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Home My WebLink About2016-00130 - advance plan review fee CITY OF ORONO * 2 0 1 6 - 0 0 1 3 0 * ` 2750 KELLEY PARKWAY DATE ISSUED: 02/09/2016 � ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 565 LEAF ST PIN : OS-117-23-41-0028 LEGAL DESC : FOX HOLLOW : LOT 003 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 40,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 40,000.00 TYPE OF PERM[T THIS PAYMENT IS FOR: STONE STAIRWAY CONNECTED TO HOME PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00129 APPLICANT ADVANCED PLAN REVIEW 391.96 TOTAL 391.96 GOODWIN, BEN&HEATHER Payment(s) 565 LEAF ST CREDIT CARD 5336 391.96 LONG LAKE,MN 55356- Minnesota State License#: BUIL-BC323192 OWNER GOODWIN, BEN&HEATHER 565 LEAF ST LONG LAKE,MN 55356- AGREEMENT A1vD 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 l80 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 any time for due cause. ��J �o� ��=--�� l �? i 1 c� Applicant Permitee Signature Date Issued By Signature Date . � CITY OF ORONO � BUILDING PERMIT APPLICATION . - FOR NEW STRUCTURES OR ADDITIONS Mailing Address: Permit number: �-o1Vo PO Box 66 Crystal Bay, MN 55323-0066 Date received: I ( , , �Received by: �.(Y_� �, ,, Street Address: �d. W �C s�. � 2750 Kelley Parkway Plan review fee: � �lp � �qk�,SH��.G` Orono, MN 55356 ��b'�L 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 INFORMATION: Job Site Address: ,�G� �rc �-l^ QfZ.G�vU 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 Depariment and City Council approva/60 days prior to the event. Shuttle bus service � be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will noi be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: '�tr� .� PIr i �Co��-�'F 2 -- �dn/NE�2� t Mt . State License# Expiration Date: Phone: cell office Mailing Address: Gn. c Cit :� �a IP: �. Contact Person: ��t�ii..��2 Applicant is: Contractor omeowner ircle One) Email and/or Fax: ST''cv�� S"tuw,��.Q.IG.. L,oM PROPERTY OWNER INFORMATION: Name: (3EN Gs�joOW� � Phone (day): --��g 22q a'3S� Address: �.s c,�cAM'- �T City:,b�j�N� ZIP: �'3S� Email and/or Fax �,q oo caw►�✓�r�u<o bis�-��S _ t,o�1 ARCHITECT/ENGINEER INFORMATION: Name: �F P 1:H cG 2EN S��-� +� D'�.SI 6 N Phone (day): �`3 , �.{��l . +{�{01 Address: Cit : ZIP: Emailand/orFax: ��;� G ne..�.! � ,�c�l:n �-bc�tb�? . t�OM PROJECT INFORMATION: Description of project: O`�'pdoR R.s�k- R:r'S 1. Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal& Water Supply ❑ New Construction � Single Family with ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck �Public Sewer ❑Accessory Building ❑ Single Family with ❑ Office/Commercial ❑ Relocation detached garage ❑ Residence ❑ Private Sewer �Other: (specify)�'�f�osfl STh��S ❑ 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. (speClfy) '� Othe�(speClfy) 15320 Minnetonka Blvd ,s-t/�;r-s Minnetonka, MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 �,�ww.minnehahacreek.or Estimated Construction Valuation (excluding land) $ �{a, pts0 . 0 0