HomeMy WebLinkAbout2016-00448 - minor alterations CITY OF ORONO * 2 0 1 6 - 0 0 4 4 8
2750 KELLEY PARKWAY DATE ISSUED: 06/22/2016,
ORONO,MN 55356-
952)249-4600 FAX: (952)249-4616
ADDRESS : 4635 TONKAVIEW LA
PIN : 07-117-23-32-0027
LEGAL DESC : REG. LAND SURVEY NO. 1036
LOT 000 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE MINOR ALTERATIONS(MULITIPLE ITEMS)
ACTIVITY O/S BUILDING-UNDEFINED
VALUATION $ 20,000.00
NOTE: REPLACE:DOORS,WINDOWS&SIDING
APPLICANT PERMIT FEE SCHEDULE 356.22
STATE SURCHARGE(VALUATION) 10.00
Severson Masonary TOTAL 366.22
SEVERSON,LUKE Payment(s)
4635 TONKAVIEW LA CREDIT CARD 5846 366.22
MOUND,MN 55364
OWNER
Severson Masonary
SEVERSON,LUKE
4635 TONKAVIEW LA
MOUND,MN 55364-
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 con ance with the State Building Code.This permit may be ,n
revoked at any col
e for due use.
e , o l 22� lCo
Applic t P rmitee ignature ate Issued By rignature Date
City of Orono
Building Permit Application for Maintenance/ Replacement/ Remodel- Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANS(ON) 11
QMailing Address: Permit number: l r
A'O PO Box 66
Crystal Bay,MN 5632MO66 Date received: d'7- (P
5tmot Addtcss: Received by:
2750 Kelley Parkway /
'• Y Y Plan review fee:
�rq �G� Orono.MN 55356
Total Fee:
Main: 952-249-4600 Fax: 952-249616 www.ci.erono.mn.us
This application form must be completed in full and all required information must be su Ittod. ��/b
Incomplete applications will be returned. (Please print) , t[I2
GENERAL INFORMATIO
Job Site Address: M L(Gt��C'�� � �1'�'.-6�......!_! -0-yes_Q
Will this be a Parado of Homos,Relmodelers Showcase Home or other Display Home? 0]Yes �,�1
N yos.a special event pormlt is required with Police Department and C/fy Coanci/approval 60 days prior to the event. Shuttle bus so ice wf11 he
Avquired unlass applicant dornonstratos sufficient onsito pork/ng is available. Non permitted ovonfs will not be allowed,
CONTRACTOR/AP UCANT INFORMATION: LL(-
Name: vo I
State License# Expiration Dale:
Lead Certification Number: Expiration Date: _
(for work on homes that were constructed prior to 9978 ()J& V)Z--7 -7-9 3ZZ �y
Phone: (cell) (office)
Mailing Address: VtwIgn e City: _
Contact Person: e, "Gy"1 Applicant is: Contractor / Homeowner la ono)
Email and/or Fax: Gj '
PROPERTY OWNER IV f ORMATION:
Name:
Phone(day): p
Address: '�j �(Q� '�1/��iUJ G /I\V :..� City, 116no ZIP: C� 72(04
Email and/or Fax: el l^lA✓_U2 M 01
PROJECT INFORMATION: Overall project description: _
Type of Project: Any earth movement may also require
*oor(s) ❑Remodel ❑ Fire Damage MCWD review&permits:
❑ Re-roof,asphalt Repair ❑Storm Damage Minnehaha Crock Watershed District(MCWD)
15320 Minnetonka Blvd
❑Re-roof,coder ❑Restoration ❑Water Damage Minnetonka,MN 55345
❑Re-roof,other(speoity) (.Siding ❑Other:(specify) Phone: 952-471-0590
Fax: 952-471-0682
W indow(s) www.minnehahacreek.orr-
Estimated Construction Valuation of Project(excluding land) $ T
APPLICANT ACKNOWLEDGEMENT:
• Agrocs 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 knowlodgo- The applicant recognizes that they are
sololy responsible for submitting a complete application being aware that upon failure to do so,the staff has no altemative but to
rojoct it until it is complete;
• Some or all of the information that you are asked to provide on this application is classified by Stato law as either private or
confidontial. Private data is information which gonerally cannot be given to the public but can be given to the subjoct of the data.
Confidential data is information which gonerally 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 requirod by law- If
you refuse to supply e inform n,the application may not be issued. _ _
2/7�_
Applicant's Signature' /v ✓ Date: 7 At
Owner's Signatur�`/�- Date:
Last Updated;January 2016
1 'd 2901*L*296 ut.100 d A-IWW
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N CE SCHEDULED
PERMIT NO. `� COMPLETED r _ _ x
ADDRESS. '' E E � e� �� H
OWNER TELEPHONE NO.
CONTRACTOR
DESCRIPTION
W ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
C ❑ 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 ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
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W ❑WORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE
cc ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
[ATOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
]INSPECTION REQUIRED-CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
on site:
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