HomeMy WebLinkAbout2017-00087 (Plan review Fee) CITY OF ORONO * z 0 1 7 — 0 0 0 8 � *
? 2750 KELLEY PARKWAY DATE ISSUED: OU30/2017
. ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4765 AUGUSTA ST
PIIY : 06-117-23-33-0009
LEGAL DESC : LAKEVIEW OF ORONO
: LOT 7 BLOCK 1
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 800,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 800,000.00
TYPE OF PERMIT TH[S PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00087
APPLICANT ADVANCED PLAN REVIEW 3,383.20
TOTAL 3,383.20
Swanson Homes Payment(s)
1360 HAMEL RD 3,383.20
MEDINA, MN 55340-
(763)478-0320
OWNER
Swanson Homes
1360 HAMEL RD
MED[NA, MN 55340-
AGREEMENT AND SWORN STATEMENT
"The 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 grant permission for additional or related work which requires separate
permits. All provisions of Iaws 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
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time atter 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 e for due us r) ,
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Applicant Permitee Signature � Date Issued By Signature Date
' CITY OF ORONO
BUILDING PERMIT APPLICATION C� 37S�k�
FOR NEW STRUCTURES OR ADDITIONS ��� �
�O A, Mailing Address: Permit number: p�6�7
`wO PO Box 66
Crystal Bay, MN 55323-0066 Date received: �"—�
�, y Street Address:'
Received by: �
�'�. G: 2750 Kelley Parkway b� �� Plan review fee: � � �
`qkESHO�� Orono, MN 55356
Main: 952-249-4600 Total Fee:
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. (P/ease print)
GENERAL INFORMATION:
Job Site Address: �5 n.. �r��_ r
Will this be a Parade of Homes, Remodelers Showcase H me or other Display Home? ❑ Yes No
If yes, a specia!event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: 5 c�,h �S a r.j `
State License# f: ��.��s� �„ Expiration Date: �
Phone: cell �ri Z. . � — — office (,, • �{ . � �,G
Mailing Address: / � Cit : (�l �.,`c-� ZIP: �� �
Contact Person: ! �'�r,�. '�,.J Applicant is: n ractor meowne (Circle One)
Email and/or Fax: ur ' � �,,; ,✓ �-._ �
PROPERTY OWNER INFORMATI N:
Name:
Phone (day): -
Address: �S � �v+t_ Cit : ZIP:
Email and/or Fax
ARCHITECT/ENGINEER INFORMAT ,N: ^ ' )
Name: �,►, �- �d,�,5 i N
Phone (day): �, . � � �,o
Address: �/pC2 (.�� !-�,��e ��-_ City: ����� ZIP: S,j`{y y
Email and/or Fax: r h,{�e� ����,(�< <�,,,' .
PROJECT INFORMATION: Description of project: ' "�� ���—
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
�New Construction Sin le Famil with Water Supply
Addition �attached garage ❑ Deckssory Bldg./Garage
❑Accesso Buildin ❑ Public Sewer
ry g ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage ❑ Residence �Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
"*Any earth movement may also require ❑ Commercial ❑ Storage
MCWD review&permits. ❑ Industrial ❑Warehouse �Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ Other(specify)
15320 Minnetonka Blvd
Minnetonka, MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) � ��s�']
Last Updated: January 2016