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Home My WebLink About2010-01181 - addn/remodel/repair i CITY OF ORONO PERMIT NO.: 2oiaoiigi � 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 12/07/2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 2725 SHADYWOOD RD �� PIN : 21-117-23-24-0004 � LEGAL DESC : PHEASANT LAWN : LOT 026 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 12,500.00 NOTE: WATER DAMAGE-BASEMENT REPAIR. APPLICANT pERMIT FEE SCHEDULE 236.00 { PETERSLETTEN 11455 TACOMA AVE STATE SURCHARGE(VALUATION) 6.25 ; YOUNG AMERICA,MN 55268- TOTAL 242.25 (612)743-6890 Minnesota State License#:20113289 OWNER MEEK,MICHEAL&ROBERT 2725 SHADYWOOD RD EXCELSIOR,MN 55331 AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to t 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 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 aze requested in conformance with the State Building Code.This permit may be revoked at time for due cause. � � ^'l / 1� l � D ! Applicant Permitee Signature Date Issue y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �, City of Orono Buifding Permit Application for tnternal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: d l�''d/ �� O.¢,D,�.O PO Box 66 � Crystal Bay, MN 55323-0066 Date received: i C7 ,� �`� �, Street Address: Received by: '�, � Gti�' 2750 Kelley Parkway Plan review fee: t.�q�Hog*� Orono,MN 55356 �--- Total Fee: a C�� • �J� Main: 952-249�1600 Fax: 952-249�616 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) GENERAL{NFORMATION: Job Site Add�ess: 2�--�--5 Sb�1��L�� , �(,Ci�SI�� ` YYl►'1 `�3�I Will this be a Parade of Homes, Remodeters Showcase Home or other Display Home? Yes No lf y�es,a special event permit is requrred with Police DepaRment and City Counci!approval 60 days prror to the event. ShutUe bus service wift be requi►ed unless applicant demonstrates sufficient on-site part6ng is available. Non pemritted events will not be aUowed. CONTRACTOR/ ICANT INFORMATION: Name: �-��-F',� �j�jti�-r� State License# Z,"�t 1?;Z P�`� Expiration Date: Phone: �p 12��'3� c_��iL� (c�iee) (cell) Mailing Address: � � �/e� C : G tP: Contact Person: �,h-�, Sj��-, Applicant is: ontt / Homeowner �c��o�e� Email and/ar Fax: �,��-x-��;�y.��. C`�.v 1�(�t-rY�G�,� , Lp►-Y� PROPERTY OWNER lNFE}s'�3�?:Cs�: Name: r��C�-� Y1'��IL- r�nnp r��y� � ' 2`3 �...,. ,. . Address: �-2S �v��L��$]C Y�� G�Y��k��Y" ZIP: �3`31 FmBil�n�/pr Fax �-,�/�-v��l^[Y 1�51� ( C�� t?.fE�T 3N�(3RMATlON: Type ot Project: Any earth movemeM may reqaire M f I �cwo��W�� ! ❑ �oor(s) I ❑F�emociei �water t�amage f rivilrtrt�ha�ta��eek'v'Vai�rsFi�ti uisufci�iviC'vVD} ' ❑V:�indo�:,s} �4�pa�r ❑3ta�m Darrage ' t3202 Minnetanka�lvd �RP;?haven,MN �5�9'! � ❑Siding � ❑Restoration ❑Qther:(specifyl Phone: 952�71-0590 Fax: 952-471-0682 ❑Re-roof ❑Fire Damage www.minnehahacreek.orq �s•�!�!! P�CjE'Ct DBSCT:�3tl�.^.: Estimated Constructio��fatuation of Pro;ect(excluding land) � �"j_, '�,� APPLiCANT ACKNt3WLEDGEMENT: . Agrees to provide a!!informatian required or requested by the Building Departmerrt; • Certifies that the information suppiied is t�ue and caRecE ta the best of his/her knowledge. The applicant recagnizes 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 uniit it is complete; • Some or aii of tfie information that you are asked to provide on this apptication is ciassified 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. Confidentia! data is information which generally cannot be given to sithsr the public or ihs subject of the data. Our purpose and intended use of this information is to annua�ly update our records and records of other governmental agencies re u+red b law !f ou refuse to su I the information,the a lication ma not be issued :a:�ai:�i;�.:.v;�;u.>,-�. � u..,�,. ��I� l �� _��:'v;:�iczc•�": ET4=ti�2--�=i:�.. � DAT TIME v CITY OF ORONO CALLED IN a�a INSPECTION NO�IC� _O�� / SCHEDULED �-�� ✓ �� PERMIT N0.aZ / / COMPLETED ADDRESS a� ,5 S �- OWNER TE EPHONE NO. Z �`� �8�0 CONTRACTOR S �: DESCRIPTION � � - � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS 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 i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � o �- ��°l�-�l�:C� �� 'C C-�p�' '' � � C>��-f � i �� , e � �'�t. � _� �� '� � CJ�.l� �.¢� i�l tx.� � Q � -� � 5 �i � � -U � �� -� � C" f U (�' ' �/.,��t/ � � � � P ��( �Q c�rG> M W � � � " Q - ,.,�,� iJ�. � �' �-f�� r'r'� � a W� ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY ��aARRECT WORK,CALL FOR REINSPECTION TEMPORARY V �NG PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. �952� Z49-46QQ OwnerlContractor on site: Inspector. � . / �"� 0) � White Copyllnspector's File Canary CopylSite Notice i , / '�� '�` DATE TIME V CITY OF ORONO CALLED IN � INSPECTION f�OTICE SCHEDULED �i- �� /lr��-1/ � PERMIT NO.��/�� '� �J'�� COMPLETED -^� ADDRESS � �:� � �,� ��f ; (�; �6� �l OWNER ��L �� 1� TELEPHONE [�O. �r /�'M��-��-�� CONTgACTOR �` ��_ •.� ( �- .S �C�7�fC�y�'7 '� ��-x �- �,� � ' � r >: DES�RfPTION � :,�i � � ��-�/ �' /1�7' ✓�.�' G �?i�'�(` � �/i;�`t � � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS 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 � O DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/CONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W 0. � J O � � O � W � Q ti Z W � W � � d W� ❑WORK SATISFACTORY:PROCEED '�PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CAIL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALI TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (J52� 249-460� OwnerlContractor on site: Inspector. � 1 A White Copyllnspector's File Canary CopylSite Notice