CITY OF MINNETRISTA PERMIT APPLICATION
CITY OF MINNETRISTA
PERMIT APPLICATION
7701 County Road 110 W Minnetrista, MN 55364 (952) 446-1660
DATE
BUILDING PERMIT # _______________
SITE ADDRESS PID# OWNER Name / Address / City / State / Zip
CONTACT NAME - PHONE - EMAIL - FAX
ARCHITECT (If Required) Name / Address / City / State / Zip / Phone CONTRACTOR Name / Address / City / State / Zip / Phone
Expiration Date
CONTRACTOR LICENSE #
WARNING: The City of Minnetrista has permanent weight restrictions on many city roads. PLEASE check with city staff prior to construction. TYPE OF SEWER SYSTEM (circle one): TYPE OF WORK □ Commercial
□ Residential
Use of Building: _________________ EST. VALUATION OF WORK $ ____________________________
city sewer
septic system
□ New Home Height:____ Stories:_____
□ Addition
□ Re-Roof
□ Retaining Wall Height: ____
□ Remodel
□ Re-Side
□ Fence Height: ____
□ Pool
□ Stucco Demo
□ Finish Basement
□ Deck
□ Accessory Structure
□ Stucco
□ Window Replacement □ Other:________
SCOPE OF WORK:
Year Home Built (if applicable): ________________________ If built pre-1978, Lead Certification #: _____________________ Watershed District Permit (if applicable):___________________ Signature of this application by the legal property owner or a licensed contractor, as the owner's representative is required and authorizes the City Zoning Administrator or designee and the City Building Official or designee to enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have read this application and state that all information is true and correct to the best of my knowledge. I further agree that all work performed will be in accordance with approved plans, specifications and conditions and to abide by all ordinances of the CIty and the laws of the State of Minnesota regarding actions taken pursuant to this permit. I agree to pay all plan review fees even if I choose not to proceed with the work. Permit expires when work is not commenced with 180 days from date of permit issued, or if building and work is suspended, abandoned or not inspected for 180 days. Call the City of Minnetrista at (952) 446-1660 for inspections. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT: PRINTED NAME:
DATE:_________ For Office Use Only
ZONING APPROVAL BY:
DATE:
BUILDING APPROVAL BY:
DATE:
Paid: ________________ Date: _______________ Receipt No. _______________ By: _______________
BUILDING INSPECTION DEPARTMENT
Retaining Wall
SUBMITTALS FOR PERMIT SUBMISSION CHECKLIST FOR WALLS OVER 4' IN HEIGHT The following items are required to be submitted along with the items listed on the permit application for all retaining walls over 4' in height. Incomplete applications will not be processed. Complete Permit Application Data Privacy Advisory Form (Form A) Two (2) sets of Engineered plans showing: Plan view indicating: *
Type of material to be used
* * *
Method of installation Cross section view Elevations
Three (3) NEW or UPDATED Registered Land Surveys. Surveys must include the following:
* * * * * * * * * * * * * * * *
Location, Floor Area, and Building Envelope of Existing and proposed structures Lot Lines Building Setbacks (Front, Rear, Side, Lake, Wetland, Shoreland District) Floodplain, Floodway Delineations, Ordinary High Water Mark, Wetlands, Watercourses, Reservoirs, Ponds Hardcover Calculations - % & square footage of all impervious Wells & Neighboring Wells if New Drainfield is Installed Septic System & Drainfield or Sanitary Sewer Connect Location of all Significant Trees if project is located in a subdivision with a tree preservation plan All Easements (Road & Utility) Scale & North Point Public Right-Of-Way Name as per Subdivision Plat PID Number & Site Address Legal Description Parcel Size in Acres & Square Feet Zoning Classification Signature of Surveyor and Date of Preparateion or Date of Update
"Do it Yourself" Form (if property owner is the General Contractor) Watershed Districts may also require a permit. Contact the Minnehaha Creek Watershed District at (952) 471-0590 or Pioneer Sarah Creek Water Management Commission at (612) 348-7338 for more information.
GENERAL BUILDING CODE REQUIREMENTS
* A building permit is required for any retaining wall 4'or more in height (measured from the footing base) * Wall height is measured from the bottom of the footing to the top of the wall. * Retaining walls are allowed in all yards. * The installation of retaining walls should not alter the grade within drainage and utility easements. Tiered walls should have a minimum separation of 3' to be considered separate walls.
For specific code requirements, please contact the Building Inspection Department at (952) 443-4219 REQUIRED INSPECTIONS Footing: When the base is complete and wall is under construction Final:
When the wall is complete GENERAL NOTES
* The State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. Any person claiming an exemption must provide a copy of a Certificate of Exemption from the Department of Labor & Industry to the City before a permit can be issued. * To determine whether a particular contractor is required to be licensed or to check on the licensing status of individual contractors, please call the Minnesota Department of Labor & Industry at 651-2845065 or toll free 1-800-342-5354 or visit their website at http://www.doli.state.mn.us.
PLEASE GIVE A 24-HOUR NOTICE WHEN SCHEDULING INSPECTIONS
“DO IT YOURSELF” FORM (If Property Owner is General Contractor)
(Form C)
I understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. By signing this document, I attest to the fact that I am building or improving this house myself. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building on speculation or for resale and that the house for which I am applying for this permit located at __________________________________, is the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic’s lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minn. Stat. 326.91, subd. 1, and that I would forfeit my rights to reimbursement from the Contractor’s Recovery Fund in the event that any contractors I hire are unlicensed. I also acknowledge that as the contractor on this project, I am solely and personally responsible for any violations of this state building code and/or city ordinance in connection with the work performed on this property.
___________________________________________ Signature of Property Owner
___________________________________________ Property Owner – Print Name
________________ Date
To determine whether a particular contractor is required to be licensed, or to check on the licensing status of individual contractors, please call the Minnesota Department of Labor and Industry at (651) 284-5065, or toll-free at 1-800-342-5354. The purpose of this optional form is to have the “home-owner” acknowledge their responsibility of code and statue issues in the building of their home when they are acting as a general contractor.
Updated 5/15
PERMIT APPLICATION
7701 County Road 110 W Minnetrista, MN 55364 (952) 446-1660
DATE
BUILDING PERMIT # _______________
SITE ADDRESS PID# OWNER Name / Address / City / State / Zip
CONTACT NAME - PHONE - EMAIL - FAX
ARCHITECT (If Required) Name / Address / City / State / Zip / Phone CONTRACTOR Name / Address / City / State / Zip / Phone
Expiration Date
CONTRACTOR LICENSE #
WARNING: The City of Minnetrista has permanent weight restrictions on many city roads. PLEASE check with city staff prior to construction. TYPE OF SEWER SYSTEM (circle one): TYPE OF WORK □ Commercial
□ Residential
Use of Building: _________________ EST. VALUATION OF WORK $ ____________________________
city sewer
septic system
□ New Home Height:____ Stories:_____
□ Addition
□ Re-Roof
□ Retaining Wall Height: ____
□ Remodel
□ Re-Side
□ Fence Height: ____
□ Pool
□ Stucco Demo
□ Finish Basement
□ Deck
□ Accessory Structure
□ Stucco
□ Window Replacement □ Other:________
SCOPE OF WORK:
Year Home Built (if applicable): ________________________ If built pre-1978, Lead Certification #: _____________________ Watershed District Permit (if applicable):___________________ Signature of this application by the legal property owner or a licensed contractor, as the owner's representative is required and authorizes the City Zoning Administrator or designee and the City Building Official or designee to enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have read this application and state that all information is true and correct to the best of my knowledge. I further agree that all work performed will be in accordance with approved plans, specifications and conditions and to abide by all ordinances of the CIty and the laws of the State of Minnesota regarding actions taken pursuant to this permit. I agree to pay all plan review fees even if I choose not to proceed with the work. Permit expires when work is not commenced with 180 days from date of permit issued, or if building and work is suspended, abandoned or not inspected for 180 days. Call the City of Minnetrista at (952) 446-1660 for inspections. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT: PRINTED NAME:
DATE:_________ For Office Use Only
ZONING APPROVAL BY:
DATE:
BUILDING APPROVAL BY:
DATE:
Paid: ________________ Date: _______________ Receipt No. _______________ By: _______________
BUILDING INSPECTION DEPARTMENT
Retaining Wall
SUBMITTALS FOR PERMIT SUBMISSION CHECKLIST FOR WALLS OVER 4' IN HEIGHT The following items are required to be submitted along with the items listed on the permit application for all retaining walls over 4' in height. Incomplete applications will not be processed. Complete Permit Application Data Privacy Advisory Form (Form A) Two (2) sets of Engineered plans showing: Plan view indicating: *
Type of material to be used
* * *
Method of installation Cross section view Elevations
Three (3) NEW or UPDATED Registered Land Surveys. Surveys must include the following:
* * * * * * * * * * * * * * * *
Location, Floor Area, and Building Envelope of Existing and proposed structures Lot Lines Building Setbacks (Front, Rear, Side, Lake, Wetland, Shoreland District) Floodplain, Floodway Delineations, Ordinary High Water Mark, Wetlands, Watercourses, Reservoirs, Ponds Hardcover Calculations - % & square footage of all impervious Wells & Neighboring Wells if New Drainfield is Installed Septic System & Drainfield or Sanitary Sewer Connect Location of all Significant Trees if project is located in a subdivision with a tree preservation plan All Easements (Road & Utility) Scale & North Point Public Right-Of-Way Name as per Subdivision Plat PID Number & Site Address Legal Description Parcel Size in Acres & Square Feet Zoning Classification Signature of Surveyor and Date of Preparateion or Date of Update
"Do it Yourself" Form (if property owner is the General Contractor) Watershed Districts may also require a permit. Contact the Minnehaha Creek Watershed District at (952) 471-0590 or Pioneer Sarah Creek Water Management Commission at (612) 348-7338 for more information.
GENERAL BUILDING CODE REQUIREMENTS
* A building permit is required for any retaining wall 4'or more in height (measured from the footing base) * Wall height is measured from the bottom of the footing to the top of the wall. * Retaining walls are allowed in all yards. * The installation of retaining walls should not alter the grade within drainage and utility easements. Tiered walls should have a minimum separation of 3' to be considered separate walls.
For specific code requirements, please contact the Building Inspection Department at (952) 443-4219 REQUIRED INSPECTIONS Footing: When the base is complete and wall is under construction Final:
When the wall is complete GENERAL NOTES
* The State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. Any person claiming an exemption must provide a copy of a Certificate of Exemption from the Department of Labor & Industry to the City before a permit can be issued. * To determine whether a particular contractor is required to be licensed or to check on the licensing status of individual contractors, please call the Minnesota Department of Labor & Industry at 651-2845065 or toll free 1-800-342-5354 or visit their website at http://www.doli.state.mn.us.
PLEASE GIVE A 24-HOUR NOTICE WHEN SCHEDULING INSPECTIONS
“DO IT YOURSELF” FORM (If Property Owner is General Contractor)
(Form C)
I understand that the State of Minnesota requires that all residential building contractors, remodelers and roofers obtain a state license unless they qualify for a specific exemption from the licensing requirements. By signing this document, I attest to the fact that I am building or improving this house myself. I hereby claim to be exempt from the state licensing requirements because I am not in the business of building on speculation or for resale and that the house for which I am applying for this permit located at __________________________________, is the first residential structure I have built or improved in the past 24 months. I also acknowledge that because I do not have a state license, I forfeit any mechanic’s lien rights to which I may otherwise have been entitled under Minn. Stat. 514.01. Furthermore, I acknowledge that I may be hiring independent contractors to perform certain aspects of the construction or improvement of this house and I understand that some of these contractors may be required to be licensed by the State of Minnesota. I understand that unlicensed residential contracting, remodeling, and/or roofing activity is a misdemeanor under Minn. Stat. 326.91, subd. 1, and that I would forfeit my rights to reimbursement from the Contractor’s Recovery Fund in the event that any contractors I hire are unlicensed. I also acknowledge that as the contractor on this project, I am solely and personally responsible for any violations of this state building code and/or city ordinance in connection with the work performed on this property.
___________________________________________ Signature of Property Owner
___________________________________________ Property Owner – Print Name
________________ Date
To determine whether a particular contractor is required to be licensed, or to check on the licensing status of individual contractors, please call the Minnesota Department of Labor and Industry at (651) 284-5065, or toll-free at 1-800-342-5354. The purpose of this optional form is to have the “home-owner” acknowledge their responsibility of code and statue issues in the building of their home when they are acting as a general contractor.
Updated 5/15
