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Home My WebLink About2016-01067 - advance plan review fee t� CITY OF ORONO * 2 fd 1 6 — P1 1 0 6 7 * 2750 KELLEY PARKWAY DATE ISSUED: 08/3U2016 - ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1035 HER[TAGE LA PIN : 10-117-23-13-0009 LEGAL DESC : FOXHILL : LOT 003 BLOCK 002 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENT[AL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 55,000.00 NOTE: PLEASE FILL[N THE FOLLOWING: VALUATION OF PERMIT:$55,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION PERMIT#"I'HIS PRE-PAYMENT IS TIED TO:2016-01066 09/20/16 NOTE:THE ORIGINAL PERMIT WAS SUBMITTED AS ONE PERMIT FOR SIDWG AND A SMALL STOOP ADDITION TO FRONT OF HOME WITH ONE VALUAT[ON O['$55.000. WHGN THIS WENT THROUGII THE REVIEW PROCESS,ROGER DECIDED TO BREAK OUT THE COSTS SINCE THE BULK OF TH[S PERMIT WAS FOR THE SIDING AND WE DO NOT CHARGE PLAN REVIEW FOR THAT. TH[S ADVANCED PLAN REV[EW PERM[T#2016-01067 FOR$490.96 WILL BE APPLIED TO THE ENTIRE PRICE OF THE SIDING PERMIT AS A PRE-PAYMENT OF SORTS,SINCE THE STOOP PERMIT IS NO"I'A HIGH ENOUGH PERMIT COSTS TO DEDUCT ANYTHING. THESG WILL BE ISSUED AS TWO SEPERATE PERMITS. APPLICAIVT ADVANCED PLAN REVIEW 490.96 TOTAL 490.96 SHIMOTA PROJECT MANAGEMENT Payment(s) 5727 FRONTENAC CIRCLE CREDIT CARD 5254 490.96 LONSDALE, MN 55046- (651)387-3297 Minnesota State License#: BUIL-BC637001 OWNER FRITZ,JEFF&ELLEN 1035 HERITAGE LA WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which Ihis permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State E3uilding Code. This permit is ror 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 if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of I RO days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. / / Applicant Permitee Signature Date IssUed[3y Signature Date � City of Orono . ��•�� r , � Building Permit App�ication � �,tl.-�Or�s3 � far° t��w Structures ar Additio�s Mailing Address: �� _ ��A r PO Box 66 •/�� i number: p�/�,r� � C stal Ba MN 55323-0066 VD rY Y� Date received: � �'��'"�� Street Address:' Received by: � � ,� 2750 Kelley Parkway aQ/�..of�1_ 6�, � Plan review fee: tiP L Orono, MN 55356 �'�XFSHo�``` Main: 952-249-4600 !/Lj�� Total Fee: Fax: 952-249-4616 v✓ww.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�3 S j.,�e �;�,�E C,� Will this be a Parade of Homes, Remodelers Sh wo case Home or other Display Home? ❑ Yes ❑ No If yes, a special event permit is required with Police Department and City Council approva/60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted evenfs will not be allowed. CONTRACTOR/APP ICANT INFOJ,2M�4TION: Name: 5�.��r,� fi a e�r M�„� State License# (�`3 Expiration Date: 3 Phone: cell !� � - �z office Mailing Address: ��a 7 F�o �--� C:-c/ Cit : ., s �/� ZIp: S'��.{� Contact Person: C Applicant is: Contrac o / Homeowner (Circle One) Email and/or Fax: S M �� , , �r r-� PROPERTY OWNER INFORMATION: Name: �� Fi-r'tZ Phone (day): Address: /o��' ..� T�y e C,�/ City: '11�y Z�► ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: Phone (day): Address: � City: ZIP: Email and/or Fax: ARCHITECT/ ENGINEER INFORMATION: 1�I � Name: � Phone (day): Address: Cit : ZIP: Email and/or Fax: PROJECT INFORMATI : Des ' ion of project: � ! r �� '� `� �' � n 1,'�,�� 1.Type of Project 2. Proposed Use 3. Structure Type 4.Sewage Disposal& Water Supply ❑ New Constructio ❑ Single Family with ❑Accessory Bldg./Garage Addition attached garage ❑ Deck ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Office/Commercial ❑ Relocation � detached garage ❑ Residence ❑ Septic � Other: (specify) . �.�_ ❑ Multiple Family/Condo ❑ Retaining Wall(s) (Compliance certificate ❑ Public 4-feet or greater may be required) *"Any earth movement may require ❑ Commercial ❑ Storage MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Public Water Minnehaha Creek Watershed District(MCWD) ❑ Othef: (specify) ❑ Other(SpeCify) 15320 Minnetonka Blvd; Minnetonka,MN 55345 ❑ Private Well Phone: 952-471-0590 I Fax: 952-471-0682 www.m innehahacreek.orq Estimated Construction Valuation (excluding land) $ S�S p o�. -- . Packet Last Updated: January 2016 �• ,� r Page 21 V