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Home My WebLink About2010-01151 - addn/remodel/repair CITY OF ORONO PERMIT NO.: 2010-01151 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 11/23/2010 952 249-4600 FAX: 952 249-4616 ADDRESS 295 TONKA AVE PIN 05-117-23-13-0028 LEGAL DESC BAYSIDE ADDN TO LAKE MINNETONK LOT 000 BLOCK 003 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDN/REMODEL/REPAIR ACTIVITY 434-RESIDENTIAL VALUATION $ 4,680.00 NOTE: NEEDS TO BE INSPECTED DURING INSTALLATION 104'INTERNAL TILE SYSTEM,SEALED BASKET AND PUMP,PLUMBED TO EXTERIOR. APPLICANT PERMIT FEE SCHEDULE 118.00 JESSE TREBIL FOUNDATION SYS INC. STATE SURCHARGE(VALUATION) 5.00 700 PLEASANT AVE W MN 56209- TOTAL 123.00 (320)974-8729 PAID WITH CC# 3188 Minnesota State License#: 20446489 OWNER FRANK,CORY 295 TONKA AVE 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 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. 33//D Applicant Permitee Signature Date ssue y Signature Dat SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NOO-18-2010 02:45 FROM:TREBILFOUNDATION SYS 3205938720 TO: 19522494616 Total Fee: $ � 3. 0-0 Date Received: i,/ - Entered -Entered By: Per niit#: CITY OF ORONO - BUILDING PERMIT APPLICATION All information must be submitted in full before plan review will be started. (please print all Information) THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR JOB SITE ADDRESS: J`-V 0 ,r o-ro /K\,(\f ZIP: Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? Yes ;�No 1jyes,a special event paimil is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant dernortistrates sufficient an-site parking is available. Non permitted events will not be allowed. NAME OF OWNER: PHONE: (home) _ (ga - a e�a� (Work-) MATLINGADDRESS: /x,-� CITY: r-,c,,,-� ZIP; CONTRACTOR: PHONE: s CONTACT PERSON: Y .; .t_. \�,cr� MOBILE/PAGER: MAILING ADDRESS: 1 �?,5�,� �,�.�, \�_ CITY: <�\ ZIP: c, STATE LICENSE: #—,&U 4, � �j EXPIRATION DATE: 3 - R i- Q n i :Z ARCHITECT/ENGINEER: PHONE: MAILING ADDRESS: CITY: ZIP: NAME: REGISTRATION: # TYPE OF WORK: New Addition Accessory Structure Move Home Remodel/Alteration \PROPOSED WORK(describe in detail):1��-�' STORIES: SQ.FEET OF EACH FLOOR: NO.OF BEDROOMS: GARAGE STALLS: ATTACHED DETACHED ESTIMATED CONSTRUCTION VALUATION(excluding land): S 1 hereby apply for a building permit and I acknowledge that the information above is completo and accurate; that the work will be in conformance with the ordinances and codes of the City and with the State Building Code;that I understand this is not a permit and work is notto start witho t a permit;and that the work will be in accordance with the approved plan, APPLICANT'S SIGNAT DATE: 31 Sri 5I cn0 j ,�✓2IAj ,LNSj�GCr AAJ O J-r/vy'C NOV-18-2010 02:46 FROM:TREBILFOUNDATION SYS 3205938720 TO:19522494616 P.4/4 3ac1a.W R1OtrMOR5UndWl'1lOFDATA Subd.1. Type of des. 7be riehb of individual on whom the dale is eland or to be stored doll be a sct form in this radian. 5ubL a hdosssstknt wquitod to be givw ivl"nr�Ao sndivids.l admdlo wPP1Y P O e.oenfidaalid dna aaaoanimg hvrsalrsba0 be iofeaoed nr(a)the pr<pmo and Wooded rseof Iba regYmtod data within thm collecting state Marcy.political subdivision,or s dowido aystoor,(b) wlaUarbe may-dine ar s legally mplirod tasapply the tequatad data;(o)arty Itaowa poaaagtrespce arising fano his supplying w refusing M supply piv000reoeGdmgaldateand(d)Moidmlityofotbcrptaaasoreatingadbamodbysmarradadbwtotecehvamodm71ii tmqubcon.rAshoa amt apply when■e hrWvtdwl Is"cad to apply love uplive data,pwaunt to suction 13.02,subdivisiat S.to a law cafaarnmu 611100F. The cumisginigner of ro MU elm 64 Owns�ivad a_ lit as..I.d:yi■im in me individual inoome tae or Renate in tduad iemumd"M iatoad a[-e d ow fame. Sobel.3.Aoova to dela by individeaL Upon sequel to a r m"Wo authority.as individual doll be idamodwladtwbo is thio suhjcct of etaad dola an individuab4 sad whdher it is cls W led a public,pihw or camfidetial Upas bis(blow-equal an i-tdvidaul who is ehoWlIjod or shmod privsle or public data on individuals shall be Wave mo dela tritbma say dwV to him and,if he doahns.shall oa inranned of tbo coma-and nvooiae of that data. Allam itdividnl tea bout shown the"laden sal infonood or hu meaning.the data mood not be d'vdmed to him far six sewdhs tbwomflarunlw a dispule or sclion pamusnt to Ibis■ectiea is posdimg or additional data on me imr(vidmal bas hem oollaclad or acs"'rhe mspatuiblo astho-ily shall provide topics of me privue or public dw upon-spot bithe imdividtul sabjw of thio data.Tho responsible sWhorky may require da"n"ling lance Ia pay the sent cogs of msk4 cas"ying,and aompilins an oupias. Marcel ill,archon'tysbaticanplyinmodiably.Wlma&,wilhbay roquolmdepaawnllothis subdivision,ur within Cryodaysor Ow datourduo roqumyexclndims Swtdays.Snepdsya m d loll belidays.ifimurpedidsoomplistseo n ndpossibls.ICheesmwd araplywim 1ha requsN within thiel fine.hn:dug so inl'erm the individual,and"have me addkkoW Gvedays within which to comply with 1ht ntt(nealaotelullitg 5nn-d.ys. Sundays and Weal holidays. Svbd.a.nhumdumwhmdstaoaolmwmmooroomplda Aa odividualarroanlapgwaaaor uraompbtonwofpu64eorprivModsa ouuomntiogbim&dC1'mgsgmisemsrirblmjA%"wltd0nodrynwuoormodinew I.The eeaporlsible awha ty dug willin 30 days a0w.. (a)call t this data farad b be kwcuedo or' and attempt to notify pat tecipiaas of imacamau or sroomplea dab,including adpiara anacd by Iia hmilvidast.or(b)mthly the mdwWoat"he bdiovo mo data to bo oorrooL Dale en disputedullbodisclosedonlyirUraidivWkwhobftmmlordimg- wwM66c)a od.ridsdwd'scbseddsla. Tho datmmiaYhom oClhe tesponanble ssdbtnity wy�>��pneusM to the pvviainoa of ane ndminshalivo p�ooadu-e ad relating W ctalcodc+l as. DUANVACY ADV_ISORar In accordance with M.S.13.04,SUN.2,"Rights of subjects of dela",We would like to inform you that your wquost fur a 1ximit or tic coo Fran the City of Orono or any of its departments may roquire you to furnish certain privhle or confidential information. You are notified that. 1. The information you furnish will be used to determine your quulirmalion for the permit or license rraluested. 2. You may refute to supply data.but refusal may require Oat the City deny the permit or license. 3. The information may be shared with o0w local.onto or federal agencics to the extent-necessary to prones ft permit or license. 4. 1f your requested permit or license requires Council action to approve,some:information may become public.. S. You have certain rights ander MS- 13.04(available upon request)to review private data an yourself. 6. Yaw full name is rcquind to process this application or permil- Fwm h11idAM loon Addrm — _ f N N 55 3 Ste, _ 3 O --m3 city State Zip 11bow I understand my rights as stated above v�U ffihRrndura Resat Form 32 NOV-18=2010 02:45 FROM:TREBILFOUNDATION SYS 3205938720 TO:19522494616 P.2/4 URUN 11, IFW INSTALLATION Bid Date Start r Phone Date H / '2 - L;2FOUNDATION SYSTEMS INC. Foreman Quality We Can Guarantee _ W I-800-430.5851 41 C 37. M. ral"kca) 50. ('6,Wq (20 -eY Al Job Sddrei Mailing Address S i 0A1v 1Y) City,State city,state .1_ C'. F AA 1 f i.. __ .._... --- -�- �-a- � ....._............. ............. ... _ .. .— - _..._ - — -- 5 71 ... . . i q I e:a , �w•ia�gra i {�'.' �,,�-� 1�n:n -�'� 'Y wt_ IF Approximate number of days for job completion: &j4es1 .(p ALL - AND LABOR ARE INCLUDED IN TOTALPRICE. Additional charge for moving Gopher One Amount of bid S Sro +4v9U/�. objects out of the work area $ 0Y'es ❑No t344us permit fees if required (I'd is ❑homeowner to get permit Our priority is to fix the problem with your foundation,that's what our customers rely on us for.Keep in mind that we can not be responsible for any finish carpentry,painting,paneling,etc, that may be necessary after our work is completed.Jesse Trebil Foundation Systems,Inc, will not be responsible for any landscaping,reseeding or re-soding, unless otherwise noted on bid. We will call "Gopher One"to have all public underground lines located: If you have private lines such as satellite dish cables,propane line, sprinkler system,etc.you are responsible for marking them, Jesse Trcbi) Foundation Systems, Inc.will not assume responsibility if there is damage to private lines. If you live at a rural address,public lines will only be located to the pole or your property 1 int. If damage to any of these lines in an area that was not marked occurs,you will be responsible for all repairs. If your city requires outside engineering,this quote may need to be rewritten to meet their recommendations. Any additional fees incurred are not included in this bid and are the customer's responsibility, Ea rnt 14 due on compledon. 3%surcharge Maslerear&Msa Keprescmadve's Signature �f ��4-ru. '• AuthoriZcd Signature