HomeMy WebLinkAbout2016-01376 - detached pool house CITY OF ORONO III 1 1111111 11 0 1 111 1111 II
2750 KELLEY PARKWAY DATE ISSUED: 10/28/2016
ORONO, MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 1125 PINE VIEW DR
PIN : 28-118-23-42-0007 •
LEGAL DESC : PINE VIEW
: LOT 1 BLOCK 1
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 25,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 25,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: DETACHED POOL HOUSE
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-01375
APPLICANT ADVANCED PLAN REVIEW 281.89
• TOTAL 281,89
OUTDOOR EXCAPES,INC. Payment(s)
2345 DANIELS STREET CREDIT CARD 4948 281.89
LONG LAKE,MN 55356-
(952)926-6899
Minnesota State License#:BUIL-20630819
OWNER
NYQUIST,MATTHEW&JENNIFER
6126 MAIN STREET W
MAPLE PLAIN,MN 55359-
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
11WIA
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Appli ant '"" • atu = Date Issued By tgnature Date
f CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
��O A , Mailing Address: Permit number: c is 0 � '0 13 �
�
PO Box 66 /
Crystal Bay, MN 55323-0066 Date received: O f2�5 I 1 1e
A S. Street Address:' Received by: D
1‘.e\ 1, c'\:'" 2750 Kelley Parkway 0 1 it -7 _ Plan r view fee: 8/. 89
tlkEsHo��` Orono, MN 55356 13 (r, _�
Main: 952-249-4600 To al Fee:
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: \\2S ;, vt\e„. ntvr_.____
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes I I 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: Ou:-69ca- c ..e9 r
State License# —C S3 c('5'.3 Expiration Date: 3/../7`$'
Phone: (cell) -7(0S-2- - 2.-('Z9 (office) ei2-9 (62(1? )(l•(
Mailing Address: '2-3't _ �<.te.ts ►c_._- Cit : L,,,„ Lr., ZIP: .Sc3
Contact Person: eS Applicant is: ontrac j/ Homeowner (Circle One)
Email and/or Fax: k fvec e-o�., .64r c5:c,„rte
PROPERTY OWNER INFORMATIO :
Nome: ✓,Kcr A - ;\(.7,:n.-\.t'
Phone (day): is 2-22/ rZ
Address: I\2S - vi' N)N=v City: C)(-0(. . ZIP: S3.j-L)
Email and/or Fax pty ,�;c-( e.cp,,\.�e„-
ARCHITECT/ ENGIN ER INFORMATION:
Name: , _ Lc:NZ
Phone (day): `is2--e 2c12_,--9-7 1 '2
Address: 'Z3yc .br.4 _& S' eke City: (,.cr LCL ZIP: sc -
Email and/or Fax: 0,(%.,}z..fin„,- „(2x.e r c„;...._
19 PROJECT INFORMATION: Description of project: co o s �Q -0
1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal &
Water Supply
❑ New Construction ❑ Single Family with ccesSOry BI /Garage
❑Addition attached garage ❑ Deck ❑ Public Sewer
,Accessory Building ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage ❑ Residence ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
**Any earth movement may also require ❑ Commercial ❑ Storage
MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) "O her: (specify) ❑ Other(specify)
15320 Minnetonka Blvd ` \' AS
Minnetonka,MN 55345 /�.—
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.orq
Estimated Construction Valuation (excluding land) $ Z'4
Last Updated: January 2016