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Home My WebLink About2011-00737 - windows . CITY OF ORONO PERMIT NO.: 2011-00737 ' 2750 KELLEY PARKWAY � *. ORONO, MN 55356- DATE ISSUEn: 08/10/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 2138 SHADYWOOD RD PIN : 17-117-23-42-0013 LEGAL DESC : WILEYS PARK LAKE MTKA : LOT 000 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 1,762.00 NOTE: REPLACE(1)WINDOW WITHIN EXISTING OPENING. APPLICANT pERMIT FEE SCHEDULE 67.25 RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 0.88 1920 COLJNTY RD C. WEST TOTAL 68.13 ROSEVILLE,MN 55113 (612)502-4777 Minnesota State License#:20130983 OWNER LAGUE,MR&MRS JEROME 2138 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 with whether or not specified herein.This permit will expire and become null and void if consVuction 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 requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. ��/ �`n , / � / / / / G��. Applicant Permitee Signature Date Issued y Si ture Date SEPARATE PERMITS REQUIRED FOR WORK OTHER T N DESCRIBED A . City of Orono l �� V • Building Pe�mit Application for Internal Work (windows, doors, sidin , re-rcof, etc. Mailing Add�ss; O�"�^�' PO 800c 66 Permit number: 021�//-�73� � Crystal Bay, MN 55323-0066 Date received: a 7/ ''� � '� St�et Address: Received by: � V o~� 2750 Kelley Parkway �sao�'f°' �rono, MN 5535B Plan review fee• Main: 952-248-4600 Fax: 952-249-4616 www,ci.orono�*+�„a Tatal Fee: �r�j�� j�. This application forrn must be completed in full and all required information must be submitted. Incomplete applicatlons will be reivrr�ed, (p�eBse prinf) GENERAL INFORMATION: Job Site Address: o��j� ��0.d �j�� 00� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes Kyes, a specla!ev�snt permlt is riequir�d with Polica pepeynent and City Council approva/60 days prior to Ghs event. Shuttte bus service will be O requiied un/ess epp/lcenf demonstret�s sulf"icient on-site parking is evailab/e. Non-permitted events wi!!not be aUowed. CONTRACTOR/APpLICANT INFORMATION: Name: Renewa] By Andersen State License# Phone: �-- 1920 County Road "C" West E�cpiration Date: Mailing Address: Roseville, MN 55113 �� Contact Person: License #20130983 C�� ZIP• Email and/or Fax: - 651-264-477� �t is: Contractor / Homeowner (ClrCle One) -- PROPERTY OWNER INFORMATION: Name: ,�� Phone(day): ' + ��b� Address: 5� Email and/or Fax C� � Z�p; PROJECT INFORMATION: TYPe af Project: Any eartfi movement may requlre ❑Ooor(s) ❑ Remodel MC1ND review�permits ❑Water Damage Window(s) ❑Repair Minnehaha Cresk Watershed Oistrict (MCWD) ❑Storm Damage 18202 Minnetonka Blvd ❑ Siding ❑Restoration Deephaven,MN 5539'I ❑Other: (specify) Phone: 952-477-0590 ❑ Re-r�pF ❑ Fire Damage Fax; 952-471-06g2 Overall Project Descrlption: � �a�v.minnehahac.r�ek ora Estimated Conatruction Valuation of Pro ect(excluding Ia d1�� $ S� � ` APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; � Certifies thal the information supplied is true and correct to the best of his/he� knowledge. The applicant recognizes that they are solely responsible for submitting a complete applicatian being aware that upon failure to do so, the stafF has no alternative but to reject it until it is complete; • 5ome or all of the information that you are asked to provide on ihls application is classified by State law as either private or confidential. Private data is information which generally cannot be given io 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 annuaHy update our records and records of ather governmental agencies re uired b law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: � `,A �rn��,�� d� � Date: p� -� 1 Lasf Updated: 05-D4-2009 Z 'd 06T9trG9TS9 3�II1213S 1IW213d Q B S �I 9S =B TTOZ LZ i�C C��O� DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED �� _� PERMIT NO.aD/�—007�� COMPLETED ADDRESS �� (L��C�I�I�l?�d„� � OWNER TE EPHONE NO. Z�� CONTRACTOR ��D�(��__C�� i1 � DESCRIPTION �l�� i�`�" ��w S � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: W � a j � O � � O � W � Q � Z W � W � � d W� ❑WORKSATISFACTORY:PROCEED �PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CARRECT WORK,CA�L FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. �952� Z49-46QQ Owner/Contractor on site:. Inspector. �, � White Copyllnspector's File Canary Copy/Site Notice