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Home My WebLink About2015-00371 - adv plan review CITY OF ORONO * z 0 1 5 - 0 0 3 7 1 * 2750 KELLEY PARKWAY DATE ISSUED: 04/OU2015 , ORONO,MN 55356- ;-� 952 249-4600 FAX: 952 249-4616 PRINTED WITHOUT ISSUING 9/16/2015 ADDRESS : 3596 SHORELINE DR PIN : 17-117-23-43-0107 LEGAL DESC : NAVARRE HEIGHTS : LOT 000 BLOCK 007 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : COMMERCIAL-BUSINESS CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 55,000.00 NOTE: ADVANCED PLAN REVIEW FEE BASED ON$55,000 VALUATION APPLICANT ADVANCED PLAN REVIEW 490.91 TOTAL 490.91 HANSSON BUILDER Payment(s) 1301 WPPDHILL ROAD CHECK 7463 490.91 BURNSVILLE,MN 55337- OWNER PATNODE,LAUREN 2901 OAK LEA TR 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 permits. 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. / / Applicant Permitee Signature Date Issued By Signature Date / � City of Orono uilding Permit Application for Maintenance / Replacement / Remodel (�.�. ;i✓indows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O • Mai��PO Bo�r66� Permit number: o��' �v3 � �j� Crystal Bay, MN 55323-0066 Date received: 7""��S Street Address: Received by: -- - _ - ._-_--�_ y �" 2750 Kelley Parkway ��`� lan review fee: �� `�q ��,G Orono, MN 55356 / � ��, ,� � p,� J—dQ 37 �r '�ESH� \�C�_—� 98— --—_—_ _..- Main: 952-249-4600 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: L�; � � Job Site Address: �,�"/ � UY� i �/2 - Will this be a Parade of Homes, Remodelers Showcase Horrye r her Display Home? ❑Yes o If yes,a special event permit is required with Police Department and City Co pproval 60 days prior to the event. Shutt/e bus service wiU be required unless applicant demonstrates sufficient on-site parkin� vaila�. Non-permitted events will not be allowed. CONTRACTOR 1 APPLICANT INFORMATION: \1� � n , V,., �i Name: � �e�v State License# (�a� v �` Expiration Date: 3�3� � Z�� ( Lead Certification Number: /�//�j— r I 2�r Z�`'2-—/ � Expiration Date: �� s � Z�, ;� (for work on homes that were constructed prior to 197� Phone: (cell) �� Z 3 g-� �o,;j 2 (office) Mailing Address: j�j�/ ;, ;` `� City: s�,,�` Z�P: S's 33 Contact Person: .�,��,.N f.{� , Applicant is: ontract / Homeowner (Circle One) Email and/or Fax: �� ' , PROPERTY OWNER INFORMATION: Name: .Srq1✓� � Phone(day): 6 3 �--� Address: C, w City: �` ZIP: 3 Email and/or Fax: C �o��r � ',u,.� PROJECT INFORMATIO : Overall project description: Type of Project: Any earth movement may also require � � MCWD review 8�permits: ❑ Door(s) L�J'Remodel ❑ Fire Damage ❑ Re-roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other eciry) ❑ Siding ❑ Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated nstruction Valuation of Project (excluding land) $ �S.00c� APPLIC NT ACKNOWLEDGEMENT: . Agrees to provide all information required or requested by the Building Department; . Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Some or all of the information that you are asked to provide on this application is classified by State law as either private or confidentia►. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this_information is to annually update our records and records of other governmental agencies required by law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: Date: ��/��S � Date: �//1� Owner's Signature: ��TrI.�J Last Updated:January 2015