HomeMy WebLinkAbout2016-01089 - adv plan review ' ' CITY OF ORONO * Z 0 1 6 - 0 1 0 8 9 *
�� 2750 KELLEY PARKWAY DATE ISSUED: 09/07/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952)249-4616
ADDRESS : 3145 NORTH SHORE DR
P[N : 09-117-23-33-0013
LEGAL DESC : REG. LAND SURVEY NO. 1113
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 350,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 350,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: ADD[TION TO HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-01088
APPLICANT ADVANCED PLAN REVIEW 1,745.20
TOTAL 1,745.20
BOYER BUILDING CORPORAT(ON Payment(s)
3435 COUNTY ROAD 101 CHECK 051004 1,745.20
MINNETONKA,MN 55345-
(612)475-2097
Minnesota State License#: BUIL-2988
O W 1vER
PETERSON, SVERON
3145 NORTH SHORE DR
WAYZATA,MN 55391-
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 l80 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. �
__�
� _.. t _._.� _ r � _ ? _� � �-��c�-'� ��`--���-�'z-' c� � `��
Ap�kicant Permitee Signature Date Issued By Signature Date
- .
�� CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
�O�O Mailing Address: Permit number: " l �O�D I O�
PO Box 66
Crystal Bay, MN 55323-0066 Date received: � �-- �—��
Street Address:� /�
� G� 2750 Kelley Par �a �K'� Plan review fee:
��q'�FSHo4� Orono, MN 5535 Cj��,1 '�� C�
Main: 952-249-4600
Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in fuil and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: 31�1 S Nor�4-�, Sl�or� .�r-.
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes [g No
If yes,a special event permit is required with Police Department and City Council approva160 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: [�jo er (3k.►1d� Cay� .
State License# (;C �S L9�8 Expiration Date: ( f
Phone: (cell) 61t-S1R - 2.2.00 (office) 9SZ ' 4�1 S ' 209?
Mailing Address: 3`�3S C� (O� Cit : y►1TKfF ZIP: SS yS
Contact Person: e� F'�-o�nso� Applicant is: ontract / Homeowner (CircleOne)
Email and/or Fax: �oe, ��Anse,�, Q boye�-bu►ildi�q. Com
PROPERTY OWNER INFORMATION:
Name:
Phone (day):
Address: City: ZIP:
Email and/or Fax
ARCHITECT I ENGINEER INFORMATION:
Name: P�t�- R. �r-
Phone (day): IZ.,- 3og- Iq7�{
Address: I�1bgS Ex�elsio� (31� . City: �x�e(siar' ziP: $S33/
Email and/or Fax:
PROJECT INFORMATION: Description of project: - 1 -TC�
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
❑ New Construction �Single Family with ❑Accessory Bldg./Garage
�Addition attached garage ❑ Deck ❑ Public Sewer
❑Accessory Building ❑ Single Family with ❑ Office/Commercial
❑ Relocation detached garage Residence ❑ Private Sewer
❑ Other:(specify) ❑ Multiple Family/Condo Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
'*Any earth movement may also require ❑ Commercial ❑ Storage
MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other: (specify) ❑ Other(specify)
15320 Minnetonka Blvd
Minnetonka,MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.orq
Estimated Construction Valuation (excluding land) $ .350 000
Last Updated: January 2016