HomeMy WebLinkAbout2011-00819 - windows ' ' �'" CITY OF ORONO PERMIT NO.: 2011-00819
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE IssuEn: 08/08/2011
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
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 63,318.00
NOTE: REPLACE(2�WINDOWS AND(4)DOORS INTO EXISTING OPENINGS
APPLICANT pERMIT FEE SCHEDULE 786.75
SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 31.66
10751 EXCELSIOR BLVD
HOPKINS,MN 55343 MAIL-IN FEE 2.00
(952)277-1600 TOTAL 820.41
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 pertnit 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 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
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
� CQ �' �� /� � � �
Applicant Permitee Signature Date Issue By �gnature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
� Aug.�B, 2011 2: 23PM No. 7798 P. 1
Clty Of OI�OnO
Building Permit Application for internai Work
(windows, doors, siding, re-roof, etc.)
MailingAddress, Permitnumber. ���'(�v
O.¢,O�.O PO Box 66
Crystal Bay, MN 55323-0066 Date received:
a � `T e. Street Address: Received by;
'��, ,� � � ��ti 2750 Kelley parlcway Plan review fee;
�ao�.� , Orono,MN 55356
Total Fee: � ,
Main: 952-2a9�F600 Fax; 952-249�616 www.ci,orono.mn.us
This application fo�m must be completed in full and all required information must be submitted. .
Inccmplete appiications will be retumed. (Please prinf)
GENERAL INFORMATION: . � �
Job Site Address: �O�C O p c��, , �
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes �No
K yes,e speaial event peimit is required with Podce Departmenr and C;ty Council approva!60 days privr b the event Shuttle bus servlca will be
required unless applicant demonstrdtes sufficient on-�te pai►dng is available. Nan-permifted evenfs wilf not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name; �j�,h,�� �,ro�
State License# �o a.3�3<o q Expiration Date: 3 [1
Phone: ySa-,� �o C) office cell
Mailing Address: I t��.sl � t� kitr (v . Ci : '� S ZIP: S 3 �/
• Contact Person: ,���}.�`"�,,���;c I,�; Applicant is: ontra / Nomeowner �circie oM�
�mail and/or Fax;
PROPERTY OWNER INFOwuI�►naN:
Name: C_In v�S � }�ec�'��r I�o.�.l�
Phone(day): 9S'�- �-( 7(n� �o 06
Address: ?,b loo Cs��w�. �cQ (Q ��Y�V'o n cJ � ZIP:S,5"�S�o
Email and/or Fax
PROJECT INFORNWTION:
Type of ProJect: � Any earth movement may requlre
MCWD review&permib
❑Door(s) ❑ Remodel �Water Damage
Minnehaha Creek Watershed Districi(MCWD)
'�Wrndow(s) ❑Repair ❑Storm Damage 19202 Minnetonka Blvd
Deephaven,MN 55391
❑Siding ❑Restoration ❑Other.(specify) Phone: 952-471-0590
Fax: 952�i71-0682
❑Re-roof ❑Fire Damage www.minnehahacreekorg
Overall Project Descrlptlons �, ` n �.'�'.� ov'kS s- co+S il� Q, f�S ` v� o e►�i�c�,s:__„
Estimated Construction Valua�on of Project(excluding land) $ (�� ��_�_(Tt�
— , .
APP�icaNT ACEavow�EQGEMENT:
. Agrees to provide all informaaon required or requested by the Building Department;
. Certifies that the information supplied 'Is true and coRect 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 altemative
hut to rejed it until it is complete;
� Some or all of the information that you are asked to provide on this application is dassified by State Iaw as either private or
confidential, Private dat� is information which generally cannot be given to the public but can be given to the subjed of the
data. Gonfidentia! data is information which generally cannot be given to either the public or the subject of the data. Our
purpose and intended use af this infonnstian is to annually update our r�ec9rds and records of other govemmental agencies
� _ raquired b r�law. If you refuse to supplY the infoRnatlon,the dpplication may not be issued.
ApplicanYs Signature: .��. w Date: �-�!� '
i��i�i..�+e►a.�• n�n��nno