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Home My WebLink About2012-00182 - doors � CITY OF ORONO * 2 0 1 z - 0 0 1 B z * . "' 2750 KELLEY PARKWAY DATE ISSUED: 03/14/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 380 RUANN RD PIN : 36-118-23-32-0008 LEGAL DESC : WAKEFIELD FARMS 3RD ADDN : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DOORS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 3,707.00 NOTE: (1)BACK ENTRY AND STORM DOOR REPLACEMENTS APPLICANT pERMIT FEE SCHEDULE 103.25 PELLA NORTHLAND STATE SURCHARGE(VALUATION) 1.85 15300 25TH AVE N.-SUITE# 100 PLYMOUTH,MN 55447 MAIL-IN FEE 2.00 (952)345-6047 TOTAL 107.10 Minnesota State License#: BC645090 OWNER SCHUMACHER,JAMES J P.O.BOX 25556 ST PAUL,MN 5512� 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 sepazate 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 aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. �� " / / / / Applicant Permitee Signature Date Issued By ' nature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB . �ar-12-2012 10:15am From-CITY OF ORONO +9522494616 T-4T5 P.002/002 F-255 �� City of Orono Building Permit Application for Infiernal Work � (windows, doors, s�ding, re�roof, etc_) MailingAddress: Permit number. �� — � Q PO Box GB g � Crystal Bay,MN 66323-0D66 Date recaived: 0�. 4 Sp eet Addl6ss: a�ivAd by: . �„ �� otiF 2750 Kelley ParkHrdy Plan revlewf�_ � � orono,MN 56358 T��F�: /o�,/U Malr1: 952-249-4600 F�c 852-249-46'16 wunti►.ci.orono.mn.us This app{ication form must be completed in tull and all required infnrmabo�must be submitted, . . Incomp�ete�applications will be returned, (P/eese print) G�NERAI.INFORMATIOy:y� �!r �On ,�a ,�,� Rd ` � e � �L� D�n I�� Job Site Address: �+ �l .�I(this.��Par.ade af hlomes, Remodelers Showcase Hom�or other Display Home? Yes Na • Il yes,a speoial sven!p•'r�nlr ia nquved�virh f�ol�c�•Depatinent:and C�y Co�ncii approv�.BO deys pr'ror fo;fhe avenG ShuUle btis servlcs wjH 6e reqv"aed uMesa applicant demonstrafe�suMlGent on-sIre�rkJng/s avallable. Non-pern�id9d Oven�s Wi/I not be allow�d. CON7RACTQR I APPUCANT INFORMATION: • ste eeucense# Pe�la Northland �S? •� e Phone: 15�00 25thAveN. Ste 100 (celll Mailing Address: . Pl�tnauth,MrT SS447 . Z�P� Contact Person: � � Lic#BC64509U P}�.�63/745-1400 �omeowner ��o�.� Email and/or Fax; . _._. . .... . . PROPER7Y OWNER INFOR 71qNt' Name: . , . A�F�1 J� �` .. .. . . . ... Phone(day): S� � � a'� Address: 6 Y o / e Cit : d/'O I1 O ZIP: 5+S 3 'p/ �mall and/or Fax PROJECT INFORMATION: Typa of Project: _ Any earth movement may requi� , � MGYVD raview 8 permits Door(s) j]Remodo� ❑Water pomege - Minneh8ha Creek Watarshed(�iatri�t(MCWp) �]wndow(s) Repair []Storm Damage 98202 Minnetonka Blvd •� pe9pheve�, MN 65391 •Q siding Q Resioration ❑Other.(specify) Phone: 952�?1-0590 � . Fax: �,52-471-068z ❑Ra�roof ' ❑ Flre Damage wunN minr�eh'ahacreek:�g ,.- - - OveralF Praject Des� tlon: �' � �Eatimated Ga�struction Valuatiun of Project(excludi g land) $ 3 x e 9 • — APPLICANT ACKNOWI�EDGEMENT: � . Agraes to provfde all information requlred or reqUested by the B�Ilding Departfient; � • CerGfies that the information supplled is true and conact b the best af his/her know�edge. The appllcant recognixes that they ' ' are solely re5ponsible for submitpn9 8 complgte application being aware tha�upon failure to do so,the staff has no altemative 4 but So releCt it urttil it le o0mplete: •� . � Some or all of t1te Information that you ere askad to provlCe on this appllcetion is ol8sslfied 6y State law es effhe�private or ,co�dentlal. P►ivate data is irrformeRion which generally eannot be givBn to the publlo but ca� bo given to the subjeGt of the � � data. ConfldenGal data.is informatian whlch penerelly Gannot be given to elther the public or the subjecC of tne data. Qur • purpoea and Intsnded use of thls Iniormauon is to annually updat� our fecords and record6 or other govemmonta) a9bnciss � re ulred b iaw_ ff u refuse to su I the Information,thrs a lication ma not be issued. ��APPlicanCs Sig�ature: �.S Date_ ^„ 3[ �a! �/� '��: � (