HomeMy WebLinkAbout2009-00578 - windows CITY OF ORONO PERMIT NO.: 2009-oo5�s
�,. 2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE ISSUEn: 09/1 U2009
952 249-4600 FAX: 952 249-4616
ADDRESS : 2001 SUGARWOOD DR
PIN : 34-118-23-21-0009
LEGAL DESC : SUGAR WOODS
: LOT 001 BLOCK 002
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 4,436.00
NOTE: REPLACE ONE WINDOW IN EXISTING OPENING
APPLICANT pERMIT FEE SCHEDULE 118.00
SCHERER BROS LUMBER STATE SURCHARGE(VALUATION) 2.22
10751 EXCELSIOR BLVD
HOPKINS,MN 55343 MAIL-IN FEE 2.00
(952)277-1600 TOTAL 122.22
Minnesota State License#:20239369 PAID WITH CC# 3989
OWNER
BALAN,TODD
2001 SUGARWOOD DR
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. 1'his permit is for only the work described and dces
not gant permission for additional or related work which requires sepazate
permiu. 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.
1'he applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. � ,// _ �G�
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Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
Sep, 10, 2009 4: 23PM No, 3503 P, 2
� + Cifiy of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
MailingAddress: Permit number . "� �'u -C;��✓�"�
Og,O j� PO Box 66
� Crystal Bay, MN 55323-0066 Date�ec�ived: �
o, Strset Address: Received by: �., C
�, � G� 2750 Kelley Parkway Plan re,►iew fee: (���
'�h.��og� Orono,MN 55356 �,2 � �
7otal Fee: �,n�� , � \
Main, 852-249�600 Fax: 952-249-4616 www.ci.orono.mn.us ` ` p
This application form must be completed in full and all required information must be submitted. , �(0�
Incomplete epplications will be returned. (Please print) �-G
GENERAL INFORMATION: d 1� _ ������
Job Site Address: ��( Sky�afwl,b J('�1lQ
Will this be a Parade of Homes, Remodele�s Showcase Home or other Display Home? ❑ Yes � No
!f yes,a special event permit Is required with Pollce Department and City Councll approval 60 days prio�lo the event. Shunle bus service will De
requlied unless applicant demonstrates sulflGent on-slte paiking(s ava!!able. Non-permltted events will nat be allowed,
CONTRACTOR/APPLICANT INFO ATION:
Name: .,S"cher�e,� � C� •
State License# 9 Expiration Date: �' ! l
Phone� '1- p office cell
Mailing Address: ,�'� ` Y Ci . in S ZIP: 3 3
Contact Person: Applicant is: Contractor / Home�wne� tc►�e o�e)
Email and/or Fax: x ��—1�Qo
PROPERTY OWNER I�RNIA��N���
Name: Od�d
Phone(day): - - 7
Address: �061 �aarwr�d riVc Ciry: ��'DrlO ZIP� ,S.Sj�o
Email andlor Fax
PROJECT INFORMATION:
Type af ProJ�ct: Any eerth movement mey require
MCWp review 8�permits
❑poo�(s) ❑ Remodel ❑Water Damage
Minnehaha Greek watershed�istrict(MCWD)
�findow(s) ❑ Repair ❑Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55381
❑Siding ❑Restoration ❑Other:(specify) Phone: 952-471-0590
Fax: 952�71-D682
❑Re-roof ❑Fire Damage www.minnehahacreek.om
Ove�all ProJect D�scMptlon:� 1 r a C2r►�,�� � bne W ' 0 u ��n�o �Q n �
Estimated Constructlon Valuatlon o ProJect(excluding land) $ 1�� 1-j3(o
APPLICANT ACKNOWLEDGEMENT:
. Agrees to provide all information required or requested by the Buifding Department;
• Certifies that the information supplied is true and corred to the best of his/her knowledge, The applicant recognizes that they
are solely responsible for submitting a compfete application being eWare thet upon failure to do so,the staff has no altemative
but to reject it until it is complete;
• Soma or all of the information that you are asked to p�ovide on this application is Gassified by State law as either private or
confldential. 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 tha public or the subject of the data. Our
purpose and intended use of this information is to annually update our �cords and records of other govemmental agencies
re uired b law. If ou refuse to su I inform 'on, the a lication ma not be issued.
Applicant's Signature: � Date: _ �/���09
Last Updated� D5-04-2D08