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Home My WebLink About2015-00013 - advance plan review fee CITY OF ORONO * 2 0 1 5 — 0 0 0 1 3 * '� 2750 KELLEY PARKWAY DATE ISSUED: OU05/2015 j ORONO, MN 55356- (952) 249-4600 FAX: 952 249-4616 ADDRESS : 517 FERNDALE RD N PIIv : 36-118-23-14-0007 LEGAL DESC : UNPLATTED 36 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL COIYSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 1,300,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT: $ 1,300,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-000 l4 NOTE:FEES HAVE INCREASED 5%,BUT SYSTEM HAS NOT BEEN UPDATED YET. `A DIFFERENCE ON THE ADVNACED PLAN REVIEW MAY BE DUE WHEN YOU PICK UP THE BUILDING PERMIT. INITIAL: �,,=-• APPLICANT ADVANCED PLAN REVIEW 4,651.89 TOTAL 4,651.89 DENALI CUSTOM HOMES, INC. Payment(s) 18283 MINNETONKA BLVD. CHECK 11236 4,651.89 DEEPHAVEN,MN 55391- (952)476-2679 Minnesota State License#: BUIL-20175394 OWNER City ot Uron� 275U Kelley Parkway Orono MN 55356 952-2d9-46UU BURNET,RALPH&PEGGY 392 FERNDALE RD Receipt No: 3.012551 Jan 5, 2015 WAYZATA,MN 55391- Denali Custom Homes Previous Balance: .00 Permits AGREEMENT AND SWORN STATEMENT 2015-OOU13 517 Ferndale 4,651.39 Rd N The work for which this permit is issued shall be performed according to 101-34410 the approved plans and specifications,applicable City approvals,and the Plan CheCk/S1 te txam Fees State Building Code. This permit is for only the work described and does Tot21: 4,651.89 not grant permission for additional or related work which requires separate ___,_______i__ permits. All provisions of laws and ordinances governing this type of work Cheek shall be compied with whether or not specified herein.This permit will Check No: 11236 4,651.�9 expire and become null and void if construction authorized is not Payor: commenced within 180 days of the date of issuance,or if construction is Denal l Cust�m Homes suspended for a period of 180 days at any time after work has commenced. Tn ta 1 App 11 ed: 4,651.;.'+ The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be 'hai r i�� 1.��i�i�,��i e�1. U�� revo ed at any time for d cause. � � � ` � � �ti .��.� IYY�Cc�'� � / � / � c � Ap a�ca ermitee ' nature Date Issued By Signature Date �u J . CITY OF ORONO BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �O ` _� Mailing Address: � C;>b�5 ��l PO Box 66 Permit number: �C/ Crystal Bay, MN 55323-0066 Date received: ��S � � � 6 a StreetAddress:' Received by: I�--1-� � � __ .__..._..._._. � 2750 Kelle Parkw " �� 'R' _�-- �, Plan review fee: . , �j�"�'~ �;� �lq �G` Orono, MN 55356 ��L GIS ' ��'� 3 {��J� i-1.2..�..(cd.—.._._– ��-. R ' ._.. _. _____ �5�� 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 prinf) GENERAL INFORMATION: Job Site Address: 517 Ferndale Road N. Orono,MN 55391 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: Denali Custom Homes Inc. State �icense# BC175394 Expiration Date: 03/31/2015 Phone: (cel►) 763-452-8347 (office) 952-476-2679 nnaiiin9 address: 18352 Minnetonka Blvd ci : ee aven ziP: 55391 Contact Person: Joe Mailhot Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: JOe's Cell Phone: �763)452.8347 PROPERTY OWNER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax ARCHITECT/ENGINEER INFORMATION: rvame: Alexander Design Group Phone (day): 952-473-8777 address: 401 East Wayzata Blvd ciry: Wayzata ziP: 55391 Email and/or Fax: PROJECT INFORMATION: Descri tion of pro'ect: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal& Water Supply � New Construction � Single Family with � Residence ❑ Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑ Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ O�ce/Commercial � Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo ❑ Warehouse ❑ Public ❑ Storage ❑ Public Water �'Any earth movement may also require ❑ Commercial ❑ Other(specify) MCWD review 8�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.minnehahacreek.or Estimated Construction Valuation (excluding land) $ 1 ,3��,�lYU�