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Home My WebLink About2014-00456 - adv plan review CITY OF ORONO * z 0 1 4 - PJ 0 4 5 6 * 2750 KELLEY PARKWAY DATE ISSUED: OS/15/2014 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 Arf'?i2ESS : 345 NORTH ARM LA PIN : 06-117-23-24-0015 LEGAL DESC : NORTH ARM OVERLOOK : LOT 001 BLOCK 001 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 55,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERM[T: $ $55,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT PERMIT#THIS PRE-PAYMI;NT IS TIED TO:2014-00457 APPLICANT ADVANCED PLAN REVIEW 467.51 LECY BROS HOMES TOTAL 467.51 15012 HWY 7 Payment(s) CREDIT CARD 1979 467.51 MINNETONKA, MN 55345- (952)944-9499 Minnesota State License#: BUIL-20325555 OWNER SIPPRELL, DAVID&CARLA 345 NORTH ARM LA MOUND, MN 55364- AGREEMENT AND SWORN STATEMENT The�vork 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 permi[is for only[he work described and does not grant permission tbr addiYional or related work which requires separate permits. All provisions of laws and ordinances goveming 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 da[e of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. I�he applicant is responsible for assuring all required inspections are requested in confonnance with the State Building Code.This permit may be revoked at any time for due cause. � - !3 / � - / / A pli t Permi ee Signatur ate Issued B ' nature � Date �------ City of Orono Building Permit Appiication for Maintenance / Replacement / Renovation - (No structural expansion. Only windows, doors, siding, re-roof, etc.) � � Mailing Address: Permft number: 6/ Q d 5 ` :��N��`�°, PoeoXss � i� � � Crystal Bay,MN 55323-006 Date received: - — � i �., �� . Street Address: ` Receiv��I by;__ ; ��, 2750 Kelley Parkway aI Plan review fee;` �.,41�,� �`��`;` Orono,MN 55356 J "" a 01 � d D � - T � Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us � This application form must be completed in fuii and all required information must be submitted. � Incomplete applications will be retumed. (Please print) �' GENERAL INFORMATION: � � Job Site Address: 3 'y� � �� WIII this be a Parade of Homes,Remodelers Showcase Hane or other Display Home? Yes Plo ff yes,a specia!everrt permit is required wlth Pofice Department and City Councll approva!60 days pNa to the evenf. ShuKle bus wil!be required urtless applrcani demonstrates suffrcieM onsite parking is availabfe. Non-permitted events wlfi not be aUowed. CONTRACTOR/APPLICANT INFORMATION: Name: C.C��I �Yt`�.�.5 ��t�j � ��'LJ D��Z/sL� State License# f3Ci 3� SS'SS' Expiration Date: � 3 � Lead Certification Number: ^/f,¢ Expiration Date: (fer work on homes that were constructed prlor to i978 Phone: (cell) 952—7 lo-3'78'3 C�� (office) 9'�2—g� —�'+{! Mailing Address: O('Z, � Cit :/Lir/Z1Ltr�/¢-ZIP: S3'Y Contact Person: � �- � Applicant is: Contracto ! Homeowner �ci.�b o�� Email and/or Fax: /1��/�y�.t�x•�1JQ L��t^�3 2,� $�y PROPERTY OWNER INFORMATION: Name: �� 'r�'��' ',.��' � P��ZZ�.. Phone(day): .2�. Q.- ��G�r.c-� Address: �L� / dT2T2� L�'LL` C�Y� B+�tJ'F� ZIP: ��3�� Email and/or Fax: ��q��1�� ',�l.TIBl2+tIL'T' NET PROJECT INFORMATION: Overall ro'ect escri tion:/1�OJV—S�V�R� �7 C� !/G/pl�6cf3�4�vT'� Type of Project: �p� My earth movement may also require ❑Door(s) �Remodel l�❑Fire Damage MCWD review 8 permits: ❑Re-roof,asphalt ❑Repair /� ❑Storm Damage Minnehaha Creek Watershed Dfstrict(MCWD) ❑Re-roof,cedar ❑Restoration 18202 Minnetonka Blvd ❑Water Damage Deephaven,MIV 55391 ❑Re-roof,other(specHy) ❑Siding ❑Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.ora Estimated Construction Valuation of Project(excluding land) $ APPUCANT ACKNOWLEDGEMENT: • Agrees to provide all information required o►requested by the Building Department; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete apptication being aware that upon failure to do so,the staff has no altemative but to reject it until it is complete; • Some w alt of the infoRnation that you are asked to provide on this application is classified by State Iaw as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is lnformation which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other govemmental agencies required by law. If ou refuse to su the i orma' a lication ma not be issued. ApplicanYs Signature: Date: _� � � � � � . Owner's Signature: Date: