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Home My WebLink About2010-00068 - adv plan review . � CITY OF ORONO PERMIT NO.: 2010-00068 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE ISsuE�: 02/10/2010 952 249-4600 FAX: 952 249-4616 REPRINTED ON 2/23/2010 ADDRESS : 2600 PHEASANT RD PIN : 21-117-23-23-0023 LEGAL DESC : PHEASANT LAWN : LOT 000 BLOCK 000 PERMIT TYPE : ADVANCED PLAN REVIEW PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADVANCED PLAN REVIEW VALUATIOIV : $ 375,000.00 NOTE: PLEASE FILL IN THE FOLLOWING: VALUATION OF PERMIT: $ $375,000.00 TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME PERMIT#THIS PRE-PAYMENT IS TIED TO: 2010-00069 APPLICANT ADVANCED PLAN REVIEW 1,759.39 LECY BROS CONSTRUCTION TOTAL 1,759.39 15012 HWY 7 MINNETONKA, MN 55345 (952)746-3783 Minnesota State License#: 20325555 OWNER HADDEN&J JOHNSON,T 2600 PHEASANT RD EXCELS[OR, MN 55331- AGREEMEIVT AND SWORN STATEMENT �he work for which this permit is issued shall be performed according to the approved plans and specitications,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 no[specified herein.1'his pennit will cxpire 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. / / �J jl�� Z �� l fi /C, Applicant Permitee Signature Date �� Issued�y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. ( . Clty Of �P'OYb 275� Kelley Parkway Orono hNV 5535b 952-�49-46� Receipt Na: 3.402079 Feb 1U, 201G Ti� Hadden Pera�its 201U-QO�iB 2655 Shadywoad 1,759.39 Rd 1U1-34410 Plan Che�k/Site E�a� Fees Tatal: Y 1,759.39 Check � � ~ Check Na: 25564 1,759.39 Payor: Tirs Hadden Tc,tal Applied: 1,759.39 Ghange Tendered: .t� Oc/10/10 1I:09Wi . j � City of Orono Building Permit Application for New Structures or Additions Mailing Address: ,� 'gv 0.� PO Box 66 Permit number. �L �� •-(�,�C;(�,� Q � Crystal Bay, MN 55323-0066 Date received: 2 ! �� U � ��' s. Streef Address:' �-'fC�— Z��Co� Received by: (=?T7 ��t y ��F 2750 Kelley Parkway�'(L,'� ZS�(��#- Plan review fee: � �S� � � `�ESHo4 Orono,MN 55356 Total Fee: Main: 952-249-4600 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: �f�SS �� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No lf yes, a specia!event permit is required with Police Department and City Counci/approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates su�cient on-site parking is avaifable. Non-permitted evenfs will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: !�, Q r�,� �c'�v�nc-S State License# an��SS _ Expiration Date: � -��.-._(p Phone: q office �{ _q4c�_ �e� cell Mailing Address: -7 Cit : „� ZfP: 5 Contact Person: _�y �� Applicant is: ontractor / Homeowner (CircleOne) Emaif and/or Fax: � c�s�—�4�� Y�bB PROPERTY OWNER INFORMATION: Name: �iwco� sf. Ju�cc�v�v1 � Phone (day): q S'oL^ -t 1 - "'7o�i4 Address: �LSS �,Qd�w�� , Cit � ��ro�nb ZIP•5��3� Email and/or Fax � ARCHtTECT/ENGINEER INFORMATION: Name: �otv»e, c�.S �ovr��^.s�ir Phone (day): Address: �itY. Z�P. Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal & Water Supply �New Construction �Single Family with �esidence ❑Addition attached garage ❑ Garage/Accessory Bldg. �Pubfic Sewer ❑ Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation detached garage ❑ Office/Commercial ❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse ❑ Private Sewer ❑ 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.or Estimated Construction Valuation (excluding land) $ '3`j c�'� �� .� Last Updated: 9/29/2009 - 17- + - STRUCTURE INFORMATION: ' 1. Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= 'l�l } Number of bedrooms=_� �Wood/Frame ❑ Masonry b.Width (ft.)= �Z ± Number of garage stalls: ❑ Metal Attached =_� ❑ Pole Bldg. Areas in spuare feet Detached = ❑ ICF g2 F�K�G,.,d. ❑ On-site Prefab c. Basement= `5e3 �.c.a-�ve,� ❑ Off-site Prefab d. 15t Story = 1 SSS ❑ Other(please specify): e. 2"d Story= �� f. '/Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable � � Permit A lication �- ❑ Pro osed Buildin Plans � ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form � ❑ Surve meetin all re uirements � '� Stormwater Pollution Prevention Plan � ❑ Hardcover Calculation s ❑ � Se tic S stem Site Evaluation Re ort ❑ � Access Permit ❑ � Wettand Buffer Im rovement Plan ❑ � En ineered Plans for Retainin Walls 4 feet or above ❑ ❑ Plan Review Fee ❑ ❑ 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 altemative but to reject it until it is complete; • Acknowledges the Escrow Agreement is completed and signed; • 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�ther governmental agencies required by law. If you refuse to supply the information,the application may not be issued. ApplicanYs Signature: � Date: �-9—f� �' ��° �� Last Updated: 9/29/2009 - � --� - 18-