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Home My WebLink About2011-00253 - windows � ! CITY OF ORONO PERMIT NO.: 2011-00253 2750 KELLEY PARKWAY ORONO, MN 55356- DATE IssuEn: OS/06/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 3060 SIXTH AVE N PIN : 28-118-23-32-0014 LEGAL DESC : LESLIE ADDN : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTNITY : O/S BUILDING-UNDEFINED VALUATION : $ 5,108.00 NOTE: REPLACING(2)WINDOWS INTO EXISTING OPENINGS. APPLICANT pERMIT FEE SCHEDULE 132.75 SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 2.55 10751 EXCELSIOR BLVD HOPKINS, MN 55343 MAIL-IN FEE 2.00 (952)277-1600 TOTAL 137.30 Minnesota State License#:20239369 PAID WITH CC# 3989 OWNER KOSEK,CHRISTOPHER&HEATHER 3060 SIXTH 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 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 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 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. � ��-� �-� � � �J7�yzcyr i �v—�/// Applicant Permitee Signature Date Issued By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCWBED ABOVE. t Apr. 27. 2011 11 ;40AM Na. 7111 P, 1 r City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) g O� MailiP B�6sGs: Permit number, a��`�D� Q �w0 Grystal Bay, MN 55323-0066 Date received: a ,�'b, a St►eet Add�ess: Received by: m�, � �E�' 2750 Kelley Parkway Plan review fee: ��og6 Orono,MN 55356 �_=' Total Fee: �3�.3 � Main: 952-249�600 Fax: 952-249�1616 www.a.orono.mn.us �� ' This application form must be completed in full and ali requir�d irifonnation must be submitted. . Incomplete applications will be r�etumed. (Please print) GENERAL INFORMATION: ` Job Site Address: 30(p0 (,` oc-�.h� �Cl �O WII this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes No N ya�a speaal event permit is�quired with Police Depaitment and Ciry Counal approva160 days prior to the event. ShuCJe bus seivice will De m.quired unless applicant demonstrates suff►cient on-sile padaing is available. Non-per►nitted evenfs will not ba allowed. CON7RAC'rOR/APPLICANT INFO��NIATION; Name: Jc.i�aare.�r "�v�oS Y,_._ __. State License# �,o��„�.3 G, � ��' _�.,, Expiration Date: 3 J � ,�.. Phone: ��—,� 7>— /�D O office � (cell) Mailing Address: �7SL � �e, � (� Ci �v1 S ZIP: �S 3�/ Contact Person: '}3�}� ��v.:c k: Applicant is: ontra o / Homeowner �circioa,.� Email and/or Fax: �S�-—a 7�— I�td _.,_, PROPERTY OWNER INFORMATION: Name: C.�r'�S �- ��`�-1�9..r �c�� _.. _ Phone(day): 9,Sa-- - !ac)o� Address: ,.. �o�v o c�r..� � Cp ----M CitY:�ro r�c� • ZIP: 3�5,3.�� Email and/or Fax PROJECT INFORMATION: 7ype of ProJec� �� Any earlh movement may require MCWD revlew S permits ❑Door(s) ❑Remodel ❑Water Damage Minnehaha Creek Watershed Distric�(MCWD) (�Window(s) ❑Repair ❑Storm Damage 18202 Minnetonka BNd Deephaven, MN 55391 ❑Siding ❑Resiordti0n ❑Other.(speclfy) Phone: 952-471-0590 FdX; 852�t71-0682 ❑Re-roof ❑Fire Damage www.minnehahacreek.om Overall Project Descri�tion: � �.h o1 c.��►. 'ows 1►�. ��i s�:v�s o�e.►�'��nS S Estimated Constructlon Valuatlon of Proje �excludin�land) � S/ 6 S APPLICANT ACKNOWLEDGEMEMT; . Agrees to provide all infortnation required or requested by the Building Department; . Certifies that the information supplied is true and corred to the best of his/her knowledge. The applicarrt recognizes that they are solely respansible 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 alf of the information that you are asked lo provide on this application is Gassified by State law as either private or confidential. Private daca is information which generally cannot be given W the public but can be givan Io the subject of the data, Gonfidential data is information which generally cannot be given to either the public or ihe subjeet of the data, Our purpose and intended use of this information is to annually update our reca�ds and fecords of other govemmental agenaes re uired b law. If you�h,se to supply the inFormation,the applippon ma not be issued. . . X:, Applicant's Si9nature: 1�� _ R Date: 7 '� 7"� � , Last Updated: 05-042009 � r y . v 1 . • O�'��p � , � o�On� � � � �� G� �p4 . 2750 Kelley Parkway P.O. Box 66 Crystal Bay, MN 55323 (952) 249-460Q Fax: (9S2) 249-4616 FAX TRANSMISSION COVER SHEET Date: `Zl 2�` To: (� S F�: 95 2� - �7 7-��9� Re: � �a ��l/l � � Sender: `d1/�,��(�' GC- YOUSHOULD RECENE � PAGE(S), INCLUDING THIS COVER SHEET. IF YOUDO NOT RECEIVE ALL THE PAGES, PLEASE CALL (952) 249-4600. � � � � � �� 1 -