HomeMy WebLinkAbout2016-00061 - adv plan review � CITY OF ORONO * 2 0 1 6 - 0 0 0 6 1 *
� 2750 KELLEY PARKWAY DATE [SSUED: OU19/2016
ORONO, MN 55356-
(952 249-4600 FAX: (952) 249-4616
ADDRESS : 1375 PARK DR
PIN : 07-117-23-41-0079
LEGAL DESC : SIDWELL ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 130,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERM[T: $ 130,000.00
TYPE OF PERMIT TH[S PAYMENT IS FOR: ADDITON/REMODEL
PERMIT#THIS PRE-PAYMENT IS TIED TO:2016-00060
APPLICANT ADVANCED PLAN REV[EW 844.30
HANSEN HOMETECH INC. TOTAL 844.30
7920 KERBER Payment(s)
CHECK 29843 844.30
CHANHASSEN, MN 55317
(952)394-0854
OWNER
GEHL, LARRY
1375 PARK DR
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 onty 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
expice 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 {I,� )
revoke t any time for due cause. �,.{/
� � � 1� r� �v'C �' �'� ��,��`� � �:- � � j `�1� 4�
A cant Permitee Signature D e Issued By Signatur6 Date
. CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
�O A, Mailing Address: Permit number: ZdC �
f Vo PO Box 66
Crystal Bay, MN 55323-0066 Date received: � -� �Cj — 1
� Received by:
.� �, StreetAddress:' ._--�- — - ----- ._-- -- — _____------------
- . __--
S'�. G: 2750 Kelley Parkw y ��( �p—�� Plan review fee: u'� � '��
(�k£SH��� Orono, MN 55356 �__ 3 _- ----_- __
Main: 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.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: ► - 75 (���(e �d;Je, (��oy�c , M�;' �s�(G�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No
If yes, a special event permit is requi�ed 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: Hav�S� �"lvwre�ec�, lhc,
State License# gG �/ZG I Expiration Date:
Phone: cell (�Z- � h-i y�b office �SZ �13 y 0�Sy
Mailing Address: 7y2.d KG�`b�� �(v. City: G�„��l��s��H� M ZIP• S53/7
Contact Person: (ru✓� yU � � Applicant is: ontrac / Homeowner (Clrcle One)
Email and/or Fax: ��y(i�h,�y�(�aehef"� �Co:+�
PROPERTY OWNER INFORMATION:
Name: Lc���y Gc�,�
Phone(day):
Address: City: ZIP•
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name: ��/c,
Phone (day):
Address: Cit : ZIP�
Email and/or Fax:
PROJECT INFORMATION: Description of project:
1.Type of Project 2. Proposed Use 3.Structure Type 4. Sewage Disposal&
❑ New Construction Water Supply
� Single Family with ❑Accessory Bldg./Garage
�Addition attached garage ❑ Deck
❑ Accesso Buildin ❑ Public Sewer
ry g ❑ Single Family with ❑ Office/Commercial
❑ Relocation ` detached garage � Residence ❑ Private Sewer
�Other. (specify) �n-��of �8n'�od�, ❑ Multiple Family/Condo ❑ Retaining Wall(s)
❑ Public 4-feet or greater ❑ Public Water
*"Any earth movement may also require ❑ Commercial ❑ Storage
MCWD review 8�permits. ❑ Industrial ❑Warehouse
Minnehaha Creek Watershed District(MCWD) ❑ Other: s eci ❑ Private Well
15320 Minnetonka Blvd � p �� ❑ Other(specify)
Minnetonka,MN 55345
Phone: 952-471-0590
Fax: 952-471-0682
�vww.minnehahacreek.orq
Estimated Construction Valuation (excluding land) $ 13G� �(�Q
� �
Last Updated: January 2016