c n_dor Ale' ,i - r- 14 CC 46 , — / ) V1 lam_of40 e — kb 4/ 2 0 WORK SATISFACTORY:PROCEED 4� �/ �0 0 PR ECT COMP ETE�rQs_z Lt RRECT WORK&PROCEED 0 ISSUE CERTIFICATE 05010144,12/ C ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CAU.TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector: / 4 White Copyllnspectot's File Canary Copy/Site Notice