HomeMy WebLinkAbout2016-00624 - adv plan review CITY OF ORONO * 2 0 1 6 - 0 0 6 2 4 *
� 2750 KELLEY PARKWAY DATE ISSUED: 06/0U2016
� ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRE5S ' : 1360 RAILROAD AVE
pIN ' : 10-117-23-31-0007
LEGAL DESC : UNPLATTED 10 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 8,200.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$8200.00
TYPE OF PERMIT THIS PAYMENT IS FOR: DECK
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00625
APPLICANT ADVANCED PLAN REVIEW 120.79
TOTAL 120.79
LEMMERMAN CONST.INC. Payment(s)
9037 CTY.RD 17 SE CHECK 7176 120.79
DELANO,MN 55328
(763)972-3003
Minnesota State License#:BUIL-4854
OWNER
TWELVES,STEVE&SALLY
1360 RAILROAD AVE
WAYZATA,MN 55391-
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 tt►e
State Building Code. 1'his permit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ondinances 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.
/ /
Applicant Permitee Signature Date Issued By Signature Date
CITY OF ORONO �
. �
''�- BUILDING PERMIT APPLICATION ! �g � 3
FOR NEW STRUCTURES OR ADDITIONS
�O A, Mailing Address: Permit number: o�'�(p - ���jo
1 VO PO Box 66
Crystal Bay, MN 55323-0066 Date received: —/ �i�
Rec ' •
� StreetAddress:' - O �
ti�. G'� 2750 Kelley Pa �� v�v +�lan review fee:
t�kESHO�� Orono, MN 553 L
Main: 952-249-4600 Tota ee: ��� � ���a
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: � � (�ct�.��i�� ��'E , �� �� (�j� 5 5 3� �
Will this be a Parade of Homes, Remodelers Showcase Home o other isplay Home? ❑ Yes No
If yes,a specia/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 sufficient on-site parking is available. Non permitted events will not be al/owed.
CONTRACTOR/APPLICANT INFORMATION:
Name: �.e-w�►�'cxw�aw. �rt,�c�sv� ��c. .
State License# (., C�Q 4 ��xpiration Date: �� A �
Phone: cell �(Q?j - 2 2�i - 1,�O office
Mailing Address: q 0�v� G�i,� _ 1� � Cit : ac1� ZIP: `� 3 Z
Contact Person: ''�c�vv� ��,w.w�;r r,-�ca,L. Applicant is: Contractor�, / Homeowner (CircleOne)
Email and/or Fax: L�.v�c.@-+ti ��C @ v�n ��('� �
PROPERTY OWNER INFORMATION� ��i
Name: s-�'�V�(; �^ i• '1 hl �Y�S
Phone (day): '76� °- 3 Q - 3 o
Address: -�i3• 'Bp X io 1 Cit : 1 � hn� Z�p; J J��
Email and/or Fax W�. v�-SS c+ O.�ti .
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: Z�p•
Email and/or Fax:
PROJECT INFORMATION: Description of pro'ect: �{'��
1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal&
Water Supply
�New Construction �Single Family with ❑Accessory Bldg./Garage
❑Addition attached garage �Deck
❑Accessory Building ❑ Sin le Famil with ❑ Public Sewer
g y ❑ 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 also require ❑ Commercial ❑ Storage
MCWD review 8 permits. ❑ Industrial ❑Warehouse
Minnehaha Creek Watershed District(MCWD) ❑ Other: s eci ❑ Private Well
15320 Minnetonka Blvd � P �� ❑ Other(SpeC'tfy)
Minnetonka, MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.m innehahacreek.or
Estimated Construction Valuation (excluding land)
$ '�.�'Q � � �
,_ �
CITY OF ORONO
Last Updated: January 2015