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HomeMy WebLinkAbout2011-00597 - adv plan review � t CITY OF ORONO PERMIT NO.: 2011-00597 2750 KELL�Y PARKWAY ORONO, MN 55356— DATE �SSVEu: 07/07/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3315 GRAHAM HILL RD PIN : OS-117-23-I1-0007 LEGAL DESC : GRAHAM HILL PRESERVE : LOT 000 BLOCK 000 - ;,; ,;� _-._ PERMIT TYPE : ADVANCED PLAN REVIEW t�:��1 Ke�i�y =a, ,; . �:_�r-�U MN 55u�c. -- - - PROPERTY TYPE : RESIDENTIAL -��- � - =-- CONSTRUCTION TYPE : ADVANCED PLAN REVIEW ��-��zpt Nu: -_, - VALUATION : $ 1,450,000.00 - - - - �,_:. NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT: $ 1,450,000.00 -��..• c��3,;�;,; ;-;ii; �� _ 1u1-34�1Ca . .._� TYPE OF PERMIT TFI[S PAYMENT IS FOR: NEW HOME r"lan ChecklSite Exam Fees PERMIT#"I'HIS PRE-PAYMENT IS TIED TO: 2011-00598 T����I' ` �r�l.�'- .�r���k =______--=_ Check No: Oc1345 5,U41.�; F'ayor•: � Char�les Cudd -ota: Appl ied: 5,G41.9� -----------.. _;;3fit;2 TiY�u�t'2C�: APPLICANT ADVANCED PLAN REVIEW 5,041.89 CHARLES CUDD LLC TOTAL 5,041.89 15050 23RD AVENUE N PLYMOUTH, MN 55447- �) Minnesota State License#: 20635245 OWNER HEURUNCT, MARK& SUE 225 6TH ST S#2900 MiNNEAPOLIS, MN 55402- AGREEMENT AND SWORN STATEMENT The work for which this permit is issucd shall be performed according to thc approved plans and specifications,applicable City approvals,and the State E3uilding 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 goveming this type of work shall be compied with whether or not specitied herein.This permit will expire and become null and void it�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 after work has commenced. The applicant is responsible for assuring all required inspections are requestcd in conformance with the State E3uilding Code.This permit may be revoked at any time for due cause. / / / / ApplicanC Permitee Signature Date Issued E3y Signature Date SEPARATE PERM[TS REQU[RED FOR WORK OTHER THAN DESCRIBED ABOVE. � } City of Orono Building Permit Application for New Structures or Additions Mailing Address: Permit number: b��- �J� ���j,0,�. PO Box 66 ,s, \ Crystal Bay, MN 55323-0066 Date received: � �� ( 1 �� �,:, s�� , � • Received b /� I`a �y �t�,� „_ a, Sfreet Address: y� �\ ���,�t� �ti 2750 Kelley Parkway Plan review fee� Q� , g� �� 2��,� rqkE8H04� 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: ?7�j�,—rj � (�,t/ �'�jFJp 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 Cify Councrl approval 60 days prior to the event. Shuttle bus service ill be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not 6e allowed. CONTRACTOR/APPLICANT INFORMATION: Name: � �f �/O State License# Expiration Date: Phone: - -�— � office cell Mailing Address: `(�Cj(� ," , Cit •('/}�l(� ZIP: Contact Person: � ����-�-- Applicant is: ontractor / Homeowner (Cirde One) Email and/or Fax: ,���fJ;� L C�Q,C.�%����i��l,d/�✓1 PROPERTY OWNER INFORMATION: Name: R/1P'�(G- �� SUC }-I(:�/ry(JN�� Phone(day): �Z -�Z21 — 43 Z F� Address: Cit : ZIP: Email and/or Fax jl�Ip�Jt�� � urJ�- � j�M �(/1 . (,Dil/� ARCHITECT/ENGINEER INFORMATION: Name: �.�"� � C-CI�(1���7Cj�"=-.� Phone(day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply �New Construction �Single Family with (�,Residence Addition attached garage �❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water **Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review 8�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) $ �C"�O