HomeMy WebLinkAbout2016-00848 - advanced plan review fee CITY OF ORONO * Z 0 1 6 - 0 PJ 8 4 8 *
2750 KELLEY PARKWAY DATE ISSUED: 07/20/2016
• ORONO, MN 55356-
: (952) 249-4600 FAX: (952) 249-4616
.:
ADDRESS : 440 NORTH ARM DR
PIN : 06-117-23-31-0003
LEGAL DESC : VICTORIA ESTATES
: LOT 001 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 PERMIT THIS PAYMENT IS FOR: SCREEN PORCH ADDITON ON TOP OF EXISTWG DECK
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00847
APPLICANT ADVANCED PLAN REVIEW 391.96
SAND CREEK DESIGN BUILD LLC TOTAL 391.96
3496 W 220TH ST Payment(s)
JORDAN, MN 55352- CHECK 5209 391.96
(952)994-6682
Minnesota State License#:BUIL-BC649608
OWNER
STERNAU,RENE
440 NORTH ARM DR
MOLJND, MN 55364-
AGREEMENT 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 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 180 days at any time afrer 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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i t Perm' ignature D Issued By�ignature , Date
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, City of Orono
, �
'� Buiiding Permit Application
for New Structures or Additions
Mailing Address:
PO Box 66 Permit number: � D�� —dQ � '
�O�Q Crystal Bay, MN 55323-0066 Date received: �7
, I StreetAddress:' Re�ived by: �-� TCt%� �c
y ,� 2750 Kelley Parkway � % 1,� - ��'S
F� c,` Orono, MN 55356 �-2� �(1P � F►an reviewfee: �� ..
1KfSHV�� Main: 952-249-4600 otal ee:
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: n� D M
Will this be a Parade of Homes, Remodelers Showcase H e or other isplay 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 wi 1 be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICA T INFORMATION:
Name: �« l,�t„�
State License# Q E ir tion Date:
Phone: cell office
Mailing Address: ^ ^ O*N Cit . ZIP: -Z
Contact Person: ' Applicant i • ontractor / Homeowner (Circle One)
Email and/or Fax: _ � `
PROPERTY OWNER INFO�MATION:� /�
Name: ���1`t �%���[r►�4V
Phone (day): —' r—
Address: g� � City �ou�� ZIP� s�3��
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name: _�j�ft� ���/�/.c�c.
Phone (day): 9SL- ?4�- 7?0�
Address: 7' �; City: /� p ZIP: ;S"�'Z
Email and/or Fax: M�KF Q��y,Q��T, a� t �r�
PROJECT INFORMATION: Description of ro'ect: ..5 �G�--f-�- 1�1� `� �-�=j��Sf7!'1 �.EC";k-
1.Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Dispos & �
�❑ N w Construction Sin le Famil with �Nater Supply
9 y ❑Accessory Bldg./Garage � ����
Addition attached garage ❑ Deck ❑ Public Sewer
Accessory Building ❑ Single Family with ❑Office/Commercial
❑ Relocation detached ara e �� �
❑ Other: s ecif g 9 ❑ Residence ivate Sewer
� P Y) ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water ��
""Any earth movement may require ❑ Commercial ❑Storage
MCWD review 8�permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) �ther: (SpeCify) . Other(specify
15320 Minnetonka Blvd
Minnetonka,MN 55345 ,��� a'�'�f
Phone: 952-471-0590 ��r �UA�
Fax: 952-471-0682 Sj.�YL� ����
www.minnehahacreek.or
$ /� �-�=
Estimated Construction Valuation (excluding land) ��•.�, Q pQ.
Packet Last Updated: August 2015
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