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Home My WebLink About2012-00722 - adv plan review CITY OF ORONO * z 0 1 z - 0 0 7� 2750 KELLEY PARKWAY DATE ISSUED: 07/27/2012 � ORONO, MN 55356- • (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3443 CRYSTAL PL PIN : 17-117-23-43-0005 LECAL DESC : NAVARRE HEIGHTS : LOT 002 BLOCK 002 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL COIVSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUAT[ON : $ 120,000.00 NOTE: YLEASE FILL 1N"I�HE FOLLOWING: VALUATION OF PERMIT: $ 120,000 TYPE OF YERM[T THIS PAYMENT IS FOK: NGW HOME NERMIT#T�IIS PRG-PAYMENT IS TIED 1'O: 2012-00722 APPLICANT ADVANCED PLAN REV[EW 764.89 GULLICKSON, FRITZ TOTAL 764.89 3443 CRYSTAL PL WAYZATA, MN 55391- Cit�y of llrono OWNER 2754 Kelley Parkway Oror� M�I 55356 952-249-46G0 GULLICKSON, FRITZ 3443 CRYSTAL PL � Receipt No: 3.007313 1u1 27, 2012 WAYZATA, MN 55391- Fritz Gullickson Previous Balanre: .04 AGREEMENT AND SWORN STATEMEIVT Gernits Thc work for which this permit is issued shall be performed according to 2412-00722 34�43 Crystal 7�.89 the approved plans and specitications,applicable City approvals,and the Plaee State Building Code. This permit is for only the work described and does ip�'��ld not grant permission for additional or related work which requires separate Plan Cheek/5ite Exa� Fees'__ �___ pennits. All provisions of laws and ordinances governing this type of work TOtdl: 7�1.B� shall be compied with whether or not s��cified herein.This permit will �____ _� expire and become null and voi�t;c�,struction authorized is not ��k commenced within 180 days of,Hfe�1ate �issuance,or if conslruction is �h�� 311� 7�.89 suspended for a period of I80 da,� any time after work has commenced. PgYpp; The.applicant is respons'ibt � �assuring all required inspections are Fritz 6ulliekson requested in conform �� ith[he State Building Code.This permit may be TOtdl App11E�: 7�F.8`� revoked at any ti o ue cau . -.: - � Z� �� , A yi�ant Pennitee Signa re Da � � �� """�� -a`� � Issued By S�g ature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �ity of Orono . � Building Permit Application for New Structures or Additions Mailing Address: Permit number: O�j,O,�.O PO Box 66 � Crystal Bay, MN 55323-0066 Date received: l� .� //Z � ,� ��' � �, StreetAddress:' Received by: c:�� '.�, y� Gti`S' 2750 Kelley Parkway Plan review fee: � �'(� �/. �r ��kESH�4'� Orono, MN 55356 Total Fee: 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 a plications will be returned. (Please print) GENERAL INFORMATION: 3�� ,.� Job Site Address: ./�(,��, �'� i4`'�� Will this be a Parade of Homes, Remtidelers Sh wcase Hom 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 be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APP ICANT INFORMATION: Name: r�. � �,� State License# - Expiration Date: Phone: �� office cell Mailing Address: �C,' Cit : ZIP: �- ' Contact Person: Applicant is: Contractor / Homeowner �c��ie o�e� Email and/or Fax: PROPERTY OWNER FORMATION: Name: •-� � �.�..6,L"� Phone (day): Address: ��-� � City: �jt,��,r'✓ ZIP: ��% � Email and/or Fax �� I 7��-�=r�1�� ' �_�, �_ t= _�> �.,L�' �'�� '' �-�:�:��, � ARCHITECT/ENGINEER INFORMATION: Name: �� ,: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & Water Supply � New Construction �Single Family with �Residence ❑ Addition attached garage ❑ Garage/Accessory Bldg. �Public Sewer ❑ Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage �Public Water "`Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review& permits. ❑ Industrial ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ / ��--��/'G�� , Packet Last Updated: 03-06-2012 -21 -