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HomeMy WebLinkAbout2014-01221 - adv plan review CITY OF ORONO 111 I 11111111 11111111112 21111 2750 KELLEY PARKWAY DATE ISSUED: 10/21/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1060 TONKAWA RD PIN : 08-117-23-13-0019 LEGAL DESC : RYAN WOOD : LOT 001 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 75,526.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 75,526.00 TYPE OF PERMIT THIS PAYMENT IS FOR: POOL PERMIT#THIS PRE-PAYMENT IS TIED TO:SWIMMING POOL APPLICANT ADVANCED PLAN REVIEW 569.89 TOTAL 569.89 OLYMPIC POOLS, INC. Payment(s) 135 S ATWOOD STREET CREDIT CARD 7656 569.89 SHAKOPEE, MN 55379 (952)445-7779 Minnesota State License#: BUIL-20458239 OWNER LANSING, WILLIAM&MEGYN 1060 TONKAWA 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 f City of Orono Building Permit Application for a Swimming Pool .0/�, Mailing Address: Permit number: C:741/1-0/tea -_ :°,hr Cr Box 66 I y Crystal Bay,MN 55323-0066 Date received: �Q -2/-/c./ I il:4;`,,,, / 1/44'1%." '„ StreetAddress: =• ed by: 2750 Kelley ParkwayPlan review fee: /'�-�/p�g0Orono,MN 55356 i o r: ee: I' .5-b% 39 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: /d 60 �QJO//,ty t,../A ?D, ©R o/v a . NM/ .y3s- " CONTRACTOR/APPLICANT INFORMATION: Name: ©LT/APic. Poco S State License# Zr,6 3 9 m} Expiration Date: Phone: '9cZ - 7-21-- Z z a p Fax: 15-2-`1,95'- 7$6 7 Address: /3 c A-1,,c.._19 S;, S. City: p ZIP: £ 3 7 4 Contact Person: Contact's phone number 04GE�1 I- 6k-4 1 I VI c of y/20©l sc (,14/1 Applicant is: Contractor Homeowner (Circle One) PROPERTY OWNER INFORMATION: Name: DE LA Ki_ i.-1,C— Phone LCPhone(day): 763.360, 2139 Mailing Address: o ET K.ei Iv ASSCC.i 5001 American 131val„ *I 661.1/ 81Donr' ZIP: 5',5 37 Email and/or Fax di ( gmct ! - s I JJ ENGINEER INFORMATION: J Name: AI;c v.Aki... c,. Phone: 76 3 - Z, ' - 71 Address: o ss : — Cit • . ZIP: SS Email cl ck& re. evil ir,ec,., ,J ,„,to.. Fax: _ PROJECT INFORMATION: 1.5l Dimensions: 4.Accessory to: 5.Pool Type: 6.Sewage Disposal& !2 X I Z. feetWater Supply IJ Single Family 0Above ground 0 Public Sewer 2.Heated? ❑Multiple Family/Condo In-ground yes ❑n° ❑Public ❑Private Sewer 0 Other(specify) 3. Excavated materials will be: ❑Commercial 0 Public Water ❑re oved from site ❑Industrial 6. Retaining Walls? 0 Private Well used on site 0 Other:(specify) ❑Yes ❑no EDOther:(specify) Height Z I Total Cubic Yards Estimated Construction Valuation $ 75,S2-6. o o Last Updated: 10/28/2010 -7-