HomeMy WebLinkAbout2017-00333 - adv plan review CITY OF ORONO * 2 0 1 7 — 0 0 3 3 3�
2750 KELLEY PARKWAY DATE ISSUED: 04/06/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDI:�SS�. : 1700 SHORELINE DR
PIN : 10-117-23-14-0022
LEGAL DESC : UNPLATTED 10 117 23
: LOT 4 BLOCK 1
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 200,000.00
NO'I'E: PLEASE FILL IN THE FOLLOWING:
VALUAT[ON OF PERM[T:$ 20Q000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW CARE"I'AKER'S HOUSE
PERM[T#TfiIS PRE-PAYMENT IS TIED TO:2017-00332
APPLICANT ADVANCED PLAN REVIEW 1,130.95
HNH HOMES TOTAL 1,130.95
Payment(s)
1391 1 RIDGEDALE DRIVE#406D CREDIT CARD 3005 1,130.95
MINNETONKA, MN 55345-
(952)288-3746
Minnesota State License#: BUIL-654037
OW1vER
IRWIN JACOBS REV TRUST
1700 SHORELINE DR
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
"1'he 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 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 l80 days at any time after work has commenced.
The applicant is responsible for assuring alI required inspections are
requested in conformance-y�ith the State Building Code.This permit may be �
revoked at any tim r e cause. f(��
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pplica er e Sig ture Dat w Issued By Signatu e Date —T—
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- �( Meiling Address: �/...7 ` � � Z_
A.,'`� PO Bo�c 66 Parmit�umber. ��
� O`Vt3� CrysWl Bay.MN 553230066 Dafe received: ��`/�/�/
1 �
Street Ad�Bess' fieceived by: �
2750 Kelle Par
`\� �' Orono,MNy5535& y` �J/�C��i�J Ptan review fee: �� , g�
�x�s ri na� M ain: 952-249-4600
�`""'�'""`� Fax: 952-249-4616 www.a.orono.mn.us �� ��
This appliption form must be completed in full and all required infortnation must be submitted.
Incomplete applicatiw�s will be returned. (P/ease prirrtj
GENERAL INFORMA710N:
Job Site Address: 7Q0 7 e r'v�.
Will thls be a Parade of omes, Remodelers Showcase Home w other Display Home? Yes No
M yes,a special evenf permtls iequired wdh Po!!ce DepaRment and CityCoundlapp�ovel 60 days pnor to the event Shuftle bus servrce wi
required unless appikgnt demonstrates sulficienf on-site parldng is aveilabfe. Non�s�mitted eveMs wlll not be elbn+ed.
CONTRACTOR/APPIICANT INFORMA710N:
Name: �[,
State License# 03 xp�iratan Date: — —'Z�
Phone: (cell 2 office
Mailing Address: : �✓a ZIP: _
Contact Person: Applicant is: ontre / Homeowner �ct2ka»�
Email and/or Fax: jv-�y�d� 6"y ��� ��
P120PERTY OWNER INFORMAl10N:
Name: __ .�J"wi:� �iCc+bS
Phone(day):
Address: f�60 .S/�o,-a_f.r�n �.— City: o`-o,�Cj ZIP�„��/
Email and/or Pax
ARCHITECTI ENGINEER INFORMIATION:
Name: cC,
Phone(day): _ f� �p ., 9�$_
Address: . C� : � ZIP��S
Email andlor Fax: � r- /y` �*.iCatC�,SG,r� C
(/,, T1 ��
PROJECTINFORMAl10N: Descritionof roed: �-f�� �C)-�.1.5�,
1.�+pe of Projed 2 Proposed Use 3.�ture lype 4.Se�wege Disposel& �
Water Supply
�New Construction Single Family wRh ❑Accessory Bldg./Gerage
❑Addtion attnched garege ❑peck ❑Public Sewer
❑Accessory 8uilding ❑ Sin�e Famify with ❑Office/Commerdal
❑Relocation detached�rege Residence ❑Private Sewer
❑ane��s��ry� ❑Mul�ple Femily!Condo ❑t�em����wa�i�s�
❑Public 4feet or greater ❑Public Water
"Arry earth movement may re�ire ❑Commercial ❑Storege
MCWD review&pertnits. ❑Industrial ❑Werehouse ❑Private Well
Minnehaha Creefc Watershed District(RdCWD) �Q�pr(�g�j{y� �p�pr�yPe4��
15320 Mmnetonka BWd
Minnetonka,MN 55345
Phone�. 952-07i-0590 �
Fax.- 952-471-0682
Estimated Construction Valuation(excluding land) s �'�QC�t�
PaGcet Lest Updated�August 2015
Pege 21