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Home My WebLink About2016-00676 - adv plan review CITY OF ORONO * Z 0 1 6 - 0 0 6 7 6 * ..`' 2750 KELLEY PARKWAY DATE ISSUED: 06/14/2016 � ORONO,MN 55356- 952)249-4600 FAX: (952)249-4616 ADDRESS : 115 SMITH AVE PIN : 02-117-23-21-0016 LEGAL DESC : ORONO ORCHARDS : LOT 063 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW ACTIVITY . VALUATION : $ 4,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 4,000.00 TYPE OF PERMIT THIS PAYI�NT IS FOR: BATH REMODEL PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00677 APPLICANT ADVANCED PLAN REVIEW 70.45 RAM HOMES INC TOTAL 70.45 5524 DICKSON RD Payment(s) MINNETONKA,MN 55391- CREDIT CARD 3180 70.45 OWNER MILLER,THOMAS 115 SMITH AVE WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT 1'he work for which this pertnit is issued shall be perfortned 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 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. / / Applicant Permitee Signature Date Issued By Signature Date . • CITY OF ORONO �f D. 3 � r BUILDING PERMIT APPLIC�4TION FOR NEW STRUCTURES OR ADDITIONS �O/�� Mailing Address: � ` �O PO Box 66 Permit number. 0��j - � Crystal Bay, MN 55323-006 �� Date received: �P� ! `a-l (,o C �� I� Received by: � �, Sfreet Address:' y�. : 2750 Kelley Parkway � �� Plan review fee: p2� - U � ��kESH��G Orono, MN 55356 � Main: 952-249-4600 Total Fee: 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: /is Sv�� I,vG o Rr��' Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No /f yes,a specia/event permit is required with Police Department and City Council approval 60 days prior to the evenf. Shutt/e bus service wi//be required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ��N�w�c.5 '�C State License # � $qo 1�3 Expiration Date: 3 �r� Phone: (cell) (�iz-23g•,1,SZ (office) — Mailing Address: S�y ��-Y-�� 2� Cit : ZIP: 5'S3�t� Contact Person: �^'�L�Lc�• Applicant is: ontra / Homeowner Email and/or Fax: `Z��"�MS�,� �j� �r�I�-i,ca� (Circle One) PROPERTY OWNER INFORMATIq,l�: Name: ��tC; ��C.��+-� Phone (day): (,tt• y i`i =5 Sz-7 Address: .. ��5 S+^�titT1 vG- City: ��'*'A ZIP� �533'1 Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: Cit : ZIP: Emai� and/or Fax: PROJECT INFORMATION: Description of ro'ect: 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal& ❑ New Construction �Sin le Famil with �Nater Supply g y ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck ❑Accessory Building ❑ Sin le Famil with ❑ Public Sewer g y ❑ Office/Commercial ❑ Relocation (� D' detached garage ❑ Residence ❑ Other:(specify) `KE,f'�Df3C:.L(�'({� ❑ Multiple Family/Condo ❑ Retaining Wall(s) � Private Sewer ❑ Public 4-feet or greater �Public Water **Any earth movement may also require ❑ Commercial ❑ Storage MCWD review 8�permits. ❑ Industrial ❑Warehouse Minnehaha Creek Watershed District(MCWD) ❑ Other: S eCi ❑ Pflvate Well 15320 Minnetonka Blvd � P �� ❑ Other(SpeCify) Minnetonka, MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ 7��^ Last Updated: January 2015