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Home My WebLink About2011-01002 - screen porch CITY OF ORO O PERMIT NO.: 2011-01002 2750 KELLEY P�R AY ORONO, MN 53 fi- DATE ISSUED: 09/06/2011 952 249-4600 FAX: 95 249-4616 � REPRINTED ON /6/201 1 ADDRESS : 4465 BAYSIDE RD PIN : 06-117-23-21-0006 LEGAL DESC : JOHNSON WHEELER 1 ST ADDN : LOT 001 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 2,000.00 N01'E: PAID$49.00 CK#2212,OVERPAID BY$1.06 WHICH WILL BE DEDUCT D FROM PERMIT#201 1-01000. VALUATION OF PERMIT: $ 2,000.00 TYPE OF PGRMIT THIS PAYMENT IS FOR: SCREEN PORCH PERMIT#THIS PRE-PAYMENT IS TIED TO:2011-01000 APPLICANT ADVANCE PLAN REVIEW 49.00 CARLSON, ROBERT 4465 BAYSIDE RD TOTAL 49.00 MAPLE PLAIN, MN 55359- OWNER I CARLSON, ROBERT '� 4465 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 [he 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 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. / / / / Applicant Permitee Signature Date Issued�y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OT ER THAN DESCRIBED ABOVE. I C i ty of O ro 0 Building Perr�it A plication - � for New Structures r Additions Mailing Address: ��(� -- �.'f�� /�.,O,j� PO Box 66 Permitnumber: � � Crystal Bay, MN 55323-0066 Qate recei�ed: � '- � �' �� ` Received by: 1,a q �t�-: �,�; Streef Address:' �— � -' �'1 ��' �' �`�� ti% 2750 Kelle Parkwa oc:� ,�/g � q# �' „i a��a c, Y Y ��J Plan review fee: '� ��`� '� Orono, MN 5535 Dl� ' C'� \�'�Esxo�``'� �z a Pa s��.D1�-F��t�us+-�-r�s+� `yc�u r.�s:�-�. ' — � �� Total Fee. Main: 952-249-4600 Fax: 952-249-4616 www.ci.oro o.mn.us This appfication form must be completed in full and all r quired information must be submitted. fncomplete appiications will be ret rned. (Please print) GENERAL INFORMATION: Job Site Address: �y� fj�i� ;� S�� < Will this be a Parade of Homes, Remodelers Showcase Hortne r other Dispiay Home? ❑ Yes ❑ No If yes, a specia!event permit is required with Police Department and City Council appr val 60 days pnor to the event. Shuttle bus service will be required unless applicant demonstrates su�cient on-srte parking is available. Non-per ifted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: State License# L-�C� Expiration Date: Phone: ' office (cell Maifing Address: City: ZIP: Contact Person: Appfic nt is: Contractor / Homeowner (CircYe One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: /{ �� T ��,C�S�n Phone(daY)� �_ �5-�� c7/-/�� Address: �/ i �r Y Si r /zc-�� Cit : �� ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: — Phone (day): Address: Cit : ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use . Structure Type 4. Sewage Disposal 8� Water Supply ❑ New Construcfion ❑ Single Family with Residence �Addition attached garage Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building ,��Single Family with Deck ❑ Relocation � detached garage Office/Commercial �rivate Sewer �Other. (specify)��i�� v C'C?� ❑ Muitipfe Famify/Condo Warehouse ��f¢�r�> ,' D/�t/ �X i 5 7-i�t� ❑ Pubiic Storage ❑ Public Water ""'Any earth movement may require / ❑ Commercial ther(specify) L` MCWD review& permits. ��'�'h ❑ Industrial cF n �a (7 �Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other:(specify) 18202 Minnetonka Blvd , �/ � X � S � l�"�5 Deephaven, MN 55391 Phone: 952-471-0590 �� C' � Fax: 952-471-0682 www.minnehahacreek.or Esfimated Construction Vafuation (excluding land} $ I p � `""