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Home My WebLink About2009-00176 - adv plan review ' � CITY OF ORONO PERMIT NO.: 2009-00176 � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE �ssuEn: 04/24/2009 952 249-4600 FAX: 952 249-4616 ADDRESS : 3186 NORTH SHORE DR PIN : 09-117-23-32-0010 LEGAL DESC : CRYSTAL BAY PARK : LOT 000 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW NOTE: BUILDING PERMIT#2009-00177 PLAN REVIEW PAID 4/24/09-CHECK#4553 APPLICANT ADVANCED PLAN REVIEW 1,856.89 NEDDERMEYER, GLEN TOTAL 1,856.89 709 MINNETONKA H[GHLAND LA LONG LAKE, MN 55356- '�nu t�+f 5;;,��iz OWNER s�ti,L �tin: .� NEDDERMEYER, GLEN 709 MINNETONKA HIGHLAND LA LONG LAKE, MN 55356- _ �h^tve� ,,.� , _ AGREEMENT AND SWORN STATEMENT 4��'�'� f r�: Ci��ack.��tr Exau= , - �- 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 ��E'`'� �'6` '�r shall be compied with whether or not specified herein.This permit will �yUw' �'pn �Si��Y"�I' expire and bewme null and void ifconstruction authorized is not i! !?a�2iE�' commenced within ]80 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 responsibie 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. / / / / Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. STRUCTURE INFORMATION: 1.Strvctur+e Dimensions 1.Strvcture Dimensions(continued) 2.Type of Construction a. Length(ft.)= x Number of bedrooms= y �Wood/Frame ❑Masonry b.Width(ft.)= X Number of garage stalls: ❑Metal Attached=�_ ❑Pole Bldg. Areas in sauare feet Detached= ❑ICF ❑On-site Prefab c. Basement= l�n od ' ❑Off-site Prefab d. 1�Story = «00(0 ❑Other(please specify): e.2n°Story= o�a-I(e f. �Story = g.Total Area= Jraea REQUIRED SUBMITTALS: All of the information must be submitted in order for our a plication to be rocessed: Not � Enclosed A licable ❑ ❑ Permit A lication ❑ ❑ Pro osed Buildin Plans ❑ � MN State Ene Code Calculations and Mechanical Code R uirements Form ❑ ❑ Surve meetin all re uirements ❑ ❑ Hardcover Calculation s ❑ Se tic S stem Site Evaluation Re ort ❑ .0' Access Permit ❑ Wetland Buffer Im rovement Plan ❑ �' En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ Other APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering ao�ultant review costs in excess of t500; • Certifies that the infortnation supplied is true and c�rrect to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a completie application being aware that upon failure to do so,the staff has no altemative but to reject it until it is complete; • Adcnowledges the Escrow Agreement is completed and signed; • Some or all of the informa6on that you are asked to provide on this application is Gassified by State law as either private or confidential. Private data is information which generally pnnot be given to the public but can be given to the subject of the data. Confide�Ual data is information which generally pnnot be given to either the public or the subject of the data. Our purpose and intended use of this infortnation is to annually update our records and recorcJs of other govemmental agencies required by law. If you refuse to supply the information,the application may not t�issued. ApplicanYs Signature: � a�� Date: �^ '� �'� - 19- � , �� 5 �� City of Orono A�'� � � �� Buiiding Permit Application c�� '�� 5556.�s for New Structures or Additions 3o5�.7S Tz3�� ,_—� Mailing Address: Permit number - �/ 7� ��,�:\ PO Box 66 ; Crystal Bay, MN 55323-0066 Date received: O :� 01 ' '�� Received by: � '� � � a � �,; StreetAddress:' vc,., � �, , �\`��, � � Gti� 2750 Kelley Parkway Plan review fee: � �5 � r7 / � �,Ly;Y�� Orono, MN 55356 �G �1 � y��/L `�,E3H� � OZO OCJ— UO �7Jo ( -- Total ee: 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 print) GENERAL INFORMATION: Job Site Address: 318(n PIo2�4� Ho�2. 1 �II this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o !f 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 demonstrafes sufficienf on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: G�E� 1��'D'�ER�nnE`�f�2 State License# Expiration Date: Phone: (offi�) L I a�°I t la-�I S O o (cell) MailingAddress: '7oq M�1.tiNEZ�NICA 1��.H�c��.� �n� City: �o�vc� �p+�KE Z�P� 553S�o Contact Person: Applicant is: Contractor / omeown (Circle One) Email and/or Fax: G1E N o'�. KM HERECT�i25 CoM PROPERTY OWNER INFORMATION: Name: C�\EN Ne'DDE2rv�.E`(E12 Phone(day): (01 a —`i l lc - '�i 5 O O Address: "Toq M �ntrtETor�Kp I-}tc�t+lAN� Lnr City� �oNt, L�kE ZIP: SS3S�o Email and/or Fax ��E,�', kMHER cc.�oR S� Orn ARCHlTECT/ENGINEER INFORMATtON: Name: Phone(day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal� Water Suppty �New Construction �Single Family with �esidence ❑Addition attached garage ❑Garage/Accessory Bldg. �Public Sewer ❑Accessory Building ❑ Single Family with ❑ Dedc ❑ Relocation detached garage ❑Office/Commercial ❑ Private Sewer ❑Other. (specify) ❑ Multiple Family/Condo ❑Warehouse ❑Public ❑Storage ❑ Public Water "`Any earth movement may 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�71-0682 www.minnehaha creek.or Estimated Construction Valuation (excluding land) $ �feD,, o G>� �c'-� - 18-