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Home My WebLink About2013-01305 - siding CITY OF ORONO * Z 0 1 3 - 0 1 3 0 5� � 2750 KELLEY PARKWAY DATE ISSUED: 12/19/2013 , ' ORONO,MN 55356- (952 249-4600 FAX: (952 249-4616 ADDRESS : 2155 SHEVLIN DR PIN : 03-117-23-34-0006 LEGAL DESC : WEBBER HILLS : LOT 009 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : 'RESIDENTIAL CONSTRUCTION TYPE : SIDING ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 21,099.00 APPLICA T PERMIT FEE SCHEDULE 368.75 HOME EXTERIORS INC STATE SURCHARGE(VALUATION) 10.55 7950 CO RD 26 TOTAL 379.30 MINNETRISTA,MN 55359- , Payment(s) (612)270-2142 CHECK 9490 379.30 Minnesota State License#: BUIL-�C 2031530 OWNE PAULSON,MR.&MRS. 2155 SHEVLIN DR WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shsll be performed according to the approved plans and specifications,appliicable City approvals,and the State Building Code. This permit is for onl�the work described and does not grant permission for additional or relate work which requires sepazate permits. All provisions of laws and ordin es goveming this type of work shall be compied with whether or not speci ed herein.This permit will expire and become null and void if construc ion authorized is not commenced within 180 days of the date of i suance,or if construction is suspended for a period of 180 days at any ti e after work has commenced. The applicant is responsible for assuring all equired inspections aze requested in conformance with the State Bu Iding Code.This permit may be revoked at any time for d ause. � / / plicant Permitee Signature Date Issued By ' nature Date � " � � � . '�� ; � � City of Orono `� � �. Buildi�ng Permit Application for Maintenance / Replacement / Renovation � :f � � (No structural expansion. Only windows, doors, siding, re-roof, etc.) � �O . `O Mailing Address: Permit number: � 1V PO Box 66 `� Crystal Bay, MN 55323-0066 Date received: � � Street Address: Received by: a� � ' y�, ` 2750 Kelley Parkway Plan review fee: � �.� �' Orono, MN 55356 `qkESHOR� 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: Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes ❑ No ,,=s; If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/AP:PLICANT INFORMATION: Name: }� "{-flr t��`v� State License# , � �� Expiration Date: - ��,( � Lead Certification Number: �� ;� � a � 6 - + Expiration Date: '� -3-- �� {• (for work on homes that were constructed prior to 1978 � Phone: (cell) (office) Mailing Address: `� C� � City: 4 �� I �u- ZIP: `-'�' � Contact Person: � � � (�-�'�Q _ �j y Applicant is: Contractor / Homeowner (Circle One) �' ;. 5.x, Email and/or Fax: ¢. s� �`"` PROPERTY OWNER INFORMATIO • �'.. Name: �� v�— G��t �S 0� � Phone (day): '� Address: � � � Cit : ZIP: �Y � V �i �. �� Y �(/u h r Email and/or Fax: 4 PROJECT INFORMATION: Overall project description: � ��- Type of Project: Any earth movement may also require �: MCWD review 8�permits: ,� ❑ Door(s) ❑ Remodel ❑ Fire Damage � �� ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) '� 18202 Minnetonka Blvd ��:`� ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 t ,� � Phone: 952-471-0590 "� "€.` ❑ Re-roof, other(specify) Siding ❑ Other. (specify) Fax: 952-471-0682 � ❑ indow(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) , G u �`:; 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 � i �� intended use of this information is to annually update our records and records of other govemmental agencies required by law. If � �� ou refuse to su I he informati n, a lication ma not be issued. k'.` ApplicanYs Signature: Date: �.Q;l Owner's Signature: Date: G�'� �� Last Updated: 03/06/2013 ,�� : r�; �.,. _ _ _� . ,. _. .� /�� TE [� TIME V l'/4 CITY OF ORONO CALLED IN �I 7 INSPECTION NOTIC SCHEDULED / � PERMIT NO. Z0� "��5 COMPLETED ADDRESS , o� t b 5 �h�V'�I/� � . OWNER TELEPHONE NO. �2 –2��/ CONTRACTOR , YVI�- ,��. � � DESCRIPTION , `� � � ��U' �! �l a � � ❑ FOOTiNG ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI O LAKESHOREMfEfLANDS ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PRpGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. O FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J � PLUMBING RI ❑ SE FINAL ❑ FOUNbATION/REMOVAL ? �IIfNERICONTRACTOFi TO M�T YiOU: YES_NO � COMME . ` ` a I'C`�t/�!� . ry1dN�Z�G✓t� �3'i�•ir � j ' ��M�r�C�a�c� 5 Pt�� , � � ' �'tklk�•�c /�io�c�d��P ,riae�r.P Fit.r� .�. 0 W �oo�'S � � Q 2 GcJQ�K t��P<�f Cy••��l,�yc � � W � J { O W� ❑VYORKSATISFACTORY:PROCEED �ROJECT COMPLETE W ❑CORRECT WORK 8 PROCE� ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CdVERING PERMANENT O CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WILL RETUFiN O CITATION ISSUED ❑STOPORDER POSTED.CAL4INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwneHContractor on site: Inspector:�,,,I �-�— (/ YVhits Copyllnsp�ctor's File Canary CopylSite Notiee