HomeMy WebLinkAbout2014-01227 - adv plan review CITY OF ORONO * 2 0 1 4 - 0 1 2 2 7 *
2750 KELLEY PARKWAY DATE ISSUED: 10/22/2014
� ORONO,MN 55356-
f (952)249-4600 FAX: (952)249-4616
ADDRESS : 41'74 HIGHWOOD RD
PIN : 07-117-23-44-0026
LEGAL DESC : HIGHWOOD LAKE MTKA
: LOT 032 BLOCK 000
PERMTT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 225,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$225,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOUSE
PERMIT#THIS PR�PAYMENT IS TIED T0:2014-01228
APPLICANT ADVANCED PLAN REVIEW 1,174.39
TOTAL 1,174.39
CNC CONSTRUCTION,LLC Payment(s)
4540 210TH LANE NE CREDIT CARD 0182 1,174.39
EAST BETHEL,MN 55011-
(612)817-0386
Minnesota State License#:BUIL-BC580107
OWNER
WILLOW CREEK,DEV
P O BOX 4551
ST PAiJL,MN 55104
AGREEMENT AND SWORN STATEMENT
7'he work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. 'This permit is for only the work described and does
not gant pertnission 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 specified herein.7'his 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.
1'he applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revo ed at any time for due cause.
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Applicant Permi e Signature Date Issued y Signature Date
= CITY OF ORONO
.
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
Mailing Address: Permit number: a 0��—� � �
��nj PO Box 66 _�
� Crystal Bay,MN 55323-0066 Date received: �� �
Street Address:' Received by:
y � 2750 Kelley Parkwa review fee:
F� L� Orono, MN 55356 Q� �6/ �
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Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us � � 7 �. 3 / _i�
This application form must be completed in full and all required information must be s bmi .
Incomplete applications will be retumed. (Please print)
GENERAL INFORMATION: I,�� � � � 2Z
Job Site Address: J
Will this be a Parade of Homes, Remodelers Sh case Home or other Displa Home? Yes � No
!f yes,a specia/event permit is requfred with Police Department and City Council approva160 days prior to the evenf. Shuttle bus service will be
required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLIC NT INFO ATIO : ��
Name: 1�
State License# Expiration Date: �
Phone: cell office
Mailing Address: — Ci : • ZIP: �5(�)
Contact Person: � ' Applicant is: ontractor / Homeowner (Circle One)
Email and/or Fax: S
PROPERTY OWNER NFO�MATIO : .�� ,
Name: ► bl.�
Phone (day): 2' — �
Address: �� Ci : �} � Z�P: , ��1
Email andlor Fax � � � �
ARCHITECT/ENGII�EER INF RMATION:
,
Name: —
Phone (day): 7--� - �
Address: Ci : YL ZIP: -rj '
Email and/or Fax:
PROJECT INFORMATION: Descri tion of ro'ect: I� �n�e �nn��
1.Type of Project 2. Pr osed Use 3.Stru ture Type 4.Sewage Disposal8�
Water Supply
[V�New Construction Single Family with �esidence
❑Addition attached garage ❑Garage/Accessory Bldg. dPublic 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 also 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.m innehahacreek.or
Estimated Construction Valuation (excluding land) � ZZS�U(.i�'UU -