The URL can be used to link to this page

Home My WebLink About2016-00173 , ' CITY OF ORONO 2750 KELLEY PARKWAY * 2 0 1 6 - 0 0 1 7 3 * DATE ISSUED: 02/17/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3960 BAYSIDE RD PIN : OS-117-23-22�9t1'1�00<<j � � LEGAL DESC : AUDITOR'S SUBD.NO.203 "��t: ,,_ : LOT O55 BLOCK 000 �� 4'� � '``� PERMIT TYPE : ADVANCED PLAN REVIEW ��"'`" PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 300,000.00 NOTE: PLEASE FILL IN THE FOLLOW[NG: VALUATION OF PERMIT:$ 1,540.45 TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00172 APPLICANT ADVANCED PLAN REVIEW 1,540.45 TOTAL 1,540.45 MODERN CONSTRUCTION OF MINNESOTA Payment(s) 621 MAIN ST NW CHECK 1419 1,540.45 ELK RIVER, MN 55330- (763)200-6376 Minnesota State License#: BUIL-BC648528 OWNER LOVELESS,CHRISTOPHER&KATIE 3960 BAYSIDE RD MAPLE PLAIN,MN 55359- 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 construc[ion 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 applic t is responsible for assuring all required inspections are requested' conformance with the State Building Code.This permit may be revoked any time fo due ause. r" �� ,� /��'� j� �, � 1�1 �4� ' v �� f ��.�..�.� �f Sc> 2_ l� � � /U i�"an Permitey ig ature Date Issued By Sign re Date � �. „ . t� � CITY OF ORONO BUILDING PERMIT APPLtCAT10N FOR NEW STRUCTURES OR ADDITIONS � A, Mailing Address: ��_ � � `vQ PO Box 66 Permit number. � Crystal Bay, MN 55323-0066 Date received: �. �7 �l lp a ,. Street Address:' � ��----�_ � �'�� G. 2750 Kelley Parkway ��p'a� �� Plan review fee: 5 r S �k�'SHo�� Orono,MN 55356 �[_, � Main: 952-249-4600 Total Fee: Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completEd in fuil and ali r�quired infoRnation must be submitted. fncomplete applications wilf be returned. (P/ease print) GENERAL INFORMATION: Job Site Address: �� e �' Will this be a Parade of Homes, Remodelers Sho case Home or other Disptay Home? Yes o If yes,a special event peimit is required w#h Police Department and City Councii approval 60 days prior to the eveni. Shuttle bus service wid be required uMess applicant demonstrates sulficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT IN`F,OR ATION: Name: ��s s� _— N►OC��r� �sC�-��'^ A� �1/lr nvl�Sc�s•� i rC State License# f�.��[g �a s� Expiration Date: ,��,��- Phone: _(cell) 95�-�� 7- l F,�7 (o�ce) �6� -aoo�-6 3�� Mailing Address: \�1 ,.v�u,� � j.} ,v,,•� City: CII� R:v.�.� ZIP• �5 3�c� Contact Person: y� � �-,.},,,.. Applicant is: C�p_rtTr'�cf��l Homeowner (Circle One) Email and/or Fax: "e.1 �J yvt� Q,�r �„s.}�w,,.�.,�r �v,✓�. ��,,,� PROPERTY OWNER INFORMATION: Name: �,�c � ��u,c.�tss Phone(day): ��3 � aa9- 5 g�E Address: ,��4s�( L�1� 51.,,,.,,.� i�,'� CitY' �nee �.- ZIP• �'lu 55 3 5� Email and/or Fax LoJ� y'7b C� 1��Ew,�.;( , � -�- ARCHITECT 1 ENGIN�ER INFORMATION: Name: 1 ,�,� +�1�,,,",.� � Phone(day): '76 � 7 K 6 -d o � Address: �d 3�9 Gw,,1.«.1 ��; Cit�,�.,�� Lk � k ZIP' S,�'�3 a Email and/or Fax: _�/,z� T� PROJECT INFORMATION: Descri tion of pro'ect: �� 1.Type of Project 2.Proposed Use 3.Structur Type 4.Sewage Disposal8 Water Supply ,�New Construction �ngle Family with ❑Accessory Bldg./Garage ❑Addition attached garage ❑Deck ❑Accessory Building ❑ Sin fe Famil with ❑Public Sewer ❑Relocation 9 y ❑ �ce/Commercial detached garage 0""Residence �Private Sewer ❑Other:(specify) ❑ Multiple Family/Condo ❑ Retaining Wa11(s) ❑ Public 4-feet or greater ❑Public Water "*Any earth movement may also requlre ❑Commercial ❑ Storage MCWD review&permlts. ❑tndustrial ❑Warehouse `�rivate Well Minnehaha Creek Watershed District(MCWD) ❑Qiher:(SpeCify) ❑Other(specify) / 15320 Minnetonka Blvd Minnetonka,MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www,minnehahacreek.o Estimated Construction Valuation(excluding tand) � ��, �y`� Last Updated: January 20J6