HomeMy WebLinkAbout2016-00791 - garage addition of 115 sq ft � � CITY OF ORONO * Z 0 1 6 - 0 0 7 9 1 *
2750 KELLEY PARKWAY DATE ISSUED: 07/15/2016
' ' ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2660 PHEASANT RD
PIN : 21-117-23-23-0022
LEGAL DESC : PHEASANT LAWN
: LOT 000 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCT[ON TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 4,000.00
NOTE: SEPARATE PERMITS REQUIRED: ELECTRICAL(STATE)
GARAGE ADDITION OF 115 SQUARE FEET
APPLICANT PERMIT FEE SCHEDULE 108.38
PLAN REVIEW 70.45
MCNULTY CONSTRUCTION CO. STATE SURCHARGE(VALUATION) 2.00
400 2ND AVE. S.
SUITE 650 TOTAL 180.83
MINNEAPOLIS,MN 55402 Payment(s)
�� CREDIT CARD 8842 180.83
Minnesota State License#: BUIL-BC1560 �
OWNER
HAYHURST,GREGORY&GAYLE
2660 PHESANT RD
EXCELSIOR,MN 55331-
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
no[grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming 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.
i
n,<< �1�� i ` 7 � �S� �-�
Applic nt rmitee Signature Date Issue y Signature Date
, . �
� KtVtIV�U
City of Orono
Building Permit Application JU� � 82016
for New Structures or Additions C�OFORONO
Mailing Address: Permit number: �U�(Q-UtJ 7 ,�
QA, PO Box 66
� f v0 Crystal Bay, MN 55323-0066 Date received: 7-�f -� (O
Street Address:' � � ��, ec ved by:
� ,�- 2750 Kelley Parkway ��"r�^�" ;
y�' c,` Orono, MN 55356 .�yL lan review fee: .
t"�xEsr►o4�' Main: 952-249-4600 Total Fee: �l� ���
Fax: 952-249-4616 wt��v��.ci.orono mr�.us
This application form must be completed in full and all required information must be submitte / 4�D` �
Incomplete applications will be returned. (Please print) 6 U
GENERAL INFORMATION:
Job Site Address: �-,��(��C`� ���'���,,���.��
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 approva!60 days prior to the event. Shutt/e bus service will be
required unless applicant demonstrates suHicient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT II�FORMATION:
Name: ti�r.-�.�,4- ���5������l � � A�./
State License# `�iC �� t �r� Expiration Date: 3 �, ' �'�
Phone: (cell) �� �-Za o�-{•�-� (office) (f„� ����-}— �,-.�K
Mailing Address: _� S',.� � ' Ci : ,�� ZIP: �5 yn(
Contact Person: �M� �'Y�� E.1�,t�--�� Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax: 'k ,n.�G��,��,,,�, mc��.�-Lc��, . ��;�,,.�
v �
PROPERTY OWNER INFORMATION:
Name: � � � �,.2 ,q�,Th�.t _ -{-
Phone (day): �'S 2 - Z'u --�i��—
Address: �� G .���� �,,a� City:� r-,n 3�, ZIP:5��� �
Email and/or Fax ���_,_. �,�� �,y��,,.����.�.�L,N„� ��
ARCHITECT/ ENGINEER INFORM qTION:
Name: �,;:�., al 1S�
Phone (day): �,�z —�-�� — , �
Address: ; �- �' � �,..�:, �\ Cit : !� ,p ZIP��/Z�_
Email and/or Fax: Y�e�c��cJ `�2`�� C�r�n.cfl.�o �t �
PROJECT INFORMATION: Description of project:
1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8�
Water Supply
❑ New Construction �Single Family with ❑Accessory Bldg./Garage
�--Addition attached garage ❑ Deck ,�Public Sewer
❑Accessory Building ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage �Residence ❑ Private Sewer
❑ Other:(specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater �Public Water
**Any earth movement may require ❑ Commercial ❑ Storage
MCWD review 8� permits. ❑ Industrial ❑Warehouse
❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) ❑ Other(speCify)
15320 Minnetonka Blvd
Minnetonka, MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
�
Estimated Construction Valuation (excluding land) $ � vc� , �, �DO
Packet Last Updated: August 2015
Page 21
STRUCTURE INFORMATION:
a_.._
1. Structure Dimensions 1.Structure Dimensions(continued) 2. Type of Construction •�.•"`� ;/,�/�
..��`S C�
a. Length(ft.)= Number of bedrooms= �`�/ood/Frame �
b.Width(ft.)= Number of garage stalls: Mas ry �C C v�c+G1 u�� ��C--�
/
Areas in sauare feet Attached= � e � C� �e ` �Q��� �
❑ P e Bldg. �
c. Basement= Detached = � ,�,
���
d. 1 St Story = �On- ite Prefab
e• 2"d St°ry- [(] Off- 'te Prefab
f. '/�Story = �] Othe (please specify):
g.Total Area=
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
R R� � �s� -� Buildin Permit Escrow A reement and Fees
❑ ❑ Plan Review Fee
❑ Com leted A lication Form
❑ Pro osed Buildin Plans-2 full size sets,to scale and 1 reduced 11 x 17 or 8 Yz x 11 set
❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements
❑ Surve -2 full size,to scale meetin ALL surve requirements
❑ Hardcover Calculations
❑ O Se tic S stem Certification
� ❑ Minnehaha Creek Watershed District(MCWD)Permit or
��,,�,o�S �.Dz �ji� Documentation from MCWD statin no ermit is re uired
❑ Landsca e Walls and/or Retainin Wall Plans
❑ Stormwater Pollution Prevention Plan SWPPP
❑ Access Permit
❑ ❑ Data Privac Adviso 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 govemmental 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 sunrey and all site improvements.
ApplicanYs Signature: ��= �' Date: � �
Owner's Signature: Date:
Packet Last Updated: August 2015
Page 22
Pernr,�� Application: Self-Checklist for Completeness
� Please note, the applicant must initial in the boxes below to acknowledge the minimum
required information is included with the submittal. If not, the application will NOT be
accepted. Call 952.249.4620 to schedule a meeting with staff if you have questions on
application submittal requirements.
KCtiCIVtU
JUL 0 S 2016 �
Completed Application
CITY OF ORONO
Plan Review Fee Paid
f
�
�', `
Signed Escrow Agreement & Escrow Payment
Building Plans (to scale) x2
.- Certificate of Survey (to scale) showing the proposed project &
meeting all requirements x2
Hardcover Calculations (if applicabfe)
I am aware that Orono will not issue a building permit without a
opy of MCWD permits (or documentation from the MCWD stating
the proposed project does not trigger their permitting
requirements). I will contact the MCWD at 952-471-0590
regardin this project.
Signed by: � :� � � ��,��
Address: �J..� A '' %> .S�`�� (
Permit #: '2c���,— G����ci c
Packet Last Updated: January 2015
Page 2
� orK�
City of Orono
��on,o Hardcover Calculation Worksheet�u� o ��ot6
Property Address: � ' .,�ITY 4F 0RON0
_ � 2 b6v ���.as��r �k o,�� �•��`��tx�� ,,
f��KESHO�'E Prepared by: Date:
GR�N���.���l�so�►�-��� ��,r�- 8-� �rs
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tie 2 Tier 3 Tie�4 Tier 5
Step 2: PROPOSED HARDCOVER �� C�
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 separately for each portion.
Key to Hardcover Item (Describe) Length x Width Total
Surve S uare Feet
Exam le Gara e 24'x 30' -- 720 S.F.
A �C� 7i�+i °�3'U�� S.F.
g '� S{.�" S.F.
C �i �/ .�'� �1v?'+�°D - 9 5�_ �I 5+= �.t frrG, �M�v� S.F.
D r� 4AL117c'? {t rt ,�-,9 2 0� S.F.
E �� D1�C. SL�t S.F.
F i� �C1t/!!2 N Ur q S.F.
G �� STD �.�?Tt b S.F.
H �� TpN 1=0�NT�4 N + s���.��,rA S.F.
I I� c,T ' �p t S.F.
J �' 0 2 RET yt..!-5 52-NaRrN+S3-Sr� � I s.F.
K �� ,4/� �a S.F.
L JI 1� PL/� T !► F1V,�" S.F.
M �� Lo L i �4 (2�t,nrOVE S.F.
N tl 5T0 T. .t+ 85� ��nl e. S.F.
O �� G 0�..� . ti � 2 S.F.
P 1� Q ut� .£�'Z � ¢����t 4 S.F.
Q n �� p S.F.
R �+ � S.F.
S D S.F.
T + � S.F.
V � �� t�0 ,4 � l 27.D x ++,2�S � S.F.
W S.F.
X S.F.
Y S.F.
Z S.F.
1 Total Pro sed Hardcover 6 S.F.
Excludable Hardcover See Ct Code Sec 78-1684 :
�� �T, A�-L a �ON 4� S.F.
7 hT, t �. S.F.
S.F.
• S.F.
S.F.
2 Total ExGudable Hardcover 7 S.F.
3 Net Pro sed Hardcover Subtract line 2 from line 1 S.F.
4 Total Lot Area S.F.
Proposed Hardcover Percentage [(3)+(4)] '23s� %
3�40 �35 8'CQd = �d.Z a�Io
Subdivision Application-January 2016 This is an information packet regarding Hardcover. Every effort has been made to
ensure the accuracy of the information contained herein;howev�er,if any information is
not consisterrt with provisions of the City Code,fhe Code provisions wil!prevail.
Page 19
.
,
. . ��c�rr���
City of Orono
� �oNo Hardcover Calculation Worksheet�U� � ��ot6
Property Address: 2 66v �f��Ay4N T °�DAQ ��+�Y��#I��ST�oF ORONO
t�t SNO�'E`` Prepared by: . 0 £ $ Date: ��
R N� ,�,d�s er � �. g-7 •!S
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tisr 3 Tier 4 Tier 5
Step 2: PROPOSED HARDCOVER
in the following tabie, identify ail 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 separately for each portion.
Surve� Hardcover Item (Describe) Length x Width S tuare Feet
Exam le Ga e 24'x 30' 720 S.F.
A �(t #d•1 pt� S.F.
B " S N� S.F.
C �i � i ,ti i2�0 - 9 5 F y � E�r�G� REM�+�£' S.F.
D i� �AG.�L� V t 2oi S.F.
E �� O . St�4t S.F.
F �� ,4 /� < 9 S.F.
G �► STD T� S.F.
H i� TOh 1=0 v T/+ � SP�uuJA S.F.
I i� S� /.# � S.F.
J +' 0 2 RET �itL S2-NoRrN+S3-S F� I S.F.
K ►� ,4 G S.F.
L ll t p T F dV S.F.
M i� Co C AI� S.F.
N t� T� , ,4 F1 S.F.
O t� COi..I . �r 2 S.F.
P �+ ✓4 � Oi2 S.F.
Q �� '� �l S.F.
R ir S.F.
S S.F.
T � S.F.
U �� S.F.
V R �� A i 27.o x �+ 2� � S.F.
W S.F.
X - S.F.
Y S.F.
Z S.F.
1 Total Pro ed Hardcover S.F.
Excludable Nardcover Sae C Code Sec Ta-1884:
►. 'T. �.6 S.F.
T - S.F.
S.F.
S.F.
S.F.
2 Total Exdudable Hardcover S.F.
3 Net Pro ed Hardcover Subtract line 2 from line 1 S.F.
4 Total Lot Area S.F.
Proposed Hardcover Perc�rKage L�3)+(411 2 3.� '�
Swbdfvision App/kation-January 2016 This is an Inlnrma�on packet reg�+ding Handoov�er. Eve►y efl�Ort has been made to
ensure the accuracy of the informatfon oontained hereln;howewer,if any infa►nadon is
not consisterrt wlfh provisions of the City Code,the Code provislons w/ll prevall.
Pege 19
� ' PLAN REVIEW CHECKLIST FOR N W STRUCTURES / ADDITIONS
Addcess: � �SG�� � Permit No.:�(/l(O`'��7��
Description of work: n Date Rec'd: �
Septic review by: 1 V � Date Approved: '�--
Zoning review by: Date Approved: �• � •
Building review by: Date Approved:
Grading review by: �� Date Approved: ��
Zoning District: ��f� �1=J Zoning File#: Reso#: Reso Date:
,.. � .. �
Zoning: Lot Area: � S /AC Width: Lot Coverage: ✓�� SF l���� %
_ _..
_.
Survey Submitted: Yes � No Date of Survey: � � i � Revised date(?):
✓ w�
Landscape plan submitted? 0 Yes No Landscaper: _�.� ., ' ��
Proposed Setbacks:
,�J� �, � ip i��
F nt (Lake) R r(Street) ( N E W ) ( N S E W ) Other Buildings Wetland
Side Side
�L.' ,+
�;,
�?'��; ;` '� � �`, __•---•-�-___�--�..
Defined Height: Peak Height: F F inus 6 feet= �( xis -�ontour;
Perimeter(linear feet)= 50%= L.F. below grade
Basement? � Yes � 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—
START W ITH floor(of the basement or crawl space)and measure from hiqhest existinq
the highest point of the roof. ra ade to the�ighest point of the
START WITH roof eyvrtifi�fill was brought in to
ate home.
If you have a...
SUBTRACTION • GABLE OR HIPPED ROOF(no r'� Slab below grade—measure
(BASED ON windows): Subtraet'half the distance .J°� from highest existing grade to the
ROOF TYPE) between the highest point of the roof "' hi hest oint of the roof.
to the low point of the corresponding If you have a...
gableor hipped roof 'SUBTRACTION • GABLE OR HIPPED ROOF
GABLE OR HIPPED ROOF(with r'� (BASED ON (no windows): Subtract half
� 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 corresponding gable or
roof
hipped roof
• ALL OTHER ROOF TYPES(flat, • GABLE OR HIPPED ROOF
mansard,etc):No subtraction. (with windows): Subtract
SUBT CTION Subtract the distance between the half the distance between
(BA$ED ON basemenUcrawl space floor and the the top of the highest
E�CISTING highest existing grade adjacent to the window and the highest
U�RADES) foundation OR 10 feet(whichever is less). point of the roof
• ALL OTHER ROOF TYPES
(flat,mansard,etc):No
EQUALS Defined building height subtraction.
Defined building height
EQUALS
Updated: May 2016
z:\forms\plan review checklist 5-2016.docx
Shoreland District MCWD Permit Average Lakeshore Setback Bluff
Met?
Yes p �o Permit Number: � Yes 0 No N/A � Ye No
0 N/A—see attached Setback:
Stormwater Quality Existing Proposed
Overlay District Tier Hardcover Hardcover Variance Required CUP Required
circle one % and sf °/a and sf
�� ���"��� ��,�3�l� 0 Yes No � Yes No
1 2 3 4 5 Type(s): Type(s):
�3q�3��. �3�3��.
Fees to be Char ed YES NO
Permit ��
Plan Review (�-�
State Surcharge (�
Investigation Fee
SAC—Number of SAC Units
Other(specify)
Square Foota e $ per Square Foota e
Basement X = $
1 S� Floor X = $
2nd Floo� X = $
Garage X = $
Estimated Construction Value: $
D °
Orono Inspections Required Work Requiring Separate Permits
�Footing 0 Site � Plumbing � Grading/Filling
� Poured Wall � Silt Fence/Erosion Control � Mechanical � Fire
� Foundation Survey 0 Hardcover Removal � Fireplace � Water Connection
0 Framing � Other(specify) � Masonry � Sewer Connection
� Waterproofing/Drain tile 0 Mfg. 0 Lawn Irrigation
� Foundation Waterproofing 0 Other(specify) � Landscaping
Framing
� Insulation
s-Built Survey
Final
Lathe Required State Permits
0 Other(specify)
� Well Electrical
REMARKS (in-house):
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED:
0 See Builder Acknowledgement Form
�Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved.
Updated: May 2016
z:\forms\plan review checklist 5-2016.docx
DATA PRIVACY ADVISORY KEC�IVED
• in accordance with Minnesota State Statute 13.04 Rights of Subjects of Data, Subd. 2, "Tennessen arning", we
would like to inform you that your request for a permit or license from the City of Orono or ar,�J�f���$ments
may require you to furnish certain private or confidential information. ,
You are notified that: CI'TY OF ORONO
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary
to process the permit or license.
4. If your requested permit or license requires Council action to approve, some information may
become public.
5. You have certain rights under Minnesota State Statute 13.04(see following page)to review private
data on yoursetf.
6. Your full name is required to process this application or permit.
�. �/D�M+ZS ✓�C �
First Middle Last
�°a� 5���� Q��. S.
Address
f�m is �r�✓ ��d / ��2 � -c��P�
City State Zip Phone
I understand my rights as stated above.
Signature �
/
Packet Last Updated: August 2015
Page 7
. , , . , Kt�t�vtu
City of Orono JUL 0 8 2016
� �oNo Hardcover Calculation Workshee,�oFORONo
, � PropertyAddress: 266d �N,fAS�r�t'T �DAD i-�AYI� VZST�
��'t SNOO�'` Prepared by: //.�' ^�r• �± (/��c p��y / t )/°'' Date: y/�� �
�i.����.7G��(7� �I'�7�DI�Fl��.? i �0�1`• VT�' ��
Stormwater Quality Overlay District Tier: (Circle one) Tier 1 Tier 2 Tier 3 Tier 4 Tier 5
Step 1: EXISTING HARDCOVER
In the following table identify all items of existing hardcover on the property, keyed by letter to Certificate of
Survey (survey must accompany this form). Use as many lines as necessary to accurately depict existing
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 separately for each portion.
Key to Hardcover Item(Describe) Length x Width TO��
Surve S uare Feet
Exam le Ga e 24'x 30' 720 S.F.
q S.F.
g S.F.
C V' t1 � S.F.
D ICT P R�v /1 G S.F.
E N S.F.
F � Wl�1 LIC S.F.
G T A T S.F.
H ' O r �. .. Q� .�5',m S.F.
I STo e 2 S.F.
J G' LD�ft ElAlr1�lGk 1s t - 1�72tf+1��3� s�uTH Q S.F.
K z� S.F.
L N R S.F.
M G C S.F.
N T N E �MCn 7 S.F.
O C 6 S.F.
P O t O S.F.
Q �t +, S.F.
R S.F.
g S.F.
T S.F.
� S.F.
V S.F.
yy S.F.
x S.F.
Y S.F.
Z S.F.
1 Total Existi Hardcover 7 S.F.
Excludabls Har+doovar S�e C Code 8ec 7&1a84 :
E . oVT I "' O S.F.
A l. S.F.
S.F.
S.F.
S.F.
2 Total Excludable Hardcover S.F.
3 Net F�cistin Hardcover Subtract line 2 from line 1 O S.F.
4 Total Lot Area S.F.
Proposed Hardcover Percentage I(3)+(4)] 22.�7 y'
(Proposed Hardcover next page)
Subdivisfon ApplkeHon-Jenu�y 2016 This is an information padcet iegarding Hardcov�er. Every efl�Ort has been made to
ensure the aa:urecy of the fnformeBon�telned hereJn;however,if any information is
not consishsr►t with provlslons of the Cfry Code.H►e Code provisions wfll prevail.
Page 18
�,.
.
[Mte�a Trme ,_ Inspedor MspxtionType �at H Pern�## Address --_ .Permi#TXP� . . . _�oQatyTYPe'Cans�anTj�e ._T
_- -_.__ __ _ __s
_ ( i , � � i _. I , . t
11192�i6 42:OOAtMII A+�TJ Framing P Y 2Q1fst10791 26�PheasantRd Addi6nnlRemodd/Repar ReSidentid AddnlRemoddJRepsir
InsWetion 201600791 26S4fheasantRd�Additifln/Remodei/Rep� Residentiel ,�CnlRanoddiRepair
3I15t1017 12:OOAhi tuETJ Fnal P Y 2016-00791 2�OPheasantRd AdditioniRemoddlRepa'r Residenti� AddnfRanoddtRepair
Leth �2016-t1a791 26�tlPheasantRd AdditionlRemodeilRepai Resida�6al AddnlRanoddlRepair
fi119t1017 12:OOAM CMAT As-Buil#5lrvey P Z016�06791 26fi0PheasantRd AdditioniRanoddtRepa'r Resid�6d AddnlRanoddlRepair �
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