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Home My WebLink About2013-00321 - addn/remodel/repair � � CITY OF ORONO * 2 0 1 3 - 0 0 3 2 1 * 2750 KELLEY PARKWAY DATE ISSUED: OS/07/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1480 SIXTH AVE N PIN : 26-118-23-32-0008 LEGAL DESC : DOUGLAS ESTATES : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 30,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING, ELECTRICAL(STATE) BONUS ROOM ABOVE GARAGE REMODEL APPLICANT pERMIT FEE SCHEDULE 466.75 PRAIRIE HOME REMODELING LLC STATE SURCHARGE(VALUATION) 15.00 9830 BALMORAL LN. TOTAL 481.75 EDEN PRAIRIE, MN 55347- (952)941-8291 Minnesota State License#: BC521184 OWNER GULBRANDSON, DAN& ERICKA 1480 SIXTN AVE N LONG LAKE, MN 55356- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved p(ans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission Yor 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 are re uested in conformance with the State Building Code.This permit may be ev t any ime o e cause. � � � �� " � ;�L �� i i / � ant Pe rt� ature Date I �� d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. >; � ,� City of Orono Building Permit Application for Maintenance / Replacement / Renovation _ ` � (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O�O Mailing Address: Permit number: PO Box 66 Crystal Bay, MN 55323-0066 Date received: e'`' '� Street Address: Received by: ; � yF �� 2750 Kelley Parkway Plan review fee: �' Orono, MN 55356 ��'�FSH�� gI� �� 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. (Pleas print) GENERAL INFORMATION: _ry� ,_ ( �� Job Site Address: ��_� ��/E, �� , = Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No 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/ LICANT INF RM TIO • 'r3 �`�� Name: �1l�C.S/� r �IL State License# � e Sa l ( �-I' Expiration Date: b3-3 I-1 S Lead Certification Number: Expiration Date: � "'' (for work on homes that were constructed prior to 1978 Phone: (cell) �,�2 -oZto- �f�l-SS (office) s'Z . 9�-t � - Z°1 I �� Mailing Address: �gj�jQ .�` City:�t� �,�i,q�E„ ziP: �53 4 Contact Person: � Applicant is: ractor / Homeowner (Circle One) � Email and/or Fax: e �� •Cprv� z ,;� PROPERTY OW R INFORMATION: /� Name: f�h� � �� l_SU�� Phone (day): _ Qq -U�� ( Address: p �'�" �f� �-�(d,� City: Q�Zy-�f d ZIP: �53J�`, Email and/or Fax: PROJECT INFORMATION: Overall project description: d+`» �bd� A�� E RE:/'►a�t�- 6(�C— ` Type of Project: Any earth movement may also require MCWD review&permits: � ❑ Door(s) �emodel ❑ 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 ❑ Re-roof, other(specify) ❑ Siding ❑ Other. (specify) Phone: 952-471-0590 c� Fax: 952-471-0682 d� ❑Window(s) www.minnehahacreek.orq �� Estimated Construction Valuation of Project(excluding land) $ �• �d � � ' APPUCANT ACKNOWLEDGEMENT: <� • Agrees to provide all information required or requested by the Building Department; ;;� =,r • 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 intended use of this information is to annually update our records and records of other governmental agencies required by law. If ou refuse to su inf rmation e a lication ma not be issued. Applicant's Signatur : Date: �' 0?'� 3 Owner's Signature: Date: Last Updated:03/06/2013 �►c�� av�-- ��s Sl��-- �C�e.� � �-�,� �uC�-rc�.1 . � ► � � � �,, ��,su�a �N r�.r�- T��--, s-(-�x�c,:� ; �-��- C��';�'� � � � � fi�,�,., �,,��,,g..�--r�,r , ,.�� 5�� . N�� . - +�� A� : �`�`v �15 � , ��- 5�� b�.�.a„ �r�. y -�-��' �S " �� .�� /�r a.' ��-� �` �►�� 5 '�1��E�s� . � � � �� ` �� $� �� —�K�,�,� 6U �� ,�v8- Ha� �G� � � ,<� �S �J��i�►�� Y� l/ `h� �� . � ;; _, � '�`.��f .� . �� , i H� 'i ..� � . . '.'� 5 � � ¢x,�4 . 5 ;� � j '� :a � }• . . - �� _ •/�� 1 '. e`li`a��^-+ . q . . � ' � , "� ..:F . ., � ... `.. �e.�..' . : , .��r �F . . >,.„� „ , L �� ; ``� ... . :-1 . `� �' r � .. � . ..�.�. . � � � . . . �fi . � � . ... . . � . . . .. �S . ' � . � ... . 1-:S}�� -`.: . .. . . . � t.♦ ,. t .. � . 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' . ,..._ : . :� ., .. . .. ,.. . . � g . . � . . � . �� .. . ... .. . .. . . .. . . � . � ' . . � . � _ . . .�i . .... ... . .. . . . . . 1� '.:.-�. . :. . . . . . .. .. .. . . . .. . . . . . . , . . iT��.� . �� DATE TIME V CITY OF ORONO CALLED IN INSPECTION NOTI E SCHEDULED -s / —/.� �� PERMITNO.aol�-�°3�-� COMPLETED ADDRESS `��0 �'X-`� 17�-t'� OWNER T LEPHONE NO.�P�z z�o �� CONTRACTOR �: DESCRIPTION ` ��Z-��- � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ 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 ❑ WARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a o ��-_� "�� ( t ,e, � a � � �i ,ti..J � � t�� . �S ; Q a�r3 - ocx� � 3 z r 3 --C�v '7 ✓ W � j �n/�al�� S a W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITI�NWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL RETIfRN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� Z49-46�� OwnerlContractor on sit : Inspector. � White Copyllnspector's File Canary Copy/Site Notice