HomeMy WebLinkAbout2010-00793 - adv plan review CITY OF ORONO PERMIT NO.: 2oiaoo�93
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 09/02/2010
952 249-4600 FAX: 952 249-4616
ADD�ESS : 2106 SUGARWOOD DR
PIN : 34-118-23-21-0023
LEGAL DESC : SUGAR WOODS
: LOT 004 BLOCK 004
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 25,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$25,000
TYPE OF PERMIT THIS PAYMENT IS FOR: CONVERT SCREEN PORCH TO 3-SEASON PORCH
PERMIT#THIS PRE-PAYMENT IS TIED TO:2010-00794
APPLICANT ADVANCED PLAN REVIEW 268.45
SUSSEL CORPORATION TOTAL 268.45
654 TRANSFER ROAD
16B PAID WITH CC# 5455
ST.PAUL,MN 55114
(651)645-0331
Minnesota State License#: 1934
OWNER
SCHOMMER,R&E
2106 SUGARWOOD DR
LONG LAKE,MN 55356
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 sepazate
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 t 80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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' Applicant Permitee Signature Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono . ����`;� �,a
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Building Permit Application for Internal Work�.��,� �� ��' �
_ ;r ' (windows, doors, siding, re-roof, etc.)
� Mailing Address: Permit number: v2���'� 7�
O�,L D,�O PO Box 66
Crystal Bay, MN 55323-0066 Date received: %2-�d
a �, Street Address: Received by:
�'� Y� �titi 2750 Kelley Parkway Plan review fee: 8•
�9kESH�4'� Orono, MN 55356 ���p _�U�
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 be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: Z�� �,�����,��;;, ���:,.aJ��"
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No
If yes, a specia!event permif is required with Police Department and City Council approva160 days prior to the event. Shutfle bus service ill be
requiied unless applicanf demonstrates sufficient on-site parking is available. Non-permitted events wil/not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: �"'; :.:°.,�,
�_-;`'
State License# ,� °��,�,,. Expiration Date: � �.
Phone: `� a.��,�j. � office cell
Mailing Address: � ��-R "� � Cit : T� F��J�... ZIP:
Contact Person: � "�,,, Applicant is: o�c�,:r / Homeowner (Circle One)
Email and/or Fax: �,r;, �— ��t' _��;.'� �
PROPERTY OWNER tNFORMATION:
Name: �.€��fa�-'-Q ��6��e�d�t�E��l�-
Phone(day): �j� _ ���, �- -����—
Address: �' x�A �:•�lo'"r�'�r'� w`-�k��"`` �� �=" Ci ' U�r�� ZIP• �'~ �
Email and/or Fax "�
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review 8�permits
❑ Door(s) � Remodel ❑Water Damage
Minnehaha Creek Watershed District(MCWD)
❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55391
❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑ Re-roof ❑ Fire Damage www.minnehahacreek.ora
Overall Project Description: Cp�/v�=;�,.-�-- ��,���� �,,;�;'�.�F ;��i :*,.�°�,;,rf..,�� �,�`��`
Estimated Construction Valuation of Project(excluding land) $ �2����
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 altemative
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..us�of this information is to annually update our records and records of other governmental agencies
re uired b law. If u refus�;Cm su I thc�information,the lication ma not be issued.
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ApplicanYs Signature: ;' ��r � � {`. ` r� Date: `"'� `� ��`'-��
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Last Updated: 05-04-2009 �
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