HomeMy WebLinkAbout2010-00669 - adv plan review CITY OF ORONO PERMIT NO.: 2010-00669
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 08/05/2010
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 4720 WATERTOWN RD
PIN : 31-118-23-22-0005
LEGAL DESC : UNPLATTED 31 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
City of Oicno
PROPERTY TYPE : RESIDENTIAL 2750 Kelley F'arkway
CONSTRUCTION TYPE ADVANCED PLAN REVIEW
Oros: ^"N 55,55 952-249
VALUATION : $ 20,000.00 Receipt No: 3.00030. 7 Aug 05, 01':
NOTE: SEPERATE PERMITS REQUIRED:ELECTRICAL(STATE) Mlehaffey
POLE SHED& 15 CUBIC YARD OF EARTH TO BE MOVED
Permits
2010-00E69 4720 Watertown 220.51
TIED TO PERMIT#2010-00670 Rd
:, -_t441
iar, C eet.rSite Exam Fees
Total: `20.51
Creel.i 6 C?'V
Check Nc-: CCU
ELI:, 2. ,J1 51
Meha tey
Total applied: 220.51
Change Tendered: .00
08/05/110 12:36P
APPLICANT ADVANCED PLAN REVIEW 220.51
JERRY PHILLIP'S CONSTRUCTION TOTAL 220.51
18706 JUNEBERRY RD
MANKATO,MN 56001- PAID WITH CC# 6311
(507)380-4503
Minnesota State License#: 7510
OWNER
MEHAFFEY,MILES&CATHERINE
4720 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
011)14-1114
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is I COJI
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.
' /�1'-66/-10
dY1�u r
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
•
' City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address:
�'�0,� PO Box 66 Permit number: Z(7/ 0 —00470
Crystal Bay, MN 55323-0066 Date received: $ /500
A '441`!: Received b
.01,,;' �. Street Address:' y: IT •
-
��'�L t,igi '.�p�- 2750 Kelley Parkwaypd2O /CI 6°4(17%n review fee: '� c''c O S1'vi CC'
sxo� Orono, MN 55356
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us Total Fee:
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: c7.11 ki-ioA_ r ® 1S
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes rk 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 w�i%be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION: n
Name: 5 - s -�r'� h', t pf t l 6v\
State License # '7 cm Q Expiration Date: 3 i 3► j'ZO(
Phone: V3- - a - Li '-c,3 (office) S 6.,,,t.s� (cell)
• ' `Mailing Address: 1V-1 t) ,--e rr City: ZIP:
Contact Person: v- ��' �rr � � ���''��`� S��`t
• ` it ,\7•� .�- ; •- Applicant is: Contractor / e caner ,(circle One)
Email and/or Fax: ' '(, ___ 1 a C�.
f' ' � ' C -1 ate. ` ��
PROPERTY OWNER I ORMATION: , .
Name:
Q 'e�Phone (day): . ,.
Address: l ` City: Ority ZIP: S-f-3
Email and/or Fax e-k.e. W `� �' i
ARCHITECT/ ENGINEER INFORMATION:
Name: At ra — S
Phone (day): i_
4 Z --S ti t- C( -r'
Address:
AddrEmailandJor Fax: G V1L. Wi-,\-?(-4-e, ` i.IA- City: Wt,Lcv. l'c,t({\ZIP: 'S-S-4.-Z-4
X43 - 1t I -LI/
PROJECT INFORMATION:
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal &
ew Construction Water Supply
❑ Single Family with ❑ Residence;
Addition attached garage Gara e/ • cesso Bldg.
Accessory Building �- g ry ❑ Public Sewer
❑ Single Family with ❑ Deck -
❑ Relocation detached garage E Office/Commercial
❑ Other: (specify) ❑ Private Sewer
❑ Multiple Family/Condo 0 Warehouse
❑ Public ❑ Storage 0 Public Water
**Any earth movement may require ❑ Commercial ❑ Other(specify)
MCWD review & permits. E Industrial Private Well
Minnehaha Creek Watershed District(MCWD) „Other: (specify)
"�++
18202 Minnetonka Blvd ®tSt- ektti
Deephaven, MN 55391 P
Phone: 952-471-0590 p u.re®W
Fax: 952-471-0682
www.minnehahacreek.orq
Estimated Construction Valuation (excluding land) $ a`�,U`
Last Updated: 9/29/2009 'j`d "' ��
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