HomeMy WebLinkAbout2014-00346 - windows - � ,
�"� • CITY OF ORONO �
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2750 KELLEY PARKWAY DATE ISSUED: 04/22/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3050 SUSSEX RD
PIN : 04-117-23-32-0010
LEGAL D SC : FOX BEND
: LOT 004 BLOCK 001
PERMIT YPE : MINOR ALTERATIONS
PROPER Y TYPE : RES[DENTIAL
CONSTR CTION TYPE : WINDOWS
ACTIVIT : O/S BUILDING -UNDEFINED
VALUATI N : $ 5,045.00
NOTF,: WI DOW RF.PLACEMENT IN EX[STING OYENINGS
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APPL[CANT PERMIT FEE SCHEDULE 132.75
STATE SURCHARGE(VALUATION) 2.52
HAMEL UILDING CENTER TOTAL 135.27
18710 HI HWAY 55 Payment(s)
PLYMO TH, MN 55446- CHECK 31986 135.27
(763)478- 601
Minnesot State License#: BUIL-20631040
OWNER
FEUSS, IHARLES & LINDA
3050 SU SEX RD
LONG L KE, MN 55356-
A REEMENT AND SWORN STATEMENT
The work r which this permit is issued shall be performed according to
the approv d plans nnd specitications,applicable City approvals,and the
State Buil ing Code. This permit is for only the work described and does
not grant ermission for additional or related work which requires separate
permits. II provislons of laws and ordinances governing this type of work
shall be c pied with whether or not specified herein.1�his permit will
expire an become null and void if construction authorized is not
commene d within 180 days of the date of issuance,or if construction is
suspende for a period of 180 days at any time after work has commenced.
The appli ant is responsible for assuring all required inspections are
requested n conformance with the State Building Code.This permit may be
revoked a any time for due cause.
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Applica t Permitee 'gnature Da[e Iss �d By Signature Date
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City of Orono
Buil ing Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. Only windows, doors, siding, re-roof, etc.)
O� Mailing Address: Permit number: �� —
O PO Box 66
� Crystal Bay, MN 55323-0066 Date received: �Z"
Street Address: Received by�
y � 2750 Kelley Parkway Plan revie ee:
`�tq �,� Orono, MN 55356
fSHUR �� '�j 9��
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. (Please print)
GEN L(NFORMATION:
Job S te Address: �Oso SvsS �C'/� /
Will t is be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes ' No
If y s,a specia/event permit is requrred with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required un/ess applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not 6e aflowed.
CON RACTOR/APPLICANT INFORMATION:
Nam : �jrrf� ,adi���.�� �`'s-�'Ta`�_
State License# ��•'�3'iG yp Expiration Date: p,3 �i a�i�
Lead ertification Number: �,�T ^�7v7Ci —/ Expiration Date: p�� � ��,�
(f work on homes that were constructed prior to 1978
Phon : (cell) ����� 6�6 - �Sa G (o�ce) ���j� %�€-G��o /
Maili g Address: /�- iv �� ss� C�tY� �Ys���/ ZIP: ss-yy
Cont ct Person: �f�.�` i3, L-�<<f�,yt�c�>� Applicant is: ontrac o / Homeowner (CircleOne)
Ema' and/or Fax: ,r��<<��s�yE<<�� Q° jf.��-,.`z./��.�n.-- C c-s�,..-trrr . c�-,.--L.
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PRO ERTY OWNER INFORMATION:
Nam : l'�i✓�e�i�� ,�`�'��S
Pho e (day): ��.�) 31 s - �3 so �,c�,
Add ss: �o � G•�� ,P��� P� , City:�`�„�6l /�l1 i ZIP: �7fi 7
Em I and/or Fax:
PR JECT INFORMATION: Overall ro�ect descri tion:
Typ of Project: Any earth movement may also require
❑ oor(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits:
❑ e-roof,asphalt ❑Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ e-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑ e-roof, other(specify) ❑Siding ❑Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
[j�'Window(s) r�t s��r �,,,w�+.6s www.minnehahacreek.orq
Es mated Construction Valuation of Project(excluding land) $ S"o ys'
AP LICANT 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.
Ap IicanYs Signature: .�� /�� Date: �' �' �S�
O ner's Signature: Date:
La Updated:03/O6/2013
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