HomeMy WebLinkAbout2017-00027 - adv plan review CITY OF ORONO * 2 0 1 7 — 0 0 PJ 2 7
2750 KELLEY PARKWAY DATE ISSUED: 01/12/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS 540 WILLOW DR S
PIN 03-117-23-32-0018
LEGAL DESC N/A
LOT 002 BLOCK 001
PERMIT TYPE ADVANCED PLAN REVIEW
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ADVANCED PLAN REVIEW
VALUATION $ 1,105,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 1,105,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00026
APPLICANT ADVANCED PLAN REVIEW 4,352.35
TOTAL 4,352.35
NOR-SON INC Payment(s)
700 LAKE STREET E CREDIT CARD 2752 4,352.35
WAYZATA,MN 55391-
(952)767-7949
Minnesota State License#:BUIL-BC001969
OWNER
BOHLANDER,LAURA
2260 FOX ST
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 •me for due cause.
App scant Permitee Signature Date Issued By Signature Lj Date
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
Mailing Address:
^jO Permit number: ;
PO Box 66
Crystal Bay, MN 55323-0066 Date received: — / —/-7
Street Address:' _._., _ ...
Received by:
�F L: 2750 Kelley Park�ay` �-7 Plan review fee:
!�k@SHOOrono, MN 55356
Main: 952-249 �_.�,�(..
-4600 Total Fee:
Fax: 952-2494616 www.ci.oron6.mn.us
This application form must be completed in full and all required information must be submitted.
GENERAL INFORMATION: Incomplete applications will be returned. (Please print)
Job Site Address: aq W llahl I w e S ,
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes will b� 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 e
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: 4,br-
State License# 1q(oQ Expiration Date: 3//1-
Phone:
/1-
Phone: cell So? Z Z- office)
Mailing Address: (,)4-- City: ZIP: 3
57
Contact Person: C r n Applicant is: ontra or / Homeowner (circle one)
Email and/or Fax: S . C , CUI4
PROPERTY OWNER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
Email and/or Fax /wa{� , P, rg 6il�lrri CD�,I
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone (day):
Address: City- ZIP:
Email and/or Fax:
PROJECT INFORMATION: Descri tion ofproject: Irl) ec�l
1.Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal&
X New ConstructionWater Supply
Single Family with ❑Accessory Bldg./Garage
❑Addition attached garage ❑ Deck
❑Accessory Building ❑ Single Family with El Public Sewer
g y El
❑ Relocation detached garage ❑ Residence J'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) ❑ Other: (specify) ❑ Other(specify)
15320 Minnetonka Blvd
Minnetonka, MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) , lQsj dUb
Last Updated: January 2016