HomeMy WebLinkAbout2014-01391 - adv plan review I CITY OF ORONO HI I 01 I >I II III III 111111
* Z 1 4 - 0 1 39 1
. if - , j 2750 KELLEY PARKWAY
DATE ISSUED:: 12/05/2014
ORONO, MN 55356-
952) 249-4600 FAX: (952) 249-4616
ADDRESS : 105 ORO O ORCHARD RD N
PIN : 35-118-23 33-0003
LEGAL DESC : UNPLATTED 35 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANED PLAN REVIEW
VALUATION : $ 110,00¢.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 110,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: GARAGE
THIS PRE-PAYMENT IS TIED TO:2014-013 2
i
11APPLICANT ADVANCED PLAN REVIEW 725.89
TOTAL 725.89
GORDON JAMES CONSTRUCTION Payment(s)
5159 MAIN STREET E CHECK 9228 725.89
P.O.BOX 306 I
MAPLE PLAIN,MN 55359-
(763)479-3117
Minnesota State License#: BUIL-20531961
City of Orono
OWNER 2750 Kelley Parkway
Orono MN 55356 952-249-4600
LOWE,JAMES
105 ORONO ORCHARD RD N Receipt No: 3.012420 Dec 5, 2014
LONG LAKE, MN 55356-
Gordon James
Previous Balance: .00
Permits
AGREEMENT AND SWORN STATEMENT 2014-01391 725.89
101-34410
The work for which this permit is issued shall e performed according to Plan Check/Site Exam Fees
the approved plans and specifications,applica le City approvals,and the
State Building Code. This permit is for only t e work described and does Total: 725.89
not grant permission for additional or related ork which requires separate --
permits. All provisions of laws and ordinance governing this type of work Check
shall be compied with whether or not specifie4 herein.This permit will Check N0: 922$ 725.89
Payor:
expire and become null and void if constructs n authorized is not GC r'1" I'M":
commenced within 180 days of the date of iss ance,or if construction is Tot, .
suspended for a period of 180 days at any timeafter work has commenced. --
The applicant is responsible for assuring all r quired inspections are Chal .. ._ _ _ __
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. I
itirl (7-)-1ICa t-" / 5 /V
Applicant Permitee Signature Date
Issued By Signature Date
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
Mailing Address:PO Box 66 Permit number: -.... / f -
Crystal Bay,MN 55323-0066 Date received: / c2-Li--/Li
,� Streei Address:'
Received by
yes4 27613 Kelly Parkw y Plan review fee: •
1dkfs140-$ Orono,MN 55356 �r ! RQ/2Z /'
Tutdl Fees. J
Main: 952-249-4600 Fax: 052-249-4616 www.ci.orono.rnn.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: 1 S Df.-wNc 0 tr :.ane.N . ..1. , t�.J -
Will.this be a Parade of Homes,Remodelers Showcase Home or other Display Home? ❑Yes -No
If yes,a spacial even(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-sile parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLIC NT INFQRMA ION: k1
Name: c,r6,,, .vti S CAI:fi 54.Cu -'�(
Ci c n
State License# Crze.5 31 q 6 1 Expiration Date: 3 S
R'
Phone: (cell) St, 2C, t,- c6 9(,"3 (Office) 36'3• `i3`� • 3 t
Mailing Address: '51'r'f, pA.,..1, S-> . 20 'i(ACit :IAA,L•C A..a,.) ZIP: c 3s`l
Cgntact Person: ._ c.1,-,,-, V az n �y �-- Applicant is: ontrac / Homeowner (circle one)
Email and/or Fax: ',r,inn d Ca).- C ar c an- 'see.nn2 S . C6 ill
PROPERTY OWNER INFQRMATION:
Name: 0-7,.e n. IL LA A 1.-.640 e._
Phone(day): f./S'2. - 6 g'‘ '-'-)`)'f I J
Address: • Its Of%: c• Ori3 , (
�u�l n.,�. City: Uro.-;C. ZIP: 5 35
Email and/or Fax j e$1 A r r•_nri:S Qc r.0 e (`�,�- c rvr ti:-:.I, C.;,n-t
ARCHITECT/ENGINEER INFORMATt N:
Name: 1-r V>e S .r-N,n\ AC .
Phone(day): c'1 2.4. 1. (6. 3'3 02-
Address: _ City: . ZIP:
Email and/or Fax: .1,,,1 It t to 6c In r a r2 'k r.n A A P
PROJECT INFORMATION: Descri tion of pro ect: _
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
o New Construction ❑Single Family with 0 Residence
❑Addition attached garage ❑garage/Accessory Bldg. 0 Public Sewer`
'[):Accessory Building 0 Single Family with 0 Deck A
-0 Relocation detached garage 0 Office/Commercial El Private sewer f
❑Other:(specify) ❑Multiple Family/Condo 0 Warehouse
0 Public 0 Storage ❑Public ter -,
"*Any earth movement may also require 0 Commercial 0 Other(specify)
MCWD review&permits. in industrial 0 Private Well
Minnehaha Creek Watershed District(MOND) . Other:(specify)
18202 Minnetonka Blvd c'o.cc,.PI 12
Deephaven,MN 55391 Jl
Phone: 952-471-0590
Fax: 952-471.0682
tw w.minnehahacreek.oro
Estimated Construction Valuation(excluding land) $ /1 0 : 0 L C)