The URL can be used to link to this page

Home My WebLink About2010-00731 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2010-00731 - . 2750 KELLEY PARKWAY ORONO, MN 55356- �ATE IssuEn: 08/18/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1650 SHADYWOOD RD PIN : 17-117-23-21-0014 LEGAL DESC : SHADY-WOOD : LOT 000 BLOCK 000 PERMIT TYPE : ADD[TION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 5,000.00 NOTE: SEPERATE PERMITS REQUIRED: ELECTRICAL(STATE) REMOVE AND REPLACE DAMAGED WOOD,FRAMING PORCH,INSULATE AND SHEETROCK,EXISTING HEADER SIZES UNCHANGED APPLICANT pERMIT FEE SCHEDULE 118.00 SHORELINE BUILDERS STATE SURCHARGE(VALUATION) 5.00 2184 SHADYWOOD RD TOTAL 123.00 WAYZATA, MN 55391- (763)506-0629 PAID WITH CC# 4377 Minnesota State License#: 20630814 OWNER KREISLER, JERROLD& BARBARA 1650 SHADYWOOD RD WAYZATA, MN 55391 AGREEMENT AND SWORN STATEMENT 'I�he work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State f3uilding 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 com enced within 180 days of the date of issuance,or if construction is susp ded for period of 180 days at any time after work has commenced. The a licant i respo ible for assuring all required inspections are requ in co rman with the State Building Code.This may be revo any t e for e cause. / / �� CJ /� �/ / � Applic mi ig ture Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � . .. . , yF ,�,� r � �E'1��'� � '� ,��"� r w r ,�-�eg s� �'�'�� a . . . � :4 �'ls�S . �. 1 h �i'� �*t� � � r� �., �i�� "�'� ��k �n 3r �,t s�'�� .zi._ � - ,�s,.€«s, s �.,�+ �s� s t w� „�U � City of Orono �'�`�'�� '� � T P �`�� w � .. ♦ � e:� �" c>w�'`F�'k,R� �� Building Permit Application for Internal Work �'�� (windows, doors, siding, re-roof, etc.) �� ~' Mailing Address: �j��U- �Z 7� ��-�' �,� PO Box 66 Permit number. r'� Crystal Bay, MN 55323-0066 Date received: ��/v ��. � �� =� j�� Received by: ,f� � � � ��a;,_� a � Street Address: < i' �'�,c,� ° �'� �ti 2750 Kelley Parkway Plan review fee: `' " �xESH�4� Orono, MN 55356 ` �� Total Fee: �� ;.�� ` 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 be submitted. �� - Incomplete applications will be returned. (Please print) � GENERAL INFORMATION: , � �� , i� Job Site Address: Will this be a Parade of Homes, Remodelers Showcase Ho e or other Display Home? ❑ Yes ❑ No If yes, a specia/event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. �°` CONTRACTOR/APPLICANT INFQRM T�ON: �` Name: /�� i,'I � / � State License# / Expiration Date: "� — � :' Phone: Q L off ce cell i,.*��. y.'�- ,, Mailing Address: Cit : ,/� ZIP: � �. Contact Person: Applicant is: ontract / Homeowner (Circle ne) � � Email and/or Fax: �� ; PROPERTY OWNER INFORMATION: � Name: �' Phone (day): �,;,'; Address: City: ZIP: Email and/or Fax +� t�� PROJECT INFORMATION: � Type of Project: Any earth movement may require MCWD review&permits �;� ❑ Door(s) ❑ Remodel Water Damage � Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd a. Deephaven, MN 55391 ;� ❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 �� . ❑ Re-roof ❑ Fire D mage www.minnehaha ek.or „ � '-� Overall Project Description: � �� - �.;> Estimated Construction Valuation bf Project(excludin land $ V � '� v� < � �.. � APPLICANT ACKNOWLEDGEMENT: �'�l l� � `"S��S �C �� , .. ',;..�,;: • 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 do 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 by 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 " k� purpose and intended use of th� infor ation is to annually update our records and records of other governmental agencies �'� � re uired b law. If ou refuse t su I the in rmation,the a lication ma not be issued. � �.-' � ��: � L :' ApplicanYs Signature: Date: �� /� �'� P � 3 " Last Updated 05-04-2009 }; *� �;:w� � k �� ' ,' + �� ,� a a:s �". 4 F .,,a� y,_. . _.,,�_ __ . . � Na�tX��;#�, z,'�.� �_,x_,e Stm y_ s�._._..3.a�. __.�.��. .,-a�.n�,��u:�:�a�`a�„�.,,�.<.�z�#�Aus�''�,�uy,a�.'..+�ts�:`-:w..��.�