The URL can be used to link to this page

Home My WebLink About2012-00414 - doors CITY OF ORONO * 2 0 1 2 - 0 0 4 1 4 * .� " � , 2750 KELLEY PARKWAY DATE ISSUED: 05/16/2012 ' , ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 1205 SHORELINE DR PIN : 02-117-23-43-0015 LEGAL DESC : REG.LAND SURVEY NO.0397 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DOORS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 5,435.00 NOTE: REPLACE(1)DOOR WITHIN EXISTING OPENING. APPLICANT pERMIT FEE SCHEDULE 132.75 RENEWAL BY ANDERSON STATE SURCHARGE(VALUATION) 2.72 1920 COUNTY RD C.WEST ROSEVILLE,MN 55113 MAIL-IN FEE 2.00 (612)502-4777 TOTAL 137.47 Minnesota State License#:BC130983 PAID WITH CC# 8788 OWNER JACKLEY ET AL,JAY M 1205 SHORELINE DR 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 dces not grant percnission for additional or related work which requires sepazate pertnits. 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 any tir�e for due cau . �/ / / l �/ Cl?/ �� Applicant Permitee ' nat e Date Is u By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . c:ity ot orono � Bullding Permit Application for Maintenance / Renovation . , � ' windows, doors, siding, re-roof, etc.) MeqinD Addrea�: Permit number. � � �r 0.� PO Box 68 Q 0 Crysial Bay, MN 55323-OOBB Date reo�ved: �-- —/ � � SYreet Address: Reoeived by: � 2750 Kefley Parkway Plan review fee: Orono, MN 55356 Main: 952-248-4800 Fax: 952,249-4618 www.a.orono.mn.us Tolal Fee: /�� This application form mus�t be oompleted in full and ell required information must be su6rnitted. fncomple�be applicatlons wlll be returned. (P/ease print) aENERAL INFORMATION: Job Site Addre�s: �a cJ `j �`l�� (t u� WIII thia ba a Parade of Home�,Ramodelers 3howcase Home or oth�r Display Hvrr�? Y�s No Ny�ea,a apecial event pennrY ls reqWred with Polhce DeparhneM and Cily Coundl approval 60 days pNor to ths event. 5hult►e bus sen�lae wUl be �qulred uMesa applfcent demonstrefea suffklenf on-s/le parking is eveNeb/e. Non�permlfted evo�nte wNl not be allow�ed. CONTRACTOR/APPLICANT INFORMATION: Name: t�,rkl�o.1 �'K ��trSeiN State License# '�C ti 30 9 S 3 Expiretion Date: 3 j 3� Lead Cert�Rcation Number: (`j�T- o?�-a83 -� Expiration Date: y Jis (fbr woNt on honfea thet w�ue conab�uet�sd prlor to f978 Phone: (05�— o'�(�y—4�'}�- (otfice) (cell) Mailing Address: �� • WCy� City: ; C ZIP: s Contact Person: APPlicant is: / Horneovmer {an�.on.� Ernail and/or Fax: PROPERTY OWNER iNFORMATION: Name: ��,� 1� Phone(day): �a , � � Address: ; City: ZIP: Email and/or Fax PROJ ECT I NFORMATION: Typa of ProJact Any earth mowment may rsquire ❑�Kg) ❑Remodel ❑ Flne Damage NC�review 8 permib: ❑Re-roof,asphalt ❑Repalr ❑Storm Damage Minnehaha�M��B�c((RqCWp) ❑ Re-roof,cadar ❑ Restoratlon ❑Wa6er�amage Deephaven,MN 55391 ❑Re-roof,other(sp�cliy) ❑Sidin Phone: 952�71-0590 9 ❑Other:(spediy) Fax: 952-471-0682 �Window(s�� C�C/� w�rw.minnehahacreek.ora OvereN Pro eet Descri ion: • � , Estimabed Construction Valuatlo of Pro oct(sxNuding land ; _ APPLICANT ACKNOWLEDGEMENT: • Agrees to provlde all information requlred or requealed by ihe Building Departrnent; • Certefies that the information supplied is true and correct�the best ef hia/her knowledge. The app�icant recogn�es that they are solely responsible for submitting a complete application being aware tl�at upon failure bo do so,ihe staPf has no altemetive but to rejed it untii�is oomplete; � Some or all of ihe information thet you are asloed to prvvide on this applicatEon Is clasaified by 3te�e law as either privarte or canftderttial. Prfvate data iB infoRnatio� which generally cerpmt be given t�o the public but can be yiven to the subject ot the data. Confidentlel data is informetion which generally cannot be glven to either the public �r the subjeci of the dats. Our purpose and ir�tended use af this informetion is to annually updete our records and records oi olher govemmeirtal agenaes r� uired b law. 1 u refuse to su I 1he tMormatbn the a lication ma not be iasued. Aoolicant's Sianature: ��-� ��: �� Z z 'd 06T9bG9TS9 3�IA213S 1IW213d Q '8 S I� Z�► �ST ZtOZ Si �eW Jun 18 2012 16: 09 W S & D PERMIT SERVICE 6516746190 p. l � . � � ' ' rT_ ..�.,�...�. ' ` . . ""' �a�+��si�,.�a irai�c�isnoo�ax� � �`.�av�+o�r�n�anaua o�u�x��o hr� . . � . . �'� °��' — .{+oe��roo+��11l�Ml1�Yo�dsn8 ti�laN 7�/St.�''19 f �' G��v'p�►NN N4�'�'i)M3G�1�1�d N011�01 � . , . , � . . ' . ' /� +�vnM 6wl �nislPrp�i�addn=�0 w�p , ---....--... .. . _ ._... .. ..._.... . , , ,, ---r�+�� . •..:._«�.,�.,�.�.� IIiO�l1.�d G1�li IiJ1�31y Safi14 f�IDI elO 11NII1flN. ._ ��il'JCIIlN a10 Oliti il�11/90f11�1110ddr1t�tl3�Y,1fIN _ w�?oa�yr t x��'7� b' ��a�av��u�vw�os�t ....,.. 77 ' O911r►!!�QIY11N a0� `�� illCl�fi AIL'!N�0 Nlldt � ��Q �Ma311�19 H1aNN ONlN�dO �NIa31lV Z!O�ONtN3d0 M3N � �"11a�� 5�� 1'"6�1�'�Sb p � . S � IS�I -��. °�' 'o c�°�� .��, � � � ax �,�,,,r �.,�h, I �� `" � � /�TE TIME / � J CITY OF ORONO CALLED IN �� INSPECTION f��,/„ / SCHEDULED � �^ //:OD PERMIT NO. �� 77�7`� COMPLETED ADDRESS l�D� !�l � �L (/`2� OWNER TEL PHONE NO.� �-� �� CONTRACTOR C� G��'�� ' ,(7✓1 Q{7 � DESCRIPTION ��`-�`"' �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVA� 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 i ❑ DEMO-F�NAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES�NO c��, COMMENTS: � W C � J O a � O � W � Q � 2 W � W � � d W� ❑WORKSATISFACTORY:PROCEED �ROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WlLL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUtRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-46�� OwnedContractor on site Inspector. White Copyllnspector's File Canary CopylSite Notice