HomeMy WebLinkAbout2015-00096 - adv. plan review � ..� CITY OF ORONO * 2 0 1 5 — 0 0 0 9 6 *
2750 KELLEY PARKWAY DATE ISSUED: OU23/2015
• ' ORONO, MN 55356-
` (952) 249-4600 FAX: 952 249-4616
ADDRESS : 767 BRIDGEWATER DR
PIN : 33-118-23-12-0089
LEGAL DESC : STONEBAY SEVENTH ADDITION
: LOT 2 BLOCK 1
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 350,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT: $ 350,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PERMIT#TH[S PRF,-PAYMENT IS TIED TO:2015-00093
APPLICA1vT ADVANCED PLAN REVIEW 1,744.98
TOTAL 1,744.98
WOODDALE BUILDERS INC. Payment(s)
6117 BLUE CR DR CHECK 82292 1,744.98
MINNETONKA, MN 55343-
(952)345-0543
Minnesota State License#: BUIL-BC002926
C i ty of ri;���io
2750 Kelley Parkway g52-Z49-4600
OWNER Oror� MN 55356
Stonebrook Development LLC Receipt No: 3.012686 Jan 2;. ?_015
6117 BLUE CR DR
MINNETONKA, MN 55343- Wooddale Builders
Previous Balance: ���
Permits �,744.9�
2015-00097 767
Brid�ewater Dr
AGREEMENT AND SWORN STATEMENT 101-�4410
Plan Gheck/Site Exam Fees
The work f'or which this permit is issued shall be performed according to ------- - --
the approved plans and specifications,applicable City approvals,and the Total: 1,744.`35
State Building Code. This permit is for only the work described and does -----"-------
not grant permission for additional or related work which requires separate Cheek �
permits. All provisions of laws and ordinances goveming this type of work Cheek Na: $2292 �,744..J8
shall be compied with whether or not specified herein.This permit will Payor:
expire and become null and void if construction authorized is not WOOdd81e BU1 LdOY S �,744.98
commenced within 180 days of the date of issuance,or if construction is Total Appl ied:
_.__------
suspended for a period of 180 days at any time after work has commenced. nn
Chanye Tendei�ed:
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. t�p�)
1 !
� 1 Z3 l� r-- L� C`�ti �(:�� ( ( � 2j / �
Applicant Pe rtee Signature Date Issued By Signature Date
.��-�
" . .
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
�O A � Mailing Address: Permit number. 2a ��—
1Y� PO Box 66
Crystal Bay, MN 55323-0066 Date received: -- /
,� Street Address:' �I1 •
y�; G� 2750 Kelley Parkway ���—t�� plan review fee: � �
t,���s�o��, Orono, MN 55356
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: '�(o� j"Z �� �- C.� ; � 7Tf,���i/?�'.
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? 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 seivice will be
required un/ess applicant demonstrates suffcient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT I MATION:
Name: ' L t
State License# � p Expiration Date: 3 3 �
Phone: cell - ,g- office S ,s'OS 3
Mailing Address: Cit � ;,,,,..�T,..�� ZIP: S"'
Contact Person: c�f,�.,.'e 7"e�ti 's Applicant is: Contractor / Homeowner (Circle One)
Emaii and/or Fax: $7zcJ,� Q �.' o n �..,-/E �,-LD�ti s ,Go ra�
PROPERTY OWNER INFORMATION:
Name: �T'o.�.� B,�t.aciC D� v . C L �'
Phone (day): QS .? � 3 y 3�- G S y 3.
Address: G 7 Cit : .�,..µ.� Twlr«ZIP: ,s'
Email and/or Fax ��Tc � G � B„ (,�,9 ao .� ,�;��.�� Ca »---
ARCHITECT/ ENGINEER INFORMATION:
Name: '�
Phone (day): 2 - 3� . Q
Address: // Cit : .r-,,..� 7rv.�,.,�",rZIP: f ,3 y
Email and/or Fax: '- v �. '� c w s . ...�.
PROJECT INFORMATION: Description of project:
1. Type Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8�
New Construction Water Supply
❑ Single Family with Residence
❑ Addition attached garage ❑ Garage/Accessory Bldg. � Public Sewer
❑ Accessory Building 0 Single Family with ❑ Deck
❑ Relocation ched arage ❑ Oifice/Commercial ❑ Private Sewer
❑ Other: (specify) [�ulti le Famil Condo ❑ Warehouse
❑ Public ❑ Storage Public Water
**Any earth movement may also require ❑ Commercial ❑ Other(specify)
MCWD review&permits. ❑ Industrial
Minnehaha Creek Watershed District MCWD ❑ Prlvate Well
( ) ❑ Other. (specify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ 3� Q d Q Q ,