HomeMy WebLinkAbout2014-01083 - doors CITY OF ORONO * 2 0 1 4 - 0 1 0 8 3 *
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2750 KELLEY PARKWAY DATE ISSUED: 09/24/2014
„ ORONO, MN 55356-
952) 249-4600 FAX: 952) 249-4616
ADDRESS : 2320 SHADOWOOD DR
PIN : 27-ll 8-23-32-0014
LEGAL DESC : SHADOWOOD FARM
: LOT 002 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
COI�ISTRUCTION TYPE : DOORS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 4,369.00
NOTE: 1 PATIO DOOR REPLACEMENT IN EXISTING OPENING
APPLICANT PERMIT FEE SCHEDULE 118.00
STATE SURCHARGE(VALUATION) 2.18
THE HOME DEPOT A.H.S. MAIL-IN FEE 2.00
2690 CUMBERLAND PKWY, STE 300
30339- TOTAL 122.18
(763)542-8826 Payment(s)
Minnesota State License#: BUIL-20268257 CHECK 69257 122.18
OWNER
REHBEIN, RONALD&DAWN
2320 SHADOWOOD DR
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permi[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 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. �
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Applicant Permitee Signature Date Issued By ignature Date
SE.P/22/2014/MON 04: 57 AM Elder Jones Building FAX No, 952 854 4909 P, 002
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City of 4rono
Building Permit Application for Infiernal Wor �
(windows, daors, siding, re-roof, etc.) � � ' � '
Mai/ing Address: � 2 Z, �
��,� PO Box 6fi Permit number
Q Y � Gystai Bay, MN 55323-0066 �ate received: �� l�- C � U
�?t' Received by_
� !,�'���;c,-�y �, 5treet Address'
3'J ��"� 4. 2750 Kel(ey Parfcwa
� � Y Plan revfewfee:
?��"��t'ti�� Orona, MN 55356 � V� ;,
�S�o� l 2 Z �
Total Fee:
Nlain: 952-249�6�0 Fax: 952-249-�4616 w+niw.,�j.or�n ;mn.us
`I"his appfication fonr� must be completed in full and all required information must be submitted.��, j�L31�S
Inaomplete application�w#(I be returned. (Please print)
G�NERAL IN�ORMATION: _/ -/ � r
Job Site Address: � 3 � a c�h�k �Y V �1 d V {d ` � �.
Will fhis be a Par�de of Homes, Remodelers Showcase Home or ofher Displ�y Home? ❑Yes [] No
IP yss,a speclal event permlt!s reqerlred wlth Pollce Department and Cfry Councl!approva!SO days prlor to ths event. Shuttle bus servrce will be
requirecl unless appllcant d�moi�strat¢s suff]Gent on�slte parklnc�Js avalfabla. Non-permltted events wUI not b�allowed.
GONTRACTOR 1 APPLlGANT INFORMATION:
Name: �5?f�3tlS ' 4 aY7
State �icense# THD At-T�ome Se�t-vice, Inc, ' o�(,
Phone: �� 26y0 Cunzbez-land Pk�vvy, Ste 300 (cen)
Mailing Address: Af�at2ta, GA 30339-3913 Zlp:
Contact Person� Lic# C.TZ268257��. 763/542-$$26 ��"�eowner �c���ieo�a�
Email and/or Fax:
PiZOP�RTY OWNER I�ORMATIO�a h b d ;n
Name� O /3
Phone(day): G '9 i � • '.� Z i�
Address� 0"2 3 � a �h � a!J 0 U C� D/ City:� 0/�� �Q �Q ZIP: 'S� S � S (s
Email and/or Fax
PROJECT INFORMATION:
Type of Project: ; Any earEh movernent m�y require
' � MCW�review&permits
�..�oof(S) ❑ Remode[ ❑Wafer Damage �
Mlnnehaha Creek Watershed C7istrict(MCWD)
❑ Window(s) Repair ❑Storm D�m3ge 18202 Minnetonka Blvd
� Daephaven, MN 55391
❑Siding ❑ Restoration ❑ OCher. (5pecify) Phone: 952-471�0590
� , Fax: 952-471-0682
❑ Re-roof �] F�re Damage I www.minnehahacreek.orq
Overatl Project Description: �� qr [ .0 C�D r rE rl C� d � O
Estimated Construction Valuatiorc of Project(excluding land) $ y � �, � �
APPLICANT ACKN4WL�DG�M�NT:
. Agrees to provide afl infonration reyuirsd or requestecJ by the�uilding Department;
• Certlffes that the information supplied is true and correct io the best of his/her knowledge. The applic2nt recognizes that they
are solely responsible for submitting a complete application being aware that UF�On failUre to do So, CY1e StafF ha5 r10 altem2tive
but to reject it until it is compiete;
. Some or all of the information that you are asked to provide on this application is classifiEd by State law as eitlzer private or
confidentia[. Private data is information which yanerafly ca�znot be given to the pubUc but can be given to the subject of the
data_ Confid8nt��1 d�t3 is informatlon whiCh generally cannot be given to either the public or the suU)qCt of the d�ta. OUr
purpose and intended use of this infomtation is to annual(y update our records and records of other gOvernmental agenCles
reqUirgd by law. If you refU5e to supply the information,the appfication may not be issued.
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AppficanYs 5ignature: �— Date:
Las[Updated: OS-04-200�
SF.P/22/2014/MON 04; 58 AM Elder Jones Building FAX No, 952 854 4909 P, 003
. t-m,;f: pL1.Llce��s,
wcr�:,irc: www.rlfi.n�n
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SEP/22/2Q1^%'.vIC�� 04: �; :�I�dI Elder Jones Bui lding FA�; rdc, 957 854 490� P, 001
1120 East 80�"Street,Ste.#211;Bioomingtan,MN 55A2p � _ � � �
952-345-6047—bir�ct 952-8G54-4969-Fax
To: Orono,Ciiy of Attn: Bidg. Dept. From:
Fax: 952-249-4616 � Pages:
Phpn�; 952-249�600 Date:
Re: �uilding Permit(s) CC:
❑Urgent ❑ For Review ❑Pleas�Cortfm�n4 X Pl�aso Rsp[y ❑Please Recycle
• Comments;
Please call when ths permit fee(s)'have been figures, So I can cut a check, _ , __ ,_ _.
Thank You,
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952-345-6047
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�/I��?"� DATE �ME
CITY OF ORONO CALLED IN '�
INSPECTION NOTICE SCHEDULED � - /
PERMIT NO. -���co Ereo
ADDRESS � ��
OWNER LEPHONE NO. - �� �
CONTRA TO
� DESCRIPTION
�
� ❑ FOOTING ❑ PLUMBING FINAL O EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
y ❑ FRAMING 0 MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� �INAL ❑ SEWER HOOK-UP O COMPLAINT
J O DEMO-SITE ❑ SEPTIC MAINT. � FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNEWCONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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� ❑1NORK SATISFACTORY:PROCEED ROJECT COMPLEfE
W ❑CORRECT Y1�RK 8 PROCEED ❑ I UE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDEH POSTED.CALL INSPECTOR
❑INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (952) 249-460�
Owner/Contractor on site:
Inspector: `
Wh te Copyllnspector's Flle Canary CopylSke Notke