HomeMy WebLinkAbout2015-00033 - adv plan review CITY OF ORONO * Z 0 1 5 — 0 0 0 3 3 *
� 2750 KELLEY PARKWAY DATE ISSUED: OUl2/2015
ORONO, MN 55356-
� 952 249-4600 FAX: 952 249-4616
ADDRESS : 2617 CASCO POINT RD
PIN : 20-117-23-24-0035
LEGAL DESC : WINSHIPS SUBD LOT 1 SPRING PK
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOiY TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 200,000.00
NOTE: PLEASF,FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 200,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION TO HOMG
PF.RMI'I'#THIS PRE-PAYMENT IS TIED TO:2015-00034
APPLICAIVT ADVANCED PLAN REVIEW 1,130.73
TOTAL 1,130.73
AMEK CUSTOM BUILDERS Payment(s)
9340 JAMES AVE S CREDIT CARD 0430 1,130.73
BLOOMINGTON,MN 55431-
(952)888-1200
Minnesota State License#: BUIL-20164402
OWNER
MARQUARDT,GARY&JOAN
2617 CASCO PT RD
WAYZATA, MN 55391-
AGREEMENT AND SWORN STATEMENT
"The work for which this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or rela[ed work which requires separate
permits. All provisions of laws and ordinances goveming 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 responsible for assuring all required inspections are
requested in conformance with[he Sta[e Building Code.This permit may be
revoked at any ime for du ause. �
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App i a ermitee Signature ate Issued By Signature Date
.
�' City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address: ����J 3
QA,. PO Box 66 Permit number:
� `v0 Crystal Bay, MN 55323-0066 Date received: � " �z ��
StreetAddress:' Received b : 1 "'"{,1 �
2750 Kelley Parkwa
��' L` Orono, MN 55356 ��� �5`�� �✓'3 Plan review fee: � �.3
tq'�E S HO4� Main: 952-259-4600 T o t a l F e e:
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: 2�p `j CC CO �O�- ��-
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 service will b
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT I�ORlVIVA�TION��. l�
Name: us�u ui/ rS
State License # G J� �/O Z Expiration Date: 3-$�- J$'
Phone: cell -g/Q�fSZ� office 2�$$�-�va
Mailing Address: � p awus . � Cit : ZIP: �
Contact Person: < < Applicant is: Contractor / omeowner (Circle One)
Email and/or Fax: a wS c ' C • C6 w�
PROPERTY OWNER INFORMATION:
Name: �v4 1�' J 4� IMQY'�Ua✓�
Phone (day):
Address: 2Got� C4'Co �,p�v�-� �� City: ��� o ZIP:
Email and/or Fax
ARCHITECT/ ENGINEER INFORM�4TION: r
Name: �-tc Nc�tL� '�412 Lt i�C)s �C
Phone (day): �Z - G - �o/s'
Address: /`j�a �q ��yvqG� City: ��p�S • ZI P: Sj'r'L{I!�
Email and/or Fax:
PROJECT INFORMATION: Description of project:
1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8
Water Supply
❑ New Construction �Single Family with ❑Accessory Bldg./Garage
(�Addition attached garage ❑ Deck ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage Residence ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
"'Any earth movement may require ❑ Commercial ❑ Storage
MCWD review&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.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ 2��� l�C� �
Packet Last Updated: January 2015
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