HomeMy WebLinkAbout2010-01159 - adv plan review CITY OF ORONO PERMIT NO.: 2010-01159
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 1 U30/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 2740 ETHEL AVE
PIN : 20-117-23-24-0010
LEGAL DESC : CASCO HEIGHTS
: LOT O10 BLOCK 002
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 50,000.00
NOTE: PLEASE FILL IN TI IG FOLI.OWING:
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VALUATION OF PERMIT: $ 50,000.00 �r`�r�� M� "���'
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TYPE OF PERMIT THIS PAYMF,NT IS POR: BUILDING PF,RMIT
PERMIT#1�HIS PRE-PAYMENT IS T[ED TO:2010-00160
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APPLICANT ADVANCED PLAN REVIEW 443.14
VICKNAIR, LANCE& RHONDA TOTAL 443.14
2740 ETHEL AVE
WAYZATA, MN 55391
OWNER
VICKNAIR, LANCE& RHONDA
2740 ETHEL AVE
WAYZATA, MN 55391
ACREEMENT AND SWORN STATEMENT
The work lor�vhich this permit is issued shall be performed according to
the approved plans and specitications,applicable City approvals,and the
State Building Gode. This permit is for only the work described and does
not grant permission for additional or related��ork which requires separate
permits. All provisions ot�laws and ordinances governing this type ofwork
shall be compied with whether or not specitied herein.This permit will
expire and become null and void if construc[ion authorized is not
commenced within I 80 days of thc date of issuance,or if construction is
suspendcd for a period of 180 days at any time atter work has conunenced.
"Che applicant is responsible for assuring all required inspections are
r -in- � ee with the State Building Code.This pennit may be
revo�ed at any[ime for du ause. .
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� icant P mitee Signature Date Issue [3y „ ature te
SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO .
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� City •f •r�n• �v� �al�
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number: a�d�0"4l�lv�
Og,�,�.0 PO Box 66
� Crystal Bay, MN 55323-0066 Date received: �l"�—��
,� �' ��?,; ,, Street Address: Received by:
�'�n ' '�� ���' 2750 Kelley Parkway Plan review fee: �3• �
r9kESH0¢� Orono, MN 55356 0��5 q
Total Fee:
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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: y�/�
Job Site Address: �'ej�(� � ���� ,���� (,���' ���L; /�' � ��J��'�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [�filo
If yes, a special event permit is required with Police Department and City Council approva/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,LICANT INFOp�ATION: �`
Name: �i,�tC c� (s'j C�yt cGf l�
State License# Expiration Date:
Phone: (office) (cell)
Mailing Address: Cit : ZIP:
Contact Person: Applicant is: Contractor / Ho eow er- Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMA ION: t
Name: �.e�'1'1C_E' ��G��� {�
Phone (day): , � � . �a ,�
Address: 2'7siCy �--�-/�� /,�_ City: L.�f«'r1,2� ZIP: �J�:��'j' )
Email and/or Fax L��.1�r�=�o �. t�oc,�i�3te�,WT2c"r��:c �G-�'n'� r
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review 8�permits
�Door(s) �Remodel ❑Water Damage
Minnehaha Creek Watershed District(MCWD)
�Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55391
❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑ Re-roof ❑ Fire Damage www.minnehahacreek.orQ
Overall Project Description:
Estimated Construction Valuation of Project(excluding land) $ ��, � s�
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they
are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative
but to reject it until it is complete;
• Some or all of the information that you are asked to provide on this application is classified by State law as either private or
confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the
data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our
purpose and intended use of th�n.far.mation is to annually update our records and records of other governmental agencies
re uired b law. If ou re o su I the`infi�rmation,the a lication ma not be issued.
ApplicanYs Signature:- Date: �� � ��
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Last Updated: 05-04-2009