HomeMy WebLinkAbout2012-00905 - pool CITY OF ORONO * Z 0 1 2 — 0 0 9 0 5 *
27.50 KELLEY PARKWAY DATE ISSUED: 09/1U2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3340 GRAHAM HILL RD
PIN : OS-117-23-11-0012
LEGAL DESC : GRAHAM HILL PRESERVE 2
: LOT 4 BLOCK 2 Cit of Orono
PERMIT TYPE : ADVANCED PLAN REVIEW ��`� Kelley F'arkway
Or�no M�V 55356 952-^c49-46{J�
PROPERTY TYPE : RESIDENTIAL
Receipt No: 3.OG?598 5ep 11, �Ulc
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 71,000.00 Yardscapes
NOTE: PLEASE FILL IN THG FOLLOWING: previous Balance: ,UU
VALUATION OP PF,RMIT:$ 71,000.00 Per0it5 < < �
2012-00945 3340 6raham .,4.,..,1
Hill Rd
I''�'PE OF PERMIT THIS PAYMENT IS FOR: POOL 141-34410
Plan ChecklSite Exam Fees
PERMIT#THIS PRE-PAYMENT IS TIFD TO: 2012-00904
Total: 545.51
------���---
Check
Check No: �6083 545.51
Payar:
Yardscapes
Tutal Applied: 545.51
Change Tendered: .00
-------------
49/11/�12 O�:c�PM
APYLICANT
QUALITY POOLS ADVANCED PLAN REVIEW 545.51
10350 WOODHILL BLVD TOTAL 545.51
LAKEVILLE, MN 55044
(612)985-7665
OWNER
MCCARTY, LEROY& LISA
3340 GRAHAM HILL ROAD
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work tbr which this permit is issued shall be performed according to
the approvcd plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission tbr 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
commeneed 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
requested in conformance with the State E3uilding Code.This permit may be
revoked at any time for due cause. �
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X ".t��'�l '�L _� / ��I /Z-O I� �.__�..�, �F' �I�t�'-'\
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Applic nt Permitee Signature Date Issued By S�, ature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO .
� !
City of Orono
Building Permit Application
for a Swimming Pool
Mailing Address: Permit number: �D�o� " '� ;
0�.,�,�0 PO Box 66
�
Crystal Bay, MN 55323-0066 Date received: �� —/ �" !�'
a �`�,��-�+' �, ) Street Address: Re ' d b : --.__ ___
�'�n ���`'` '� y ���' � 2750 Kelley Parkway Plan review fee: <.-� � J 5� `�,
r�kE3H0�'� Orono, MN 55356 _ �pb`,:
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: �,� � ��� ���(��� �Q�/
CONTRACTOR/APPLICANT INFO�ATION:
Name: �v!>-Z c'��1 '1'tiC�s � �L �
State License# Expiration Date:
Phone: Cj'SZ c���l�(�� Fax:
Address: �35'G1 �.�o�.�� �a� �i��.a/- CitY�l.�/4p i � ZIP: �-s�vy
Contact Person: ,::�;�,,�t, t,�f,s�°Z� ContacYs phone numberC,l1- p�9 ��o�IQ
Email Applicant is: Contractor Homeowner (Circle One)
PROPERTY OWNER INFORMATION:
Name: � pQs .
Phone (daY)� .�3Yc� �'r��a,��-r� /,<<f/ �
Mailing Address: ZIP:
Email and/or Fax
ENGINEER INFORMATION:
Name:
Phone:
Address: City: ZIP:
Email Fax:
PROJECT INFORMATION:
1. Pool Dimensions: 4.Accessory to: 5. Pool Type: 6. Sewage Disposal &
Water Supply
ZC? X �`,/�Q feet �ngle Family ❑ Above ground
2. Heated? ❑ Public Sewer
�� ❑ Multiple Family/Condo �n-ground
�yes ❑ no ❑ Private Sewer
❑ Public
❑ Other(specify)
3. Excavated materials will be: ❑ Commercial ❑ Public Water
�removed from site ❑ Industrial 6. Retainin Walls?
g ❑ Private Well
L� used on site ❑ Other: (specify)
❑ yes ❑ no
❑ Other: (specify)
Height
Total Cubic Yards
Estimated Construction Valuation $ °���av
Last Updated: 10/28/2010
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