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Home My WebLink About2016-01198 - windows � t * CITY OF ORONO 2750 KELLEY PARKWAY * 2 0 1 6 - 0 1 1 9 8 * DATE ISSUED: 09/26/2016 ORONO,MN 55356- (952)249-4600 FAX: (952)249-4616 ADDRESS : 3185 SIXTH AVE N PIN : 28-118-23-32-0006 LEGAL DESC : LJNPLATTED 28 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-LJNDEFINED VALUATION : $ 2,162.00 NOTE: REPLACE(1)WINDOW INTO EXISTING OPENING APPLICANT PERMIT FEE SCHEDULE 92.89 STATE SURCHARGE(VALUATION) 1.08 THE HOME DEPOT A.H.S. TOTAL 93.97 2690 CUMBERLAND PKWY,STE 300 payment(s) ATLANTA,GA 30339- CHECK 75950 93.97 (763)542-8826 Minnesota State License#:BUIL-CR268257 OW1�1ER BRANTINGHAM,HENRY&NANCY 3185 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. . � � � �� o Applicant Permitee Signature ate Issued By gnature Date R . � City of Orono Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) O Mailing Address: Permit number: — � � �O PO Box 66 Q�(`�v�D Crystal Bay, MN 55�3 "5 Date received: —,Z Street Address: SEP 2 6 z�1� Received by: y � �, G� 2750 Kelley Parkway Plan review fe t �, Orono, MN 533 � �k�Ski�� OF ORONp Total Fee: g� � Main: 952-249-4600 Fax: 952-249-461 www.ci.orono.mn.us ' This application form must be completed in full and all required information must b submitted. Incomplete applications will be returned. (Please rint) GENERAL INFORMATION: Job Site Address: .��S �` �/ i� �(� . d. G 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/p"-" '-""�- "---- Name: THD At- Ho�ne Service, Inc, State License# 2690 Cumberland Pk��y, Ste 300 Expiration Date: 3- �-17 Lead Certification � Atlanta, GA 30339-391� i�a�_ZExpiration Date: I-�q-w (for work on hon Lic # CR268257 Ph. 7h3/542-8826 Phone: (office) Mailing Address: City: ZIP: Contact Person: �.,�,L,� C��-Z 3�(S' �o S-� Applicant is Contractor / Homeowner (Circle One) Email and/or Fax: �` PROPERTY OWNER INFORMATION: - Name: �mrV . �GtV1'�'!1(�!1 Vl'� Phone (day): l'�I� �C�--7 3�C� � Address: � ��M,� City: ZIP: Email and/or Fax: ' � , PROJECT INFORMATION: Overall project description: / ' ('�C?iI'h �e/'j . Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 �/indow(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ c�/loa- - 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 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 I the information,the a lication ma not be issued. ApplicanYs Signature:l, �� Date: / ��'�� Owner's Signature: Date: Last Updated:January 2016 ��G�J� _ _ TIME ✓ CITY OF ORONO CALLED IN l� � INSPECTION SCHEDULED l� ' -�l� PERMfT NO.� � � COMPLET � ADDRESS -� � OMINER NE NO. CONfRACTOR �� DESCRIPTION � � "`� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPT FINAL � ❑ POUHED WALL ❑ PLUMBING RI ❑ EXCAV!(iRADIN(i/FILLIN� Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI � SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑WOOD BURNER/FIREPLACE � COMPLAINT Q 0 FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP W �AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATIOWREMOVAL _ v ❑ DEMO-SITE � SEPTIC INSTALL TO MEET YOI$,�YES_NO � coMME� f,Ur✓l�'o� r� �oca�� OY� �ovt��c�Z ��t�c� 4 �l. `�-2 �t..s�-s�Z�f Clv wi v�1 �� o . � � �� ,�,� ,r s � ca �- o � p � � 1N ,C� ' W � Q z -S„� s '��S � - r-c.vl� ...�,�,o l� ��fe.� �� -� , � W OG , W ❑YMOFiK SATISFACTORY:PROCEED COMIPLETE � O OORRECT W�OfiK a PRO(�ED ❑ISSUE C@iTIFlCATE OF OCWPVINCY o�.� ❑OOf�ECT WOFiK CALL WR REtNSPECTION TBrIPORAFIY V �F�� PEAMANB�IT ❑ppRRECT UNg/►FE ppNqT10N WITHIN HOUR3. ❑pHpTO TAKEN INSPECTOR WILL RETIJRN O STOP ORDER PO�TED.CALL INSPECTOR O CITATION ISSUED O INSPECiION f�0U1RED.C/1LL TO ARRANf3E ACCESS. CsN Ior the nent t�repecaon 24 ha�rs 1n adnanoe. (952) 249-4600 �nspector � 6�L' vI1M/��p�Ans�� c.n.ry co�dsll.NoNa