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Home My WebLink About2016-01562 - adv plan review . CITY OF ORONO * Z 0 1 6 - 0 1 5 6 2 * 2750 KELLEY PARKWAY DATE ISSUED: 12/22/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 290 CRESTVIEW AVE PIN : OS-117-23-14-0018 LEGAL DESC : BAYSIDE ADDN TO LAKE MINNETONK : LOT 000 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REV[EW VALUATION : $ 75,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 75,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION/REMODEL PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-01561 APPLICANT ADVANCED PLAN REVIEW 593.40 BETZ BUILDERS INC. TOTAL 593.40 300 CRESTVIEW AVE. Payment(s) CHECK 7425 593.40 LONG LAKE,MN 55356 (612)221-2963 Minnesota State License#: BUIL-BC3515 OWNER HOCHSTEDLER, SCOTT 290 CRESTVIEW AVE LONG LAKE, MN 55356- 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 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 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 conformance with the State Building Code.This permit may be revok at any time for d�cause. _ j , �y � � �� -'`-' ;;�,;� �� ' /� ��? - /� ��'C E_ .1 �� _I�S . ��' � �'�'� �G� Appticant Permitee i nature Date Issued By Si ature Date . City of Orono • Building Permit Application for New Structures or Additions Mailing Address: ^ �Q A.O PO Box 66 Permit number: �-�C- ��G - O/ r� j `V Crystal Bay, MN 55323-0066 Date received: J<� l Z %�'' StreetAddress:' -} ft � Received�y�_______. �!-' /` I� �' "7�t � — --- yF ,� 2750 Kelley Park�y �� _��5�1 Plan reviewfee: � - > y� ` c,` Orono, MN 55356 _--= ----- - ---- -- -- __-- !q�t SH� 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. (Please print) GENERAL INFORMATIO� �� Job Site Address: � i !`�".S��E�-� ��v� . �"v�� 1 �`�� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No /f yes, a special event permit is required with Po/ice Department and City Council approval 60 days prior to the event. Shutt/e bus service wil/ required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT FORMATIO : J � Name: �Z �C�-� rS -- �L� �i� �Z State License# �� Ex�iration Date: ��3�- Phone: cell �� -- - office /J� � 7 - t Mailing Address: C'✓e vi.�w �/� Cit : CJ�rC�r�u ZIP: S (v Contact Person: /O n� Z Applicant is: Contractor / omeowner �(Circle One) Email and/or Fax: P Z L� � �ii c� ` 4 L� • C.c� • PROPERTY OWNER INFO MATIC�N: � �� j� � Name: C'�`,"["t" �Ct-�-� Phone (day): !S� - �/ - / 933 Address: �� T P '�1 /i•�Ptti/ vZ Cit : �YC�rc ZIP: .55:�.`J � mail nd/or Fax �rnr�: l � � � � -e �� C``� fr� cL h Co• �Z��-� ARCHITECT I ENGINEER INFORMATION: /� �,.�c / Name: c f`/ tiL�NS, � � � ` L /� .0 `�Cl � � ll C�f� Phone (day): `__�,� _ � 7 - /S Address: � c� • p v� . Cit : l��h� f�i�S�iLZIP: �� Email and/or Fax: ry C' � / � Cc . PROJECT INFORMATION: Descri tion of ro�ect: ��! ��l��Yl ` -�G ��'''�-- 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8� Water Supply ❑ lyew Construction ❑ Single Family with ❑Accessory Bldg. /Garage �Addition attached garage ❑ Deck f�Public Sewer ❑Accessory Building ,� Single Family with ❑ Office/Commercial ❑ Relocation detached garage f�Residence ❑ Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater ❑ Public Water `*Any earth movement may require ❑ Commercial ❑ Storage MCWD review 8�permits. ❑ Industrial ❑Warehouse [�f'rivate 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) $ ��j��LN , Packet Last Updated: August 2015 Page 21