HomeMy WebLinkAbout2015-00956 - adv plan review CITY OF ORONO * 2 pJ 1 5 - 0 0 9 5 6 *
2750 KELLEY PARKWAY DATE ISSUED: 07/28/2015
T ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADllRESS : 2730 SILVER VIEW DR
PIN : 33-118-23-42-0007 '
LEGAL DESC : MEYER DAIRY ADDN
: LOT 006 BLOCK 001
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 10,000.00
NOTE: PLEASE FILL IN TI�FOLLOWING:
VALUATION OF PERMIT:$ 10,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: KITCHEN REMOD
PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-00955
APPLICANT ADVANCED PLAN REVIEW 130.88
TOTAL 130.88
BOYER BUILDING CORPORATION Payment(s)
3435 COUNTY ROAD 101 CHECK 049313 130.88
MINNETONKA,MN 55345
(612)475-2097
Minnesota State License#:BUIL-2988
OWNER
MONSON,DALE&CAROL
2730 SILVER VIEW DR
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit is issued shall be performed according to
the approved plans and specifications,applicable Ciry approvals,and the
State Building Code. 1'his 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 appl' t' responsible for assuring all required inspections are
requ d' c formance ith the State Building Code.This permit may be
re e tim cau e. �r7/
r I Z D t$ / �%�-� l
Applic e itee igna re Dat Issued By Si re Date �
�
1
City of Orono
2750 Kelley Parkway
Orona MN 55356 95?-249-460U
Receipt No: 3.013880 Jul 28. 2015
Boyer Building
Previous Bal<�nce: .00
Permits
2015-00955 G73U 130.�8
Silverview Rd
101-3441U
Plan Check/Site Exam Fees
Total: ----+---130.8fl
Check
Check No: 049313 130.88
Payor:
Boyer Building
Total Applied: 130.88
------------ -
Change Tendered: .�0
---------------
07/28/2015 11:09AM
City of Orono
Building Permit Application for Maintenance 1 Replacement / Remodel
(i.e,. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION}
OAT Mailing Address: Permit number. O� ! "J�`�(� S
� 1 Y PO Box 66
� Crystal Bay, MN 55323-0066 Date received; � /
Stieet Address: ,`�'`'
y�, � 2750 Kelley Parkwa 0�,� � Plan review fee: .-
�' Orono, MN 55356
��k�SH04�
Total Fee:
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 l�retumed. (Please print)
GENERAL INFORMATION:
Job Site Address: 2.��� Si�v{,rvit��d. nro�o M1� �535b
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home� Yes No
If yes,a specia/event pem►it is iequiied w�h Police Depaitmerrt anci City Courta/appivva!60 days p►ior to the ev�ent. Shuttle bus servioe wiU be
iequi►ed uMess applicant demonshates su�cie�on-site paiking is available. Norrpeimitted events will not be allowed.
CONTRACTOR/AP LICAN FORMATION: ^
Name: • � � ,
State Lioense# Expiration Date: 3 3i ��
Lead Certification Number: Expiration Date:
(for work on homes that wene constructed prior to 7978
Phone: (cell) 1012- (085-��D I (office) 9rJ2-'-��5- ZOS�
Mailing Address: ,� City: ;n,.ie.}�y��� ZIP: � 3c f$
Contact Person: � Applicant is: ontracto / Homeowner �c�.��o��
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: �iq,1�t,-414r0� �YlO�I�On
Phone(day): 12- V►
Address: 2�?�p 5;�,,�c��;1,,,,, �, c�ty: Q�ohv z�P: 5535(�
Email and/or Fax:
PROJECT INFORMATION: Overall pro'ect description: ���.� w►��d�c.
Type of Project: Any earth movement may also require
❑ Door(s) emodel ❑Fire Damage
MCWD review�permits:
Minnehaha Creek Watershed District MCVND
❑Re-roof,asphalt Repair ❑Storm Damage 18202 Minnetonka Blvd ( >
❑Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑Re-roof,other(specity) ❑Siding ❑Other:(specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.ora
Estimated Construction Valuation of Project(excluding land) S
APPLICANT 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 knovNedge. 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
confiderrtial. Private data is information which eneraly cannot be given to the public but can be given to the subject of the data.
Confidenti which enera cannot be given to eithher the public or the subject of the data. Our purpose and
intended`use of this 'nformati is t nnual upda ur records and records of other aovemmental agenae required by law. If
ou refuse to orm "o e a tiom m �ot be issued. � ��
ApplicanYs Signature: '� Date: �
OwnePs Signature: Date:
Last Updated:January 2015