HomeMy WebLinkAbout2011-00479 - siding F CITY OF ORONO PERMIT NO.: 2011-00479
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: 06/16/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 2320 SHADOWOOD DR
PIIv : 27-118-23-32-0014
LEGAL DESC : SHADOWOOD FARM
: LOT 002 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : SIDING
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 9,000.00
NOTE: TEAR OFF AND RESIDE HOUSE AND GARAGE
APPLICANT pERMIT FEE SCHEDULE 177.00
MIDWEST ROOFING STATE SURCHARGE(VALUATION) 4.50
6541 SYCAMORE CT N
MAPLE GROVE,MN 55369- TOTAL 181.50
(763)427-9696
Minnesota State License#:20637010
OWNER
REHBEIN,RONALD&DAWN
2320 SHADOWOOD DR
LONG LAKE,MN 55356
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 retated work which requires sepazate
permits. All provisions of laws and ordinances goveming 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 are
requested i conformance with the State Building Code.This permit may be
revo at a ti for due cause. /'/ !� / � `
a% �Sl ! (
Applicant Permitee Signature Date / �
Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
�
City of Orono
' ' Building Permit Application for Internal Wnrk
(windows, doors, siding, re-roof, etc.)
MailingAddress: Permitnumber: O//— `�7
O�,D,�O PO Box 66
Crystal Bay, MN 55323-0066 Date received:
���''' Received by:
,� � .��;-� �, Street Address:
�'�,c, �' ;r �r.�' 2750 Kelley Parkway Plan review fee�
t�kESH�4'� Orono, MN 55356
Total Fee: � ��, 5�
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 ' e submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION• /� j
Job Site Address: � � v�� �`����G� �✓ti�/ �f�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No
If yes,a specia!event permit is required with Police Department and City Council approva160 days prior to the eve�nt. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events w�ill not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: f'�'Jj�;,�t'S f
State License# ��(� � � � Expiration Date: �� - �/�- (�
Lead Certification Number: Expiration Date;:
(for work on homes that were constructed prior to 1978
Phone: �ci 3 !-�,,� 7 ��{!L-, (office) (cell)
Mailing Address: S'( S -�r�,.t�,.-� f_ City:r�f>'�e� � �,�.� ZIP: �-c s�'
.S�.�
Contact Person: ' ,��f%� Applicant is: ntrac / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: �/t�I c! �'���,�',/l �
Phone (day):
Address: � �: �c Cc..� G•��tr`icl �/� City:�J�'-?C� ZIP:
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth m�ovement may require
❑ Door(s) ❑ Remodel ❑Water Damage MCWD review 8�permits:
Minnehaha Creek Watershed District(MCWD)
❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
Siding ❑ Restoration ❑ Other: (specify) Deeph�aven, MN 55391
Phone: 952-471-0590
❑ Re-roof ❑ Fire Damage Fax: 952-471-0682
www.minnehahacreek.orq
Overall Project Description: %��„� c;�f��- �'��-.5;��' � �� c.,�c� `�" _y����y�
Estimated Construction Valuation of Project(excluding land) $ �7�U
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• 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 dc� so, the staff has no alternative
but to reject it until it is complete;
• Some or all of the information that you are asked to provide on this application is classified t>y 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 other governmental agencies
re uired b law. If ou refuse to su I the information, the a lication ma not be issued.
ApplicanYs Signature: — Date: ���-r�
Last Updated: 03-01-2011
� — ` DAT TIME ✓
CITY OF ORONO CALLED IN �
INSPECTION NO I �,/7q SCHEDULED
PERMIT NO. `t� � COMPLETED
ADDRESS
OWNER TELEPHONE NO. 3 �Z� " �Z
CONTRACTO
. �
� DESCRIPTION �
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EX AV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ KESHORFJWETLANDS
y ❑ FRAMING ❑ MECHANICAL FiNAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
c�., COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED D�PROJECTCOMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�/ERING PERMANENT
❑CORRECTUNSAFECANOITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUiRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46��
OwnerlContractor on site:
Inspector. J
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