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HomeMy WebLinkAbout2018-00205 - addn/remodel/repair CITY OF ORONO I I Ii I I I II I II I� INT I I I 2 I 0 I I S 11 I� 2750 KELLEY PARKWAY DATE ISSUED: 03/07/2018 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4009 NORTH SHORE DR PIN : 07-117-23-44-0004 LEGAL DESC : HIGHWOOD LAKE MTKA : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 7,000.00 NOTE: INSTALL(1)SERVICE DOOR IN GARAGE APPLICANT PERMIT FEE SCHEDULE 154.85 PLAN REVIEW 100.65 LBC CONSTRUCTION STATE SURCHARGE(VALUATION) 3.50 8830 GREENFIELD RPAD GREENFIELD,MN 55357- TOTAL 259.00 Minnesota State License#: BUIL-BC570568 Payment(s) CHECK 5408 259.00 OWNER SPLINTER,JAMES&VICKI 4009 NORTH SHORE DR MOUND,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. 642.a-( ) io 4-41S-6) 3 /7S Applicant Permitee Signature Date Issued By&gnature Date CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS "O`Y Mailing Address: PO Box 66 Permit number: DG g '' �� Crystal Bay, MN 55323-0066 Date received: c73- ,2)6 4 S Received by: Street Address:' y 2750 Kelley Parkway Plan review fee: ,tilt:'''<lkEst-101-4" Orono, MN 55356 Main: 952-249-4600 Total Fee: 0. 5' , e0 Fax: 952-249-4616 www.ci.orono.mn.us • This application form must be completed in full and all required information must be submitte4 yl Incomplete applications will be returned. ase print) GENERAL INFORMATION: 0 Job Site Address: co 7 by fYIA4,‘, r/ f-(G. d/i drawer Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ii Yes n No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus servic- will.e required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMA N: Name: L i3 C 3 -1 51'{t-e CP l C/t'-- State License# Ac 57 o 3%, ' Expiration Date: W'VLc r Za/ Phone: cell ..1.. i II 6 lir office Mailing Address: $ 0 • I PFJ I Cit :. re.: ZIP: 3S". Contact Person: o .A.,,_ Applicant is: o tr.ctor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION ^ Name: .-_-.-0 •7 ,' ()-- Phone(day): S�,� g 9 ) 7-,0Y .�,/ Address: ( 1 L'� 54- "-' - City: D %�'fi -5-6 \"- ZIP: S /2 //A(o Email and/or Fax ARCHITECT I ENGINEER INFORMATION: /(7/4 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& N. Water Supply ❑ New Construction )Single Family with 111 Accessory Bldg./Garage /Addition attached garage 111Deck Public Sewer ❑Accessory Building (( ❑ Single Family with ❑ Office/Commercial ❑ Relocation I ;),9 �p,,,b,,,,,;,r detached garage ''Residence ❑ Private Sewer ❑Other: (specify) 1.1tam //�� �❑�l, Multiple Family/Condo [' Retaining Wall(s) J r rt\ GxfxwLJ Public 4-feet or greater 0 Public Water **Any earth movement may o require 111Commercial ❑ Storage MCWD review&permits. 60-4-...i. ❑ Industrial ❑Warehouse iOZ.erivate Well Minnehaha Creek Watershed Di rict(MCWD) ❑ Other:(specify) ❑Other(specify) 15320 Minnetonka Blvd Minnetonka,MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.orq v u Estimated Construction Valuation (excluding land) $ 1-000 Last Updated: January 2016 • 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 Construction: d. 151 Story = e.2nd Story= 5. Code Edition: f. '/z Story = 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 O 0 Plan Review Fee O ❑ Completed Application Form ❑ 0 Proposed Building Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'/z x 11 set ❑ 0 Minnesota State Energy Code Calculations and Mechanical Code Requirements O 0 Survey—2 full size,to scale(meeting ALL survey requirements) O 0 Hardcover Calculations ❑ 0 Septic System Certification O 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) O 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 completi�• i- as-b rvey and all site improvements. R .. Applicant's Signature: 4 Date: Owner's Signature: Date: Last Updated: January 2016 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES // ADDITIONS Address: e'©"/ �(pj4i ,_3JO /j 'C Permit No.: -0/8'1.)0Z615---- n/8' WZO Description of work: i//c ' !( 4�/Y/C e r/0ytp�/' Date Rec'd: Septic review by: Date Approved: Zoning review by: Date Approved: //,, Building review by: 6i� .,..c. ..47 Date Approved: C�7( Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Co erage: SF Survey Submitted: 0 Ye 0 No Date of Survey: Revised date(?): Landscape plan submitted? 0 Yes 0 No Landscaper: Proposed Setbacks: FrontLake Rear Street / (Lake) (Street) ( N S E W ) ( S E W ) Other Buildings Wetland Side Side Defined Height: Peak Height: FE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% L.F. below grade Basement? 0 Yes 0 No, Stories / FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: OR A BUILDING ON A SLAB FOUNDATION: The distance between the lowest proposed Slab at or above grade— START WITH floor(of the basement or crawl space)and measure from highest existing the highest point of the roof. START WITH grade to the highest point of the roof even if fill was brought in to If you have a... elevate home. 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 Ow point of the corresponding If you have a... gable,or hipped roof SUBTRACTION • GABLE OR HIPPED ROOF (no windows): Subtract half • GABLE OR HIPPED ROOF(with (BASED ON the distance between the windows): Subtract half the distance ROOF TYPE) highest point of the roof to between the top of the highest 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 ,.basementicrawl space floor and the the top of the highest EXISTING /Defined highest existing grade adjacent to the EQUALS 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 building height subtraction. Defined building height Updated: October 2015 z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? Permit Number: 0 Yes 0 No 0 N/A 0 Yes ❑ ❑ Yes ❑ No 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 ❑ No ❑ Yes ❑ No 1 2 3 4 5 Type(s): Type(s): Fees to be Char!ed Y .NO ■iit 'n � r a `; . '� sort c"•. 6`ifA Plan Review State Surcharge 5 R } ':M Investigation Fee F- 'd k t Y Y+rf 5 Y 5• X - t Y SAC umb Other(specify) -_ Square Footage $ per Square Footage Basement X = $ 1st Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ ‘7000 U Orono Inspections Required Work Requiring Separate Permits ❑ Footing 0 Site 0 Plumbing 0 Grading/Filling ❑ Poured Wall 0 Silt Fence/Erosion Control 0 Mechanical 0 Fire ❑ Foundation Survey 0 Hardcover Removal 0 Septic 0 Water Connection ❑ Foundation Waterproofing 0 Other(specify) 0 Fireplace 0 Sewer Connection 'Framing 0 Masonry 0 Lawn Irrigation 0 Insulation 0 Mfg. 0 Landscaping ❑ As-Built Survey 0 Other(specify) Final ❑ Lathe Required State Permits ❑ Other(specify) 0 Well 0 Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: ❑ See Builder Acknowledgement Form O Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 \fnrmc\nlan roviow rhorklict 1h_901'S rinry I-. fs. N3 G c - ._, t 1 --, c IT 0 -....„, t , 4 , _, , --e-- t., I .1 \ op*•::,, C, V 73 O G� °' n In 3 73 L. ra 4'„ ^•S ,,, f;j ,, 1 u C\ DATE TIME CITY OF ORONO CALLED IN INSPECTIO NOT E('' ' ce SCHEDULED PERMIT N® COMPLETED ADDRESS CZ-1)g MC)lc ' OWNER TELEPHONE NO. '2C-0?) (5-1 C' 1 CONTRACTOR CAC C co•-„*._. 3, DESCRIPTION t~y ❑ FOOTING 0 DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL 0 PLUMBING RI. 0 EXCAV/GRADING/FILLING O 0 FOUNDATION DRAIN TILE 0 PLUMBING FINAL 0 TREE REMOVAL ❑ LATHE 0 MECHANICAL RI 0 SITE INSPECTION Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT .14C 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL ✓ ❑ DEMO-SITE 0 SEPTIC INSTALL - OWNERICONTRACTOR TO MEET YOU: YES_NO COMMENTS: *C-r4 M d " "cc ok /-7.4 di.,'. ter,1 Cr11.CIN-4,^ lao f t% ak �_21a S� • w rr4 P i"S cf/' &'o' 4 ‘..)c. b 4 " ci r v k cc Fe hi S L erh'►^-' baa) - a1t-JUn • o� To vg 1v a 1 W CC Q W CC CI13WORKSATISFACTORY:PROCEED PROJECT COMPLETE • 0 )• 7 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY O 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑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) 249-4600 OwnerlContractor on site: Inspector. e/ White Copyllnspector's File Canary CopylSks Notice