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Home My WebLink About2010-00533 (adv. plan review) , CITY OF ORONO PERMIT NO.: 2010-00533 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE�SSUEn: 06/29/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 3265 CARMAN RD PIN : 20-117-23-14-0011 LEGAL DESC : CARMAN COVE : LOT 005 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTIOIv TYPE : ADVANCED PLAN REVIEW VALUATION : $ 26,000.00 NOTE: PLEASE FILL IN"I'HE FOLLOWING: VALUATION OF PERMIT: $ 26000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING-REMODEL PERMIT#1'HIS PRE-PAYMENT IS TIED TO:2010-00534 APPLICANT ADVANCED PLAN REVIEW 275.44 C N OSTROM AND SON INC TOTAL 275.44 23400 PARK ST PO BOX 758 PAID WITH CC# 1462 EXCELSIOR, MN 55331- Minnesota State License#: 1907 OWNER HECTOR, MARK& BONNIE 3265 CARMAN RD EXCELSIOR, MN 55331- 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 no[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 da[e 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�t any time fo due cause. / � /�� / `� / / Applicant ermitee Signature Date Issue By � ature � ate SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO ��, �� ' 3�,�`� . . City of Orono !,� Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: o?��0"0O 53 Q�O�Q� COrysBtal Bay, MN 55323-0066 Date received: b Zq /� �� ,� �, Sfreet Address: Received by: 5 �',�, �L Gti 2750 Kelley Parkway Plan review fee: �OlD"06 533 �9kESH�4'� Orono, MN 55356 ��s y �� 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. (P/ease print) GENERAL INFORMATION: Job Site Address: �z�5 ��c 2ri � E;r�e.�sr v�� 533/ WII 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 approva!60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficrent on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/AP�IC,ANT 1 FORMATION: Name: �`� 6 Q --�'u' �A1� State License# , 9 t�' Expiration Date: 3 3� Z� 1� Phone: `j�� - � Z-- R b O office cell Mailing Address: 2 �ob p�-rri� Sr Cit :� C�L�S s c�:_. ZIP: S�3 Contact Person: rtv-ifLE�� 5�'�ri Applicant is: Contractor Homeowner �c��ieo�e� Email and/or Fax: X�-n-��0 G�.las-n��"'�- c��NJ PROPERTY OWNER INFORMATION: Name: l''/�� v n!u i� f-F�c-��- Phone (day): "7r�3 - 39 �-$(� �J Address: 3 Z�5 G,�-n�r�--� (��' City: �S«-r��a� ZIP: .��-3.�) Email and/or Fax I�I�riK-Q,SUn!'P/��.c dirl PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits ❑ Door(s) �Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑Siding ❑ Restoration ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: ��1`'tbQ �L -� ,� �/�9}t`� �d� tfl C Estimated Construction Valuation of Project(excluding land) $ a(�O on. � APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • 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 altemative but to reject it until it is complete; • 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 re uired b law. If ou refuse to su I the information,the a lication ma not be issued. , ApplicanYs Signature: `-5��< _� -- Date: � � � /� Last Updated: 05-04-2009