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Home My WebLink About2014-00660 - voided - dated 6/30/2014 � ' CITY OF ORONO * 2 P1 1 4 - 0 P1 6 6 0 * 2750 KELLEY PARKWAY DATE ISSUED: 06/30/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 2699 KELLY AVE PIN : 21-117-23-23-0041 LEGAL DESC : WALTERS PORT : LOT 002 BLOCK 002 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 21,700.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT: $ 21,700.00 TYPE OF PERMIT THIS PAYMENT IS FOR: DECK PERMIT#THIS PRE-PAYMENT 1S TIED T0:201400661 �� ` �� V APPLIC NT ADVANCED PLAN REVIEW 239.69 TOTAL 239.69 PRECISION DECKS Payment(s) 20170 75TH AVE N CREDIT CARD 0066 239.69 MINNETRISTA, MN 55364- (763)228-4429 Minnesota State License#: BUIL-20583025 OWNER MORIN&TANYA SKEPEL, CHARLES 2699 KELLY AVE EXCELSIOR, MN 55331- 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 perniission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shail 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 construc[ion is suspended for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. / / Applicant Permitee Signature Date Issued B��Signature Date _ � CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS ��,. `O Mailing Address: Permit number: �/ �(,� Iv PO Box 66 / Crystal Bay, MN 55323-0066 Date received: : cP�� —� StreetAddress:' Received by: y�, � 2750 Kelley Parkway Plan review fee: � �l. �T L Orono, MN 55356 �'kESHo��' ��/ �_� 40 Totaf Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This application form mus#be completed in full and all required information must be subrnitted. Incomplete applications will be retu�ned, (Please print) GENERAL INFORMATION: Job Site Address: q �, ` � Will this be a Parade of Homes, Remotlelers Showcase Home or other Display Home? ❑ Yes o ffyes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will e required un/ess applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/ PLICANT INFORMATION: Name: ►'�CjS101'1 ��IC.S LLG State License# � Expiration Date: I Phone: ce�l -2,Z - q office -3 5"�)Z33 Mailing Address: Ci : ZIP: Contact Person: Applicant is: Contracto / Homeowner (Circle One) Email and/or Fax: ObE..° YYl PROPERTY OWNER INFORMATION: Name: � Phone (day): — -� 2 Address: 2 e c� : ziP: 55331 Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone(day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Descri tion of ro'ect: 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal8 Water Supply ❑ New Construction �Single Family with ❑ Residence ddition 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 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.minnehahacreek.or Estimated Construction Valuation (excluding land) $ �I ,� � � � . • . • • � • , emo To: Finance Department From: Christine Mattson, Planning Assistant CC: Street File f�� Date: September 22, 2014 GIL: 101-22205 Re: Escrow Refund Building Permit Application #2014-00661 was never started and since has been voided in PermitWorks. Please refund the advance plan review fee of$239.69 to the applicant, Tanya SrepeL The following is attached: • Copy of cash register receipt showing escrow amount received Mail to: Tanya Srepel 2699 Kelly Ave Excelsior, MN 55331 � w:�.street filesUcelly avenue�escrow refund form 2014-00661.doac City of Orono r Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) �� Mailing Address: Permit number. o? (��J '��o %�,L,0,� PO Box 66 , �,�:., 0 Crystal Bay, MN 55323-0066 Date received: —v� —� �I,a '' ��:,?fy reet Address: Received by: � ' �"�' ti 2750 Kelley Parkway Plan review fee: t9'kESH�� Orono, MN 55356 Total Fee: Main: 95 49-4600 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 returned. (Please print) GENERAL INFORMATION: Job Site Address: 07�9 1� r��/Y ,�V4 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a specral evenf permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicanf demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: j7'1t1�1�(. ��^S�D:�C�.�� L,L� State License# �� i,, 3 g/5�,� Expiration Date: 3� 3/ � /`! Lead Certification Number: � - I - 3C'S3�y._ /I ' t,�/G>G�7 Expiration Date: Z -iy_ �� (for work on irom ucfed prior fo 1978 Phone: �SJ - �7/3- �� (office) (cell� Mailing Address: � 3 `r' 7 S Clf€�t�:�� p; City: ,y�.�,�d G� ZIP: �— Contact Pers�n: mq�k mEN�c� Applicant is;�"�ontractor Homeowner (CircleOne) Email and/or Fax: n•� n,�f ...,tc� 6 MS�• �e M PROPERTY OWNER INFORMATION: Name: CN.��5 /�ck:,..y Phone(day): • Address: aL�i�i K�l��/ �� City: ZIP: C)a� � Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other s eci Phone: 952-471-0590 ( p fy) ❑ Siding � Other: (specify) Fax: 952-471-0682 ❑Window(s) �A��=�� Y�il � �✓w.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ �� ;� a�� APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete applicafion being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies re uired b law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: � �� Date: (�� a�, J�d'Z Last Updated: 08-09-2011 � � , � RECEIV�D � k ^, u� Q � � Av � . � y ��N 2 7 20,2 � C�TY�F ORONO ______ �5=z5o' R = ZO 9. 6 �� 5E aJio 0 U` 30 28 �5 "'� � -, ;. 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