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Home My WebLink About2015-00232 - adv plan review CITY OF ORONO * 2 0 1 5 - 0 0 2 3 2 * � � 2'750 KELLEY PARKWAY DATE ISSUED: 02/26/2015 � ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 99 SIXTH AVE N PIN : 25-118-23-44-0012 LEGAL DESC : HOLLY ACRES 2ND ADDN : LOT 000 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 43,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 43000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: REMODEL PERMIT#THIS PRE-PAYMENT IS TIED TO: 2015-00232 APPLICANT ADVANCED PLAN REVIEW 413.97 CHOICE WOOD COMPANY TOTAL 413.97 3300 GORHAM Payment(s) ST.LOUIS PARK,MN 55426 CHECK 20172 413.97 (612)924-0043 Minnesota State License#: BUIL-1532 OWNER BRISCOE,MR.&MRS. 99 SIXTH AVE N WAYZATA,MN 55391- AGREEMENT AND SWORI�i 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. 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.1'his permit may be re7�oked any time for d cause. � , \ � ,� ,�. � / / Applic t ermite Si n re Date Issued By Signature Date w ♦ City of Gror�, 2750 Kelley ��rkway 952_zag_4600 Orono MN 55356 Rereipt No: 3.01?871 Fe6 26. 2U15 Choice wood company Previous Balance: •�� Fermits 2015-00232 99 Sixth Ave 413.97 101-34410 Plan Check/Site Exam Fees 1ota1: --------413.97 Check 413.97 Check No: 20172 Payor: Choice wood company 413 a7 Total Applied: Change Tendered: •00 02/26/2015 12:34PM City of Orono �ui�cling Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O� Mailing Address: Permit number: p��.7"U�o� O PO Box 66 � Crystal Bay, MN 55323-0066 Date received: ,� Street Address: iued by: ti�, Gfi 2750 Kelley Parkway �yJ � �� Plan review fee: �,�. , j�KESHO�� Orono, MN 55356 f a a i`7 0��/�- DC��,� 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: Job Site Address: Cl� �,j p 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 City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is availa6le. Non-permitted events will not be allowed. CONTRACTOR/APPLICAN INFORMATION: Name: �J N �R� � State License# 'i3��( r�',�a Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 J Phone: (cell) a (office) q ,� Mailing Address: � City: � ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: Q PROPERTY OWN INFORMATI Name: �� Phone(day): Address: C�T'�N—�-�/ City: � �� ZIP: 5,�� Email and/or Fax: � PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door s Remodel MCWD review&permits: ( ) � ❑ Fire Damage ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) ❑ Re-roof,cedar 15320 Minnetonka Blvd ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.ora Estimated Construction Valuation of Project (excluding land) $ 3 � 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 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 confidential. 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 ' or tion is to a nually update our records and records of other governmental agencies required by law. If ou refuse to su I th i o 'on, t a lication ma not be issued. Applicant's Signature: Date: �'��'�� Owner's Signature: Date: Last Updated:January 2015