HomeMy WebLinkAbout2012-01192 - adv plan review CITY OF ORONO * 2012 - 01192
2750 KELLEY PARKWAY DATE ISSUED: 11/20/2012
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS 1065 TONKAWA RD
PIN 08-117-23-13-0001
LEGAL DESC AUDITOR'S SUBD.NO.217
LOT 006 BLOCK 000
PERMIT TYPE ADVANCED PLAN REVIEW
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ADVANCED PLAN REVIEW
VALUATION $ 1,000,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 1,000.000
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-01191
APPLICANT ADVANCED PLAN REVIEW 3,871.89
BEBO,JAMES
1065 TONKAWA RD TOTAL 3,871.89
LONG LAKE,MN 55356-
OWNER
BEBO,JAMES
1065 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 tim cause.
. ! —LIZ
Applicant P n itee S Date �DIssued By Signat re Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
40
City of Orono
1750 Kelley Parkway
Orono MN 55356 952-249-4600
Receipt No: 3.008030 Nov 20, 2012
James Bebo
Previous Balance: .00
Permits
Plan Review 3,871.89
101-34410
Plan Check/Site Exam Fees
Total:otal: 3,871.89
Check
Check No: 16540 3,871.89
Payor:
James Bebo
Total Applied: 3,871.89
---------------
Change Tendered: .00
11120/2012 02:07PM-
City of Orono
Building Permit Application
for New Structures or Additions
-�-; Mailing Address: Permit number:
g,0, PO Box 66 _
0 , O Crystal Bay, MN 55323-0066 Date received:
a { ,, Street Address:' --
„j Gti 2750 Kelley Park6�7
1Cp�40 Plan review fee:0Orono, MN 5535
Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mmus
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:
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ' Yes ❑ No
if 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:
State License# Expiration Date:
Phone: (office) (cell)
Mailing Address: City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name:
Phone (day) 1 p 11- c� �%i; — I -rc�_1:
Address: e-yP_r_1U;% i �'r� `y, 7' i7 (1.e_ /J City: ,/l�ir�li ZIP:
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name: I'ZiN
Phone (day): jp f 2, fJ
Address: I C t '3 '� �► ! k` if\. z tJu City: '� �� ,,-� .�) ZIP:
Email and/or Fax:
�✓ —
PROJECT INFORMATION:
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal &
Water Supply
%New Construction i Single Family with Residence
/]Addition attached garage ❑ Garage/Accessory Bldg. ublic Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
"Any earth movement may require ❑ Commercial ❑ Other(specify)
u�
MCWD review&permits. ❑ Industrial rivate Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
$
Estimated Construction Valuation (excluding land)
f