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HomeMy WebLinkAbout2011-00338 - adv plan review CITY OF ORONO PERMIT NO.: 2011-00338 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 05/13/2011 952 249-4600 FAX: 952 249-4616 1111.4-ss 220 WAKEFIELD RD PIN 36-118-23-31-0010 LEGAL DESC WAKEFIELD FARMS 2ND ADDN LOT 001 BLOCK 001 PERMIT TYPE ADVANCED PLAN REVIEW PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADVANCED PLAN REVIEW VALUATION $ 140,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 140000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT PERMIT#THIS PRE-PAYMENT IS TIED TO:2011-00339 i APPLICANT ADVANCED PLAN REVIEW 842.89 LECY BROS CONSTRUCTION 15012 HWY 7 TOTAL 842.89 MINNETONKA,MN 55345 (952)746-3783 Minnesota State License#:20325555 OWNER DAVIS,RICHARD 220 WAKEFIELD RD 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 Voed at any time fo e. 5 / C3 / /? Applicant Permit a Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono fti.ld-Ing Permit Application__ for New Structures or Additions Mailing Address: 0. PO Box 66 Permit number: Q 0 Crystal Bay, MN 55323-0066 Date received: Jr a. Street Address:' Received by: ��t r Gtiti 2750 Kelley ParkwayPlan review fee: O / 9 4w Orono, MN 55356 kEsxo Main: 952-249-4600 Fax: 952-249-4616 wwvv.ci.orono.mn.us Total Fee: coo// -DOqt 75 This application form must be completed in full and all required information must be sub Itted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: n Job Site Address: �a O �,;a'k� Ci yza 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: L�c y F3�^os 4�rr1 c State License# Expiration Date: 3–,a 1 is Phone: Q _ �y office cell Mailing Address: d Cit . e V ZIP: Contact Person: �„�'c L.Qh r,,-sQt- Applicant is: ontract / Homeowner (Circle one) Email and/or Fax: on c c� 1 6� Goan PROPERTY OWNER INFORMATION: Name: Phone (day): Address: —[2 i� >�� City' ©(�-�rZIP: Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: LQcv } OS Phone (day): Address: 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 ® Single Family with 19 Residence $[Addition attached garage ❑ Garage/Accessory Bldg. ® Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑Relocation detached garage Other: (specify) g g ❑ Office/Commercial El Private Sewer ❑ Multiple Family/Condo ❑Warehouse F`- ❑ Public ❑Storage ® Public Water "Any earth movement may require ❑ Commercial ❑Other(specify) MCWD review&permits. ❑ Industrial ❑ Private 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) $ 40`CXDQ Last Updated: 9/29/2009 - 17-