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Home My WebLink About2013-01239 - adv plan review -� CITY OF ORONO * z 0 1 3 - 0 1 Z 3 9 * � 2750 KELLEY PARKWAY DATE ISSUED: 1 U22/2013 ORONO, MN 55356- � (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3805 NORTH SHORE DR PIN : 17-117-23-21-0029 LEGAL DESC : SHERRI LAKEVIEW ESTATES : LOT 002 BLOCK 001 PERMIT TYPE : ADVANCED PLAN RF,VIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 33,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT: $ 33,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: BUILDING PERMIT � I PERMIT#THIS PRE-PAYMENT IS TIED TO:2013-01240 i �' APPLICANT ADVANCED PLAN REVIEW 32435 SCHNETZER,THOMAS TOTAL 324.35 3805 NORTH SHORE DR MOLJND, MN 55364- PAID WITH CC# 8795 OWNER SCHNETZER, THOMAS 3805 NORTH SHORE DR MOUND, 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 does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type oY 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[he t Id ode.This permit may be voked at � ue /l� ZZ� /3 �9��''��- / pplicant Per e gnatur Date Issued By Sig re ate SEPARATE PERMITS REQUIRED FOR WORK OTHER T AN DESCRIBED ABOVE. .. . �'�2-�3 5i 5 � , . City of Orono `'�� a� Building Permit Application for Maintenance / Replacement / Renovation - (No structural expansion. Only windows, doors, siding, re-roof, etc.) j` O �� Mailing Address: Permit number. �D/3— �/ z � � N ��, Po BoX ss � � \ C rystal Ba y, MN 55323-0066 Date received: //—Z��3 �� Sfreef Address: Received by: !�d � �� 2750 Kelley Parkway Plan review fee: 3 z�.3J`� C� � � ' Orono, MN 55356 � � ' d0! \��k�sHO� �� Total Fee: r �.. � 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: 3� `�� '`"'��` ��o�''"" ��'� '� Will this be a Parade of Homes, Remodelers Showcase Home ar other Display Home? ❑Yes No If yes,a special event permif is required with Police Department and City Council approval 60 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 INFORMA�TION: Name: ��r+�.... , ✓��'�i State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructedp rior to 1978 Phone: (cell) G/� - � �i `�- .,,,� � ?ea (office) � � �+' '�'F 9 �`� Pl s�%.�°ra. J�rGi�r s^ ��v, lp,.� City: ��-':r'.t�.+�. ZIP: ��y"� <`'". Mailin Address: � 5 ':�+ �; Contact Person: �"'�s�-� ��"t� ,,�,,,a �'"+�- Applicant is: Contractor / omeowner �c�.�ie one> Email and/or Fax: r�wf�°�.�.,�.,r-��,,*�- �``*� ��,rr�, G''�,� , 1�,�� PROPERTY OWNER INFORMATION: ,! Name: ��ll�� C f'�.�.ri��'�'��`�--_ Phone (day): ��',�- ��. � '� �` �� Address: }�,t�5'� ,�'� s��r='�, ~�i�'rt' ,�'.,-.'��' City: �:;�w��` ZIP: .�'C`'"�' Email and/or Fax: ,,�.� ,,�-�.,,�� -.�.�- /� .�.� ,�� , /�.,r 4 L PROJECT INFORMATION: Overall ro'ect descri tion: ��'"�'"�'`� '`�"�`p�`"� � ''�'�`�`f`f��`� Type of Project: Any earth movement may also require ❑ Door(s) �'Remodel ❑ Fire Damage MCWD review&permits: ❑Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Siding ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ ��, Q�'�' APPLICANT ACKNOWLEDGEMENT: . Agrees to provide all information required or 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 application being aware that upon failure to do so, the staff has no altemative but to reject it until it is complete; • Some or all of the information that you are asked to provide on this application is classified by State law 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 information which generall ot be given to either the public or the subject of the data. Our purpose and intended use of this information i o annua pdat rec rds and records of other governmental agencies required by law. If ou refuse to su I the in n icati a be issued. Applicant's Signature� ' Date: �l��Z'��.3 Owner's Sign re: Date: Last Updated:03/O6/2013