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HomeMy WebLinkAbout2017-01084 - addn/remodel/repair w CITY OF ORONO * 2 0 1 7 - 0 1 8 8 4 2750 KELLEY PARKWAY DATE ISSUED: 09/19/2017 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS 2505 OLD BEACH RD PIN 21-117-23-22-0018 LEGAL DESC THE MARSH AT LAFAYETTE LOT 005 BLOCK 001 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDN/REMODEL/REPAIR ACTIVITY 434-RESIDENTIAL VALUATION $ 8,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) MASTER BATH REMODEL APPLICANT PERMIT FEE SCHEDULE 170.34 PLAN REVIEW 110.72 COLSON CUSTOM HOMES STATE SURCHARGE(VALUATION) 4.00 216 WATER STREET TOTAL 285.06 EXCELSIOR,MN 55331- Payment(s) 0 Minnesota State License#:BUIL-20276966 CREDIT CARD 1440 285.06 OWNER SHERMAN,MR.&MRS. 2505 OLD BEACH 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 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. 9 Applicant Perrnitee Signature Date Issued VSignature Date City of Orono Building Permit Applicati®n for New structures or Additions Mailing Address: ®A, PO Box 66 Permit number: p�Oi7—D/D vQ Crystal Bay, MN 55323-0066 Date received: nJ Street Address:' Received by: y ,C 2750 Kelley Parkway Orono, MN 55356 Plan review fee: }/ SH L),9,. Main: 952-249-4600 Total Fee: Fax: 952-249-4616 vmmrw.ci.orono.rnn.us This application form must be completed in full and all required information must be submitted. GENERAL INFORMATION: Incomplete applications will be returned. (Please print) Job Site Address: 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/APP CANT INFO,jRMATION: Name: o: State License # Expiration Date: Phone: (cell) �; .Z 2 W 7 (office) Mailing Address: ✓ , rY �� ' Cit Zlp. S 3 Contact Person: �d Email and/or Fax: Applicant is: Contract0r / Homeowner (Circle One) PROPERTY OWNER INFORMATION: Name: Phone (day): Address: S`� S ;-� j r°� C� / -� Cit • l•% _-a' ZIP Email and/or Fax ARCHITECT / ENGINEER INFORMATION: Name: Phone (day): Address: Citv: RECEIVacup. Email and/or Fax: ARCHITECT / ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP. Email and/or Fax: PROJECT INFORMATION: Description of project: 1.Type of Project —7 2. Proposed Use 3. Structure Type 4.Sewage Disposal & ❑ New Construction ❑ Single Family with ❑ Accessory Bldg./Garage Water Supply ❑Addition attached garage ❑ Deck ❑Accessory Building El Single Family with ElOffice/Commercial ❑ Public Sewer ❑ Relocatione J�Cf 4 detached garage ❑ Residence EI Other:(specify) j El Septic ❑ Multiple Family/Condo ❑ Retaining Wall(s) (Compliance certificate ❑ Public 4-feet or greater may be required) **Any earth movement may require ❑ Commercial ❑ Storage MCWD review& permits. ❑ Industrial ❑Warehouse ❑ Public Water Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ Other(specify) 15320 Minnetonka Blvd; Minnetonka,MN 55345 Phone: 952-471-0590 i Fax: 952-471-0682 ❑ Private Well www.minnehahacreek.orc Estimated Construction Valuation (excluding land) $ �p Packet Last Updated: January 2016 Page 21 STRUCTURE INFORMATION: 1. Structure Dimensions 1. Structure Dimensions(continued) a. Length (ft.)= Number of bedrooms= 2. Occupancy: b.Width (ft.)= Number of garage stalls: 3. Occupant Load: Areas in square feet Attached = c. Basement= Detached = 4. Type of Construcion: d. 15'Story = e. 2"a Story= 5. Code Edition: f. '/2.Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ ❑ Building Permit Escrow Agreement and Fees ❑ ❑ Plan Review Fee ❑ ❑ Completed Application Form ❑ ❑ Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/x 11 set ❑ ❑ Minnesota State Energy Code Calculations and Mechanical Code Requirements ❑ ❑ Survey—2 full size,to scale(meeting ALL survey requirements) ❑ ❑ Hardcover Calculations ❑ ❑ Septic System Certification ❑ ❑ Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD stating no permit is required ❑ ❑ Landscape Walls and/or Retaining Wall Plans ❑ ❑ Landscape Plan ❑ ❑ 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; • 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; e 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 f the a#-built survey and all site improvements. Applicant's Signature: Date: Owner's Signature: Date: Packet Last Updated: January 2016 Page 22 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: v it ©/` Permit No.: Description of work: Date Rec'd: / Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: 13 Yes 0 No Date of Survey: Revised date(?): Landscape plan submitted? 0 Yes 13 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? 13 Yes 0 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 highest existing START WITH the highest point of the roof. rg ade 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 highest point 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 the low point of the window and the highest 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 basement/crawl 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 I 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? 13 Yes 13 No Permit Number: 13Yes 13No 13N/A 13 Yes Ell 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 ❑ No 1 2 3 # 5 Type(s): Type(s): Fees to be Charged YES NO Permit V Plan Review State Surcharge Investigation Fee SAC— Number of SAC Units Other(specify) Square Footage $ per Square Footage Basement X = $ 1st Floor X = $ 2nd Floor X $ Garage X _ $ Estimated Construction Value: $ , Orono Inspections Required Work Requiring Separate Permits ❑ Footing ❑ Site Plumbing ❑ Grading/Filling ❑ Poured Wall ❑ Silt Fence/Erosion Control Mechanical ❑ Fire ❑ Foundation Survey ❑ Hardcover Removal ❑ Septic ❑ Water Connection ❑ Foundation Waterproofing ❑ Other(specify) ❑ Fireplace ❑ Sewer Connection Framing ❑ Masonry ❑ Lawn Irrigation ❑ Insulation ❑ Mfg. ❑ Landscaping ❑ As-Built Survey ❑ Other(specify) 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: October 2015 7•\fnrmc\n1an ravia l rharlrlici 10-901 F rinry ORONO COPY ( / /So, ( � "y) 11a4��� �(/,2 7 FF 7Reviewed for code ono liance City ` Comp - - — - _ A/eU/ k/a)ls Date MANUFACTURER'S LABELED Reviewer SAFETY GLAZING REQUIRED ED 1 D ` �a � ��w dere D�►.� h er S�®�✓e/ 4 � see /,QCC :.0n E RECEIVEU �� 7�ha�i�Op SEP U 7 YU t CITY OF ORONO