HomeMy WebLinkAbout2014-01130 - adv plan review CITY OF ORONO
* 2014 - 01130 *
2750 KELLEY PARKWAY DATE ISSUED: 10/02/2014
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1015 TONKAWA RD
PIN 08-117-23-24-0002
LEGAL DESC CARLWOOD
LOT 001 BLOCK 001
PERMIT TYPE ADVANCED PLAN REVIEW
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ADVANCED PLAN REVIEW
VALUATION $ 100,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$100,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: INTERIOR REMODEL
PERMIT#THIS PRE-PAYMENT IS TIED TO:2014-01131
APPLICANT ADVANCED PLAN REVIEW 686.89
OSLO BUILDERS TOTAL 686.89
Payment(s)
6844 POINT DRIVE
CREDIT CARD 5231 686.89
EDINA,MN 55424-
Minnesota State License#: BUIL-637407
OWNER
PARTEN,MARK&JULIE
1015 TONKAWA RD
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 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 issue q` Signature Date
City of Orono
Uuilding Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
�OtY Mailing Address: Permit number: am/ _z�
O PO Box 66
Crystal Bay, MN 55323-0066 Date received: &-07
Street Address: Received by:
S 2750 Kelley Parkway Plan review fee: (�f
Orono, MN 55356
l,9KfSHOC�F
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 sJtibmiffed.
GENERAL INFORMATION:
Incomplete applications will be returned. (Please print)
Job Site Address: '� o W G Q
Will this be a Parade of Homes, Remodellers Showcase Home or other Display Home? El Yes o
ff 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 available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: i \1.
State License# C_- (p3 C) Expiration Date:
Lead Certification Number. n �7 Expiration Date:
(for work on homes that were nstructed prior to 1978 'Vol -1
Phone: (cell) _a-a _ (office)
Mailing Address: Co LALA �A t , City: z A C., ZIP: 3
Contact Person: Applicant is: on ctor / Homeowner (Circle One)
Email and/or Fax: �� �S��b��\�erS cc)
PROPERTY OWNER INFORMATION:
Name: fV_ ` J N9C 01-C-V3
Phone (day): - C1 -7
Address: , -� City: rove ZIP:
Email and/or Fax: Ma e OA��e-,-N C W\\ t(S
VNCP
PROJECT INFORMATION: Overall project description:_ VVI \ te r' cN �' Z �\0d
Type of Project: Any earth movement may also require
❑ Door(s) 'Remodel ❑ Fire Damage MCWD review&permits:
❑ Re-roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑ Re-roof,other(specify) ❑Siding ❑Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
)KWindow(s) www.minnehahacreek.om
Estimated Construction Valuation of Project(excluding land) $ 0 D I Q _6
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
confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the d
Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpos,
intended use of this information is to annually update our records and records of other govemmental agencies required by
you refuse to supply the i ormatio ,thellappliqation may not be issued.
Applicant's Signature: Date: Z
Owner's Signature: Date:
Last Updated:03/06/2013