HomeMy WebLinkAbout2011-00060 - adv plan review . _
CITY OF ORONO PERMIT NO.: 2011-00060
,
2750 KELLEY PARKWAY
, ORONO, MN 55356- �ATE �SSUED: OU3U2011
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 170 BIG [SLAND
PIN : 23-117-23-23-0029
LEGAL DESC : MORSE ISLAND PARK
: LOT 000 BLOCK 000
= NERMIT TYPE : ADVANCED PLAN REVIEW
� PROPERTY TYPE : RESIDENTIAL
iCONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 50,000.00
NOTE: PLF.,ASE FILL IN`Cf IE FOLLOWING:
VALUATION OF PGRM11�: $ �0.000.00
TYPE OF PERMIT TH[S PAYMF_NT IS FOR: BUILDINC ADDITION
PERMIT#"I'I iIS PRE-PAYMGNT IS TIED TO:201 1-00059
APPLICANT ADVANCED PLAN REVIEW 443.14
FSACKES, STEVEN& KAREN
PO BOX 183 TOTAL 443.14
EXCELSIOR, MN 55331-0183
I
City nf Orano
OWNER �75(i Kelley Parkway
` Oror�o M1� 5535fi 952-249-46t)U
BAC`:'-ES, STEVEN & KAREN
PO BUX 183 Receipt No: 3.004456 .)ar� 31, PUIi
EXCFLSIOR, MN 55331-0183
5teve Backes
�CIZGI;MENT ANU SWORN STATEMGNT �r�its
2p11-�06U 17G 8ig Islan 443.14
I'hc w� k lor which this permit is issucd shall bc per�i�rmcd according to d
the apC �oved plans and specitications.applicable City approvals,and thc 1�1—��10
State B iilding Code. l�his permit is for onl��the work describcd and docs �'18t1 �12Ck/SltB EKa91 F2Q5
not gra� ' perntission for additional or rclatcd�vork which rcquires scparatc -----------
permits. AII provisions of la���s and ordinances goveming this type ot�work TOtal: 443.14
shall be compicd with whether or not specitied herein.This pennit will —____---_
expire and become null and void if construction authorized is not �eCk
commenced���ithin 180 days of the date oC issuance,or if construction is ��k �' ��g �F3.14
suspended for a period of 180 days at a�ry time afler work has commenced. pdyOP:
The applicant is responsible for assuring all required inspections are Steve Baekes
reques��d in conformance with the State Building Code.This permit may be T�tdl AppilE�: �__ 443_14
revoked at any time for due cause. ��f3p9@ T81'�eY'E�' .GU
/ / ���—_
Applicant Pennitec Signature Date Issued B��Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� �3�
�
� City af Orono
��- _
Building Permit Application �
for New Structures or Additio ���� /
Mailing Address: � I �o� a 35
0�,�,�.0 PO Bo.66 Pe�m��e��mbe�.
C�„��a� Be,,, MN 55323-0066 De�e � �e�,.ed. f O��2' J �
a �, StreetAddress:' ReCe"'ed °'' 2�T •
�',�, �ti�" 2750 Ka��e,. Pe�kweY P�e� �e..�ev,..ee: ✓,�1 "�i(�C.�
�9,gE�o4�' O�o„o, MN 55356 c?O�l—' .�3
--- Tota� Fee:
Ma�,,: 952-249-4600 Fax: 952-249-4616
Thls applicatio� form must be completed in full antl an required inTormation ust be submittetl
Incomplete applications wlit be retumed. (Please print �
GENERAL INFORMATION: ___- �
JobSiteAddress: � �� �� i ,c� .�- s�G'.���C� � C���ti1c� , �r�.� ; S � ��
W.�� th�5 be a Parade of Homes, Remodelers Showcase Hom e o� other D�sP�ey Home? ❑ Ye5 0
!f yes,a special everrt permit is required with PoliCe Department and City Council approva/60 days prior to the everrt. Shuttle bus service be
required unless applicant demonstratatis sufficient on-site parking is availatrle. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INF�RMATIO •
Nema: �-}-��� �C��es
State License # Expiration �ate.
Phone. � �2 ZS�Il�� �office� �Q�Z fZ�' ,�zlfJ �cell�
Mailing Address. -1 �p n Clty. yl{'\�Gi � Z�P. �s A
Contact Person. _��(��y\ ��(�y� Applicant is. l�ontractor � omeowner �C.�fC�B011Q)
r p /� I' / ��yy��^, � C
Email end�or rax. ��.Y\-t� • " ��.il.-`�`�('� -�� •IINI\���J�'�
PROPERTY OWNER iNFORMA710N:
N e�„a: s{�„'< �- _,� . ° ��€?�
Pno„e �aey�- �G/7 �iy �q3 � �
)� /� /� / /"��,� "`� /� �/
AdCress. Y�"C� FL�i('YYI(..�h //✓� S • 1 / City, �/tfl�✓2PG'loUl(� Z�P, �SYO('
EmaII and�or Fax r��rEj�r `. ��L�.P ��- L���.ti(�U�-^
ARCHITECT/ENGINEER INFORMATION:
Ne..,a: M.,�infll�� Sjr�r.�
PFione �tlay�� ��� ��� —�U� '1___
Add�aS�: Z ��`1 !r'I,�Yi� E'1�-� S� C�tY:�IL���r�-i����h� � ZIP: 'S�5`-/C!�S
Email and�or f ax. p'yb"�/lC��{C�(�(�, (�'_ fL'iyl.� (�r��'
PROJECT INFORMATION:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
❑ New Co„�«„«�o� ❑S��g�e Fem��y w�th R s�de„�e
[�"Add,t,o„ p attached garage Ga�a9e/A«e��o�„ B�d9. ❑ P„b��� Sewe�
�Accessory IJulltling ❑ Sfngle Family wlih ❑ Deck
❑ Ra�o�at�o., defached 9a�ege ❑0�.��e/Comme��.e� �,P��..ete Sewe�
❑Otha�: (�pe��.y) ❑ M„��,P�e Fem��y/Co„do ❑Warenouse
� PUbllc �Jtorage � Publlc Water
"'Any earth movement may require ❑Com m e���e� ❑O�ne��specify)
MCWD review 8�pertnits. ❑ I„d„s«,a� �P��„ate We��
MlnneheM1a C�eak We�e�snea D��«���(MCWD) �O�na�: (�Pa�iry�
18202 M�.,�ezo.,ke B�„d r�j I�C�E' {fcM,�i�(`Cc�'.�r. f
Dasp�a..a�,MN 55391 � C�� n ��J„'
Pho„a: 95Z-471-0590 1�U 6 h ``�Ey �
F e x: 952-471-0682 ��,-
nhwcraek.or
EstimateO l.onstruction Veivation �¢xclutling land, � ��. '��1��
—�T
Les<UPde�ea: 4/26/2011
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