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Home My WebLink About2010-00931 - adv plan review CITY OF ORONO PERMIT NO.: 2010-00931 � -, � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 10/04/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 809 BROWN RD N PIN : 27-118-23-34-0006 LEGAL DESC : UNPLATTED 27 1 18 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 65,000.00 NOTE: PLGASE FILL IN THE POLLOWING: VALUAT[ON OF PERMI"I':$65,000.00 TYPG OF PERMIT THIS PAYMENT IS FOR: BUILDING PGRMIT-POOL PERMIT#'I'I IIS PRE-PAYMENT IS TIED TO: I3UILU[NG PLIZMI�C-2010-00932 APPLICANT QUALITY POOLS ADVANCED PLAN REVIEW 516.26 10350 WOODHILL BLVD TOTAL 516.26 LAKEVILLE, MN 55044 PAID WITH CC# 4948 (612)985-7665 OWNER HAHN, JERAD& LESLIE 809 BROWN RD N LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT Thc work for which this permit is issued shall be performcd according to the approved plans and specifications,applicable City approvals,and the State I3uilding 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 oY laws and ordinances governing this typc of work shall be compied wiU�whether or not specitied herein.This permit will expire and become null and void if construction authorized is not conunenced within 180 days ofthe date oY issuancc,or if construclion is suspended for a period of 180 days at any time atter work has commenced. "I�he applicant is responsible fbr assuring all required inspections are requcsted in conformance with thc State Building Code.This permit may be revoked at anv time for due cause. / / /(./ / � / Applicant Permitee Signature Date Issu y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . - P y, �� " ` --��1� � 1��` S � � City of Orono b �'' � k ��'� � �� Buildin Permit A licatio � �� '� 9 pp � I� 0 for New Structures or Additions �a�. �S Mailing Address: Permit number: /� -�Q Gf� �,L�,� PO Box 66 Q � Q Crystal Bay, MN 55323-0066 Date received: �� O �/O �\'raT � t�`�--�:' a, Street Address:' Received by: � ��y �I �'�L� '` p�Co4�G� 2750 Kelley Parkway Plan review fee: Esx Orono, MN 55356 �U �O _ � � 9� / Total Fee: Main: 952-249�600 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 appfications will be returned. (Please print) GENERAL INFORMATION: . �` Job Site Address: ---�� i��1K-c �� l�'/t� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [�-Pdn If yes, a special event permit is required with Police Department and City Council approva!60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMAT� N: Name: � �� State License# Expiration Date: Phone: _ '�" � (office `� � � � ' cell Mailing Address: �� ? �. ' � :,L ' , Cit : � ZIP:�� Contact Person^ Applicant is: racto ' / Horneowner (Circle One) Email and/or Fax: � _ �u � PROPERTY OWNER INF9RMATION: Name: f�l/� ��Q.�, Phone (day): Address: ��' ,, - , � City� �'`)�,�'� ZIP�4�'��y Email and/or Fax ARCH(TECT/ ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP� Email and/or Fax: PROJECT INFORMATION: 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8� �✓"New Construction ❑ Sin le Famil with �Nater Supply g y ❑ Residence ❑ Addition attached garage ❑ Gara e/Accesso Bld ❑ Accesso Buildin 9 �Y 9• ❑ Public Sewer ry g ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ OfFice/Commercial ❑ Other: (specify) � ❑ Private Sewer ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Othe�: (sp fy) 18202 Minnetonka Blvd �i,3/�..a ��-- Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ ��-� Last Updated: 9/29/2009 j - 17 - � •' f STRUCTURE INFORMATION: , 1. Structure Dimensions 1. Structure Dimensions (continued) 2. Type of Construction a. Length (ft.)= � Number of bedrooms= ❑�W�od/Frame �'Nlasonry b.Width (ft.)= �L7 Number of garage stalls: ❑ Metal Attached = ❑ Pole Bldg. Areas in square feet �� Detached = ❑ ICF ❑ On-site Prefab c. Basement= ❑ Off-site Prefab d. 1 S'Story = ❑ Other(please specify): e. 2"d Story= f. '/z Story = g. Total Area= 'u REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: N ot Enclosed A plicable � ❑ Permit Ap lication � ❑ Pro osed Buildin Plans � ❑ MN State Ener Code Calcufations and Mechanical Code Re uirements Form � ❑ Surve meetin all re uirements � ❑ Sto'rmwater Pollution Prevention Plan � ❑ Hardcover Calculation(s � ❑ Se tic S stem Site Evaluation Re ort ❑ O Access Permit � ❑ Wetland Buffer Im rovement Plan � ❑ En ineered Plans for Retainin Walls 4 feet or above � ❑ Plan Review Fee � ❑ Other APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the information, the application may not be issued. �7 . � ,�s �6�, , AppficanYs Signature: Date: � "� � Last Updated: 9/29/2009 - 18 -