HomeMy WebLinkAbout2016-00839 - adv plan review CITY OF ORONO * Z 0 1 6 - PJ PJ 8 3 9 *
2750 KELLEY PARKWAY DATE ISSUED: 07/19/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS • : 2040 SPATES AVE
PIN <� : 10-117-23-31-0090
LEGAC D�SC : ORA PARK ON LAKE MTKA
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 600,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 600,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED T0:2016-00838
APPLICANT ADVANCED PLAN REVIEW 2,700.70
TOTAL 2,700.70
CITY HOMES Payment(s)
3918 SiJNNYSIDE RD CHECK 1010 2,700.70
EDINA,MN 55424-
(952)486-0567
Minnesota State License#:BUIL-BC673138
OWNER
ammer� Su�ran
2040 SPATES AVE
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 does
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. ����
....
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I
pli �tee Signature ate Issued By Signature Date
City of Orono
Building Permi# Application
. for New Structures or Additions
� Mailing Address: Permit number: y� � - - �
. �Q A TO PO Box 66
`V Crystal Bay, MN 55323-0066 Date received: �
Street Address:' � �p�O '
y ,� 2750 Kelley Parkway L � an review fee: � ��� . �
Ft �,` Orono, MN 55356 0��"
�kE5H0��` Main: 952-249-4600 o a ee:
Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required informa#ion must be submitted.
tncomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: a U .s /�/0 /'V J�3�'1 I
Will this be a Parade of Homes, Remodelers Showcase Hom or other Di play Home? ❑ Yes No
lf yes,a specia!event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service will b
required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT IN ORMATION:
Name:
State License# � Expiration Date: �.� /
Phone: (cel�) (p/2. 3 tP 3. pc�33 (office) q$2 .�f$!p,oSld�—'
Mailing Address: �I 1 Cit : �" 'rv�-- ZIP:
Contact Person: h r i s k. u Applicant is: o / Homeowner (Circle One)
Email and/or Fax: h • / . Ga»-�
PROPERTY OWNER INFORMATION:����
Name: sus�r.v �mn�,�4P�4!
Phone(day): (P�2, �p, $'jq 3 .
Address: S7l�a G�1ow�vs �}�._ S. CitY= M��,n.t��l ZIP:.Ss�lO
Email and/or Fax C�Sa,,,� . d.�,,,�_,.x p, Ga�w,�,.4.. .r�-'�'�
ARCHITECT/ENGINEER INFORMATION: _ � l � �
Name: v v /�c-Q n �nc�r N/G�--T7�S0/'�
Phone (day): , �
Address: 3�p� {L;lw.+e,r l.a,,r�a.� /�/e� S'T���'r7� City:���d,,���'h ZIP:$-s'�f��
Email and/or Fax: �,�K... /��hsbn �(�4,nSoh��q �'Q�
PROJECT INFORMATION: Descri tion af pro�ect: � v � � � ���-�
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
�New Construction �,Single Family with ❑Accessory Bldg./Garage
❑Addition attached garage ❑Deck �,Public Sewer
❑Accessory Building ❑ Single Family with ❑Office/Commercial
❑ Relocation detached garage �Residence ❑Private Sewer
❑Other: (specify) ❑ Multiple Family/Condo Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
'*Any earth movement may require ❑Commercial ❑Storage
MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other:(specify) ❑Other(specifyj
15320 Minnetonka Blvd
Minnetonka,MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) � �,('�� ��
Packet Last Updated: August 2015
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