HomeMy WebLinkAbout2012-00605 -adv plan review CITYOFORONO * 20 1 Z - 00605 *
2750 KELLEY PARKWAY DATE ISSUED: 06/26/2012
, ORONO, MN 55356-
t (952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1380 FOX ST
PIN : 02-117-23-31-0009
LEGAL DESC : MINNETONKA BLUFFS
: LOT 000 BLOCK 013
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 75,000.00
NOTE: PLEASE FILL IN THE FOLI,OWING:
VALUAT[ON OF PERM(T:$ 75,000.00
TYPE OF PERM[7'THIS PAYMENT IS FOR: REMODEL
PERM[T#THIS PRGPAYMENT IS TIF,D"i'O: 2012-00606
APPLICANT ADVANCED PLAN REVIEW 565.01
ABD Consulting Services, LLC
P.O. BOX 1 F MTKA TOTAL 565.01
MINNETONKA, MN 55345-
Ci�ty i,f Oranu
�750 Kelley Parkaay
Orono MI 55356 952-249-4b00
Receipt hlo: 3.007128 Jun 26, P012
OWNER
ABD Consulting Services, LLC ABD Consulting Services LLC
P.O. BOX I F MTKA
M[NNETONKA, MN 55345- Previaus Balance: ,pp
Persit5
1380 Fox 5treet 565.01
101-34410
AGREEMENT AND SWORN STATEMENT Plan Check/Site Exas Fees
The work for which this permit is issued shall be performed according to r6ta1� �
the approved plans and specitications,applicable City approvals,and [he ��•�i
State Building Code. This permit is for only the work described and does ��k ---"—�---
not grant permission for additional or related work which requires separate ��k �� e�5 �
permits. All provisions of laws and ordinances governing this type of work G��ayorL �J.�1
shall be compied with whether or not specitied herein."rhis permit will qBD Consulting Serviees LLC
expire and become null and void if construction authorized is not Total Appl ied: ��.01
commenced within 180 days of the date of issuance,or if construction is _______________
suspended for a period of I 80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State E3q�lding Code.This permit may be ���
revoked at any time for due cause. �
' /, � /�� i
;�.1/ � y�-� C ��Yr�C C C-j �
%� C�l � � (G ��' ��._
Applicant Permitee S' na re Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE.
. . , City of Orono
� Building Permit Application
for New Structures or Additions
Mailin Address: C��� �,
g,O,j� PO Box 66 Permit number: ��� — �� ���%
� �, �
Crystal Bay, MN 55323-0066 Date received: � �
�N y^':-v
�,,� �( -;` �, , Street Address:� Received by: �
,. � ----
\�',�,t y���,�j„�Gti�' 2750 Kelley Parkw y ,�; G/� -�>(oQJ Plan review fee: �(D S � � f �C� .
�EeH�� Orono, MN 55356 _ � �fj
�-_= Total Fee:
Main: 952-249�600 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: �,��� �jx�j� �y��yj�j�Mi7 . ������ �
Will this be a Parade of Homes, Remodelers Showcase Horne or other Display Home? ❑ Yes �o
If yes, a special event permit is required with Police Deparfinent and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted events will not be allowed.
CONTRACTOR I APPLICANT INFORMATION:
Name: _ _.
State License# Expiration Date:
Phone: (office) (cell)
Mailing Address: f City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER IN OR ATION: ' -
Name: j �L� .
Phone (day): 5 �--S —
ss: ,�j, Cit : ZIP: �
Em ' and/or Fax � ' /Y)
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: City: ZI P:
Email and/or Fax:
PROJECT INFORMATION:
1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal 8�
Water Supply
❑ New Construction [� Single Family with esidence
❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer
❑Accessory Building �ingle Family with ❑ Deck
❑ ocation ��� /f detached garage ❑ Office/Commercial ❑ Private Sewer
Other: (specify) �Y1L�(`U' ❑ 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) $ �i o C)� J