HomeMy WebLinkAbout2016-00487 - adv plan review CITY OF ORONO * Z 0 1 6 - 0 0 4 8 7 *
� 2750 KELLEY PARKWAY DATE ISSUED: OS/06/2016
ORONO,MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1885 CONCORDIA ST
PIN : 17-117-23-23-0002
LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 1,200,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 1,200,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00486
APPLICANT ADVANCED PLAN REVIEW 4,611.70
TOTAL 4,611.70
ROBERT CRAIG HOMES INC. Payment(s)
464 2ND ST.#101 CHECK 4204 4,611.70
EXCELSIOR,MN 55331
(952)470-6639
Minnesota State License#: BUIL-8846
OWNER
KAISER,BERNARD&CAROLYN
2855 PROVIDENCE PLACE
INDEPENDENCE, 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 the
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 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 afrer 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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Applicant Permitee Signature Date Issued By Sign ure Date
City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address: permit number:
��A rO PO Box 66
`w C stal Ba , MN 55323-0066
rY Y Date received: c�
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� y ,� 2750 Kelley Parkway C/L ��� Plan review fee:
F c.� Orono, MN 55356 � 20�b '
t'�k�SHo��' Main: 952-249-4600 Total Fee:
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: 18$Cj ����d�o. �_ Dro.10 , m �.1 5534
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 Counci!approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates su�cient on-site parking is avaifable. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: ohl�'t' (ir4t l�dm2S �'n.c.•
State License# $c. e�o N4 Expiration Date: D 31 Zo�
Phone: (cell) letZ.-�q�-�22l0 (o�ce) 4�2-�q� -12.7�10
Mailing Address: �Ev 2"� S�-• Su r�Y �' ��l Cit : �%tGls rb� ZIP: gS3S�
Contact Person: (Zo� �`�eoycn Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax: r�pt�G�$Gr1(fl tD �r++A.1 1 . C.o�
PROPERTY OWNER INFORMATION: • ,
Name: Ca�o►y,� $ , �t�r �1r,Q,�d j�, lta.�5c,r-
Phone {day): (o►Z- l.l d- S�o Z
Address ZQ5_S� Q�ov�1a�c...e. �1q.�4. City: S�lepr.,d,�rc�,ZIP: 553$�
Email and/or Fax C 1�(4,«.r ."7 ��r,�,�l-wn �'aa-d • Go•�+-�
ARCHITECT/ENGINEER INFORMATION:
Name: �jha,�rQc�'4' Ar��9n � Co+�►�ci��1
Phone (day): q5 Z' �"to' 9"f 50
Address: �},IoH Z^ S} sw� e i� Id0 City ��,Qls�r ZIP� w��.1
Email and/or Fax: Ko�roSS� S►'►a.�r4"H'del�i jv+ • Go�
PROJECT INFORMATION: Description of pro'ect:
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 ❑ OfficelCommercial
❑ 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) ❑ Othef(SpeCify)
15320 Minnetonka Blvd
Minnetonka,MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) � � � Zd� � 0 00 � d p
Packet Last Updated: August 2015
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