HomeMy WebLinkAbout2015-01562 - advance plan review fee �� CITY OF ORONO * z 0 1 5 - 0 1 5 6 2 *
2750 KELLEY PARKWAY DATE ISSUED: 12/16/2015
� ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 770 BROWN RD N
PIN : 34-118-23-12-0006
LEGAL DESC : REG. LAND SURVEY NO. 1275
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 300,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERM[T:$300,000.00
TYPE OF PERMIT THIS PAYMENT[S FOR:ADDITION/REMODEL PERMIT
PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-01561
APPLICANT ADVANCED PLAN REVIEW 1,540.45
TOTAL 1,540.45
SCHWARZ BUILDERS INC. Payment(s)
15119 MINNETONKA BLVD CHECK 16415 1,540.45
SUITE 100
WAYZATA,MN 55391
(952)476-6768
Minnesota State License#: BUIL-BC003922
OWNER
HUTTER, ROBI&ALICIA
770 BROWN RD N
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 Ciry 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 respon'ble for assuring all required inspections are
request d in conforman e �th the State Building Code.This permit may be
rev e t any time for ue c use.
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pplicant ermitee Sig ature Date Issued By Signature Date
, ! CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
�i /�� Mailing Address:
�"�` rO PO Box 66 Permit number: 28 �S-- �� �p
Crystal Bay, MN 55323-0066 Date received: /Z — �� - %�
�eceived by: �Z'�
,� StreetAddress:' S � S
��. G.'� 2750 Kelley Parkw 2�� _�� CJ� �Ian review fee: S
��xESH�4� Orono,MN 55356
Main: 952-249-4600 Total Fee:
Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be compieted in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: ? rpwn a
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
If yes,a specia/event permit is required with Police Department and City Counci/approval 60 days prior to the event. Shuttle bus service will be
required unless applicanf demonstrates sutficient on-site parking is available. Non permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
tvame: � warz t.ti�dt�s 2►tc .
State License# 6 C o0 3q aa Expiration Date: 3 3 ao !o
Phone: cell l - 38l0- 8Y� office � - 7 - 7 8
Mailing Address: 5/t ton� O Cit : 'n tf ZIP: 553Y5
Contact Person: Applicant is: ntractor / Homeowner (Circle One)
Email and/or Fax: r 5 wq,rL rs, e�►1
PROPERTY OWNER INFORMATION:
tvame: _ Rob i •l l��i C��I� l�tif/�"�r
Phone (day): �
Address: S Q Cit : jqd erden.�,c z�P: ,5.5359
Email and/or Fax b. ��� - �-. �o
ARCHITECT/ENGINEER INFORMATION:
Name: �l}L Ra���T�crs LLC.
Phone (day): g5 a- �O! - (0 0?!0
Address: (5/l 9 /Y1 i�nG�Onl�4 �ud_ ,SuitC lOd City: /Y�j�n�?fpnl�c� ZIP• 553�/S
Email and/or Fax: r �wt (o� �rnA�( .��rh
'� U
PROJECT INFORMATION: Description of pro'ect: c�r``f%�'+ � ����
1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal8�
❑ New Construction �Single Family with Accessory Bldg./Garage Water Supply
�Addition attached garage �Deck �Public Sewer
❑Accessory Building ❑ Single Family with ❑Office/Commercial
❑ Relocation , detached garage �) Residence ❑ Private Sewer
❑ Other: (specify) �n'�Ltior�tAo�a�'�nn ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
**Any earth movement may also require ❑ Commercial ❑Storage
MCWD review 8 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.mi nnehahacreek.or
Estimated Construction Valuation (excluding land) $ 30�� 0(�Q�, F1(7
Last Updated: January 2015