HomeMy WebLinkAbout2016-00757 - advan plan review CITY OF ORONO II II '� �! III. 'Ii III
2750 KELLEY PARKWAY * 20 1 6 - 0 0 7
DATE ISSUED: 06/29/22 011
6
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1175 MOONEY LAKE DR
PIN : 25-118-23-41-0017
LEGAL DESC : MOONEY LAKE PRESERVE
: LOT 8 BLOCK 1
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 1,700,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 1,700,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOUSE
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00758
APPLICANT ADVANCED PLAN REVIEW 5,976.70
CHARLES CUDD LLC TOTAL 5,976.70
Payment(s)
15050 23RD AVENUE N CHECK
MN 55447- CHECK 37629 5,976.70
Minnesota State License#:BUIL-BC635245
OWNER
ADELMAN,TIMOTHY
4545 TRILLIUM DRIVE
MEDINA,MN 55340-
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
City of Orono
2750 Kelley Parkway City of Orono
Orono MN 55356 952-249-4600 2750 Kelley Parkway
Orono MN 55356 952-249-4600
Receipt No: 3.015880 Jun 29, 2016
Receipt No: 3.015881 Jun 29, 2016
Charles Cudd LLC
Charles Cudd LLC
Previous Balance: .00
.00
Permits Previous Balance:
2016-00759 1175 Mooney 2,500.00 Permits
Drive 5,976.70
Lake101-2Dri 2016-00757 1175 Mooney
Lake Dr
Deferred Rev-Developer Deposit 101-34410
Total: Plan Check/Site Exam Fees
2,500.00
Check Total: 5,976.70
Check No: 037630 2,500.00 Check
Payor:
Check No: 037629 5,976.70
Charles Cudd LLC Payor:
Total Applied: 2,500.00 Charles Cudd LLC
Total Applied: 5,976.70
Change Tendered: .00
Change Tendered: .00
06/29/2016 12:49PM
06/29/2016 12:50PM