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HomeMy WebLinkAbout2016-01202 - adv plan review CITY OF ORONO 1111111111 11111111 111 11 ` 2750 KELLEY PARKWAY * 20 1 6 - 0 1 202 * DATE ISSUED: 09/26/2016 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS : 460 ORCHARD PARK RD PIN : 32-118-23-23-0012 LEGAL DESC : ORCHARD FARMS : LOT 2 BLOCK 1 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATION : $ 650,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT:$ 650,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-01201 APPLICANT ADVANCED PLAN REVIEW 2,871.32 MULHERAN,PATRICK&MELISSA TOTAL 2,871.32 Payment(s)4128 HALLGREN LA CHECK 4836 2,871.32 EXCELSIOR,MN 55331- Minnesota State License#:BUIL-BC103407 OWNER MULHERAN,PATRICK&MELISSA 4128 HALLGREN LA EXCELSIOR,MN 55331- 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 for due cause. Ai Le--� ro1 ,zplApplicant Permie Date Issued By Signature Date City of Orono 1 Building Permit Application for New Structures or Additions Mailing Address: Permit number: Po Box 66 20 — / l Crystal Bay, MN 55323-0066 Date received: /2i(4 /�C., Street Address:' `1, ��I°0 eceived 4y: E ' 2750 Kelley Parkw y 2� Plan review fee: to �` Orono, MN 55356 CIG Cf _ t"�k stto�`� Main: 952-249-4600 if.) tal : 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: ION: ix, D Q t1 4 rr) 01 Omen Job Site Address: tri d 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 ivilPtre required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APP (CANT I FORMATION: Name: 1 • )A _• State License# C ,. Expiration Date: - Phone: cell — "a — eireVAIMAJW _ - . — Mailing Address: . S I /= ! ZIP: 3 R Contact Person: - air 4 Applicant is: ontrac or / Homeowner (Circle One) Email and/or Fax: j pe;,,1en i /_e+-itoh he,evvc ,C o -441 PROPERTY OWNERFORM TION: i/ Name: p#1,,., i4 uii't.4r" Phone(day): 2_ c, 4 _g 6 FS Address: g /f/1%/�, vi L/.1e'!P City:C�C�'/Sjb� ZIP. --)J/ Email and/or Fax p rn Li /46-4-A, 17 JA /.- - G yi ARCHITECT/ENGIN§ER I FORMATION: Name: II e4.5-4,,-7 Phone (day): 7 6 7/ 7 Address: 9 / 60 2-71o( cam/ /�G City: /4;/P ZIP:5-3.—Vry Email and/or Fax: PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal & Water Supply New Construction Single Family with attached garage ❑Accessory Bldg./Garage ["Addition 0 Deck ❑Accessory Building 0 Single Family with Office/Commercial ❑ Public Sewer ❑ Relocation detached garage Residence ,Private Sewer ❑ Other: (specify) ❑ Multiple Family/Condo "'❑❑❑ Retaining Wall(s) 0 Public 4-feet or greater 0 Public Water **Any earth movement may require 0 Commercial 0 Storage MCWD review&permits. 0 Industrial 0 Warehouse XPrivate Well Minnehaha Creek Watershed District(MCWD) 0 Other: (specify) 0 Other(specify) 15320 Minnetonka Blvd Minnetonka,MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.org Estimated Construction Valuation (excluding land) $ c 50000 co Packet Last Updated: August 2015