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Home My WebLink About2012-00441 - adv plan review CITY OF ORONO 111111111111111111111 1111111111111111111111111311 * 20 1 2 - 0044 1 2750 KELLEY PARKWAY DATE ISSUED: 05/22/2012 ORONO,MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 2359 OLIVE AVE PIN : 17-117-23-44-0076 LEGAL DESC : WILEYS NAVARRE ADDN LAKE MTKA : LOT 018 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 158,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 158,000 TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT PERMIT#THIS PRE-PAYMENT IS TIED TO: 2012-00442 THE APPLICANT GUESSED AT THE VALUATION AND JUST PREPAID AN ADVANCED PLAN REVIEW FEE OF$1,000 THE PLAN REVIEW ON$158,000 THE ACTUAL PERMIT CAME UP TO BE$913.09. WE WILL JUST APPLY THE$1,000 NOW AND ADJUST IT ON THE BUILDING PERMIT WHEN THAT IS PROCESSED#2012-00442 City of Orono 2750 Kelley Parkway Orono MN 55356 952-249-4600 Receipt No: 3.006909 May 22, 2012 Dean Johnson Homes, Inc. Previous Balance: .00 Permits 2012-00441 2359 Olive Ave 1,000.00 101-34410 Plan Check/Site Exam Fees APPLICANT Total: 1,000.00 =============== 1,000.00 DEAN JOHNSON HOMES,INC. Check ; 2353 10.00 1,000.00 4700 CTY ROAD 19 Payor: MEDINA,MN 55357- Dean Johnson Hales, Inc. (763)479-4820 Check Check No: 2353 1 000.00 Minnesota State License#:20639439 Payor: ' Dean Johnson Homes, Inc. OWNER Total Paid: 1,010.00 Bamboo Properties LLC Total Applied: 1,000.00 1 171 NORTHLAND DR Change Tendered: 10.00 #100 --- MENDOTA HEIGHTS,MN 55120- 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 in conformance with the State Building Code.This permit may be revoked at any time ue cause. / Applicant Permitee Signa re Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 01/4.k.---, �5 � � City of Orono - ► -f-*ltwCV' Building Permit Application for New Structures or Additions ,„,---6,-,., Mailing Box 66 Permit number: c: C (c)--WLI y,7)� Crystal Bay, MN 55323-0066 Date received: 5�`I 11 / 0 / — exp, 0 a *.f '.` Si/ Street a Received by: ,,1 p�f a ParkwaCps.LLI is 15 c'� r *.j.kirttiyY� ;� Y q t3,oil Plan review fee: � � �'�� C,jc y a� ,c ono, MN 5535E `��' Total Fee: Main: 952-249-4600 ax: 952-249-4616 www.ci.orono.mn.us This application form ust be completed in full and all required information must be submitted. In omplete a plicatio s will be retu ned. (Please print) GENERAL INFORMATION: s.359Ol1V -. /�Ven u c- Job Site Address: Lt. I B p-t- L.\ i t �� NCi ti WI v e, I-\ &' < ,— Will this be a Parade of Homes, Remodelers Showcase H 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 INFORMATION: Name: ��c�„.... 4V1tit� L-44b-rrtia ; ..l Y\.C. State License# Z.0(p3 4101 Expiration Date: .- /..5 i f 1 3 Phone: -1(3.1- 41S - 4g7.c.;, (office) "1 to3 - 7_47_ - -I 30 I (cell) Mailing Address: 4-loo - i Cit : 01"Q',......4, ZIP: s 5 3=�7 Contact Person: -R-Q- c\.I AG`— Applicant is: ontrac o / Homeowner (circle one) Email and/or Fax: .dal-Iv ? C e�o , ec,„,a v•v5t�, ,-hos 1 C_Ar ,, -76„b i 4-iq (4-t Z.. 1 PROPERTY OWNER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax ARCHITECT/ ENGINEER INFORMATION: Name: 411,-1 vls 4-2.--. 1,- p✓U':;_Si nc,,, 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 Supply 'New Construction gi,Single Family with ff.Residence ❑Addition attached garage Garage/Accessory Bldg. Xt Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ 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&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 www.minnehahacreek.orq Estimated Construction Valuation (excluding land) $ jSi, — • STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= 5 t Number of bedrooms= 5 tWood/Frame Masonry b.Width(ft.)= 3o Number of garage stalls: 0 Metal Attached= Z 0 Pole Bldg. Areas in square feet Detached= 0 ICF 0 On-site Prefab c. Basement= P-N1 0 0 Off-site Prefab 0 Other(please specify): d. 1st Story = 1'C] e.2nd Story= °-I1 f. %Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ Permit Application 0 Proposed Building Plans 'PC 0 MN State Energy Code Calculations and Mechanical Code Requirements Form 0 Survey(meeting all requirements) ❑ Ise Stormwater Pollution Prevention Plan 0 Hardcover Calculation(s) ❑ 1>af Septic System Site Evaluation Report ❑ Access Permit ❑ Wetland Buffer Improvement Plan ❑ Engineered Plans for Retaining Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ 0 Other APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • 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 alternative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • Understands 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 generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this information is to annually update our records and records of other governmental agencies required by law. If you refuse to supply the information,the application may not be issued. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. Applicants Signature: 71)Q -_ ��1 tiL.5% Date: 5/ 11 / 1Z--