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Home My WebLink About2011-01049 - siding CITY OF ORONO PERMIT NO.: 2011-01049 r 2750 KELLEY PARKWAY f ORONO,MN 55356- DATE ISSUED: 09/13/2011 952 249-4600 FAX: 952 249-4616 ADDRESS 3680 TOGO RD PIN 17-117-23-31-0029 LEGAL DESC TOWNSITE OF LANGDON PARK LOT 004 BLOCK 010 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE SIDING VALUATION $ 2,000.00 NOTE: THIS PERMIT INCLUDES BOTH SIDING AND WINDOWS APPLICANT PERMIT FEE SCHEDULE 73.75 CARLSON&JESSE HILL,KATHRYN STATE SURCHARGE(VALUATION) 1.00 3680 TOGO RD WAYZATA,MN 55391- TOTAL 74.75 PAID WITH CC# 7140 OWNER CARLSON&JESSE HILL,KATHRYN 3680 TOGO RD WAYZATA,MN 55391- 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 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 reque in conformance with the State Building Code.This permit may be rev ed t any tinyfor due cause. ppl' ant Permitee Signature Date Is d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono ` Building Permit Application for Maintenance / Renovation (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: O �O Cr Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: 2750 Kelley Parkway Plan review fee: 0Orono, MN 55356 I' �'kESH4` Total Fee: IxljJ Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us )5 This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: _ Job Site Address: Will this be a Parade of Homes, Remodel rs Showcase Home or other Display Home? ❑ Yes 5J 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/APPLICANT INF RM TION: Name: .till- l` State License # Expiration Date: Le-d Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (office) (cell) Mailing Address: ; City: %,L;, ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: �? c,ut•1�.i oar• o "h PROPERTY OWNER INFORMATIOT4 IName: �l r'S S e Phone (day): 74, PS— Cs,ScJy Address: 3GFE n_.!5,c City: ✓0 1 ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review &permits: Minnehaha Creek Watershed District(MCWD) ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 Phone: 952-471-0590 ❑ Re-roof, other(specify) Siding ❑ Other: (specify) Fax: 952-471-0682 A�tWindow(s) www.minnehahacreek.org Overall Project Description: Estimated Construction Valuation of Project (excluding land) $ tl APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; I • 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 th' information is to annually update our records and records of other governmental agencies required by law. If ou refuse upp[V the information,the application may not be issued. Applicant's Signature: ZZ- Date: Last Updated: 08-09-2011 I/ i f t O ti t i F �° ties _..�,�•�p `� 2F 7 v � _ �ttg _ r C _ oc i 6 r Z y J, a J Q .►