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HomeMy WebLinkAbout2012-00402 - adv plan review CITY OF ORONO * z 0 1 2 - 0 0 4 0 z * ,� 2750 KELLEY PARKWAY DATE ISSUED: 05/14/2012 ORONO,MN 55356- � 952 249-4600 FAX: 952 249-4616 ADDRESS : 1220 LAKEVIEW AVE PIN : 10-117-23-24-0019 LEGAL DESC : UNPLATTED 10 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 30,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 30000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT-GARAGE PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00403 APPLICANT ADVANCED PLAN REVIEW 303.39 SCHNOOR,MR.&MRS.DOUGLAS TOTAL 303.39 1220 LAKEVIEW AVE WAYZATA,MN 55391 OWNER SCHNOOR,MR.&MRS.DOUGLAS - 1220 LAKEVIEW AVE WAYZATA,MN 55391 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 sepazate 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 revoked at time for due cause. _y �; f ��olz , , Ap licant -ermitee Sign t re Date Issued By Si ture Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � � � , ,� City of Orono � � (�!l�� �uildin Permit A lication � � � J p p ��, -��.s for New Structures or Additions --- Mailing Address: Permit number: � � (�' �� � PO Box 66 '�� �����. i0 , Q'��,, Crystal Bay, MN 55323-0066 Date received: � — �—� �1��a �^yS4�✓.J��:,_ �,��� Sfreet Address:� Received by: � ���,�e, ,�}���;�,�ty'�� ��,� 2750 Kelley Parkway Plan review fee: �Ca� .�j \"t`�g�sHOSa.�,�> Orono, MN 55356 -=—_- Total Fee: �Ofc�-��yD7-- Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us 4 -LOIL-0010 This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERQL INFORMATION: Job Site Address: � ,� � � - ,�,�j ��' ` ,� ' ti ,c J`�'1 IL j 5�� i Will this be a Parade of Homes, Remodelers Showcase Home or other Displa Home? ❑ Yes �No !f yes, a special 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 sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/qP�PLICANT INFORMATION: Name: 41G (�c �- C�;r�,r��- �� ��C�(���' State License# , Expiration Date: Phone: �� - �( ��- (�S�,� (office) (cell) Mailing Address: LC.,. � C,,,; }� � Cit : .} ` ZIP: �� � �' Contact Person: /�.i C��mc� �c_4�r�.c�n; Applicant is: Contractor / Homeowne (circ�e o�e) Email and/or Fax: ;����, r n-.«,: �,�_},r.c�n r h� � �� r� �=� i ��--.�n s��-�.� ..C�- ,v� PROPERTY OWNE�t INFORMATtON: � Name: ��� � c� � l\)p f rv��� S�hr�^r;" Phone(daY)� y��� .�/;,}� - (��3S �t'Uc,;�c_- wc . �;� Address: i 'l.�c�' Lc. k �- �; ���,�� tA- J e City: �,U(1:�?_c-t�-� ZIP: �J 5�3 r) Email and/or Fax y��, ��r•�a 6 S r (-�n��� �� �er,� r� i�,�.� �n�-!-;. c c�r�--� ._ ARCHITECT/ ENGIPIEER INFORMATION: Name: Phone(day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply ❑ New Construction [�Single Family with ❑ Residence [v]'Addition 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 require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial [YPrivate 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) $ � (1 O�"i(i