HomeMy WebLinkAbout2017-00150 - adv plan review CITY OF ORONO * z 0 1 7 - 0 0 1 5 0 *
2750 KELLEY PARKWAY DATE ISSUED: 02/17/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1750 SHADYWOOD RD
p�i� � : 17-117-23-21-0021
LEGAL D�SC : SHADY-WOOD
: LOT 016 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 880,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 880,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00149
APPLICANT ADVANCED PLAN REVIEW 3,656.20
TOTAL 3,656.20
STONEWOOD DESIGN BUILD Payment(s)
7407 WAYZATA BLVD CHECK 14606 3,656.20
MINNEAPOLIS,MN 55426-
(952)697-5075
Minnesota State License#: BUIL-BC5943]5
OWNER
SHAW,GRETCHEN& LYLE
7001 KENESTON DR
EDEN PRAIRIE, MN 55346-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable Ciry 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 l80 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. �
� �l 2 � � � � ✓�
G' � � �
Applicant Permitee Signature Date I sue By Sign ture Date
� �SC.f"U� t���,�,�.t� t°��i-
CITY OF ORONO - - ����`�Y�`'�' �`'``� �
BUILDING PERMIT APPLICATION
. FOR NEW STRUCTURES OR ADDITIONS
• � OA, Mailing Address: Permit number: 2 O 7 � � I �/
� f VO PO Box 66
Crystal Bay, MN 55323-0066 Date received: �- - -7—1 �7'
� �, StreetAddress:' R �eived by:
y�. G� 2750 Kelley Parkway D l� �Q�f I n revie fee: 36 'S(o • v�
lqk�SH04�. Orono, MN 55356
Main: 952-249-4600 Total 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.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: �'1 So S N-Prpti'wvv n �p . , DQo,uo N� N 5�36�f
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes Q No
If yes,a specia/event permit is required with Police Departmenf and Ciry Council approva/60 days prior to the event. Shuttle bus service will be
required un/ess applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: 5'rc�n�Ewoo�p� `,L.L
State License# (�� S9 �3 I S Expiration Date:
Phone: (cell) (office) (��1- �L�..-y o00
Mailing Address: 1 F_ �r L�a. Cit : � r ZIP: �
Contact Person: �on-tw�. -SvivES Applicant is: ontractor Homeowner (CircleOne)
Email and/or Fax: �w�,�-,�cz STo�U�wc�vi0. Cov�a
PROPERTY OWNER INFORMATION:
Name: �rR�Tc.r}�►J �Nn 1--Y�rz S F�Mi.�
Phone (day): (6 t�� 3��—S.'�.7 O
Address: �oo � 1cLN6'S'`� !)2rvE� City: �p��/ �1R,tFZ�P: ST3�6
Email and/or Fax 6rc-r�.,Q-r a1+�Q oK.�,rs�o�n-;nr .cv� L�/c s�4.w� e,��'s�i�, ��c. �
ARCHITECT/ENGINEER INFORMATION:
Name: A�rLx,4,�oE�. (�r_�s..9n� G'u.o�o
Phone (day): q�� - c..}73 - S'7 7'7
Address: p S?' ts/o Cit : fiYL��, ZIP: SS�
Email and/or Fax: �Q y,.� � Q.LnxG.H n.r es:a.. aror�o . �o-,�.
PROJECT INFORMATION: Descri tion of ro�ect: �l/�-P.c.c> o�l/Y\
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 � 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 also require ❑ Commercial ❑ Storage
MCWD review&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) $ g�� , ��� (� , �
Last Updated: January 2016