HomeMy WebLinkAbout2016-00822 - adv plan review CITY OF ORONO * z 0 1 6 - 0 0 8 z z *
- 2750 KELLEY PARKWAY DATE ISSUED: 07/18/2016
. ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4325 LAKEVIEW CT
PIN : 06-117-23-43-0016
LEGAL DESC : LAKEVIEW OF ORONO
: LOT 2 BLOCK 3
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:$ 800,040.00
TYPE OF PERMIT TH[S PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00821
APPLICANT ADVANCED PLAN REVIEW 3,383.20
NORTON HOMES TOTAL 3,383.20
Payment(s)
18215 45TH AVE N,STE D CREDIT CARD 6516 3,383.20
PLYMOUTH,MN 55446-
(612)386-7661
Minnesota State License#: BUIL-BC639221
OWNER
Source Land Development Inc.
18215 45TH AVE N
STE D
PLYMOUTH,MN 55446-
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 1 SO days at any time afrer 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 any time f due cause.
� 1 _
� �{' 7
.: � ' -
�ti ;�. �'C,(' j � �, L.C. '�<_ � � / �� / ��>
ppl�cant Permitee Signature Date Issued By Signature Date
._. CITY OF ORONO
• BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
Mailing Address:
�O�O PO Box 66 Permit number: _ 7/ � —(���
Crystal Bay, MN 55323-0066 Date received: �-- � �—��
Street Address:' Received by:
� ------------
y� G� 2750 Kelley Park ay2 L �(� —(��g'2 Plan review fee: 3 �8 3. �
qKESHOR� Orono, MN 5535 s
Total Fee:
Main: 952-249-4600 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: �,5 (,�c/LC VIG� Cct/'►�l�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes ❑ No
lf yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shu le 6us service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: `UQr'�j �ornt5, LLG
State License# L3G G39�a-/ Expiration Date: ,j-�/-J�]
Phone: cell /Z- b- office 7 G3-,�$Y1-�9`��
Mailing Address: S�' �, N• S �. Ci • �
dv ZIP: s
Contact Person: i5 No� Applican± is: ontracto / Homeowner (Circle One)
Email and/or Fax: Ch ' .C �fv3•SS —
PROPERTY OWNER INFORMATION:
Name: .SOII�[G�Q.f'le� Q°VP�d1�/'�7�
Phone (day): . ,$ /• n/ d
Address: ( �+ , /�/ ,d Cit : � /71 ZIP: SSYY�
Email and/or Fax
ARCHITECT/ENGINEFR INFORMATIO : /�,,` ��`
Name: JGi,I'I?�J %I')GN�°� r/�(,�jr1CP.�'tN� ,`vei5lRh
Phone (day): (�-q70 • �3g�g
Address: OSO � N Cit : � /rjdv�'j-, ZIP: ,sf
Email and/or Fax: 1G1�i'!'1 eS�LG/1�ea.� �C dv c o
PROJECT INFORMATION: Description of pro'ect:
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal 8�
Water Supply
New Construction [�Single Family with esidence
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 also require ❑ Commercial ❑ Other(specify)
MCWD review& 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.min nehahacreek.or
Estimated Construction Valuation (excluding land) $ � ����'I�"fCj