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HomeMy WebLinkAbout2014-01259 - addn/remodel/repair CITY F ORONO 2750 KELT Y PARKWAY * 2 1 4 - 0 1 2 5 9 DAT8 E ISSUED: 11/05/2014 ORONMN 55356- 952)249-4600AX: 952 249-4616 ADDRESS : 315 OLD CRYSTAL BAY RD N PIN : 33-118-23-31-0004 LEGAL DESC : UNPLATTED 33 118 23 1 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/ROAIR PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDN/REMODEL/REPAIR ACTIVITY 434-RESIDENTIAL VALUATION $ 8,500.00 NOTE: DECK REAPLCEMENT APPLICANT PERMIT FEE SCHEDULE 177.00 DRS HOME REPAIR&REMODL TATE SURCHARGE(VALUATION) 4.25 6299 BIRCH LANE TOTAL 181.25 MOUND,MN 55364 ayment(s) (612)865-5398 CHECK 23265 181.25 OWNER ENGLEMAN,MR.&MRS.ALAN 315 OLD CRYSTAL BAY RD N LONG LAKE, MN 55356- 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 time for due cause. ; App scant Permitee Signature Date I sue y Signature Date CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS O Mailing Address: Permit number: �- PO Box 66 _ Crystal Bay, MN 553 6 �\ l Date received: Street Address Received by: 7 y� 2750 Kelley Parkway �1` Plan review fee: !1 ��L Orono, MN 55356 Total Fee: KESHO 115.,!:�5 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. �73� 7 Incomplete applications will be returned. (Please print) GENERAL INFORMATION: 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/APPLICANT INFORMATION: Name: D R-5 kovv,E C-- pelrsuee: -(i State License# / Expiration Date: Phone: (cell) el,,�- ��, � X35 (office) Gam/2 - C�S 22'2`67' Mailing Address: 6, X199 ,6j.-,c e4 City: jyl&r.'kT ZIP: Contact Person: vsc% -e_X�- ���,/� Applicant is: on rac .. / Homeowner (Circle One) Email and/or Fax: ll �� !1 �^✓,gyp G��C i' (r►c c CG�� v PROPERTY OWNER INFORMATION: Name: a(Cc h ZZ_7< - Phone (day): _jS-,�A - 97.3- S l q/ Address: .315- "f e5el ��5�;� /fix— / City: e> 6,1c, ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: .�' .s•3 tis �, /�4-,�—&- 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 ❑ Residence ❑ Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ® Deck ❑ Relocation �Jlee'� detached garage ❑ Office/Commercial ® Private Sewer )f ® Other: (specify ❑ Multiple Family/Condo ❑Warehouse 1ile ❑ Public ❑ Storage ❑ Public Water **Any earth movement may also require ❑ Commercial ❑ Other(specify) MCWD review& permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) 9.1 Other: (specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or c5c� $ Estimated Construction Valuation (excluding land) STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions (continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame b.Width (ft.)= Number of garage stalls: ❑Masonry Metal Areas in square feet Attached= ❑ ❑ Pole Bldg. c. Basement= Detached= ❑ ICF d. 1"Story = ❑On-site Prefab e.2nd Story= ❑Off-site Prefab f. '/2 Story = ❑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 ❑ ❑ Permit Application ❑ ❑ Proposed Buildin Plans ❑ ❑ MN State Energy Code Calculations and Mechanical Code Requirements Form ❑ ❑ Surve (meeting all requirements) ❑ ❑ Stormwater Pollution Prevention Plan ❑ ❑ Hardcover Calculation(s) ❑ ❑ Septic System Site Evaluation Report ❑ ❑ Access Permit ❑ ❑ Wetland Buffer Improvement Plan ❑ ❑ Engineered Plans for Retaining Walls 4 feet or above _ ❑ ❑ Plan Review Fee ❑ ❑ Application Escrow&Agreement ❑ ❑ Other: APPLICANVOWNER 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 Signature: d� Date: Owner's Signature: Date: PLAN REViEw CHECKLiS FOR NEW STRUCTURES / ADDITIONS i- Address/Permit Number: . Ua�o Deecription of work. i f Septic review by. Data Approved: Zoning review by. , Date Approved: Building review by:, . Date Approved: Grading review by: Date Approved: Zoning.District: Zoning Flle#: Reso 1: Reno f' f .. Zon g: Lot Area: SF/AC Mild h: Lot Coverage: W Survey, ubmitted: D Yes ® NOT Date of Survey: Re ' d d to? f Pro ` ed ` auks: Front(Lake) Rear(Street) ( N S W ) ( N 'S 1 W er Buildings Wetland. r Sid S1de Defined Height: Peak.Height. , PPE: - Fl: minus 6 feet= (Existing Contour) Perimeter(11hear feet) so%= >�o� tones Oki ®YES FOR A BUILDING WITH A BASEMENT OR:CF2A, SPACE: Ttie'dince betwee ttielowest f START WITH proposed floor(of the - nt or yawl OR A BUtL.bING ON A SLAB FOUNDATION. space)and the highest t of the START WITH distance between the top of sib and K you have a the highest point of the roof. I If,you have-a:.. ; I + GABLE OR HIPPEb Its R GABLE oR:,HIPPED 104F(t1C windows): Subtract half#he' windows): Subtract haH des tlistanc distance between-the highest bstween:ths highest pointof 00 roof., of the roof to the low paint of. tothe low int of the-dotrea di SUBTRACTION correSppnding 9atsle ar hip roof, susTRAC?10N pa P� ng gable gr hipped roof (BASED ON ROOF.'' • GABLE Oil HIPPED R00 ( (BASED ON • GABLE OR HIPPED ROOF(with ' } TYPE) „ ,; windows): Subtract half e; ROOFTY,E) ari?�dows): Subtracl'hatfthe distance;; distance between the p of beh een ftl *,dithe highest highest jarindow and _e higFi window and the,ttighest point ofthe y OTHER P TYPES(fl • ''ALt OpciW of the,roof :�fo6f 'fiHEt, h F TYPES(stat tansard,Ste'Nos[abtra�iort ' mansard,etc 6 subtraction.Ai % ADDMON Add tbei.distance be .. n the top of slab .° $(1BTRACTION Subfrar the tl ce'beiween the (BASED ON and the Highest 8> n8 grade adjacent to basement! space floor and'the (BASED ON EXISTING EXISTING= the foundagon. GRADES) h(ghest , grade adjacent to RAMS) foundation R t0 feet(wshichever is Defined building ftelght h. EQt7 De uilding height. Shoreland District' MCWD Perirnit Rete ed: Avera a La<keshore,Setb Mpt Bluff CI_ YeS . 13 i NIA Q Yes i:1'No. 0 Yes 13 O d Yes b N.o Permit Number Setback: 5tonnwater uality fisting Prop ed Variance Requi , CUP Re ' ed r. Overly -Dl tr ct Tier Hardcover Hactl ver . -, g D Yes Q No, M Yes 13 No'- ( i'Ylje(s) Type(s)> (' updated: January 2013 �` q ' v:Vorms\olan'reWew checklist 2013.docac- r a t X 1 s r s I.# o`k Y, e N k .� ry -a t. � e e y' t �, - n ,� 'a a}9' `I y�" m td a b- .. ">` , - r. � r A I k t L !l a t J J �- s J ��tt��t C r 4� .�, - �' g f k 4 Y - ry a r { I �o, it F '-C ,J - t 5 k1 .I _ _ A, s - s"r 5 f Y a 43 7 ' �t'8 1 1. Y 1 , j' -' 'g' 1�1 �} � - r'Y� t7". 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YE1(IIB�F +r+wF'Ct 203 tYO�X` z u 4 s x 4 fy f i i �t va , } rsrd c+r s c ` -a J qtr:7` t ^ -+ate x �t :V q a t - o DATE TINI4/ CITY OF ORONO CALLED IN v INSPECTION N TICE SCHEDULED PERMIT NO. � �COMPLETED ADDRESS OWNER TELEP ONE /a- X/115 CONTRACTOR DE FOOTI ❑ DEMO-FINAL [I SEPTIC FINAL Eh POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FIN ❑ PROGRESS ❑ INSULATION ❑ WOOD BURNER/Fl EPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY SE ER HOOK-UPI El HARD COVER REMOVAL v ❑ DEMO-SITE PTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNENCONTRACTOR TO MEET YO YES—NO COMMENTS. j of o� 0 Lu cc ZSQ W W ' J d W WORK SATISFACTORY'PROCEED ❑PROJECT COMPLETE cc WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY d ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOU ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑NATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCE 1 Call for the next ins 24 ho rs in adv ( 52) 249-4600 Ownerr,ontractor on site: Inspector. White CopyAnspectoPs FI Canary Copy/S(te Notice DATE TIME CITY OF ORONO CALLED IN INSPECTIOT G� 61ZSqCHEDULED I PERMIT NO. �y' OMPLETEa, ADDRESS 00 C� �p�� OWNER TE EP�HONE NO.CO GCft 2!! iq�,% CONTRACTOR © CSS i^c e"u-'tom 9 � DESCRIPTION W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOU DATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RA ON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q F AMING ❑ MECHANICAL FINAL El PROGRESS jE SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT INAL ❑ WATER HOOK-UP ❑ FOLLOW-UP S BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL ;2t OW NERICONTRACTOR TO MEET YOU:_YES_NO o COMMENTS: CC W CL QC J O O W cc Q 2 W z W d d W ❑WORK SATISFACTORY:PROCEEDROJECT COMPLETE cc W ❑ CORRECT WORK&PROCEED LI IS E CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. O PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952 00 Owner/Contractor on site: Inspector. White Copylinspector's File Canary Copy/Site Noti e i ° 0 O N 0 4 ;7 C z -� !1 w v y 03 O ® CL —{-.zz--q r - (D -1' Cc0 O X 0 = Cl)1 ,�.f- G) CQ ,..t. C C ' ;0 a) a) r 0 0 tQ to tD C �' 0 �(1)(D 0Q)0 �CN�(D ��� '00-N =' NO • O C2. CD (J) •-+• (D , �. <• O ® iv Q C 0) OL � CD � CCD -0 T3 =---< Iy 0 Cn r-+ Co O 0 ,,.F. 5 --w �r ;0 � CD CD 0=.�'•CD ®�� a)0 z M Cn CD to CD :3O W su �. Er tl) -s Q O tD C CD 0 _ -i -.X I CD CL Cn 0-0 0 -CD -� C N 0 CD 0�� �N � 3 0 " ��.� to Q� CD Cr ®� Wsv �� O 0� 0 -Z3 /t! WO C O yv .0V 00 �D0 ® ��^y CD iD0 /gry� CD ® 0 a W N/ 0 fes` g^ 0' CD Q. 16.5 0 DATE 9-264 �+ I G RO N B E RG & AS S O VAT E S, INC ■ CIVIL ENGINEERS, LAND SURVEYORS, LAND PLANNERS 445 N. WILLOW DRIVE LONG LAKE, MN 55356 PHONE; 952-473-4141 FAX: 952-473-4435 LE 1'°=50° 0 O N 0 4 ;7 C z -� !1 w v y 03 O ® CL —{-.zz--q r - (D -1' Cc0 O X 0 = Cl)1 ,�.f- G) CQ ,..t. C C ' ;0 a) a) r 0 0 tQ to tD C �' 0 �(1)(D 0Q)0 �CN�(D ��� '00-N =' NO • O C2. CD (J) •-+• (D , �. <• O ® iv Q C 0) OL � CD � CCD -0 T3 =---< Iy 0 Cn r-+ Co O 0 ,,.F. 5 --w �r ;0 � CD CD 0=.�'•CD ®�� a)0 z M Cn CD to CD :3O W su �. Er tl) -s Q O tD C CD 0 _ -i -.X I CD CL Cn 0-0 0 -CD -� C N 0 CD 0�� �N � 3 0 " ��.� to Q� CD Cr ®� Wsv �� O 0� 0 -Z3 /t! WO C O yv .0V 00 �D0 ® ��^y CD iD0 /gry� CD ® 0 a W N/ 0 fes` g^ 0' CD Q. no Z z C G? m = C- Z =*O -n �;:z i5 N 00031'59" E 165.03 �mo r mz m n • O W � �Z m CO -� N •� W 165.13 ...... 330.26 °o z� moa > a) om3:Z ;a n-im =WUl 0>-n OComo C Doi z> SMC) �;U O-� o ; 16.5 0 DATE 9-264 �+ I G RO N B E RG & AS S O VAT E S, INC ■ CIVIL ENGINEERS, LAND SURVEYORS, LAND PLANNERS 445 N. WILLOW DRIVE LONG LAKE, MN 55356 PHONE; 952-473-4141 FAX: 952-473-4435 LE 1'°=50° 1> 14-377 S X SHEET OSHEETS 0 CD M ..a no Z z C G? m = C- Z =*O -n �;:z i5 N 00031'59" E 165.03 �mo r mz m n • O W � �Z m CO -� N •� W 165.13 ...... 330.26 °o z� moa > a) om3:Z ;a n-im =WUl 0>-n OComo C Doi z> SMC) �;U O-� o ; G .6PROPOSED DECK 46.7 N 24.0 65.2 EXISTING HOUSE N #315 3 6 % A .3 ry• A 0 W a! F, m� DO • -G "0 N 00016'00" E 165.03 A [- mm Po W � W �m W • OLD CRYSTAL BAY ROAD N. W C.0 no � Pa) C } "' C i. mem -•I Wiz= -Iz� O Z = z !v Fm F _ 148.00 — I i CO z :E® Co 7 I nm w0 °-n i z " m I ° w� I i 33027 148.00 E�� S O N S ESIGNE DATE BY REMARKS 16.5 0 DATE 9-264 �+ I G RO N B E RG & AS S O VAT E S, INC ■ CIVIL ENGINEERS, LAND SURVEYORS, LAND PLANNERS 445 N. WILLOW DRIVE LONG LAKE, MN 55356 PHONE; 952-473-4141 FAX: 952-473-4435 LE 1'°=50° DRAWN 14-377 S X SHEET OSHEETS 0 CD M ..a 0 I G .6PROPOSED DECK 46.7 N 24.0 65.2 EXISTING HOUSE N #315 3 6 % A .3 ry• A 0 W a! F, m� DO • -G "0 N 00016'00" E 165.03 A [- mm Po W � W �m W • OLD CRYSTAL BAY ROAD N. W C.0 no � Pa) C } "' C i. mem -•I Wiz= -Iz� O Z = z !v Fm F _ 148.00 — I i CO z :E® Co 7 I nm w0 °-n i z " m I ° w� I i 33027 148.00 E�� S O N S ESIGNE DATE BY REMARKS I hereby certify that this survey, plan, or report was prepared by me or under my direct supervision and that i am a duly Licensed Land Surveyor under the laws of the State of Minnesota. DATE MINN. LICENSE NUMBER t.Z DATE 9-264 �+ I G RO N B E RG & AS S O VAT E S, INC ■ CIVIL ENGINEERS, LAND SURVEYORS, LAND PLANNERS 445 N. WILLOW DRIVE LONG LAKE, MN 55356 PHONE; 952-473-4141 FAX: 952-473-4435 LE 1'°=50° DRAWN 14-377 CHECK SHEET OSHEETS