HomeMy WebLinkAbout2016-01304 - adv plan review CITY OF ORONO * Z 0 1 6 - PJ 1 3 0 4 *
� � � 2750 KELLEY PARKWAY DATE iSSUED: 10/13/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1830 SHORELINE DR
PI lV : 10-ll 7-23-42-0002
LEGAL DESC : AUDITOR'S SUBD.NO. 356
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 4,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 4,000
TYPE OF P�RMIT THIS PAYMENT IS FOR: ENTRANCE MONUMENTS
PERMIT#THIS PRE-PAYMENT IS TIED T0:2016-01303
APPLICANT ADVANCED PLAN REVIEW 70.45
TOTAL 70.45
STONEWOOD, LLC Payment(s)
153 E LAKE STREET CREDIT CARD 5568 70.45
WAYZATA,MN 55391-
(612)462-4000
Minnesota State License#: BUIL-BC594315
OWNER
TUFAA&NEDIYO SADO,TASHITTA
1224 CEDAR POINTE DR N
MINNETONKA, MN 55305-
AGREEMEivT 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 [he
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. AII 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 l80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conforman the State Building Code.This permit may be
revoked at any ti or d cause.
/ /
p ic er 'ee ' ture Date Issued By Signature Date
� ' City oi� Orano
� � �t���cfing Perr�it Ap�licatio�
far �'e�nr Structures or �4dditions
Mailing Address:
���j PO Box 66 Permit number: • b� � ��
o Crystal Bay, MN 55323-0066 Date received: /Z9 '-!�—�(�
Street Address:' Rec�ed by: �j}'1 / �
y � 2750 Kelley Parkway - � --
`�t �� Orono, MN 55356 lan review fee: .�� �
'kfSHOR� Main: 952-249-4600
Fax: 952-249-4616 www.ci.orono.mn.us Total Fee:
This application form must be completed in fuil and al(required infonnation must be submitted.
Incomplete applicatlons wfll be retumed. (P/ease print)
GENER�►L INFORIIAATION:
Job Site Address: �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
/f yes,a specia!event permit is required with Police Department and City Council approvaJ 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates su�cient on-site parking is available. Non�ermitfed events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION: ���
Name: �
State License# �� _ Expiration D te:
Phone: cell � office
Mailing Address: / " a• Cit : Z�p: �.
Contact Person: M���qe SU1N��" Applicant is: C / Homeowner
Email and/or Fax: _ �«� g.��W�) �,�+ (CfrcleOne)
PROPERTY OWNER INFORMATION:
Name: -TX�S���Tp}t� TLP.A�
Phone(day): ��?=y�a
Address: ���j_��„����, City �rx� ZIP ��j�
Email andlor Fax +�
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: Cit : Z�p:
Email and/or Fax:
ARCHITECT/ ENGINEER INFORMATION:
Name:
Phone(day):
Address: Cit : Z�p.
Email and/or Fax:
PROJECT INFORMATION: Descri tion of pro'ect:
1.Type of Project 2. Proposed Use 3.Structure T e
YP 4.Sewage Disposat&
�v Construction Water Supply
❑Single Family with ❑Accessory Bldg./Garage
❑Addition attached garage ❑ Deck
❑Accessory Building ❑ Sin le Famil with ❑ Public Sewer
❑ Relocation 9 y ❑ Offlce/Commercial
detached garage ❑ Residence
�Other:(specify) ��(�/Gl�j � Multiple Family/Condo ❑ Retaining Wall(s) �Septic
❑ Public (Compliance certificate
'"`Any earth movement may require 4-feet or greater may be required)
❑ Commercial ❑ Storage
MCWD review 8 permits. ❑ Industrial ❑Warehouse
Minnehaha Creek Watershed Distnct(MCWD) ❑ PubliC Water
15320 Minnetonka Blvd;Minnetonka,MN 55345 � Othe�: (SpeCify) ❑ Other(SpeCify)
Phone: 952-471-0590 / Fax: 952-471-�682 ❑ Private Well
www.m innehahacxeek.orq
Estimated Construction Valuation (excluding land) $
Packet Last Updated: January 2016
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