HomeMy WebLinkAbout2012-00535 - building permit • • r� CITY OF ORONO
� � 2750 KELLEY PARKWAY * z 0 1 2 — 0 0 6 3 5 *
DATE ISSUED: 07/03/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1595 MAPLE PL
PIN : 08-117-23-33-0035
LEGAL DESC : CRYSTAL BAY VIEW
: LOT 013 BLOCK 006
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCT[ON TYPE : ADVANCED PLAN REVIEW
City of Orono
VALUATION : $ 181,900.00 2750 ;;elley ParkMay
NOTE: PLEASE FILL IN THE FOLLOWING: Q'"v� � �� �-24��
VALUATION OF PERMIT:$ $181,900 Receipt No: 3.t}471b9 1u1 3, 2Q12
TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT Maole Glare LLC
PERM[T#THIS PRE-PAYMENT IS TIED TO:2012-00636 Previous Balance: .4t1
Per�its
�Q12-40635 1595 Maple 1,OOE.69
F�la�e
141-34410
Plan ChecklSite Exam Fees
Total: 1,006.69
Check ----_____�
Check Na: 30� 1,Opb.69
Payor:
Maple Place lLC
T�tal Applied: 1,006.69
Chanqe Ter�ered: ~ ~.00
APPLICANT ADVANCED PLAN REVIEW 1,006.69
DEAN JOHNSON HOMES, INC. TOTAL 1,006.69
4700 CTY ROAD 19
MEDINA, MN 55357-
(763)479-4820
Minnesota State License#: 20639439
OWNER
Maple Place LLC
550 25TH AVE N
ST. CLOUD, MN 56303-
AGREEMENT A1vD SWORN STATEMENT
The work for which this perrnit 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 wark
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is no[
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of I 80 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 permi[may be
revoked at any time for due cause.
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Applicant Permitee Signature Uate Issue y S' nature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABOV .
. '
� City of Orono
Buitding Permit Application
for New Structures or Additions �
Mailing Address: Permit number. a��a-��6 3 ' .
-�Q 7 � 3- � �
O�" �O Cry sal Bay,MN 55323-0066 Date received: j �
�. � �
���, ` Received by:
,.� ,, Street Address:'
,� 2750 Keliey Parkway Plan review fiee: o20�a"�� 3 � ,
° Orono,MN 55356 lOD�v.(�j
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\�$si�� �: r.. :
Main: 952-249-A600 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 prinf)
GENERAL INFORMATION: .��
Job Site Address: f '
Will this be a Parade of Homes, Remodeler Showcase Home or other Display Home? Yes No
If yes,a specra!event permit is required with Police Department and City Council approva!60 days prior fo the event. Shuttfe bus service rll e
requrreii un/ess applicant demonstrates suffrcient on-site parking is available. Non-permltted events will not be alfowed.
CONTRACTOR!APPLICANT INFORMATION:
i,v.c,
Name: �L.. c.c�.� ','���°�`� �"�0'TM'r� Expiration Date 3f 3 i �� �
State License# 'Z-O office "i(cr - 4 � "'►�� � cell
Phone: , � Cit : ' ..�a� ZIP: S S 3�
Mailing Address: 'T oo � ,
Contact Person: cr—.-- Applicant is: ontrac o / Homeowner (Circle One)
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Email and/or Fax: �, . �
PROPERTY OWNER INFORM�+ATION: . :
Name:
Phone(day): Ci : ZIP:
Address: �
Email andlor Fax . .
ARCHITECT/ENGINE�It��ORMATION: .
Name: �
Phone(day): Cit : ZIP: .
Address: .
Email andlor Fax: � _
PROJECT INFORMATION: � 4.Sewa e Dis osal& .
1.Type of Project 2.Proposed Use 3.Structure Type 9 p '
Water Supply
�;,Sin le Family with Residence �
"�'New Construction 9
❑Addition attached garage �Garage/Accessory Bldg. �Public Sewer
❑Accessory Building ❑ Single Family with ❑ Deck Private Sewer
❑Relocation detached garage ❑Office/Commercial ❑
❑Other: (specify) ❑Multiple Family/Condo ❑Warehouse public Water
❑ Public ❑Storage �
**Any earth movement may require ❑Commercial ❑Other(specify) .
MCWD review&permits. ❑
Industrial ❑Private Well
Minnehaha Creek Watershed District(MCWD) ❑Other:(specify)
1II202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682 ,..-
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ �.,�,a"��w� 0� ��
��-,� d .3 �SS , �8 � .�
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