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Home My WebLink About2017-00048 - adn plan review ,H. CITY OF ORONO * z 0 1 7 — 0 0 0 4 e * � 2750 KELLEY PARKWAY DATE ISSUED: OU20/2017 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 680 NORTH ARM DR PIN : 06-117-23-43-0002 LEGAL DESC : AUDITOR'S SUBD.NO. 362 : LOT 001 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 24,000.00 NOTE: PLEASE FILL IN THE FOLLOW[NG: VALUATION OF PERMIT:$ 24000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: 2017-00049 PERMI"I'#THIS PRG-PAYMENT[S TIF,D T0: BATHROOM REMODEL, SIDING,WINDOWS APPLICANT ADVANCED PLAN REVIEW 271.83 GIRARD, SANDRA& BRIAN TOTAL 271.83 680 NORTH ARM DR Payment(s) MOUND, MN 55364 CHECK 10458 271.83 OWNER GIRARD, BRIAN& SANDRA 680 NORTH ARM DR MOUND, MN 55364- AGREEMENT AND SWORN STATEMENT The�cork for which this permit is issued shall be performed according to the approved plans and specifications,applicable Ciry 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 specitied herein.This permit will expire and become null and void if construction authorized is not commenced within l80 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 conformance with the State Building Code.This permit may be revoked at any time for due cause. ;� i��'� �� ;c�� /%_�..e ��-z, i� �c� �� Applicant Permitee Signature Date Issued By Signature Date , , City of Orono , . . . . � p, /'� , Building Permit Application �9 � for New Structures or Additions Mailing Address: permit number: f_�/�7�� Q PO Box 66 �1� �" �Q Crystal Bay, MN 55323-00 �� Date received: � —ZC� ` I' Street Address:' � �'�-r' �rZ � ,� 2750 Kelley Parkway ..- y�'� c,` Orono, MN 55356 �� .� p(,�(� PI review fee: / � '�kFs�o��' Main: 952-249-4600 otal Fee: Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and alt required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: ( �� /�� , 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 approva/60 days prior to the event. Shutt/e bus service wil/be required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted evenfs will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �,211A-N � I�la'rr2 i� State License# � Expiration Date: Phone: cell l2 30� �I office Mailing Address: � f}y2 , Cit : �� Contact Person: �� Applicant is: Contra r / Ho eowner (CircleOne) Email and/or Fax: c� /-�i , ,ra�tJ�� 'f' PROPERTY OWNER INFORMATION: Name: �2�� tr�a4,2� Phone(day): �a-- / Address: /�� , ,�/�svr , City: (��QlI/f� ZIP: ��b� Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: ARCHITECT/ENGI EER INFORMATION: � Name: /rd'Le. Phone (day): �jiS L-l��, 777 Address: Cf D/ �'�T �� City: �GtyZ�i� ZIP: .`�,��'� Email and/or Fax: ' � � ,fj� l �%xf'-Gttcn PROJECT INFORMATION: Description of project: �izr , '7e`r /� r'��i '` ,tr � 1.Type of Project 2. Proposed Use 3.Struct re Type 4. Sewag isposal 8� Water Supply ❑ New Construction ❑Single Family with ❑ Accessory Bldg./Garage ❑Addition attached garage ❑ Deck ❑ Public Sewer ❑ Accessory Building ❑ Single Family with ❑ Office/Commercial ❑ Relocation i- � ` detached garage � Residence ❑ Septic �Other:(specify) f� �n ❑ Multiple Family/Condo ❑ Retaining Wall(s) (Compliance certificate ❑ Public 4-feet or greater may be required) **Any earth movement may require ❑ Commercial ❑ Storage MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Public Water Minnehaha Creek Watershed District(MCwD) ❑ Other:(specify) ❑ Other(specify) 15320 Minnetonka Blvd;Minnetonka,MN 55345 ❑ Private Well Phone: 952-471-0590 / Fax: 952-471-0682 www.minnehahacreek.orq , � Estimated Construction Valuation (excluding land) $ ?, OiDfl _,�� Packet Last Updated: January 2016 Page 21 , � CITY OF ORONO * 2 0 1 7 - 0 a 0 4 8 * ' 2750 KELLEY PARKWAY DATE ISSUED: OU20/2017 ORONO,MN 55356- � (952)249-4600 FAX: (952) 249-4616 ADDRESS : 680 NORTH ARM DR PIN : 06-117-23-43-0002 LEGAL DESC : AUDITOR'S SUBD.NO.362 : LOT 001 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 24,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 24000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: 2017-00049 PERMIT#THIS PRE-PAYMENT IS TIED TO:BATHROOM REMODEL,SIDING,WINDOWS APPLICANT ADVANCED PLAN REVIEW 271.83 GIRARD,SANDRA&BRIAN TOTAL 271.83 680 NORTH ARM DR Payment(s) CHECK 10458 271.83 MOLJND,MN 55364- OWNER GIRARD,SANDRA&BRIAN 680 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 dces not grant permission for additional or related work which requires sepazate permiu. 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 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. Z� i / icant itee ignature Date Issued By Signature Date - ,,= Orono ; :�;lley Parkway ,,. � MN 55:356 952-249-4600 -t No: 3.017269 Jan 20. 2017 ^� �� & Sandra Girard ws Balance: .00 � ':s � ' 10048 680 Nurth Arm 271.83 �-:4410 •� ;heck/Site Exam Fees 271.83 ------------- --------------- n . ;� ;k No: 10458 271•83 D�,.or: E 3n & Sandra Girard �n*: Applled: 271.83 -------------- e Tendered: .00 01/20/2017 09:27AM _ City of Qrono � � � Building Permit Application � � , for New Structures or Additions Mailing Address: Q�T PO Box 66 Permit number: (%��7'� � `�� Crystal Bay, MN 55323-0066 Date received: � �ZC� ` l' Street Address:' -- �(.`:' C,VZ � ,� 2750 Kelley Parkway ,�I.> y�' c? Orono, MN 55356 �� / - (.�(� P� {review fee: / � ��kfSH�4'� Main: 952-249-4600 � otal Fee: 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: � �� /� ��j ��, Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No /f yes, a special event permit is required with Police Department and City Council approva/60 days prior to the event. Shutt/e bus service w�e required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �21�N �5, I�G�r2� State License# Expiration Date: Phone: cell l2 �D� 21 (office) Mailing Address: N � i2 (z, Cit : �8 � Contact Person: „� Applicant is: Contra r / Ho• eowner �c��e o�e� Email and/or Fax: � �, �-q , �� PROPERT'Y OWNER INFORMATION: Name: �2�� (a cr�y4+2� Phone (day): 3�— � Address: /y�� r �}�s� CitY� �/'c'C7� ZIP• �� Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: Phone (day): Address: City: Z�p• Email and/or Fax: ARCHITECT/ENGINEER INFORMATION: • Name: - ��-� Phone (day): �Z- Address: O/ � T ' Cit : � �ei� ZIP: .`��' � Email and/or Fax: ' ��Xf..�c o� PROJECT INFORMATION: Description of project: I�°iyr � -'7e`r /� �jY' �� l , ,� . 1.Type of Project 2. Proposed Use `" 3. Struct re Type 4. Sewage isposal& ❑ New Construction Water Supply ❑Single Family with ❑Accessory Bldg./Garage ❑Addition attached garage ❑ Deck ❑Accesso Buildin ❑ Public Sewer ry g ❑ Single Family with ❑ Office/Commercial ❑ Relocation i- � ` detached garage � Residence ❑Septic [�'Other:(specify) [� �A ❑ Multiple Family/Condo ❑ Retaining Wall(s) (Compliance certificate ❑ Public 4-feet or greater may be required) *"Any earth movement may require ❑ Commercial ❑ Storage MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Public Water Minnehaha Creek Watershed District(MCWD) � Other: (speCify) ❑ Other(specify) 15320 Minnetonka Blvd;Minnetonka,MN 55345 ❑ P�iv2te Well Phone: 952-471-0590 / Fax: 952-471-0682 www.m innehahacreek.orq Estimated Construction Valuation (excluding land) $ �� p�fl Packet Last Updated: January 2016 Page 21