HomeMy WebLinkAbout2016-01545 - adv plan review 4 �s' CITY OF ORONO * 2 0 1 6 — P1 1 5 4 5 *
2750 KELLEY PARKWAY DATE ISSOED: 12/15/2016
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 3333 SHORELINE DR
PIN : 20-117-23-11-0024
LEGAL DESC : REG.LAND SURVEY NO. 1422
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 25,000.00
NOTE: PLEASE FILL IN THE FOLLOWMG:
VALUATION OF PERMIT:$ 25,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: FREE STANDING MONUMENT SIGN
PERMIT#THIS PRE-PAYMENT IS TIED TO: 2016-01544
APPLICANT ADVANCED PLAN REVIEW 281.89
TOTAL 281.89
CARLSON-LAVINE,INC. Payment(s)
2965 PARTRIDGE CREDIT CARD 8799 281.89
ROSEVILLE,MN 55113
(651)303-8762
OWNER
Lunds Food Holding Inc.
4100 W SOTH STREET#2100
EDINA,MN 55424
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 does
not grant permission for additional or related work which requires separate
permits. AII 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.
i 1.�.� ,��-�� /��--�� ��.. ,(s , ��
Applicant Permitee Signature Date Issued By Signature Date
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CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
Mailing Addness:
�. .�O Permitnumber. /(� 'L�/S
PO Box 66
Crystal Bay,MN 55323-0066 Date received: �Z �
.� Street Address:' - ' b : 1-
y�r Lti'� 2750 Kelley Parkway ��(� ' � review fee: � . ��-j
�'�kESHOR�` Orono, MN 55356 ;�.;
Main: 952-249�600 Totat Fe :
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: ��j.?��j ��,Qg�N f `�rj,1 V� ,
Will this be a Parade of Homes, Remodelers Showcase Home or other Display 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 allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: CAr2.4So N—�v V/tiE� /NC •
State License# Expiration Date:
Phone: (cell)(�/. 1�02,, E3�o12, (office)
Mailing Address: 29 1`� 2�--r�r �'Lva Cit :/l.v��'v��.c.r ZIP: /!
Contact Person:� '�2��n ,St(ynNt,P Applicant is: ntr / Homeowner (Circte One)
Email and/or Fax: r�/f��j S���LLSONLq�lµ 'G CO}�I
PROPERTY OWNER INFORMATION:
Name: 1,r� r., ,n �ve r� .�.(o�ra�, 1�c-
Phone(day): �I�'j'2• 9/ _ 2��F Z
Address: �1pQ �• Sp� t�,��- CitY: ��,v,o ZIP� �`j' �2�}
Email and/or Fax �Z.��S �P G�u K�wc��7 L�`�C/ Go H �
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: Citv: ZIP•
Email and/or Fax:
PROJECT INFORMATION: Description of pro'ect:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8�
❑ New Construction Water Supply
❑Single Family with ❑Accessory Bldg./Garage
❑Addition � attached garage ❑ Deck
❑Accessory Building �1��h/ ❑ Sin le Famil with ❑Public Sewer
g y ❑Office/Commercial
❑ Relocation t,,�O�uN� detached garage ❑ Residence
�Other:(speay) �(� ❑ Multi e Famil /Condo ❑ Private Sewer
p1 y ❑ Retaining Wa�l(s)
❑ ublic 4-feet or greater ❑ Public Water
*'My earth movement may also require �Commercial ❑Storage
MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑Qther:(speCify) ❑Other(speCify)
15320 Minnetonka Blvd
Minnetonka,MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.o
Estimated Construction Valuation(excluding land) $ 1�� Oao,
Last Updated: January 2016