HomeMy WebLinkAbout2017-00505 - advance plan review fee CITY OF ORONO * Z PJ 1 7 — PJ 0 5 0 5
2750 KELLEY PARKWAY DATE ISSUED: 05/15/2017
ORONO,MN 55356-
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 3760 NORTHERN AVE
PIN : 17-117-23-34-0051
LEGAL DESC : SOUTHVIEW ESTATES
: LOT 003 BLOCK 001
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 48,500.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 48,500.00
TYPE OF PERMIT THIS PAYMENT IS FOR: ENTRY ADDITION
PERMIT#THIS PRE-PAYMENT IS TIED TO:2017-00504
APPLICANT ADVANCED PLAN REVIEW 458.01
TOTAL 458.01
VANDEPUTTE,MARY Payment(s)
3760 NORTHERN AVE CREDIT CARD 8901 458.01
WAYZATA,MN 55391-
OWNER
VANDEPUTTE,MARY
3760 NORTHERN AVE
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 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 re ible for assuring all required inspections are
requested in pofformpdce with the State Building Code.This permit may be
re 6y ti or due cause.
O
pplicant Permitee Signature Date Issued By Signature Date
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
Mailing Address: 2 _�SO
O` r PO Box 66 Permit number. _�7
Crystal Bay, MN 55323-0066 Date received:
1 Received by:
Street Address:
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2750 Kelley Par
`ay f review fee:Z
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kESHOCOrono, MN 5535
Main: S cpy
952-249-4600 Total Fee:
Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
GENERAL INFORMATION: Incomplete applications will be returned. (Please print)
Job Site Address: 7(�,p AVC—
Will
this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No
If 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 demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT
_ IN�=en�4�
IO
Name:
State
License# Expiration Date:
Phone: rcell ZZ I—7,7 ,r office
Mailing Address: fy�tCit :�1 ZIP:Contact Person: Applicant is: Contractor / omeowne (circle one)
Email and/or Fax: /Sa.� /tel L. fr�a-. i 7�i `f7,5r b 2 .0 c
PROPERTY OWNER INFORMATION:
Name:
Phone (day): [ems•/ -Z2 f- ?'Z7(3 C �� ��,
Address: Pr o. W>e 4 / u'+
City- %'f�;1 ZIP:
Email and/or Fax 77k;_ Lf7 g-►-d_7o
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone (day):
Address: Cit • ZIP:
Email and/or Fax:
PROJECT INFORMATION: Description of project:
1.Type of Project 2. Proposed Use 3.S r ture Type 4.Sewage Dis�osal
❑ New Construction Water Supply W
'Single Family with ❑Accessory Bldg./Garage
OkAddition attached garage ❑ Deck [Public Sewer
tj-Accessory Building ❑ Single Family with ❑Office/Commercial
❑ Relocation detached garage .P-ftsidence
❑ Private Sewer
[Other:(specify,4G ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater KPublic 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
)—LAminnehahacreek.or
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Estimated Construction Valuation (excluding land) $ - r
Last Updated: January 2016