HomeMy WebLinkAbout2001-P03965 - windows PERMIT
CITY OF ORONO Permit Number:
2750 Kell��r Parkway- PO Box 66 P03965
Crysfi�al Bay, Minnesota 55323 Permit Type: ivti�or Aiter�tions
(952) 249-4600 Date Issued: 6i2�i2ooi
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SITE ADDRESS: 1620 Shadywood Rd
Wayzata,MN 55391
PID: 17-117-23-2t-oot2
DESCRIPTION: UBC occupancy R3
Proposed Use: Residential
Permit Class: Building Census Code O/S-Building
Permit Type: Minor Alterations Permit Sub-type(s): Wu►dows
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
FEE SUMMARY: Permit Fee: $ 153.25 Valuation• $ 7,338.00
State Surcharge Fee: $ 3.70
TOTAL FEE: $ 156.95
APPLICANT: Wellington Windows(See Comments) OWNER' John Ericson
3438 Meadowbrook Rd � 1620 Shadywood Rd
St.Louis Park,MN 55426 Wayzata MN 55391
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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ITEESIGNATURE ISS BYSIGNATURE
Conies: 1-File(SiQnitures Required),1-Anplicant, 1-Monthlv Reqorts, 1-Assessine, 1-Finance Page 1
06/21/O1 11:48 FAX __ WELLINGTON WINDOW 1�001
Jun-21-2001 10:13am From-CITY OF ORONO +9622464816 T-283 P.002/003 F-568
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Total �ee: $ ���C� � ' ; Date Received; � ' �5�%�'�
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i�ntered By: ,k /� , , / _�
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CIT� OF ORONO - B'kTILDIl�G� 1'ERMIT APP�ICA.T�ON
All information xnust be submitted in full bsfoxe plan review wil�be started.
' (pdease pr�nt att i�formation) �
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T�iE APPLICANT IS: (circle one) OWNL12 OR CONTRACTOR
�OS SI�'E ADD;�.F.SS: ��o�b 5 �o ZIP: cSs��. � _
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NAN]� OF OWNERI `J`�Y lv I �r `�l �.�.�Z�1� P�O�: c���> a � r�s 6�
(worlt�
1�IAII�ING ADDRESS: c5��.� �� �C��'�'Y': ZIP:
C4N1'RA�C'rOR: � w e� r/► � � P80�VE: ��� `�b C`t
::, CUNTA,CT PER.SON: II.E/PA. E�t:
` MAILI�'C'x ADA�SS: T CYTY: , ` Z�':
STATE LICENSE: �' ;--5���� ������
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ARC�IITECTlENGIN���t: pHONE:
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�IlvG ADri1tESS. _ ��ISTRATYQN� � �
TYPE OF WO�: New Addieion Aceessory Strucnire
Move� i�emv�$1/Alteration Land Alteration_____,
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P1tOFOS�n WO�(describe in detail�: 1� , � ,
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��a�$: � sp.FEET�F�AC�I FLOO�t:
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NO. O� BEDROU1ViS: C�AGE STAY,Y.S: ATT. D�?T.
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�STYMATED CONSTR�JCTION�ALUATYON (e�cludfng laa.d): $ ��
I hereby apply for a building perrxYit and I acknowledge rhat the iz�ormation abvv� is complete and
accurate; that the work will be in eanfor�m�e with the ordinances and eodes of the Ciry and with
the State Building Code; that I understand this is uot a permit �n.d work is not to start wirhout a
permit; and that tY�e work wi11 be it� accordance with the appto'ved plan.
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A:�PL�CANT S SIGNATURE.
� NOTL�! �r events r�equi separat perm�'t approvat by Police Deparlment and
� City Council 60 days prior to the event. Non,perm#ted events will r�ot be allowed.
06/21/O1 11:48 FAX WELLINGTON WINDOVY C�J002
Jun-11-2001 10:18am Fro�-CITY OF ORONO +A6224l4816 T-288 P.003/008 F-668
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SuGd.. !. Typa of data. 'Thc rl�t�a ot ladlv�t on whem rha dst�k steF+d or fo 6e ew�ed shaU be a u�toe�h in thi�Koaon.
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noC ipplY whc�an indivEdual!s ssl'ed to suppty tnvesd�dre dsn,puesuaae m aocdoa 13.8Z,sub4[vu(an 5,to a law rnto►�c�mau o�r.
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insm�adons(ns�e�d nl on�ha�tcimt. •
Subd.3. �aoss to daea hy ladtyidual. Upon roquen te a ce�ponsIDl��ho[id.�n i�vidud ih�l ba int°emed whaiher he ia rha subjeec
of ato�ed dara an 6tdividaata.oud wb�er l�Is clauitkd a�publh.Pdvaw o�oonRds�l. ZJpon b!�N�er eequese.aa iadtvldu�l who u�ha subjeae
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a�d moaain�o!�Ne�dan. Afwe at�Indiv�ual has bern cbown�he privsw daa�od in[oaaed of Ks meeaia8�t6o da�°eed p°t be diaalosed m hiia fo�
six a�nd�a dusea�aee uNa:a dl�pua or ocdoa pur�uaita ro�hls aecdon b p�ndlna oc add�oa�!d�n on tk�e indtviduaL bas bean eollmeud or creamd,
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may�q�+fn zhe�equesdng person to p�y the aem�l oo�t�oF inaktn��eeedt�It�.Aad eon�Pll�uB�s wplo�.
The responsible sudwdq s6a11 cemply immediaalY�if poadble,atd�aa,y�eq�m�de puretsent co d�fs subdtvision,o�wid�ia 6ve days oP
Wa da�e oi d�e�equss�.e7�aladiaQ Saaalays,9undqys teld lepal hofld�ye,li immadi�ce�om�+lienes!s iat pOssible. If lto caraaoe aomply wittt cha reques�
w1Win�t dme,hs s6st!ao infonn d�cidividml.and mnyy hava tn addidoasl tiva daYa witWa wtileh W eomplY a�h tfte raqunse,axeludin�Sn�urdsys,
Sundays and 1e8x1 bo4ldiye.
9ubd.a. Proeed�ue..han dat��i aot��ruu oe eumplete. Aa��my 4oa►ees au nca�+�aY oe complemnes�oPpublic oc privace
d►oa eonaamjn�ht:sisall. To�ce�nfu�tta ri�h�eA lndivldtW ahW aadty ia wtfda8 da crsPoasibk wd►orEqr das�ibin�d►e new�o o!du df9eg�eomsnr.
The�n3ponstbW aurhnriq�sl�ll wlddn,50 daqa eid�e�: (a)wtttioc the do�tvu�d�b�ina�unu or iaoowplen sad uxmpc co nodiy pu�sticipIon�ot
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(n dlspum af�sll be disctosod only it the fndividUal'�saxmaat ef dlsagreemeoc is idclud�!with du diEatosed daa.
Tho daeern�inadoa o[s6e�esfwasibfe audioda msy ba appaled pa�aenc w dw proviatona ot�a adan[alsaa�iva pmcadun eat ralaring w
con[esxd cnsas. . '
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In aceordaaca wicti M.S. 13.��Subd,2, 'Iti;hts vi sub�eecs og daca"�we would lfka to inform you thac your requesc
for a permit or lfcense from che City oe Orono or any o!its depaztmnace. may reqUire you to fumish eertaia private vr
confidenclal inlorjnation.
You aze nacitled th8t:
1, The informaaoa you furrtish w�A ba used to de�ermfae y0ur quaill�atioa for the p4tmic or licar�se tequest6d.
2. Yau u�sy rei'use w supply daca� bu� refusal may require �hat the C�cy deny tba permit or lieense�
3, Tha informaz[on may ba sharad wi�h othec loe�l, azaca or ft4eral a�encies co the axteat ancessary to process
�he permiL or lice�se.
4. If your requested pez�mit or licaqse requires Couaell a�3oa w approvo, same iaformatiou may beeome
Qulslic,
5, You have cer�atn d81i�s nnde�M.9. 13.Oa (availsble upoa request) �o revi4w privato data on yourself.
6. Your full name is raquired to proeesa rhis applica�ioa or permii. •
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I uadera�sad u�Y rl�hcs as atated abova.
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