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Home My WebLink About2015-01433 - siding CITY OF ORONO � 1 5 - 0 1 4� � '' 2750 KELLEY PARKWAY DATE ISSUED: 1U06/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 2117 SHADYWOOD RD PIN : 17-117-23-31-0044 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 011 BLOCK 002 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : S[DING ACTIVITY : O/S BUILDING- UNDEFINED VALUATION : $ 8,000.00 NOTE: RESIDING AND GU"I'TERS APPLICANT PERMIT FEE SCHEDULE 170.38 STATE SURCHARGE(VALUATION) 4.00 PRO TECH EXTERIORS TOTAL 174.38 5840 W BROADWAY Payment(s) MINNEAPOLIS, MN 55428- CHECK 2612 174.38 (763)439-8313 Minnesota State License#: BUIL-BC635887 OWNER DODSON, RALPH&REBECCA 2117 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 Buiiding Code. This permit is for only the work described and does not grant permission for additional or rela[ed work which requires separate permits. All provisions of laws and ordinances goveming[his 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 da[e 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 wi[h the State Building Code.This permit may be revoked at any time due ca L/V ` -�G�� D l-�l �� l C� l�S Applicant rmitee Signature Date Issued By ignature Date City of Orono ' Bui�ding Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) �O�O MailingAddress: Permit number: PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: ��, � 2750 Kelley Parkway Plan review fee: `'kESH��G 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: Job Site Address: ( /7 �,C� ��, Will this be a Parade of Homes, Remodelers S owcase Home or other Display Home? ❑ Yes No If yes, a special event permit is required with Police Department and City Council approva/60 days prior to the event. Shutt/e bus service will be required unless applicant demonstrates sufficient on-site parking is availab/e. Non permitted events will not be a/lowed. CONTRACTOR/APPLICANT INFORMATIO Name: Qc'd T��_ x��: o r s State License# _5��35��'� Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed rior to 1978 Phone: (cell) 76 3.-c( _ �3 (�A� (office) Mailing Address: �c/� t,J a� ,� City: ZIP: �5 �/�,� Contact Person: ��,� ,� Applicant � Contra tor Homeowner (CircleOne) Email and/or Fax: �,�y� ?�3- �}.OS- �� q PROPERTY OWNER INFORMATION: Name: �(.._ o�-„� �o . So� Phone (day): �/�,,. ��- Oat7 ` Address: P U . �DX 3a'ar�s- City�Sco��o CAZIP: �aD 3 p Email and/or Fax: PROJECT INFORMATION: Overall pro�ect description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: Minnehaha Creek Watershed District MCWD ❑ Re-roof,asphalt ❑ Repair '� Storm Damage 15320 Minnetonka Blvd ( ) ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 Phone: 952-471-0590 ❑ Re-roof,other(specify) Siding ❑ Other: (specify) Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ �,Z��. c3z� APPLICANT ACKNOWLEDGEMENT: • 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 purpose and intended use of this informatio is to annually update our records and records of other governmental agencies required by law. If ou refuse to su I the inf ation the a lication ma not be issued. Applicant's Signature: Date: �l- �- l� Owner's Signature: Date: Last Updated:January 2015 �� DATE TIME CITY OF ORONO CALLED IN � INSPECTION NOTICE SCHEDULED 12-y—�c, 3� PERMIT NO. �� ' �� COMPLETED ADDRESS 2-I�� SV�D,((�,(��f(�� OWNER TTELEPHONENO. 1�3 "�p $'vI3 CONTRACTOR ��V IN�( I � DESCRIPTION ' ` � 4� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL 2 ❑ RADO SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION i ❑ F MING ❑ MECHANICAL FINAL ❑ RATED WALLS � NSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP Q S BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL Z J ❑ DEMO-SITE ❑ SEPTIC INSTALL Z OWNERKANTRACTOR T�MEET YiOU:_YES_NO y COMMENTS: � � � � 0 � 0 W � Q � W W � j d W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE � ❑CORRECT W'ORK 3 PROCEED ❑1 UE CERTIFICATE OF OCCUPANCY W � O CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN INSPECT�i WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952 -4600 OwnerlContractor on site: Inspector: wn�e.covrn��rs F��. �nary CopyISIN Notice