HomeMy WebLinkAbout2015-01084 - adv plan review CITY OF ORONO * 2 0 1 5 — 0 1 0 8 4 *
� 2750 KELLEY PARKWAY DATE ISSUED: 08/25/2015
ORONO,MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 515 NORTH ARM DR
PIN : T000129
LEGAL DESC : LAKEVIEW OF ORONO
: LOT 22 BLOCK 3
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 730,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$730,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR:NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO:2015-01083
APPLICANT ADVANCED PLAN REVIEW 3,144.11
TOTAL 3,144.11
NORTON HOMES Payment(s)
18215 45TH AVE N, STE D CREDIT CARD 6532 3,144.11
PLYMOUTH,MN 55446-
(612)386-7661
Minnesota State License#:BUIL-BC639221
OWNER
Source Land Development Inc.
18215 45TH AVE N
STE D
PLYMOUTH,MN 55446-
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 sepazate
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 date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The appiicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. /�e�
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'� CL/��e c� 6u_7� Q ��U C� �� /S
Applicant Permitee Si ature Date Issued By Signature Date
, �
CITY OF ORONO
BUILDING PERMIT APRLICATION
FOR NEW STRUCTURES OR ADDITIONS
_ ^�O Mailing Address: Permit number. � � �j—(���
�u�� PO Box 66
Crystal Bay,MN 55323-0066 Date received:
StreetAddr�ss:' iv •
� Gti� 2750 Kelley Parkway 5���' Plan reviewfee: �
`�t Orono, MN 55356 � � 'y �
�x�sxo�`` 2 a �
Total Fee:
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.
�-yi�' Incomplete applications will be returned. (Please print)
GENERAL INFORM 10 :
Job Site Address:� o/� ti'�r�;/� LDf 2:2. 13/o�.k 3 Lc�-�i'z,cJ��e.�
Will this be a Parade o omes, Remodelers Showcase Home or other Display Home? Yes ❑ No
lf yes,a special event permit is required with Police Department and City Council app�oval 60 days pnor to the event Sh le us seivice will be
required unless applkant demonstretes s�cient on-site parking is availa6le. Non permitted events will not be ellowed.
CONTRACTOR/APPLI ANT INF MATION:
Name: �r,� �/'G
State License# G 3 Expiration Date: 3- 3 i- /?
Phone: (cell) 6 i�. 31��- 7G�/ (o��) 7C 3 5 f�1'z�9/
Mailing Address: / i� �S` de Ci : / �,d�-y�� ZIP: S`'i'yC
Contact Person: C/�y�i5 /t/o�'�ok Applicant is: Contractor / omeowne (ClrcleOne)
Email and/or Fax: CI�r.S►tl ca nvr�aK ,�Ja�o�. Go r�
PROPERTY OWNER,,�I�FORMA�'ION):
Name: C;/•r� s I'!/�i'-t�a/�
Phone(day): 6��. 3t7G-7�� /
Address: Ci : ZIP;
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name: f�F�� � l�n►•��.�-y C� P.�s.s•1 � c�� .
Phone(day): ~!6 3 -'?p Qo p °
Address: /mo c3.a,/-f,`�„�ar� ,.� �t/F City: �j (k.�'k ZIP: �S y �
Email and/or Fax.
PROJECT INFORMATION: Descri tion of ro'ect: �c.w e
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
�1�lew Construction Single Family with [�j Residence
�(]Addition attached garage ❑Garage/Accessory Bldg. ❑Public Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
❑Relocation detached garage ❑Office/Commercial �rivate Sev�r
❑Other:(specify) ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑Storage ❑Public Water
**Any earth movement may also require ❑Commercial ❑Other(specify)
MCWD review&permits. ❑ Industrial (�Private Well
Minnehaha Creek Watershed District(MCWD) ❑Other. (SpeCify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
vwvw.minnehaha k. r
Estimated Construction Valuation (excluding land) $ �3[7 2p n
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