HomeMy WebLinkAbout2015-01177 - advance plan review fee CITY OF ORONO * 2 0 1 5 - 0 1 1 7 7 *
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2750 KELLEY PARKWAY DATE ISSUED: 09/16/2015
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• ORONO, MN 55356-
(952 249-4600 FAX: (952) 249-4616
ADDRESS : 3898 CHERRY AVE
p[�1 : 08-117-23-33-0085
LEGAL DESC : CRYSTAL BAY VIEW
: LOT 000 BLOCK 003
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 30,500.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$30,500.00
TYPE OF PERMIT THIS PAYMENT IS FOR: DETACHED GARAGE
PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-01177
APPLICANT ADVANCED PLAN REVIEW 325.90
TOTAL 325.90
ENEVOR, SHAWN& BRIDGETT Payment(s)
3898 CHERRY AVE CRED[T CARD 9379 325.90
MOUND,MN 55364-
Minnesota State License#: BUIL-8846
OWNER
ENEVOR, SHAWN&BRIDGETT
3898 CHERRY AVE
MOUND,MN 55364-
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
Sta[e Building Code. This permit is for only the work described and does
no[grant permission for additional or related work which requires separate
permits. AII 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 responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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IApplicant Permitee Signature Date Issued By Signature Date
,. CITY OF ORONO
' BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
���T Mailing Address: �(���-b/�
1 VO PO Box 66 P��number:
Crystal Bay,MN 55323-0066 Date received: 9- /s'_/
StreetAddr�ss:' ry�bY� /��� p
'y�, G� 2750 Kelley Parkway p�-� plan reviewfee: � ,�'j�
Orono, MN 55356 i �C� J
j'kESHo��' ���J" ����7�
Ota ee:
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. (Please print)
GENERAL INFORMATION:
Job Site Address: '�j�q� (� �,�y �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No
If yes,a special event permit is requi�d with Police Department and City Council appioval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufBcient on-site parking is available. Non permitfied events will not be allowed.
CONTRACTOR/APPLICANT INFORM�4TION: �
Name: '�-OF�T G l� I �� c� i3
State License# '�,vpn ��:�� Expiration Date: 3y ZQ j
Phone: (cell) Ca1 Z ' �{q'�� i'ZZla (office) 5�r►n�
Mailing Address: q�µ Z�' �r i�1 D► Ci � '���0� ZIP� 5535�
Contact Person: _�Dg Apphcant is: n r / Homeowner (Clrcle One)
Email and/or Fax: Q,,b���, t,, �> ��� • C�,.,.�
PROPERTY OWNER INFORMATION:
Name: ��-H13t�A/�I�1Z1���•T7 �n�Vvr�c..
Phone(day):
Address: City• Z�P.
Email and/or Fax '
ARCHITECT/ENGINEER INFORMATION:
Name: ��-hh-�R.P� i�sy�,a.�
Phone (daY): q��.� �.}1 v , c�� S t�
Address: 4(04 Zr'� �°T #�� City•�.t-�c,l1o � ZIP� Ss��l
Email and/or Fax:
PROJECT INFORMATION: Descri tion of ro�ect:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8
�New Construction Water Supply
❑ Single Family with ❑ Residence
❑Addition attached garage �Garage/Accessory Bldg. �Public Sewer
Q Accessory Building ❑ Single Family with Deck
❑ Relocation detached garage ❑ Office/Commercial
❑ Other: (specify) ❑ Multi le Famil /Condo ❑ Private Sewer
p y ❑Warehouse
❑ Public ❑Storage ❑ Public Water
"*Any earth movement may also require ❑ Commercial ❑ Other(specify)
MCWD review 8 permits. ❑ Industrial ❑ Private Well
Minnehaha Creek Watershed District(MCWD) [7�}.Other: (Speafy)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590 �'�V��
Fax: 952-471-0682
www.minnehahacreek.or ��� �,"
Estimated Construction Valuation (excluding land) � j��; ��'�