HomeMy WebLinkAbout2011-00375 - adv plan review CITY OF ORONO PERMIT NO.: 2011-00375
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: OS/23/2011
.�. 952 249-4600 FAX: 952 249-4616
ADD�:�SS : 81 HACKBERRY H[LL
PIN : 33-118-23-44-0014
LEGAL DESC : DANIELS LONG LAKE HEIGHTS
: LOT 008 BLOCK 002
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 10,000.00
NOT�: SEPL;RATE P�RMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELGCTRICAL(STATE)
ADVANCED PLAN REVIEW PEG FOR THREE SEASON PORCH PERMIT#201 1-00377
APPLICANT ADVANCED PLAN REVIEW 124.64
MEASURCED BY THE POUND CONSTRUCTION TOTAL 124.64
9135 PIONEER TR
GREENFIELD, MN 553�7- PAID WITH CC# 8534
(763)443-9510
OWNER
STANKEVITZ, GEOFFREY&JENNIFER
81 HACKBERRY HILL
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEMENT
The work Yor which this permit is issucd shall be perYormed according to
the approved plans and spccifications,applicable City approvals,and the
State Building Codc. This permit is for only the work described and does
not grant permission for additional or relatcd work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specitied herein.This permit will
expire and become null and void if 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
requested in confonnance with the State Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applicant Permitee Signature Date Issued 13y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
, City of Orono
' � Building Permit Application
for New Structures or Additions
,—� Mailing Address: Permit number: p� ��� '���„3�
y O�O CrysBtal Bay, MN 55323-0066 Date received: � �%�3 / f/
� ��
,� -�' �, Street Address:� Recei : L-C�
�,�, Gti 2750 Kelley Parkway �()f I 'CC�37S Plan review fee: � oZLJ .��I
't•9kESHo4� 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 retumed. (Please print)
GENERAL INFORMATION:
Job Site Address: �1 F�'r�,r_ �� r.'�'v •�f �
Will this be a Parade of Homes, Remodelers Show ase Home or other Display Home? ❑ Yes No
If yes, a special event permit is required wrth Police Department and City Counci!approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: >'1/1;�=ti�,;u s�-�� � �; � ��,s,.-;fs'v��;r� L L G
State License# �O 5 7 �331 Expiration Date: � �
Phone: - y -g ' office �C�;}' - '' - $/(1 cell
Mailing Address: �� �;a�,�,,,. 7rr.�,` CitY� G rr�:-,�Je�r� ZIP: �'�'_3S�7
Contact Person: j�,��,( � ;�//o` Applicant is: n ractor / Homeowner (CircleOne)
Email and/or Fax: rh S T(' C � f�<<�,nr� Gn;/Y►
PROPERTY OWNER INFORMATION: ,/
Name: L�Pfi�v�t�° ua�r.� :,1^'��1 ; �;�.y'1 I�o.v i r �
Phone (daY): F,f�- ��((} -7`1�f� c �c
Address: $r (-�C,,G��b�r�'Yy l-f;ll City: C"i�'t;,.�,� ZIP: � ����
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: Cit : ZIP:
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 � Residence
�Addition s;�(�e����r 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 `"���e SE�ccS � Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952�71-0682
www.m i n nehahacreek.or
Estimated Construction Valuation (excluding land) $ /�, ����—
Last Updated: 4/26/2011 •
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