The URL can be used to link to this page

Home My WebLink About2014-00864 - entrance monument CITY OF ORONO * Z 0 1 4 - 0 0 B 6 4 * 2750 KELLEY PARKWAY DATE ISSUED: 08/20/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 475 OXFORD RD PIN : OS-117-23-41-0010 LEGAL DESC : STIELOWS ADDN : LOT 002 BLOCK 001 PERMIT TYPE : ACCESSORY STRUCTURE PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ENTRANCE MONUMENTS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 10,000.00 NOTE: ENTRANCE MONUMENTS. SEPARATE PERMIT REQUIRED: ELECTRICAL(STATE) NOTE: PRIOR TO RELEASE OF ES ROW FUNDS,AN AS-BUILT SURVEY AND HARDCOVER CALCULATIONS MUST BE SUBMITTED AND APPROVED. INITIAL: �l� APPLICANT PERMIT FEE SCHEDULE 191.75 STATE SURCHARGE(VALUATION) 5.00 BARKLEY LANDSCAPES 10820 46TH PLACE N TOTAL 196.75 PLYMOUTH, MN 55447- Payment(s) (612)598-9895 CREDIT CARD 5637 196.75 OWNER CKO VACATION PROPERTIES 575 OXFORD ROAD MEDINA, MN 55340- AGREEMENT AND SWORN STATEMENT The work for which this pertnit 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 aze requested in conf rma e with the St Building Code.This permit may be revoked at an e r due�e s oZ0 /Gf !p` i i Applicant Permitee Signature Da e Issu By Signa ure Date ' CITY OF ORONO 'I� � BUILDING PERMIT APPLICATION � ( �� I ►'� FOR NEW STRUCTURES OR ADDITIONS �i�` �O�O MailingAddress: Permitnumber: �d/�—DD�� PO Box 66 Crystal Bay, MN 55323-0066 Date received: �'j ��'( StreetAddress:' Received by: ��O.S ��, G�' 2750 Kelley Parkway Plan review fee: �Z T- �� `�kESHO�� Orono, MN 55356 �D��D��3 Total Fee: 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. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: „ Job Site Address: �'�5 �?( �,,� �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a specia/event permit is required with Police Department and Crty 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 INF RMATION: Name: �c�rlc.ley �� SC��S State License# Expiration Date: Phone: cell �� - - office Mailing Address: fj`�5}�J 6 Ic:ce (�r� Cit : ` �r�o.� ZIP: SSc/�/� Contact Person: 3,��e Applicant is: Contrac or / Homeowner (Circle One) Email andbr Fax: �5 j I,x��icl��, 3 .�i� oo ,c.o+�t PROPERTY OWNER INFORMATION: Name: Lc.�'`-e� �)��,.��r Phone (day): I�� I - K 5? Address: 5�5 OX City: a,^��o ZIP: Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: �tL (�rr�v��'� Phone (day): -�(7 -' �� Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Descri tion 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 detached garage ❑ Office/Commercial ❑ Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water *"`Any earth movement may also require ❑ Commercial ❑ Other(specify) MCWD review 8�permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Othef: (SpeCify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ IQ,Occ"?<�"� I (. ' � . � _ . : :. �: ; 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 Areas in square feet Attached= ❑ Metal ❑ Pole Bldg. c. Basement= Detached= ❑ ICF d. 1 St Story = ❑ On-site Prefab e.2"d Story= ❑Off-site Prefab f. 'h 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 A lication ❑ ❑ 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 ❑ ❑ Se tic S stem Site Evaluation Re ort ❑ ❑ Access Permit ❑ ❑ Wetland Buffer Im rovement Plan ❑ ❑ En ineered Plans for Retainin Walls 4 feet or above L� ❑ Plan Review Fee ' ❑ ❑ Application Escrow&Agreement ❑ ❑ Other: 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 Signature: �..;" " � Date: p � / Owner's Signature: Date: • City of Orono �otio Hardcover Calculation VNor � �p'� [� �� J Property Address: y7s- �XFa��c� �O r10 �; , , , ; t'7`iY�'la+9•t.1' �.E�".X/ �4�'t-�'�' .,F � . '��_��,��,,,�,�'' Prepared by: GR �iv9F2F f A1'J'o'C i.dT�-�'�,��t/C Date: �/2 i y Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5 Step 2 PROPOSED ARDCOVER In the following table, identify all items of proposed hardcover on the property, keyed by letter to Certificate of Survey (survey must accompany this form). Include all existing hardcover items that are intended to remain, as well as all proposed hardcover items that will be added. Use as many lines as necessary to accurately depict proposed hardcover status of the property. For Tier 1 properties, identify any features by letter which are split at the 75' setback line and calculate hardcover square footage se arate► for each ortion. Key to Hardcover Item (Describe) Length x Width Total Surve S uare Feet Exam le Gara e 24'x 30' 720 S.F, A vurf ,S S.F. B .rc,ecc�v �oRc�,� s'� S.F. � d� H S.F. � ' �oP S.F. E ' � 55!5' S.F. F f,A -- —'/9 8 S.F. G T 7,SS S.F. H //Q O S.F. i ,�� T. %6� y " s.r-. � R�' 3 S.F. K �: �� j6' S.F. � �� ' Z �y'/ S.F. M i� �� _�z�—_ S.F. N „ !i ZS S.F. O �i /� Z � S.F. P � -- Z,3 p S.F. Q / ZS '7' S.F. R IT 2 � S.F. S �� S.F. T i i c, S.F. U i i /�—S_F. U J-T�a S.F. W L L �7 S.F. X S.F. Y S.F. Z �—_��— 1 Total Pro osed Hardcover J� ----.._ .-_____-%.�_.��a' _S.F.�� Excludable Hardcover See Cit Code Sec 78-1684 : , � K � M N o fT. !.c/ -f�! t l��'i 7-��--—�,�— � F•_I -�--- --- � -.-------- �s.(=. � --------�- ------- ��.F.-_i � - �------- ----------�.F. � � F= I 2 Total Excludable Hardcover — "- -- �---- w�,;,�,'� — ,��a..._��3.��.,� 3 Net Pro osed Hardcover Subtract line 2 from line (1 __ � �_ !Sg 36 S.F. 4 Total LotArea ��c�rr S.F, Proposed Hardcover Percentage [(3)=(4)] �5+�t�� % - ,�.,..., =.,��V January 8,2013 PLAN REVIEW CHECFCLIST FOR NEW STRUCTURES / ADDITIONS Address/Permit Number: "C Description of work: �� Septic review by: Date Approved: —`�`r Zoning review by: Date Approved: O ' � 1 ' �� Building review by: Date Approved: g "� � `�y Grading review by: Date Approved: — " Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF _% Survey Submitted: � � No Date of Survey: g•�' � q' Revised date(?): Proposed Setbacks: F nt(Lake) �(Street) ( N � E W ) (Q S E W ) Other Buildings Wetland ide Side M� 12-� I LO' I l�o' Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% _ #of Stories Ok? � YES FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: The distance between the lowest FOR A B�"' ' �B FOUNDATION: START WITH proposed floor(of the basement or crawl _ space)and the highest point of the roof. ��;1 t y�Q./ The distance between the top of slab and '- _`, KI�;J" the highest point of the roof. If you have a... �Q 1 p (1]V..� �'� � If you have a... • GABLE OR HIPPED ROOF(no \,�� . GABLE OR HIPPED ROOF(no windows): Subtract half the � windows): Subtract half the distance distance between the highest point between the highest point of the roof of the roof to the low point of the to the low point of the corresponding SUBTRACTION corresponding gable or hipped roof gable or hipped roof (BASED ON ROOF . GABLE OR HIPPED ROOF(with m4 � • GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half the windows): Subtract half the distance distance between the top of the � between the top of the highest highest window and the highest window and the highest point of the point of the roof roof ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat, • mansard,etc):No subtraction. mansard,etc:No subtraction. ADDITION Add the distance between the top of slab SUBTRACTION Subtract the distance between the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenUcrawl space floor and the EXISTING the foundation. GRADES) highest existing grade adjacent to the GRADES foundation OR 10 feet(whichever is less). EQUALS Defined building height EQUALS Defined building height Shoreland District MCWD Permit Received Avera e Lakeshore Setback Met? Bluff 0 Yes 0 No � N/A 0 Yes o Yes ❑ No 0 Yes O No Permit Number: Setback: Stormwater Quality Existing Proposed Variance Required CUP Required Overla District Tier Hardcover Hardcover �� '03 S � Yes No 0 Yes No � (� 4fj�0 TYPe(S)� TYPe(S)� Updated: January 2013 v:\forms\plan review checklist 2013.docx REMARKS (in-house): ' Fees to be Charged YES NO Permit Plan Review L,,� State Surcharge t/` Investigation Fee i SAC—Number of SAC Units Other(specify) Square Foota e $ per S uare Foota e Basement X = $ 15t Floor X = $ 2nd FIoO� X = $ Garage X = $ Estimated Construction Value: $ l c�. Uo o `Y Orono Inspections Required Work Requiring Separate Permits Required State Permits � Site � Plumbing 0 Grading / Filling 0 Well � Hardcover Removal � Mechanical 0 Fire Electrical Footing � Septic � Water Connection � Poured Wall � Fireplace 0 Sewer Connection 0 Foundation Survey 0 Masonry � Lawn Irrigation 0 Radon Rock Bed � Mfg. 0 Framing � Other(specify) 0 Insulation As-Built Survey �nal � Wetland Buffer 0 Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES 0 NO New: 0 YES � NO OFFICIAL REMARKS -TO BE �o TED ON PER T AND INITIALLED �r1 �b I( ot C s n r l�C C�Ic��la�t ow� wu,�c- I�. Su�lornt}.� �-- ar,»ravcd. � Updated: January 2013 v:\forms�plan review checklist 2013.docx �-S �-- ,/ DATE TIME CITY OF ORONO CALIED IN �' � INSPECTION NOTICE SCHEDULED � — � PERMIT N - �0g co �erE� _—-�, ADDRESS 5 OWNER • TEL HONE NO.��8� �� CONTRACTOR � � DESCRIPTION � r � � � �f60TING ❑ PLUMBI G INAL ❑ EXCAV�'GRADING/FILLING Q ❑ POURED WALL ❑ MECHA IC L RI p LAKES�HORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE HEMOVAL Z ❑ INSULATION O WOOD BURNERIFIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP 0 PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HAHD COVER REMOVAL J O PLUMBING RI 0 SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OYYNER/CONTAACTOR TO MEET YOU:_YES_NO � COMMENTS: �, a a' l�ic��,,,�s -�o r YnD�titc irle.c� ��✓� 0 S�� D � �r«r e.e.��,. ', �. oc � S��lac�CS� C'')•� Q S/Za -cQa.,��iC- O�C- ,Az� ��t/l 2 � �f re�� /d� ` oc � a�t� �— W � � � �.YJ4�i� J W RK ISFACTORY:PROCEED ❑PROJECT COMPLEfE W ❑CORRECT WORK 8 PROCEED O ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFOREC01/ERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ PHOTOTAKEN INSPECTOR WILL REfURN �STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. t inspection 24 hours in advance. (952) 249-4600 Ow rlContractor on sit • Inspec � White Copylinspector's Ffle Canary CopylSite Notice DATE TIME CITY OF ORONO CALLED IN INSPECTION OTICE SCHEDULED ...� PERMIT NO. " �� COMPLETED o�- '/%/S ADDRESS �`7.S �•X�� • OWNER TELEPHONE NO. CONTRACTOR ��l� �'��C'�-/��' � DESCRIPTION GH��t y.lOA�.r1e.c1�S W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING v3 ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT r AL ❑ WATER HOOK-UP �.QLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL � ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OYYNERICONTRACTOR TO MEET YOU:_YES_NO � h COMMENTS: a � � 0 ��s s L�/iN •� 7�rl�i� �/ ��rc. �' �ts'J-�" �" 3^ OCS � a � W /- / �� Q � W � � � ? //I�1� � ❑WORK SATISFACTORY:PROCEED '�dBQ�COMPLETE W O CORRECT Y1fORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECTVYORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CdVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHpTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractoron site: Inspect '�^�' White CopyAnspector's Ffle Canary CopylSite Notks