HomeMy WebLinkAbout2017-00074 - adv plan review � ` CITY OF ORONO * z 0 1 7 - 0 0 0 7 4 �
2750 KELLEY PARKWAY DATE ISSUED: OU25/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 669 MINNETONKA HGLD LA
PIN : 06-117-23-44-0007
LEGAL DESC : MINNETONKA HIGHLANDS ESTATES
: LOT 003 BLOCK 002
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 750,000.00
NOTE: PLEASE FILL[N THE FOLLOWING:
VALUATION OF PERMIT:$ 750,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00073
APPLICANT ADVANCED PLAN REVIEW 3,212.57
LDK BUILDERS INC TOTAL 3,212.57
8242 125TH AVE Payment(s)
MILACA, MN 56353- CHECK 577756 3,212.57
(612)685-9066 �
Minnesota State License#: BUIL-1327
OWNER
SH[ELDS, MICHAEL&MELISSA
669 MINNETONKA HGLD LA
LONG LAKE, MN 55356-
AGREEMENT AND SWORN STATEME1vT
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 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 permit may be
revoked at any time for due cause. � ���
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Applic t Permitee Signature Date Issued By Signature Date
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City of arono
Building Permit Application
for New Structures or Additions
��A y Mai1rPC3 Box fifi, i'ermil nur�tber: '�3
`v� c�ys�a��ay,MN a5323-0068 oa�e r�ce�vea: l —z 5—�
sr.�rAddf�ss:� �rs�by: � ,
"" � 275U Kellsy Pa�kway �
�y� �(�� an�visw fse: �
Q�c.` Orano,MiV 55358 �—Z"7 5Jv
�'�FSH� Main: 952-249-460�
fax: 952-2+49-4616
This ap��on �Cum mu�t#a+�t� �a futi a�d�1`r ` ��n�ian rn�t b�subrrrr��d.
inc�m�r�e�i�n��rill be retu�nsd. (P/ease prinf)
GENERAL INF4RMATION:
Job Slte Address: q
Will this be a Parade of Homes, Remodelers Showcase Home or other Dispiay Home? Yes No
H yes,a sped�l event perrnit is re�rired wrth Pvficie De�arhn�t�hcJ Clty Coun�►7 approv�i fi0 days prior to tl�e eVent Shuttle bus service wt7l be
required unfess appNcant demonstratas sufiScieM on-sifa parkirrg is avalladJe. No»-p�rmitted events wiU nof be a!loweat.
CONTRACTOR 1 APPLICANT INFORMATION:
Name:
State License# , Expiration Date:
Ptwne: (c:eil) � (offioe}
Mailing Address: Ci Z1P:
Contact Person: Applicant is: o trac r 1 omeowner (Circte�no1
Email and/or Fax:
PROPERTY OWNEF�INFORMATION:
Name: ��,g� �"�iK` � ��ai.L�
Phc�ne(c�y):
Address: _i�00 ��.�cL�.r. fa.r Ciry:�yr��tl ZiP; �'���7
Email and/or Fax
ARCFiI'TECT/ENGINEER INFORMATION:
Name: ��3C��� .
Phone{day):
Address. �IoP� [�s�.�.s.�� Ciry: ��.�s—,;�,L ZIP: SS'��'�
Email and/or Fax: _/�C-r.�:���i_� e���H
PROJECT INFORMATION: Descri �on o� ro'ect:
1.Type nf Project 2.Praposed Uae 3.Structure Type 4.5ervage Disposal�
New Construction �Sin le Famil with rNater 8upply
g y ❑Accessory Bldg.!Garage
❑Addiiion attached garage ❑ Deck Public Sewer
❑Accessory Buiiding [� Single Family with ❑OffIcelCammercial
Q Relxation detached garage ❑Residence ❑Privaie Sewer
❑Other:(speaiy} ❑Muftipie Famify/Condo �R�ataining Wall(s)
❑Public 4feet or greater ❑Public Water
""Any earth movement may requlre ❑Commercial ❑Stara�e
MCWD revlew&permits. ❑Industrial ❑Warehause �Private Well
Minnehaha Geek Watershed Qistrick(MCWp) ❑Other: (spec'rfy) ❑C7ther(specffy)
15320 Minnstonka Blvd
Minnetnnka,MN 55345
Phorte: 952-471-0590
Fax: 952-471-C3682
Ru 11 9ek.cx
Estimated Construction Valuation (excluding land) � 7�Q_ �zp -�—
Packet tast Updated: August 2015
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