HomeMy WebLinkAbout2013-00894 - adv plan review CITY OF ORONO * Z 0 1 3 - 0 0 B 9 4 *
,� 2750 KELLEY PARKWAY DATE ISSUED: 08/30/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1700 SHORELINE DR
PIN : 10-117-23-14-0014
LEGAL DESC : LJNPLATTED 10 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE ; RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 75,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$75,000.00
,
TYPE OF PERMIT THIS PAYMENT IS FOR: REMODEL
PERMIT#THIS PRE-PAYMENT IS TIED T02013-00895
APPLICANT ADVANCED PLAN REVIEW 565.01
HNH HOMES
13911 RIDGEDALE DRIVE#406D TOTAL 565.01
MINNETONKA,MN 55345- PAID WITH CASH -20.00
(952)288-3746 PAID WITH CC# 6746
Minnesota State License#: 654037
OWNER
ETAL, IRWIN JACOBS
1700 SHORELINE DR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approva{s,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ / � 1'� 0 /d,U/
Applicant Permitee Signature Date Issued y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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' City of Orono � (P' �
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Building Permit Application
for New Structures or Additions
Mailing Address: ' ` ��
,�} PO Box 66 ��������" �' �—���
�'�l vO Crystal Bay,MN 55323-0066 .p���-���: ' �-
StreetAddress:' '�$�'��e�'�� ���
� ,�. 2750 Kelley Parkway p����: . ��
y� L� Orono, MN 55356 ���� _� �9,
�"�kESHo��' Main: 952-259-4600 �p�����; ,
Fax: 952-249-4616 www.ci.orono.mn.us
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: „ � �P/ease print)
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GENERAL INFORMATION:
Job Site Address: /�7do �Sl�r�/��►� �"j�- d►-raM.c, i"�''J 5��9�
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 Ciry Counci!approva160 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates s�cient on-site parlcing is available. Non-permitted events will not be allowed.
CONTRACTOR I APPLICANT INFORMATION:
Name: ,N � f7�o�.,*S LL-C-
State License# �G ps"' Expiration Date: 3/3/ �ol y
Phone: (cell) ,s/2 7 g7- S�.-SS (office) `�5�� ZSS- 3 7��
Mailing Address: —�;d �d4/ r. .Srw' � yo6 Ci : ;,,,��� ZIP: �
Contact Person: �� }f.i/u,��t Applicant is: ontrac o / Homeowner (Clyde One)
Email and/or Fax: __�fc� �„� -/,�,�S Co�,
PROPERTY OWNER INFOi2MATION:
Name: .�r�e,��Lo ?acvbS
Phone(day):
Address: /�cG ��ore/,�,5� ar City: �yn��c� ZIP:SS39/
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name: R DS �'
Phone(day): (�/2� 8'/0- 625�
Address: ljg'Op /fuy 69 5��� 30'� C�tY: ./1�'�w �"f°.P�- Z�P� �yZ�
Email and/or Fax: rS�orl•e�� CAµ�coc� - h e�
PROJECT INFORMATION: Description of ro'ect:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
❑New Construction ❑Single Family with Residence
❑Addition attached garage Garage/Accessory Bldg. ❑Public Sewer
❑Accessory Building ❑ Single Family with ❑Deck
❑ Relocation detached garage ❑Office/Commercial ,�Private Sewer
,�Other: (specify) �c�H,.�C,�� hC�� ❑Multiple Family/Condo ❑Warehouse
• ❑Public ❑Storage ❑Public Water
*`Any earth movement may require ❑Commercial ❑Other(specify)
MCWD review 8�permits. ❑ Industrial ,�Private Well
Minnehaha Creek Watershed District(MCWD) ❑Other. (speClfy)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.o
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Estimated Construction Valuation (excluding land) '�.�e p0�• '—
Packet Last Updated: 04119/2013
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