HomeMy WebLinkAbout2012-00378 - adv plan review CITY OF ORONO * 2 0 1 2 - 0 0 3
2750 KELLEY PARKWAY DATE ISSUED: 05/08/2012
t ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4295 WATERTOWN RD
PIN : 31-118-23-13-0004
LEGAL DESC : UNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 32,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 32000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT
PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00379
APPLICANT ADVANCED PLAN REVIEW 317.36
KANG,RAYMOND&KIMBERLY TOTAL 317.36
4295 WATERTOWN RD
MAPLE PLAIN, MN 55359
OWNER
KANG,RAYMOND&KIMBERLY
4295 WATERTOWN RD
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.1 or due cause.
Sim / /Z 1 i
errnitee Sip. ature Date Issued By Si ature /ThDate
SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED ABOVE.
City of Orono )-6
,k(-\
Building Permit Application 94'
for New Structures or Additions
Mailing Address: Permit number: c! O I a. - 4 0 3 7 9
x`"10 PO Box 66 ` U
Crystal Bay, MN 55323-0066 Date received: `J-0 -1 2--
t �, Street Address:' Received by:
�' , I �ja"/ tiF 2750 KelleyParkway
t I; ,�o Orono, MN55356 Plan review fee: 317. 3,6
�EeHo�' ao l a -00,3 7 g
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: 4- c, lv&-Fe---j4j-w ji-jp
�1 `e 7)6_./1, 3 �'
Will this be a Parade of Homes, Remodelers Showcase Home'or oth' r Display Horde? ❑ 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: 5heOmc�-vl �,ulibc�Y' .1-#16., `
State License# 'Y. /9 Expiration Date: 3`3/ /1 `--
Phone: 300-- 679-3'/3,, 16/24officif3 7- 6,3-0/ 3a ..-,30 -4f/66 (cell
Mailing Address: ,3F //ivy �,S /4-2— / �., , -f City: /i?ci-'/ eR SSo->%/ S 3,
Contact Person: /'4,;,n13%;55 fr Applicant is: Contractor omeowner (Circle one) f'
Email and/or Fax: /'cb,n &Skermc,n�o/J teem /r-" k.:4 , c 1
PROPERTY OWNS INFORMATIOry
Name: rc\
Phone (day): G I Z. w7 -- 6 5 t✓ t—
Address: +2 `(5 Wc.4,--{ ,11 12zi, City: q' 4 /)r/ ZIP: 3---c-3,:.
Email and/or Fax r , 8 , tea,,,. 0 y,,, A... 1 , `r;-)v,, !
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: t(--A - `�' z .5.1 'Pc1. Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal &
Water Supply
❑ New Construction ❑ Single Family with ❑Bosidence
❑¢ddition attached garage Ur-Garage/Accessory Bldg. ❑ Public Sewer
DI Accessory Building ❑ Single Family with ' ❑ Deck
❑ Relocation detached garage ❑ Office/Commercial ErPTivate Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
**Any earth movement may require ❑ Commercial ❑ Other(specify)
MCWD review&permits. ❑ IndustrialPrivate Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify)
18202 Minnetonka Blvd
Deephaven, MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.orq
Estimated Construction Valuation (excluding land) $ -3 .2-tO_ cy 0
Packet Last Updated: 03-06-2012
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