HomeMy WebLinkAbout2015-00041 - adv plan review CITY OF ORONO * Z 0 1 5 - 0 0 PJ 4 1 �
2750 KELLEY PARKWAY DATE ISSUED: OU13/2015
� ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 1100 PINE VIEW DR
PIN : 28-118-23-42-0010
LEGAL DESC : PINE VIEW
: LOT 4 BLOCK 1
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 518,624.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 518,624.00
TYPE OF PERMIT THIS PAYMENT IS FOR: NEW HOME
PERMIT#THIS PRE-PAYMENT IS TIED TO: 20 1 5-0004 1
ADVANCED PLAN REVIEW CK WAS ALREADY MADE OUT WITH 2O14 FEES,DIFFERENCE OWED AT TIME NEW HOME PERMIT IS
PICKED UP OF$115.43
APPLICANT ADVANCED PLAN REVIEW 2,308.64
TOTAL 2,308.64
GORDON JAMES CONSTRUCTION Payment(s)
5159 MAIN STREET E CHECK 2023 2,308.64
P.O. BOX 306
MAPLE PLAIN,MN 55359-
(763)479-3117
Minnesota State License#: BUIL-24531961
OWNER
WIGGINS,JASON&AMANDA
>
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 l80 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
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pli t Permitee gnature Date Issued By Signature Date
City of Oron�
2750 Keiley Parkway
Orono MN 55356 952-249-4600
a
Receipt No: 3.012594 Jan 13, 2015 � .
Gordon James
Previous Balance: .00
Permits
2015-00041 1100 Pine View 2,308.64
Dr
101-34410
Plan Check/Site Exam Fees
Total: 2,308.64
--------
Check
Check No: 2023 2,308.54
Payor:
Gordon James
Total Applied: 2,308.64
Change Tendered: .00
---------------
U1/13J2015 03:35PM
.
' City of Orono
Building Permit Application
for New Structures or Additions
Mailing Address: Permit number: �— (
� �Q PO Box 66
Q Crystal Bay, MN 55323-0066 Date received: '—� f 3—
StreetAddress:' " Received by:
�
2750 Kelle Parkw �k- �Z3 `7 j� o�
y� c?� Orono, MN 55356 ���e�"`����"Y lan revi��e: �, ��5 ��
qkfSHO�� Main: 952-259-4600 � -� �g '�1O'y
ee:
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: � �/d0 p,��'v��k! D�c��vc�
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 approva160 days prior to the event. Shuttle bus service w�ll be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: (� s
State License# q(� Expiration Date:
Phone: cell — office
Mailing Address: � ?,o�� Cit : ZIP: S
Contact Person: �'��yN�y Applicant is: a r / Homeowner (Circle One)
Email and/or Fax: �����y���pQ�O� -'7�y�s. �0�✓I
PROPERTY OWNER INFORMATION:
Name: d �,
Phone(day): � - Q
Address: City: ZIP:
Email and/or Fax ,
ARCHITECT/ENGINEER INFORMATION:
Name: -i- ,J
Phone(day): 6 - _ ,$ c
Address: v L �rt�: S . Cit : V ZIP: $$
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 �Residence
❑Addition attached garage ❑ Garage/Accessory Bldg. ❑ 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 8�permits. ❑ Industrial �Private Well
Minnehaha Creek Watershed District(MCWD) �Qther: (speCify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.m i n n e h a h a c ree k.o r
� O �
Estimated Construction Valuation (excluding land)
�- �� 3ag, �'y �� �.
Packet Last Updated: 04/19/2013 � — _ ___
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