HomeMy WebLinkAbout2016-00532 - adv plan review CITY OF ORONO * 2 0 1 6 - 0 0 5 3 2 *
2750 KELLEY PARKWAY DATE ISSUED: OS/17/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 2024 SHADYWOOD RD
PIN : 17-117-23-31-0011
LEGAL DESC : GUST S JOHNSONS ADDN
: LOT 004 BLOCK 000
PERMTT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 20,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$20,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: DETACHED GARAGE
PERMIT#1T-IIS PRE-PAYMENT IS TIED TO:2016-00531
APPLICANT ADVANCED PLAN REVIEW 231.54
TOTAL 231.54
DANBERRY BLDG CORP. Payment(s)
5413 MANITOU RD CHECK 8388 231.54
TONKA BAY,MN
(952)474-5990
Minnesota State License#:BUIL-BC6389415
OWNER
KIEFFER,JOHN&BENJAMIN
2024 SHADYWOOD RD
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 the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
pern►iu. 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. n_ _
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Applicant Permitee Signature Date Issued By Signature Date
CITY OF ORONO
BUILDING PERMIT APPLICATIDN
FOR NEW STRUCTURES OR ADDITIONS
�Q� Ma!ling Address: Permit number. (� ( �; �db�� f
O PO Box 66
Crystal Bay, MN 55323-U066 Date received: ���� —�
., ,, Street Address:'
Received b : P�
y�. L�~ 2750 ltelley Park ay����_ , �,,""�� lan review fee: �3� � S�-
��K�s�io��: Orono, MiV 5535 �
Main: 952-249-4600 Tota1 Fee:
Fax: 952-249-4616 www,ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incompiete appllcations wili be returned. (Please print)
GENERAL INFORMATION:
JobSiteAddress: 'Z.,UZ ,� a& (,y/i� �«.� QjL�� �V�lJ j�,�J-°��
Will this be a Parade of Homes, Remodelers howcase Home or other Display Home? Yes No
ff yes,a specia!event permit is iequrred with Police Department end City Council approva160 days prior to the event. Shuttle bus serv�ce wi! be
raquired unless applicant demonstrates sullicient on-slte perking Js available. Non permifted events wi!!not be allowed.
CONTRACTOR/APP CANT FORMATION: � [/
Name: ,e �� �D v�
State License# Expiration Date:
Phone: cel! Z S � / � office S 2
Mailing Address: Cit : ZIP:
Contact Person: -C Applicanf is: n ractor / Homeowner �Clrela One}
Email andior Fax: ,���. �hM.�• 1 �
PROPERTY OWNER IN ORMAT N:
Name: ,:�Z�nn. r � ,c.�R.�'�Qf
Phone(day): (��2— �-o��'Y`
Address: . w�sa Cit : CX�u ZfP: �'.3`� (
Email andlor Fax n, Q .,
ARCHITECT/EIVGINEER iNFORMATION:
Name:
Phone(day):
Address: City: ZIP:
Emall and/or Fax:
PROJECT INFORMATION: Descri tion of ro'ect: �E'`��L}�C'C� ��r� '
1.Type of ProJect 2. Proposed Use 3.Structure Type 4.Sewage Dlsposal&
❑New Construction ���- Water Supply
❑Single Family with ccessory Bldg /Garage
❑Addition attachec!garage ❑Deck Public Sewer
[�C�ccessory Building �ingle Family with ❑O�ce/Commerciai
❑f2elocation detached garage ❑Residence ❑ Private Sewer
❑Other:(specify) ❑Multiple Family!Condo ❑Retaining Watl(s)
❑Public 4-feet or greater ❑ Public Water
•kAny earth movement may also�equire ❑ Commerclal ❑Storage
MCWD review 8�permits. ❑ Industrial ❑Warehouse
Minnehaha Creek Wate►shed District MCWD ❑ P�ivate Well
( ) ❑Other:(specify) ❑Other(specify)
15320 Minnetonka Blvd
Minnetonka,MN 55345
Phone: 952-d71-0590
Fax: 952-471-0682
www minnehahacr k. r
Estimated Construction Valuation (excluding land) $ 2�",Q��
Last Updated: Janusry 2016