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Home My WebLink About2013-00564 - windows � � CITY OF ORONO * 2 0 1 3 - 0 0 5 6 4 * 2750 KELLEY PARKWAY DATE ISSUED: 06/27/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952)249-4616 ADDRESS : 2705 SHADYWOOD RD PIN : 21-117-23-24-0003 LEGAL DESC : PHEASANT LAWN : LOT 025 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY ; O/S BUILDING-UNDEFINED VALUATION : $ 18,169.00 NOTE: (16)WINDOW REPLACEMENTS APPLICANT pERMIT FEE SCHEDULE 324.50 PELLA NORTHLAND STATE SURCHARGE(VALUATION) 9.08 15300 25TH AVE N. -SUITE# 100 PLYMOUTH, MN 55447 MAIL-IN FEE 2.00 (952)345-6047 TOTAL 335.58 Minnesota State License#: BC645090 OWNER NEWRAI, SOHRAB&JULIE 2705 SHADYWOOD RD EXCELSIOR,MN 55331- 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 onty the work described and does not grant permission for additional or related work which requires separate 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 l80 days at any time after work has commenced. The applicant is responsible for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cau e. � � �P �'�7i13 � 1a17 / Applicant Permitee Signature Date Iss By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � City of Orono Building Perr�it Application for Internal Work (windows, doors, siding, re-roof, etc.) _ - Mailing Address: Permit number. �� 1►,, PO Box 66 � .�o, O O�� Crystal Bay, MN 55323-0066 Date received: � �� Received by: �U� 2B 2�� „,� �;, r y' ,; �,� Street Address: — ��'� ��}.�� r U ti j 2750 Kelley Parkway Plan review fee: � � ��, 'I��'�`��O% Orono, MN 55356 t �1i�v��• w, , :. .��si3o�" , � Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us _ Tl�is application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: � 7 U 5.,, s � a �,f w � � „j � b �j / Job Site Address: v Q ---- - Will this be a Parade of Homes, Remodelers Showcase ome or other Display Home? ❑ Yes ❑ No If yes, a special evenl permit is required with Police Department and City Council approval 60 days prior to the evenL Shultle 6us service will be reryuired unless applicant demonstrafes sufficient on-site parking is available. Non-permil(ed events will nol be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: - ---- State License# Pella Nortllland Phone: 15300 25th Ave N. Ste 100 _ (cell) Mailing Address: Plytnouth, MN 55447 ZIP: Contact Person: Lic# BC645090 Ph. 763/745-1400 ��meowner (Circle Onc) Email and/or Fax: — PROPERTY OWNER IN OR ATIONL• Name: �C � 4 /� �C ` � - --- Phone da �-- Q Address: y)� a '] v Syu 5 4�R � W VD� /� � City: �.1'(t �S/b!� ZIP: 'J�s 33 / Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review& permits ❑ Coor(sj ❑ I:emodel ❑ Water Damag� Minnehaha Creek Watershed District(MCWD) �Window(s) ❑ Repair ❑ Storm Damage 18202 Minnelonka Blvd Deephaven, MN 55391 ❑ Siding ❑ Restoration ❑ Other. (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof ❑ Fire Damage www minneh�hacre�k.orq Overall Project Description: � (� („��/� rt G �,! M� n Estimated Construction Valuation of Project (excludin land) $ / 8 / 6 9 APPLICANT ACKNOWLEDGEMENT: —_ . Agrees to provide all information required or requested by the Building Department; —� • Certifies ihat the information supplied is true and correct to the best of his/her knowledge. The applicant recoynizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no altemative 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 Siate 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 re uired by law If you refuse to supply the information the application may not be issued. �� Date: ` ` � �� ApplicanYs Signature: _ — Lasl Updated: 05-04-2009 � DATE TIME CITY OF ORONO CALLED IN �� INSPECTION NOTICE SCHEDULED �;�fo-�_ i/.'dZ� PERMIT NO. Q� —�� COMPLETED ADDRESS a�D OWNER TEL PH NE NO.��a��S7 a �( CONTRACTOR L�-� l � DESCRIPTION � 11� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Q NER/CO RACTOR TO MEET YOU:�YES_NO � COMMENTS: � W a � J O >. � O � W � Q ti Z W � W � � d W� ❑WORK SATISFACTORY:PROCEED � OJECT COMPLETE W ❑CORRECT WORK 8�PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '�CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice