HomeMy WebLinkAbout2011-00595 - adv plan review CITY OF ORONO PERMIT NO.: 2011-00595
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 07/07/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 3580 WATERTOWN RD
PIN : 32-118-23-43-0003
LEGAL DESC : UNPLATTED 32 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 45,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 45,000
TYPE OF PERMIT THIS PAYMENT IS FOR: IN-GROUND POOL
PERMIT#THIS PRE-PAYMENT IS TIED TO: 2011-00594
APPLICANT ADVANCED PLAN REVIEW 408.20
DOLPHIN POOL&SPA,INC. TOTAL 408.20
3405 N HWY 169
PLYMOUTH,MN 55441-
(612)542-9000
Minnesota State License#:20266452
OWNER
COOK,PETER&KARI
3580 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 conformance with the State Building Code.This permit may be
revoked at any time for due cause.
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
2750 Kelley Parkway
Orono MN 55356 95.52-249-4600
Receipt No: 3.004915 Jul 07, 2011
Dolphin Pool & Spa
Permits
3580 Watertown Rd 408.20
101-34410
Plan Check/Site Exam Fees
Total: --+--408.20
----------
Check
Check No: 8484 408.20
Payor:
Dolphin Pool & Spa
Total Applied: 408,20
------------
Change Tendered: ,00
07/07/11 09:21AM
City of Orono
2750 Kelley Parkway
Orono MN 55356 952-249-4600
Receipt No: 3.004917 Jul 07, 2011
copses
Other Revenue
Copies 2.00
101-34210
General Taxable Sales/Service
Total: 2.00
-----------
Cash 2.00
Payor:
copies
Total Applied: 2.00
Change Tendered: .00
07/07/11 09:26AM
T t��I( Su�v►�i�f- t
City
of Orono LTda� s -`' 0� cc,
Building Permit Application bv\
for New Structures or Additions
Mailing Address:
0, PO Box 66
Permitmumber
Crystal Bay, MN 55323-0066 Datearecelved '7 /
f A, Street Address:' 3ecervedby "�
2750 Kelley Parkway �(�� Ianeeview#ee: -Ob
\ggH�g$ Orono, MN 55356
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: Q _,. d 5�Ozj
Will this be a Parade of Homes, Remod6lers 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 ill be
required unless applicant demonstrates sufficient on-site parking is available. Non permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: �•`c� �ctx �A� I-14- '
State License# Expiration Date: ,goI3
Phone: 9oUa office .3 —30D -47eV3 cell
Mailing Address: p v City: l ZIP: 6-5 Wz
Contact Person: Applicant is: ontractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name:
Phone(day):
Address: 3S4!a2 EtiigT�,e 7 .v Pawo City: O,evAlo ZIP:
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name:
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 ❑ Residence
Addition attached garage ❑Garage/Accessory Bldg. ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
Relocation �- detached garage ❑Office/Commercial ❑Private Sewer
Other.(specify) 1�- m ❑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.m innehahecreek.o
Estimated Construction Valuation(excluding land) $