HomeMy WebLinkAbout2012-00335 - attached deck CITY OF ORONO
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2750 KELLEY PARKWAY DATE ISSUED: 04/27/2012
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS 840 NORTH SHORE DR W
PIN : 07-117-23-22-0005
LEGAL DESC UNPLATTED 07 117 23
LOT 000 BLOCK 000
PERMIT TYPE ADVANCED PLAN REVIEW
PROPERTY TYPE RESIDENTIAL City of Orono
750
CONSTRUCTION TYPE ADVANCED PLAN REVIEW Oron Kelley Parkway
Orono MN 55356 952-249-4600
VALUATION $ 4,000.00 Receipt No: 3.006751 Apr 27, 2012
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 4,000.00 Jim Hatchett
TYPE OF PERMIT THIS PAYMENT IS FOR: ATTACHED DECK Previous Balance: .00
Permits
2012-CO335 940 North 67.11
PERMIT#THIS PRE-PAYMENT IS TIED TO:2012-00334 Shore Dr W
101-34410
Plan Check/Site Exam Fees
Total: 67.11
Check
Check No: 4797 67.11
Payor:
Jin Hatchett
Total Applied: 67.11
Change Tendered: .00
04/27/2012 03:1584
APPLICANT ADVANCED PLAN REVIEW 67.11
HATCHETT,JIM&JUDY TOTAL 67.11
840 NORTH SHORE DR W
MOUND,MN 55364-
OWNER
HATCHETT,JIM&JUDY
840 NORTH SHORE DR W
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 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 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 i nfor . ce w' a State Building Code.This permit may be ��
rev cause.
--
Ap f1dwriniteeSignature Da Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
r
City of Orono
Building Permit Application
for New Structures or Additions
O MailiPO Boxr66 Permit number.
0 Q Crystal Bay, MN 55323-0066 Date received: oz
At Street Address:' Received by:
int Gtii4 2750 Kelley Parkway Plan review fee: r L/L 7 cT`7
sgog�' Orono,MN 55356 �R_a
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us Total Fee:
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: 1"d z 0
Will this be a Parade of Homes, Remodelers Showcase Home or other DisplayRome? ❑ Yes 2rNo
ffyes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus servi will le
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION: \\
Name: L State License License# Expiration Date:
Phone: (office) (cell)
Mailing Address: City: ZIP:
Contact Person: Applicant is: Contractor / Homeowner (circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: 6� i7�1f�?%
Phone(day): _ /L 721
Address: A-g zip City: ZIP:
Email and/or Fax --r->`„ y„gys��1►��� ,Pt,(,y Cart^
ARCHITECT/ENGINEER INFORMATION:
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&
❑ w Construction Water Supply
❑Single Family with ❑Residence
-PNAddition attached garage ❑G ge/Accessory Bldg. El Public Sewer
Accessory Building ❑ Single Family with
❑Relocation detached garage ❑ ce/CommercialPrivate Sewer
El Other(specify) [3Multiple Family/Condo ElWarehouse
❑ Public ❑Storage ❑Public Water
* Any earth movement may require ❑Commercial ❑Other(specify)
MCWD review&permits. ❑ Industrial vate Well
Minnehaha Creek Watershed District(MCWD) ❑Other.(specify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax. 952-471-0682 a�
www.minnehahacreek.or
Estimated Construction Valuation(excluding land) $
Packet Last Updated: 10-20-2011
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