HomeMy WebLinkAbout2015-00197 - addition remodel � CITY OF ORONO * z 0 1 5 — 0 PJ 1 9 7 *
� 2750 KELLEY PARKWAY nAT�issvEn: 02/13/2015
'� ORONO, MN 55356-
(952 249-4600 FAX: 952 249-4616
ADDRESS : 945 FOREST ARMS LA
PIN : 07-117-23-12-0019
LEGAL DESC : FOREST ARMS COUNTRY CLUB ADDN
: LOT 000 BLOCK 002
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REV[EW
VALUATION : $ 316,622.00
NOTE: YLEASE FILL[N THE FOLLOW[NG:
VALUATION OF PERMIT:$ 316,622.00
TYPE OF PERMIT THIS PAYMENT IS FOR: ADD[TION REMODEL
PL'RM[T#THIS PRI;PAYMENT IS 1'lED"CO:2015-00198
APPLICANT ADVANCED PLAN REVIEW 1,609.85
TOTAL 1,609.85
EATON, BOB&JENNIFER Payment(s)
2721 COMSTOCK LA N CHECK 13135 1,609.85
PLYMOUTH, MN 55447-
OWIYER City ut llrur �
2150 Kelley Par_kway
EATON, BOB&JENNIFER Orono MN 55356 952-?49-46U0
2721 COMSTOCK LA N kereipt Nu: 3.012804 Feb 13, 2U15
PLYMOUTH, MN 55447-
Rrbert E�ton
Previous Balarice: .UO
AGREEMENT AIVD SWORN STATEMENT Pet�mits
?_015-00197 945 Forest 1,609.8`i
The work for which this permit is issued shall be performed according to AYm5 L2
the approved plans and specitications,applicable City approvals,and the 101-34410
State Building Code. This permit is for only the work described and does P I dil CheCk%S1 te EXefO Fe05
not grant permission for additional or related work which requires separate �
permits. All provisions of laws and ordinances governing this type of work 7�ta 1: ______1,6U9.8��_
shall be compied with whether or not specified herein.This permit will Check
expire and become null and void if construction authorized is not CheCk Nu: 1"3135 1,6U9.85
commenced within 180 days of the date of issuance,or if construction is Payo� :
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Quilding Code.This permit may be
r ked at an ,fir e for due ca
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licant e itee Signature vat� Issued By Signature Date
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CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
�OA, Mailing Address: CJ ""O U �
r VO PO Box 66 Permit number:
Crystal Bay, MN 55323-0066 Date received: 2 1 �j � -r`-,
'ved b : � �'
a Street Address:' -.. --_
�'�. � 2750 Kelley Parkway ��(C;-(✓d( Gi� Plan review fee: , ��
`�'�fSH���G 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 applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: � (J�/,�S �rn� ���
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 Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: ✓ d ��� ��
State License# ;�v-��7 �� Expiration Date:
Phone: cell �� �l. •���, office
Mailing Address: � {1��, �(� Ci : Q.. ZIP: a�
Contact Person: i �� Applicant is: ontractor Homeowner (Circle One)
Email and/or Fax: �fp' � �.2�, ,��,1
PROPERTY OWNER INFORMATION: r -
Name: _ f�' 0� � L�'li'11-C�-1�- �(J�.�UIn
Phone (day): '
Address: C4l_4c, 1'��)Y.Q�✓f C1.1'►'►'tS (,1') City• ('��)YlD ZIP�
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: ZIP�
Email and/or Fax:
PROJECT INFORMATION: Descri tion of ro'ect:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal$
❑New Construction �Single Family with Residence Water Supply
Addition attached garage Gara e/Accesso Bld
' Accessory Building ❑ Single Family with ❑Deckg ry g' ❑Public Sewer
❑Refocation detached garage ❑O�ce/Commercial
❑Other: (specify) ❑Multiple Family/Condo ❑Warehouse ❑Private Sewer
❑Public ❑Storage ❑Public Water
'*Any earth movement may also 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) $ � I� � ���