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HomeMy WebLinkAbout2012-01025 - adv plan review 111111111111111111111 nil 1111111111 1111111111111M CITY OF ORONO * 2012 - 0102S * 2750 KELLEY PARKWAY DATE ISSUED: 10/12/2012 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 2645 WATERTOWN RD PIN : 04-117-23-12-0008 LEGAL DESC OLD CRYSTAL BAY ROAD ADDN : LOT 001 BLOCK 001 PERMIT TYPE ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 910,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 910,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-01026 APPLICANT ADVANCED PLAN REVIEW 3,579.39 GORDON JAMES CONSTRUCTION TOTAL 3,579.39 5159 MAIN STREET E P.O.BOX 306 MAPLE PLAIN,MN 55359- (763)479-3117 Minnesota State License#:20531961 OWNER VANOVERBEKE,PETER&AMANDA 2645 WATERTOWN 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 confouriance wi State Building Code.This permit may be revoked ata se. Apflicant Pefffiftee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City -)f Orono 2750 . ley Parkway Orono MN 55356 952-249-4600 Receipt No: 3.007768 Oct 12, 2012 Gordon James Previous Balance: .00 Permits 2012-01025 2645 Watertown 3,579.39 Rd 101-34410 Plan Check/Site Exam Fees Total: 3,579.39 Check 3,579.39_ Check Check No: 101% 3,579.39 Payor: Gordon James Total Applied: 3,579.39 Change Tendered: ~� .00 10/12/2012 11:07AM a 4L.So t%T'rAC RE D Z sET5 LE `;EP _rC- d- ' l SET OF P601- 'X U-Fo . City of Orono Building Permit Application for New Structures or Additions Q O MailiPO Box 66 Permit number: Qy_ 0 Crystal Bay, MN 55323-0066 Date received: Street Address:' Received by: 2750 Kelley Parkwayp, gol d- Bo 9 g Orono, MN 55356 �d C IL j U 1 Ian review fee: L kEs � 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: g6 q,5 6U,4`rERTOctJ_v g0A b 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. E CONTRACTOR/APPLICANT INFORMATION: Name: 66Rlk0/0 S cc'y5;XUCTJ=0-t,-, State License# ' G S3)crG I Expiration Date: 3 - j a0I 3 Phone: q?4-311 `? (office) U/,� 3(o - 3 73 C (cell) Mailing Address: PO sox so !o City: M4N't:F- LhFLn.)ZIP: SS Contact Person: �p-,E yv/c hApplicant is: ontrac or Homeowner (circle one) Email and/or Fax: 'c e ©,,d ctm es, .-, PROPERTY OWNER INFORMATION: Name: PETER + .DA (Ji4,i) 01/ER t3EKC Phone (day): t - a Address: City: ZIP: Email and/or Fax a ma vi a v. . ✓►I ✓a vi o u e 6e k e (-'- a C Ce-+i J-LA-e ARCHITECT/ENGINEER INFORMATION: Name: p F. -P. N_P,,J1V-rN6 d- J!�E S.,T6-✓ Phone(day): (7&3-) 7 FO- yo(n4 Address: QI pD 9A-L7'rr*aRE !T-, arse - -' joe, City: /3CAt.V E ZIP: S5-LM � Email and/or Fax: 'n-Po P cl p des PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& OWater Supply New Construction Single Family with Residence ❑Addition attached garage 9(Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑Office/Commercial XPrivate Sewer ❑ Other:(specify) ❑ Multiple Family/Condo ❑Warehouse ❑ 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.minnehahacM2K0_r Estimated Construction Valuation (excluding land) 9 1 V ( 00o , Packet Last Updated: 03-06-2012 -21 -