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Home My WebLink About2016-00991 - advance plan review fee , CITY OF ORONO * z 0 1 6 — 0 fd 9 9 1 * 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 865 FERNDALE RD W PIIY : 02-117-23-44-0006 LEGAL DESC : AUDITOR'S SUBD.NO. l84 : LOT 104 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 45,000.00 NOTE: PLEASE F[LL IN THE FOLLOWING: VALUATION OF PERM[T:$45,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: ATTACHED GARAGE PERMIT#THIS PRE-PAYMENT IS TIED T02016-00992 APPLICANT ADVANCED PLAN REVIEW 428.66 REV[S[ON LLC TOTAL 428.66 Payment(s) 153 E LAKE STREET CHECK 12419 428.66 WAYZATA, MN 55391- (952)540-7150 Minnesota State License#: BUIL-BC639027 OWNER ERICKSON&SHARON NESBITT, STEVEN 865 FERNDALE RD W ORONO, MN 55391- 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 l80 days of the date of issuance,or if construction is suspended for a period of l80 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. � � . � _ � �rf�� U c�._� � � '_..� f �0 � i �i �Cr Applicant ermitee Signatur Date Issued By Signature Date r ' . ' � CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �� Mailing Address: Permit number: �Ql�Q— � � PO Box 66 � Crystal Bay, MN 55323-0066 Date receive�� e y a StreetAddress:' -Reeeived by: ',C.� F '� 2750 Kelley Parkway � �n review fee; , t�,�-FSx��'�* Orono, MN 55356 �a ` _ _.. Main: 952-249�600 ---- --- - Total Fee: ---- Fax: 952-249-4616 w�,�v.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: ��j ��,f�l� � �,� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No lf yes,a special eveni permit is required with Police Department and City Council approval 60 days prior to ihe event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parkrng is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �O}l -�4'1- - ��l►� ��'V15t State License # $�(¢��p2� xpiration Date: � 2p Phone: (cell) q5Z-s`�� - �� (office) n�2-�(s�,2-�� Mailing Address: 153 S�r E Cit : W �-� ZIP: =<2 q Contact Person: IC�V�,� sAuL-r7 Applicant is: ontractor Homeowner (Circle One) Email and/or Fax: (�-�1 irJ �I�lts io►.�rM1 C�nl� PROPERTY OWNER INFORMATION: Name: `3N,4�I� pts��pE f f��g�`�T- Phone (day): Address: �p(�S (� W, City� 012-�?�-1v ZIP� �S3`�� Email and/or Fax ARCHITECT/ENGINEER INFORMATtON: ►vame: �}-J�CA-►�11��l�f �,�Jp =TD/� �t--t�`� Phone (day): Address: City� ZIP� Email and/or Fax: PROJECT INFORMATION: Description of project: ��C�-� �a-��c�-- 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal& ❑ New Construction Water Supply ❑ Single Family with �.�,ccessory Bldg. /Garage �Addition attached garage ❑ Deck ❑Accessory Building ❑ Sin le Famil with ❑ Public Sewer ❑ Relocation 9 y ❑ Office/Commercial detached garage ❑ Residence ❑ Other: (specify) ❑ Multi le Famil /Condo ❑ Private Sewer p y ❑ Retaining Wall(s) ❑ Public 4-feet or greater ❑ Public Water "Any earth movement may also require ❑ Commercial ❑ Storage MCWD review& permits. ❑ Industrial ❑Warehouse ❑ Private Well Minnehaha Creek Watershed District(MCWD) �-Other: (specify) ❑ Other(specify) 15320 Minnetonka Blvd ��a,�� Minnetonka, MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 �nnr�w.m innehahacreek.or Estimated Construction Valuation (excluding land) $ �j �� Last Updated: January 2016