HomeMy WebLinkAbout2012-01056 - adv plan review CITY OF ORONO * z 0 1 2 — 0 1 0 5 6 *
2750 KELLEY PARKWAY �ATE [ssuEn: 10/22/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRI�!3� : 2990 SUSSEX RD
�
PIN : 04-117-23-31-0020 �
.
LEGAL DESC : FOX BEND \
: LOT 3 BLOCK 4
PERMIT TYPE : ADVANCED PLAN REVIEW \
PROPERTY TYPE : RESIDENTIAL \
CONSTRUCTION TYPE : ADVANCED PLAN REV[EW \
VALUATION : $ 130,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 130,000.00
T'YPE OF PERMIT THIS PAYMENT IS FOR: IN-GROUND POOL
PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-01055
APPLICANT
QUALITY POOLS ADVANCED PLAN REV[EW 803.89
10350 WOODHILL BLVD TOTAL 803.89
LAKEVILLE, MN 55044 PAID WITH CC# 4948
(612)985-7665
OWIVER
KELLY,JUSTIN& SUSAN
2990 SUSSEX RD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this perniit 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 whe[her or not specitied herein.This permit will
expire and become null and void if cons[ruction 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 afrer work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the S[ate Building Code.This permit may be
revoked at any time for due cause. �
/ / (� / /
Applicant Permitee Signature DatP Issued By Sign ture Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
16/18/2012 04:17 9529855323 QUALITY POOLS PAGE 62103
�� Ci of Oron � � C '�
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�, Building Permit Application � ��
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. ; for a Swimming Pool
� Mailing Address: :'.�/�!
'Q`�� PO Box 66 �Permit numbsr: � G�/�D$`�jr.`
Q Crystal Bay,MN 55323-0066 Date.•received:: '� � � ����''l�!��! �
a �a. Sh�eetAddress: ReEeiv.ed b : . • � ... .
Y � . . •
� ��' 2750 Kelley Parkway .Plan�reVieVu•fee:,•��, ..g . . . .
��o�' Orono, MN 55366 . 9� ��� ��
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Ma�n: 952-249-460U Fax: 952-Z49-4816 www.ci.oronn.mn.us °�I Fee; „ � � � .
This application form must be completed in full and all required information must be submitted,
Incomplete applicatlons will be returned. (P/ease print)
GENERAL INFORMATION:
Job Site Address: .c� �_ C�u . .
_ � .Q S s �x `�o���C�'d !`10 . � �1/^ ,..
CONTRACTOR/APPLICANT INFORMATION:
Name:
State License# lLArL��,T_ LS /�C,'
Expiration Date:
Phone: – — F�:
Address: ' Ci : ' ZIP:
Contact Person: Contact's phone number ���e�.���
Email o o A licant is: ontracto Homeovmer �c��one� �
PR�PERTY OWNER INFORMATION:
Name: � �.�. _
Phone(day)� . �
Mailing Address: p u SE ZIP: s`
Email and/or Fax
ENGINEER INFORMATION:
Name:
Phone:
Address: Ci : ZIP:
Email Fax:
PROJECT INFORMATION:
1.Pao�Dimensions: 4.p►ccessory tn_ 5.Pool Type: 6.Sew�ge Disposal8�
� � � Water Supply
— � � �"a—�t �Single Family ❑Abwc ground
2•Heated' � ❑Multiple Family/Condo �In-ground ❑ Public Sewer
�y�'� �n° ❑Public �}Private Sewer
3. Excavated materials wlll be: ❑Commeraal ��her(Spedfy)
� ❑ Public Water
�nemoved from s"�te ❑Indus#rial ' 6.Retaining Walls? �Private Well
Q used on site ❑Other:(specify) .
❑yes �no
❑O#her,(specify)
Height__
Total Cubic Yards
� Estimated Construction Valuation $ 3� Q
Last Updated: 10/28/2010 •
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