The URL can be used to link to this page

Home My WebLink About2012-00518 - windows . � CITY OF ORONO * z 0 1 z - 0 0 5 1 8 * 2750 KELLEY PARKWAY DATE ISSUED: 06/12/2012 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 2040 SHADYWOOD RD PIN : 17-117-23-31-0013 LEGAL DESC : GUST S JOHNSONS ADDN : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEF[NED VALUATION : $ 1,500.00 NOTE: REYLACE(1)WINDOW INTO EXISTING OPENING. APPLICANT PERMIT FEE SCHEDULE 57.50 FLAG BUILDERS, INC. STATE SURCHARGE(VALUATION) 0.75 715 FLORIDA AVENUE S. GOLDEN VALLEY, MN 55426- TOTAL 58.25 (763)540-9404 PAID WITH CC# 2073 Minnesota State License#: BC631398 OWNER ZOSCHKE, DAVID&JUDY 2040 SHADYWOOD RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEME1vT 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 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 rcquested in conformance with the State Building Code.This permit may be revoked y time for d cause. � �� ; :,,�_ � l �L / ��i�i / / App icant Permitee ignat e Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCR[BED ABOVE. 3 ,��' ` - ��'� �.� s , ' fi' A� -� �. a� �I�y Of O�-o�O �' *�� Buif�ing Permit App[ication for Mainter�ance / Renovafion ' `�� (windows, doors, siding, re-ro�f, etc.) e : Mailrng Address: _ '' i J�-' � ' �0� PO Box 66 Permitnnumber: ;,_, � , - ;�: Crystal Bay, MN 55323-0066 Qate received: � 2 - ,'; �-; �.�r � �' a '� a, StreetAddress: Receivedby: •(J, �; �_; �� d'��l �J 2750 Kelle Parkwa `i � .��o y Y Pfan review fee: r9kESH�4 Orono, MN 55356 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 s bmitted. � - fncompfete appfications will be returned. (Please print) �� GENERAL INFORMATION: � 't+ "'= Job Site Address: � '�f �f � ��' �_y �_. �:. �'� -' Will this be a Parade of Homes, Remodelers Showcase H e or other Display Home? ❑ Yes �' >: ❑ No � /fyes, a specra/event permit is required with Po/ice Department and City Counci/approval 60 days prior to the event. Shuttle bus servrce will be � ��.< required unless applicant demonstrates sufficrent on-site parking rs available. Non-permitted events wil/not be allowed. �j CONTRACTOR!APPLICANT INFORMATION: t �� '` Name: �%,,,, ,/:�� ; f��r�� - �jv, �� State License # --� ,;'� c- S/ 3 j � - � � Expira�ion Qate: ; s� �y �� Lead Certificafion Number: Expiration Qate: � �k�. (for work on homes thaf were consfructed prior fo 9978 4� � Phone: (office) (cell} � Maifing Address � �S'� �� ;� - �'{-i� �c City: ZIP: � Contact Person: S�c�.T C-c��r Appficant is: Contractor / Homeowner (Circle One) � ��. Email and/or Fax: S��ft�(�' �1�� ; (t�er.� , c'cr,�� -------- . � PROPERTY OWNER INFORMATION: �� . :. q.�� Name: �l'�Vi�( �c�S�� '-- �° ��, Phone(day): YS z " �-I `7 ( - � yC �( ° ��a Address: ��° r, __c' Y�L �l ,:l'�� • c,�{ City: (��r-�o ZIP: Email and/or Fax ��: PR�JECT INFORMATIOI�: � , :: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑ rire Qamage MCWD review&permits: � Minnehaha Creek Watershed District(MCWD) ❑ Re-roo f, asp ha lt ❑ Repair ❑ Storm Qamage 18202 Minnetonka Blvd sF ' ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ' ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Fax: 952-471-0682 �; ,�Window(�a'j www.minnehahacreek.orq ;�� Overall Pro'ect Descri tion: �` - � � �a , P ' _ , - T`-=--T--. -.i—{�.�,–Cr–t-E.r.�� .- , ;�� i�.� .�,):k. C.i. i��`o a. _Estimated Construction Vafuation of Project (excluding land) �� , �'� � �.�� '�� . ,:; APPLICANT ACKNOWLEDGEMENT: ��" �{; • Agrees to provide all information required or requested by the Building Department; ;� • Cerfifies that the informafion supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they 'r� are solely responsible for submitting a complete applicafion being aware that upon failure to do so, the staff has no alfernative =�' but to reject it until it is complete; �� • Some or all of the informafion that you are asked to provide on this application is cfassified by State law as either private or "*`R confideniial. Private dafa is information which generally cannot be given to the pubfic but can be given to the subject of the { data. Confidential data is information which generalfy cannot be given to either the public or the subject of tne 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 t the information,th�ao lication ma not be issued. � �� A IicanYs Si nature: ��.� � �' 7 ��- ' PP 9 �''�f-_ �� Date: �� j�<=-; z---� � �-- --� ,� Last Updated: 08-09-2011 ;;� �.� u4r