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Home My WebLink About2010-00419 - siding CITY OF ORONO PERMIT NO.: 2010-00419 2750 KELLEY PARKWAY � ORONO, MN 55356- DATE ISSUEn: 06/02/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 1840 SHADYWOOD RD PIN : 17-117-23-24-0016 LEGAL DESC : SHADY-WOOD : LOT 025 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : S[DING VALUATION : $ 3,300.00 l�5 �� APPLICANT PERMIT FEE SCHEDULE 103.25 ERICKSON, SCOTT& INGRID STATE SURCHARGE(VALUATION) 1.65 1840 SHADYWOOD RD TOTAL 104.90 WAYZATA,MN 55391 PAID WITH CC# 3205 OWNER ERICKSON, SCOTT& INGR[D 1840 SHADYWOOD RD WAYZATA, MN 55391 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 separate permits. All provisions of laws and ordinances governing this type of work shall be compied wi[h 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 re5ponsible for assuring all required inspections are requested in cqnformance with the State Building Code.This permit may be revoked at y time for due cause. __.��'__� � � � � ��% ��}� / / �Applicant Permitee Signature Date Issued By Si ature ate SEPARATE PERMITS REQUIRED FOR WORK OTHER AN DESCRIBED ABO r p; �,� r � �-v .. . �. �`��: n a'��, *. �. ,, yi: i,�a;�;,�, � .�: ��; City of Orono � j : �� . � �. _ � �, t ' Building Permit Application for Internal Work � +� � � i'` (windows, doors, siding, re-roof, etc.) ��' �"; Mailing Address: Permit number: j �� v�,� PO Box 66 � � ' 0 � 0 Crystal Bay, MN 55323-0066 Date received: � � • a ��`�� Received b � G-r��. �, Street Address: y� � �; �'� ��" �,� 2750 Kelley Parkway Plan review fee: � �' t`�kEsxo4`'� Orono, MN 55356 e�r' �° 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. (P/ease print) � q�� GENERAL INFORMATION: ;� � � .�: Job Site Address: ��O ��.��/ � � - � ��,,�� .��u�i i � �� Will this be a Parade of Homes, Remodelers S wcase Home or other isplay Home? ❑ Yes ❑ No � Y P P q P y pproval 60 days prior to the event. Shuttle bus service will be � ,g� If es, a s ecial event ermit is re uired with Police De artment and Cit Council a required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. �� r;{` �+ �� CONTRACTOR/APPLICANT INFORMATION: k:�' ��;�� Name: ��;' State License# Expiration Date: �,. ) � �fi: Phone: (office) (cell �:, s�� . Mailing Address: City: ZIP: � kz,� �° Contact Person: Applicant is: Contractor / Homeowner (Circle One) � ��: Email and/or Fax: �� k�# r '` PROPERTY OWNER INFORMATION: �� ;; Name: �eff c;,�,�.so/� �� Phone (day): y��-��. �� I `� Address: �� c� �/ �a�,� � � � r� Cit : C�i-��I� ZIP: �f_.57� � '��V� Email and/or Fax ff o�c ; ;K .�c� f k��a� � ,1Y:', Ra-'. ��,�:. �.�. �'r PROJECT INFORMATION: R Type of Project: Any earth movement may require '� ' MCWD review&permits ��; ❑ Door(s) �Remodel ,�Water Damage � : Minnehaha Creek Watershed District(MCWD) w �,-� ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ;� Deephaven, MN 55391 ; ' �' �Sidin Restoration � �,• g ❑ ❑ Other. (specify) Phone: 952-471-0590 �T �� Fax: 952-471-0682 �s ❑ Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ ;33CJ ':: �� APPLICANT ACKNOWLEDGEMENT: �� ` • Agrees to provide all information required or requested by the Building Department; � ��.; Certifies that the information su lied is true and correct to the best of his/her knowled e. The a licant reco nizes that the 'Y� b`' • pp 9 PP 9 Y � s � 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; 3`,�,�. 4�`k x:, • 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 purpose and intended use of this information is to annually update our records and records of other governmental agencies :'�n re uired b law. If ou refuse to su I th information, the lication ma not be issued. ;,•s=:: �; � ApplicanYs Signature: ' Date: � �� Last Updated: 05-04-2009 n1 ,�, , '� k�9 x�:r ' � .r..� .��.. � Vx� �. .a ..�...r �..�:x.._..�..�.�.s.�c ti. ,,.aa��;�n...,. __ �. _� -�:, . ._.. r,..�.�..�.�, �.�.e u,,.rx�,....F su��....z�tT�w.�stm.��'